# 健康保険法施行令 / Order for Enforcement of the Health Insurance Act — 第四十五条の四 (Article 45-4) This is the Markdown twin of https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4. Every law, and how to address a provision: https://japanlaw.org/llms.txt. The same laws as MCP tools (no sign-in): https://japanlaw.org/mcp. - Law: 健康保険法施行令 (Order for Enforcement of the Health Insurance Act), 大正十五年勅令第二百四十三号 - English title "Order for Enforcement of the Health Insurance Act": claude-opus-5-5 - Kind: ImperialOrder — the distinction between 法律 (Act), 政令 (Cabinet Order), 省令 (Ministerial Order) and 条例 (local ordinance) decides who may issue it and what it may say. - Provision: 第四十五条の四 (Article 45-4)（支部被保険者を単位とする健康保険の財政の調整） — address `art-45-4` - Text in force since: 2026-10-01 - URL (the page that opens at this provision): https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4 - e-Gov law ID: 215IO0000000243 — never renamed. A permanent link, `/l/{lawId}/{address}` on this site, redirects to the page. - Every provision below carries its address and its URL on the line under it. - Japanese text: e-Gov 法令検索, Digital Agency (デジタル庁). English: as marked on each line below. Only the Japanese as published by the government has legal effect; the text below is a copy of it. Every English rendering below is a translation and says which kind: the Ministry of Justice's translation, or this site's machine translation, whose model and date the Sources list names. They are never merged and never substituted for one another. --- ### 第四十五条の四（支部被保険者を単位とする健康保険の財政の調整） — Adjustment of Finances for Health Insurance on the Basis of a Single Branch-Insured Person caption: machine translation, not official art-45-4 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4 **第一項** 法第百六十条第四項の規定により行う支部被保険者を単位とする健康保険の財政の調整は、年齢調整及び財政力調整とする。 art-45-4/par-1 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-1 The adjustment of finances for health insurance on the basis of a single branch-insured person that is carried out pursuant to the provisions of Article 160, paragraph (4) of the Act is to be age adjustment and financial capability adjustment. machine translation, not official **第二項** 前項の年齢調整は、次の各号に掲げる場合の区分に応じ、当該各号に定めるところにより行うものとする。 art-45-4/par-2 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-2 The age adjustment referred to in the preceding paragraph is to be carried out, in accordance with the classification of cases listed in the following items, as specified respectively in those items. machine translation, not official **一** 支部年齢勘案標準給付費額が支部平均給付費額以上である場合　当該支部年齢勘案標準給付費額から当該支部平均給付費額を控除した額を控除すること。 art-45-4/par-2/item-1 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-2/item-1 in the case where the branch age-adjusted standard benefit cost is the branch average benefit cost or more: to deduct the amount obtained by deducting that branch average benefit cost from that branch age-adjusted standard benefit cost; machine translation, not official **二** 支部年齢勘案標準給付費額が支部平均給付費額未満である場合　当該支部平均給付費額から当該支部年齢勘案標準給付費額を控除した額を加算すること。 art-45-4/par-2/item-2 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-2/item-2 in the case where the branch age-adjusted standard benefit cost is less than the branch average benefit cost: to add the amount obtained by deducting that branch age-adjusted standard benefit cost from that branch average benefit cost. machine translation, not official **第三項** 第一項の財政力調整は、次の各号に掲げる場合の区分に応じ、当該各号に定めるところにより行うものとする。 art-45-4/par-3 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-3 The financial capability adjustment referred to in paragraph (1) is to be carried out, in accordance with the classification of cases listed in the following items, as specified respectively in those items. machine translation, not official **一** 支部総報酬按分給付費額が支部平均給付費額以上である場合　当該支部総報酬按分給付費額から当該支部平均給付費額を控除した額を加算すること。 art-45-4/par-3/item-1 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-3/item-1 in the case where the branch benefit cost apportioned by total remuneration is the branch average benefit cost or more: to add the amount obtained by deducting that branch average benefit cost from that branch benefit cost apportioned by total remuneration; machine translation, not official **二** 支部総報酬按分給付費額が支部平均給付費額未満である場合　当該支部平均給付費額から当該支部総報酬按分給付費額を控除した額を控除すること。 art-45-4/par-3/item-2 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-3/item-2 in the case where the branch benefit cost apportioned by total remuneration is less than the branch average benefit cost: to deduct the amount obtained by deducting that branch benefit cost apportioned by total remuneration from that branch average benefit cost. machine translation, not official **第四項** 前二項において、次の各号に掲げる用語の意義は、当該各号に定めるところによる。 art-45-4/par-4 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-4 In the preceding two paragraphs, the meanings of the terms listed in the following items are as prescribed respectively in those items. machine translation, not official **一** 支部年齢勘案標準給付費額　厚生労働省令で定めるところにより、年齢階級ごとに、当該年齢階級に係る年齢階級別平均一人当たり給付額（厚生労働省令で定めるところにより、療養の給付等のうち協会が管掌する健康保険の被保険者及びその被扶養者であって当該年齢階級に属する者に係るものについて当該一の事業年度の翌事業年度（第四十五条の二に規定する当該一の事業年度の翌事業年度をいい、前条の規定に基づき都道府県単位保険料率を算定する場合にあっては、同条に規定する当該適用月の属する事業年度をいう。以下この項において同じ。）に要する費用の見込額から当該見込額のうち法の規定により支払うべき一部負担金に相当する額及び法第百五十三条の規定による国庫補助の額の合算額の見込額を控除した額を、当該一の事業年度の翌事業年度において協会が管掌する健康保険の被保険者及びその被扶養者であって当該年齢階級に属する者の合計数の見込数で除して得た額をいう。）に当該一の事業年度の翌事業年度において当該支部被保険者及びその被扶養者であって当該年齢階級に属する者の合計数の見込数を乗じて得た額を合算した額をいう。 art-45-4/par-4/item-1 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-4/item-1 "branch age-adjusted standard benefit cost" means the total sum of the amounts obtained, for each age group, as specified by Order of the Ministry of Health, Labour and Welfare, by multiplying the average benefit per person by age group relating to that age group (meaning the amount obtained, as specified by Order of the Ministry of Health, Labour and Welfare, by dividing the amount obtained by deducting, from the estimated amount of expenses required in the business year following the business year (meaning the business year following the business year prescribed in Article 45-2 and, where the premium rate for each prefecture is calculated pursuant to the preceding Article, the business year to which the month of application prescribed in that Article belongs; the same applies hereinafter in this paragraph) for the benefits for medical treatment, etc. relating to insured persons of health insurance administered by JHIA and their dependents belonging to that age group, the estimated total sum of the amount equivalent to the partial co-payment payable pursuant to the provisions of the Act out of that estimated amount and the amount of national subsidy pursuant to the provisions of Article 153 of the Act, by the estimated total number of insured persons of health insurance administered by JHIA and their dependents belonging to that age group in the business year following the business year) by the estimated total number of the branch-insured person concerned and the dependents of that person belonging to that age group in the business year following the business year; machine translation, not official **二** 支部平均給付費額　厚生労働省令で定めるところにより、平均一人当たり給付額（厚生労働省令で定めるところにより、療養の給付等のうち協会が管掌する健康保険の被保険者及びその被扶養者に係るものについて当該一の事業年度の翌事業年度に要する費用の見込額から当該見込額のうち法の規定により支払うべき一部負担金に相当する額及び法第百五十三条の規定による国庫補助の額の合算額の見込額を控除した額（次号において「総給付費見込額」という。）を、当該一の事業年度の翌事業年度における協会が管掌する健康保険の被保険者及びその被扶養者の合計数の見込数で除して得た額をいう。）に当該一の事業年度の翌事業年度における当該支部被保険者及びその被扶養者の合計数の見込数を乗じて得た額をいう。 art-45-4/par-4/item-2 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-4/item-2 "branch average benefit cost" means the amount obtained by multiplying, as specified by Order of the Ministry of Health, Labour and Welfare, the average benefit per person (meaning the amount obtained, as specified by Order of the Ministry of Health, Labour and Welfare, by dividing the amount obtained by deducting, from the estimated amount of expenses required in the business year following the business year for the benefits for medical treatment, etc. relating to insured persons of health insurance administered by JHIA and their dependents, the estimated total sum of the amount equivalent to the partial co-payment payable pursuant to the provisions of the Act out of that estimated amount and the amount of national subsidy pursuant to the provisions of Article 153 of the Act (referred to as the "estimated total benefit cost" in the following item), by the estimated total number of insured persons of health insurance administered by JHIA and their dependents in the business year following the business year) by the estimated total number of the branch-insured person concerned and the dependents of that person in the business year following the business year; machine translation, not official **三** 支部総報酬按分給付費額　厚生労働省令で定めるところにより、総給付費見込額に当該一の事業年度の翌事業年度における法第百六十条第三項第二号に規定する総報酬按分率の見込値を乗じて得た額をいう。 art-45-4/par-4/item-3 · https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-4/item-3 "branch benefit cost apportioned by total remuneration" means the amount obtained by multiplying, as specified by Order of the Ministry of Health, Labour and Welfare, the estimated total benefit cost by the estimated value of the total remuneration proportion ratio prescribed in Article 160, paragraph (3), item (ii) of the Act in the business year following the business year. machine translation, not official --- ## Cites - art-45-4/par-1: 法第百六十条第四項 → 健康保険法 第百六十条第四項 (Article 160, paragraph (4)), art-160/par-4 — https://japanlaw.org/ja/health-insurance-act/art-160/par-4 (e-Gov law ID 211AC0000000070) - art-45-4/par-2: 前項 → 健康保険法施行令 第四十五条の四第一項 (Article 45-4, paragraph (1)), art-45-4/par-1 — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-1 - art-45-4/par-3: 第一項 → 健康保険法施行令 第四十五条の四第一項 (Article 45-4, paragraph (1)), art-45-4/par-1 — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-1 - art-45-4/par-4: 前二項 → 健康保険法施行令 第四十五条の四第二項 (Article 45-4, paragraph (2)), art-45-4/par-2 — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-2 - art-45-4/par-4: 前二項 → 健康保険法施行令 第四十五条の四第三項 (Article 45-4, paragraph (3)), art-45-4/par-3 — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-3 - art-45-4/par-4/item-1: 第四十五条の二 → 健康保険法施行令 第四十五条の二 (Article 45-2), art-45-2 — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-2 - art-45-4/par-4/item-1: 前条 → 健康保険法施行令 第四十五条の三 (Article 45-3), art-45-3 — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-3 - art-45-4/par-4/item-1: この項 → 健康保険法施行令 第四十五条の四第四項 (Article 45-4, paragraph (4)), art-45-4/par-4 — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-4 - art-45-4/par-4/item-1: 法第百五十三条 → 健康保険法 第百五十三条 (Article 153), art-153 — https://japanlaw.org/ja/health-insurance-act/art-153 (e-Gov law ID 211AC0000000070) - art-45-4/par-4/item-2: 法第百五十三条 → 健康保険法 第百五十三条 (Article 153), art-153 — https://japanlaw.org/ja/health-insurance-act/art-153 (e-Gov law ID 211AC0000000070) - art-45-4/par-4/item-2: 次号 → 健康保険法施行令 第四十五条の四第四項第三号 (Article 45-4, paragraph (4), item (iii)), art-45-4/par-4/item-3 — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-4/item-3 - art-45-4/par-4/item-3: 法第百六十条第三項第二号 → 健康保険法 第百六十条第三項第二号 (Article 160, paragraph (3), item (ii)), art-160/par-3/item-2 — https://japanlaw.org/ja/health-insurance-act/art-160/par-3/item-2 (e-Gov law ID 211AC0000000070) ## Cited by 7 provisions cite this one. No official source publishes this direction. - 健康保険法施行令 第四十五条の二第一項（都道府県単位保険料率の算定方法） — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-2/par-1 - 健康保険法施行令 第四十五条の二第一項第一号イ（都道府県単位保険料率の算定方法） — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-2/par-1/item-1/sub-1 - 健康保険法施行令 第四十五条の四第二項（支部被保険者を単位とする健康保険の財政の調整） — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-2 - 健康保険法施行令 第四十五条の四第三項（支部被保険者を単位とする健康保険の財政の調整） — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-3 - 健康保険法施行令 第四十五条の四第四項（支部被保険者を単位とする健康保険の財政の調整） — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-4 - 健康保険法施行令 第四十五条の四第四項第一号（支部被保険者を単位とする健康保険の財政の調整） — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-4/item-1 - 健康保険法施行令 第四十五条の四第四項第二号（支部被保険者を単位とする健康保険の財政の調整） — https://japanlaw.org/ja/health-insurance-act-enforcement-order/art-45-4/par-4/item-2 --- ## Sources - claude-opus-5-5 — English title of a law in this collection, written for this site, written 2026-11-06 - e-Gov 法令検索, Digital Agency (デジタル庁) — 健康保険法施行令 — the text in force from 2026-10-01 (https://laws.e-gov.go.jp/law/215IO0000000243/20261001_508CO0000000276), retrieved 2026-11-06 - claude-sonnet-5-5 — Machine translation, batch health-insurance-act-enforcement-order-20261106T164949-016, translated 2026-11-07 - claude-sonnet-5-5, corrected on review by claude-opus-5-5 — Machine translation corrected on review, batch health-insurance-act-enforcement-order-20261106T164949-016, translated 2026-11-07 - This site's parser, version 229 — 健康保険法施行令 — structure, counts, cross-references and defined terms, computed 2026-11-06