Supplementary Provisions, Article 14

一The amount set forth in (a) or (b), in accordance with the category of Insurer set forth in (a) or (b), respectively;

イAn insurer exceeding the estimated special adjustment standard (meaning, among Insurers for which the estimated participant adjustment rate prescribed in Article 55, paragraph (2) of the Former Elderly Health Act for fiscal year 2002 exceeds one, an Insurer for which the amount obtained by deducting the amount set forth in (1) from the special pre-adjustment estimated medical expense contribution equivalent (meaning the sum total of the amounts set forth in the items of paragraph (1) of that Article for fiscal year 2002; the same applies hereinafter in this paragraph and the following paragraph) exceeds the amount set forth in (2); the same applies hereinafter in this paragraph through paragraph (3)): an amount equivalent to 7/12 of the sum of the amount obtained by deducting the estimated amount subject to special adjustment (meaning the amount obtained by deducting the sum of the amount set forth in (1) and the amount set forth in (2) from the special pre-adjustment estimated medical expense contribution equivalent; the same applies in the following paragraph) from the special pre-adjustment estimated medical expense contribution equivalent, and the estimated special adjustment amount;

（１）An amount equivalent to 7/10 of the estimated amount of medical expenses for the elderly prescribed in Article 55, paragraph (1), item (i) of the Former Elderly Health Act pertaining to the relevant Insurer for fiscal year 2002;

（２）The amount obtained by multiplying the sum total of the following amounts by the special adjustment base rate.

（ｉ）The special pre-adjustment estimated medical expense contribution equivalent;

（ｉｉ）The amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the estimated amount for fiscal year 2002 of the expenses required for those benefits of the relevant Insurer that are benefits concerning medical care under the provisions of the Medical Insurance Acts prescribed in Article 6, paragraph (1) of the Former Elderly Health Act (excluding other benefits prescribed in Article 69-3 of the Health Insurance Act before amendment by the provisions of Article 1 and benefits equivalent thereto) and fall under those specified by Order of the Ministry of Health, Labour and Welfare (including the expenses required for payment of the day laborer contribution prescribed in Article 79-9, paragraph (2) of that Act and the expenses required for payment of the contribution for medical care benefit expenses prescribed in Article 81-2, paragraph (1) of the National Health Insurance Act before amendment by the provisions of Article 4; referred to as "expenses required for benefits by insurers" in paragraph (3)).

ロInsurers other than Insurers exceeding the estimated special adjustment standard: an amount equivalent to 7/12 of the sum total of the special pre-adjustment estimated medical expense contribution equivalent and the estimated special adjustment amount.

二The amount set forth in (a) or (b), in accordance with the category of Insurer set forth in (a) or (b), respectively.

イAn insurer exceeding the post-commencement estimated burden adjustment standard (meaning, among Insurers for which the post-commencement estimated participant adjustment rate exceeds one, an Insurer for which the amount obtained by deducting the amount set forth in (1) from the post-commencement amount equivalent to the estimated medical expense contribution before burden adjustment exceeds the amount set forth in (2); the same applies hereinafter in this Article): the sum total of the amount obtained by deducting the post-commencement estimated amount subject to burden adjustment (meaning the amount obtained by deducting the sum of the amount set forth in (1) and the amount set forth in (2) from the post-commencement amount equivalent to the estimated medical expense contribution before burden adjustment; the same applies in paragraph (6)) from the post-commencement amount equivalent to the estimated medical expense contribution before burden adjustment, and the post-commencement estimated burden adjustment amount;

（１）The sum total of an amount equivalent to 66 percent of the amount obtained by multiplying the post-commencement estimated elderly medical expenses pertaining to the relevant Insurer (meaning the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the estimated amount of the expenses, borne by municipalities in fiscal year 2002, required for medical care (including payment of medical expenses), payment of dietary treatment expenses for inpatients (including payment of medical expenses), payment of specified medical expenses (including payment of medical expenses), payment of medical expenses for home-nursing for the elderly, payment of transport expenses and payment of high-cost medical expenses (hereinafter in this Article through Article 17 of the Supplementary Provisions referred to as "medical care, etc.") provided on or after the Effective Date for the participants aged 75 or over, etc. pertaining to one Insurer, as prescribed in Article 25, paragraph (1) of the New Elderly Health Act (including persons who are deemed to be persons aged 75 or more under the provisions of Article 9 of the Supplementary Provisions and are participants; hereinafter in this Article through Article 17 of the Supplementary Provisions simply referred to as "participants aged 75 or over, etc."); the same applies hereinafter in this Article) by the rate obtained by deducting the post-commencement estimated specified expense rate from one, and the amount obtained by multiplying the post-commencement estimated elderly medical expenses by the post-commencement estimated specified expense rate;

（２）The amount obtained by multiplying the sum total of the following amounts by the post-commencement burden adjustment base rate.

（ｉ）The post-commencement amount equivalent to the estimated medical expense contribution before burden adjustment;

（ｉｉ）The amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the estimated amount of the expenses required for medical-related benefits provided on or after the Effective Date, out of the estimated amount for fiscal year 2002 of the expenses required for those benefits of the relevant Insurer that are benefits concerning medical care under the provisions of the Medical Insurance Acts in Article 6, paragraph (1) of the New Elderly Health Act (excluding other benefits prescribed in Article 53 of the Health Insurance Act and benefits equivalent thereto; hereinafter in this Article, paragraph (1) of the following Article, Article 16, paragraph (1) and Article 17, paragraph (1) of the Supplementary Provisions referred to as "medical-related benefits") and fall under those specified by Order of the Ministry of Health, Labour and Welfare (including the expenses required for payment of the day laborer contribution prescribed in Article 173, paragraph (2) of that Act and the expenses required for payment of the contribution for medical care benefit expenses, etc. prescribed in Article 81-2, paragraph (1) of the National Health Insurance Act; referred to as "expenses required for benefits by insurers" in paragraph (1) of the following Article, Article 16, paragraph (1) and Article 17, paragraph (1) of the Supplementary Provisions).

ロInsurers other than Insurers exceeding the post-commencement estimated burden adjustment standard: the sum total of the post-commencement amount equivalent to the estimated medical expense contribution before burden adjustment and the post-commencement estimated burden adjustment amount.

一An amount equivalent to 66 percent of the amount obtained by multiplying the sum total of the following amounts (referred to as "post-commencement adjusted estimated elderly medical expenses" in the following item) by the rate obtained by deducting the post-commencement estimated specified expense rate from one;

イThe amount obtained by multiplying the amount obtained by deducting the post-commencement estimated medical expenses outside adjustment (meaning, where the relevant Insurer is an insurer exceeding the estimated post-commencement standard (meaning an Insurer for which the rate obtained by dividing the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the post-commencement estimated elderly medical expenses per participant aged 75 or over, etc. pertaining to one Insurer by the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the average amount of the post-commencement estimated elderly medical expenses per participant aged 75 or over, etc. pertaining to all Insurers (referred to as "per-person average of estimated elderly medical expenses" in (a)) exceeds the rate specified by the Cabinet Order referred to in Article 55, paragraph (3), item (i), (a) of the New Elderly Health Act), the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the portion of the post-commencement estimated elderly medical expenses pertaining to the relevant Insurer that exceeds the amount obtained by multiplying the per-person average of estimated elderly medical expenses by the rate specified by that Cabinet Order; the same applies in (b)) from the post-commencement estimated elderly medical expenses pertaining to the relevant Insurer by the post-commencement estimated participant adjustment rate;

ロThe post-commencement estimated medical expenses outside adjustment;

二The amount obtained by multiplying the post-commencement adjusted estimated elderly medical expenses by the post-commencement estimated specified expense rate.