When you become a member of the health insurance scheme, you need to pay insurance premiums. The amount of your insurance premiums differs according to your income (total remuneration including wages and bonuses) and the calculation methods for monthly wages and bonuses are different.
Since remuneration paid to insured people is not uniform and it also changes from month to month, it would be inefficient to calculate based on each person’s actual remuneration. Therefore, we calculate insurance premiums by matching the person’s remuneration to a standard amount (standard remuneration amount) in accordance with a certain range.
The “standard bonus amount” disregards bonuses below 1,000 yen. However, there is an annual cap for bonuses of 5.73 million yen as a cumulative total.
|General insurance premium rate||Long-term care insurance premium rate|
|Contribution rate for an insured person||4.43％||0.8％|
|Contribution rate for employer||5.0％||0.8％|
(including adjustment insurance premium rate)
(rate for insured people aged 40 to 64)
The standard remuneration amount is decided when an insured person first qualifies as an insured person, and is reviewed every year. It is also reviewed when an insured person’s remuneration changes substantially.
|When become employed
(decided when first qualifying)
|Decided on the basis of an insured person’s initial wage.|
|As of July 1 each year
(decided on fixed period)
|Based on an insured person’s remuneration for April, May and June of the current year, the standard remuneration amount for each insured person is re-calculated in principle as of July 1. The re-calculated standard remuneration amount will be applied from September 1 to August 31 of the next year.|
|When an insured person’s standard remuneration amount changes substantially
(amended as required)
|When an insured person’s fixed wage rises and the average monthly remuneration paid to him/her in three consecutive months rises by more than two ranks, his/her standard remuneration amount will be re-calculated.|
|When an insured person’s childcare leave ends
(amended when childcare leave ends)
|For an insured person caring for a child less than three years of age as of the end date of childcare leave or similar leave, if remuneration is lower because the insured person is working reduced working hours or for other reasons, he or she may apply for a revision.|
|When an insured person’s maternity leave ends
(amended when maternity leave ends)
|For an insured person caring for the child for whom maternity leave was granted as of the last day of maternity leave, if remuneration is lower because the insured person is working reduced working hours or for other reasons, she may apply for a revision.|
There are several types of insurance premium, such as general insurance premiums, long-term care insurance premiums and adjustment insurance premiums. Each insurance premium amount is decided by multiplying the standard monthly remuneration amount and the standard bonus amount by the relevant insurance premium rate.
General insurance premium is an insurance premium used mainly as a financial source of health insurance benefits, but also used as a financial source to cover expenses to assist medical treatment of the elderly. In order to provide clear explanation of the extent of assistance to the elderly, general insurance premiums are divided into basic insurance premiums and specific insurance premiums.
Basic insurance premiums: insurance premiums applied to medical benefits and health business services, etc.
Specific insurance premiums: insurance premiums applied to the funding of the elderly in later life, and payments to the younger end of this age-group (aged 65-74), etc.
The general insurance premium rate will be in the range of 3-13% and will be decided in accordance with the current conditions of the Health Insurance Association. The contributions of the employer and the insured person can be decided independently in accordance with the current conditions of the Health Insurance Association.
Long-term care insurance premiums are insurance premiums applied to long-term care insurance. Long-term care insurance is a system administrated by municipalities throughout Japan. However, medical insurers are obliged to collect insurance premiums from insured persons aged 40-64 who are members of a medical insurance scheme as well as from their dependents (both second insured person of long-term care insurance), therefore Coca-Cola Bottlers Japan Health Insurance Association collects this insurance premium from insured persons aged 40-64.
Health insurance societies throughout the nation jointly conduct cost-sharing business services for high medical care expenditures, and subsidizing business services for societies with financial stringencies (financial adjustment), and therefore Coca-Cola Bottlers Japan Health Insurance Association contributes adjustment insurance premiums for this purpose.
This insurance premium rate is decided by multiplying the basic adjustment insurance premium rate, 0.13%, by a slight increase/decrease (a correction factor) in accordance with the financial situation of the relevant association.
They are used to fund insurance benefits such as medical benefits and other benefits in accordance with the purpose of a health insurance association. Also, they are used to fund health business services as well as for mutual aid between health insurance societies.
Insurance premiums are used not only for various business services conducted by health insurance societies, but also to cover costs to assist medical care of the elderly. Health insurance societies contribute large amounts of support funds and payments to medical care systems for the elderly, such as medical care systems for the elderly in the later stage of life. For that reason, the increasing financial burden associated with the aging association is one of the major causes of the deterioration of health insurance societies’ financial situations.