Social Health Insurance plan 社会保険

Social Health insurance plan

"Social health insurance plan" covers employees at eligible companies who meet certain criteria, and the relatives financially supported by the employees. I wonder why this plan shall be called "Social". If we call this plan "Employees' health insurance plan", it should have far more matched. The employees covered by this plan are those who work at the applicable companies regularly. Non regular workers at certain large companies have been recently included into the qualified persons in case they meet the criteria regarding their working hours and employment earnings amount, which shows strong connections with the companies. The family members of the employees mentioned above are also covered in case the members are financially supported.
The employees shall be excluded from this plan when they quit the working place. However, they can be exceptionally accepted by their application, for up to 2 years after the retirement.

There are 2 types of insures of this plan, Kempo Kyohkai and Kempo Unions. The former is an affiliated body of the Central government, the Ministry of Health, Labour and Welfare. The latter are private bodies established by big companies. The relevant affairs for the companies' employees are entrusted to the Kempo unions and the Kempo unions are supposed to conduct the affairs under the supervision of the government bureau.

[In Japanese]


Enrollment Procedures

The enrollment procedures for the Social Health Insurance plan shall be conducted by the employers. Most companies have to join the Social Health Insurance plan with a few exceptions. The eligible companies are required to properly judge whether their respective employees are qualified as the insureds of the plan, and whether the dependents of the insureds can be accepted as the qualified dependents. Depending on the judgment, the companies have to accrodingly take the enrollment procedures on behalf of the employers. The individual insureds do not have to do any painful work for it. What they have to do is only to fill out some documents following instructions by the employers.

However, if you would like to join the Social health insurance plan after your retirement from the eligible working place, you have to submit an appropriate application to the insurer. This application shall be submitted within 20 days after your retirement. Therefore, you have to be careful in this case.

[In Japanese]


unrighteous avoidance by employers

Some employers intentionally omit the employment procedures mentioned above. To have their employees join in the Social health insurance plan raises large financial burden on the employers, as I tell in the following chapter. Therefore, there are proprietors who yield to temptation to ignore the obligation. In worst cases, the employers subtract some amount from salaries of their employees as the insurance premiums and embezzle the money. You can check whether you are really covered by the Social health insurance plan and the premiums for you are righteously paid, by making inquiries to the insurer.

[In Japanese]

Insurance premiums

The premiums of the Social health insurance plan is determined solely based on the insureds' salaries and bonuses, while the premiums of the National health insurance plan are based on different kinds of calculation elements. And the Social health insurance premiums are borne by the employers to the half.

Concretely speaking, the insurance premiums of the Social health insurance plan are decided according to the calculation table prepared by the insurer. The premiums amount can vary by the insurers, but only very little. If you are insured by Kempo Kyokai (the Health Insurance Association of Japan), living in Tokyo, the premium rate after March 2023 is 10.00%. The half of it, 5.00%, is borne by the respective insureds themselves. The other half is borne by the employers. The premiums are settled monthly. The monthly premiums shall be deducted from the monthly salary paid in the next month and paid to the insurer's offices by the employers.

[In Japanese]

具体的には、社会保険の保険料額は、その保険者によって策定された料率表に従って算定されます。保険者によって保険料に差がでることがありますが、その差は僅かです。 東京に住む、協会けんぽの加入者の場合には、2023年3月以降の保険料率は10.00%となっています。この半分の5.00%が被保険者個々人によって負担され、残余の半分は雇い主が負担します。保険料は月単位で納付されます。ある月分の保険料はその翌月の給与から天引きされ、雇い主から保険者に納付されることになっています。