The Society's insurance premiums
You must pay insurance premiums when you join a health insurance program. While insurance premiums are based on your income (e.g., total remuneration including salary and bonuses), methods for calculating the premiums differ between monthly salary and bonuses.
- Payment for insurance premiums is shared by the insured person and his or her employer. The amount paid by the insured person is deducted from salary and bonuses.
- After you reach age 40, premiums for long-term care insurance will be collected as well.
Method of calculating insurance premiums
Since the amounts of remuneration received by insured persons are not perfectly uniform and fluctuate from month to month, calculating premiums based on each individual's actual remuneration amount is impractical. For this reason, insurance premiums are calculated based on a standard value (standard monthly remuneration) determined corresponding to a certain ranges of remuneration amounts.
"The standard bonus" is the bonus amount (for these purposes capped at a cumulative annual maximum of 5.73 million yen) rounded down to the nearest 1,000 yen.
The Society's insurance premium rates
- Reference link
| General insurance premium rate | Long-term care insurance premium rate | |
|---|---|---|
| Percentage paid by insured person | 2.674％ | 0.85％ |
| Percentage paid by employer | 5.326％ | 0.85％ |
| Total | 8.0％ (Including regulation insurance premium rate) |
1.7％ (Paid by insured persons aged 40-64) |
- Reference dates for determining your standard monthly remuneration
Your standard monthly remuneration is first determined when you obtain your eligibility as an insured person. However, the standard monthly remuneration is revised every year. It is also revised if your remuneration changes significantly.
| Upon hiring (date on which eligibility begins) | Determined based on your starting pay and other factors |
|---|---|
| As of July 1 each year (updated periodically) | In principle, the standard monthly remuneration for all insured persons is revised as of July 1, based on their remuneration for April, May, and June of that year. The revised standard monthly remuneration will apply to the period from September 1 through August 31 of the following year. |
| When your remuneration changes significantly (revised as needed) | Your standard monthly remuneration will be revised if your average monthly remuneration over a period of three consecutive months changes by two or more grades due to a change in fixed wages: for example, when you receive a raise. |
| End of childcare or other leave (revised upon end of leave) | When an insured person caring for a child less than three years of age on the date childcare or other leave ends has experienced a change of one or more grades in average monthly remuneration over the three-month period starting at the end of the leave, for reasons including reduced working hours, he or she may apply for revision. |
| End of maternity leave (revised upon end of leave) | When an insured person caring for a child covered by maternity leave on the date maternity leave ends has experienced a change of one or more grades in average monthly remuneration over the three-month period starting at the end of the leave, for reasons including reduced working hours, he or she may apply for revision. |
Types of insurance premiums
Health insurance premiums consist of general insurance premiums, long-term care insurance premiums, and regulation insurance premiums. The amount of each premium is determined by multiplying the standard monthly remuneration and standard bonus by the insurance premium rate for each type of insurance.
General insurance premiums (base premiums + specific premiums)
General insurance premiums are generally used to help defray health insurance benefits. They also serve as financial resources for paying the cost of support for medical care for the elderly. To clarify the portion of the premiums that help defray support for the elderly, general insurance premiums are separated into base premiums and specific premiums.
Base premiums: premiums applied to services such as medical care benefits and health activities
Specific premiums: premiums applied to uses such as support payments to the medical care system for the advanced elderly and benefits for persons in the earlier stage of old age
The Society is free to determine its general insurance premium rate within the range of 3-13%, based on its specific needs and circumstances. Based on its specific needs and circumstances, it is also free to determine the shares paid by the employer and insured persons.
Long-term care insurance premiums
Long-term care insurance premiums are premiums for long-term care insurance. While the long-term care insurance system is run by each municipality across Japan, each medical care insurer is required to collect premiums from insured persons and dependents aged 40-64 who join the medical care scheme (both are regarded as category 2 insured persons under long-term care insurance). The Society collects premiums from insured persons aged 40-64.
- Reference link
Regulation insurance premiums
The health insurance societies in Japan jointly operate systems providing joint coverage of high-cost medical expenses and aid for societies facing dire financial circumstances (financial adjustments). Regulation insurance premiums fund these systems.
The insurance premium rate for these premiums is determined by multiplying the basic regulation insurance premium rate (0.13%) by the rate of slight variation (i.e., the rate of adjustment) based on the financial state of each society.
- What are insurance premiums used for?
For insurance benefits
Insurance premiums are used to pay for medical care benefits and other benefits, a Health Insurance Society's central mission. They are also used to promote health activities and to help fund mutual aid systems among health insurance societies.
To support medical care for the elderly and other individuals
Insurance premiums are used not just to cover the costs of the various services provided by health insurance societies, but to cover the cost of supporting medical care for the elderly. Significant support payments are made to medical care systems for the elderly, including the Medical Care System for the Advanced Elderly. The rising costs accompanying aging throughout society are a major cause of financial difficulties facing health insurance societies.