1,TYPES of SOCIAL INSURANCE
There are two types of insurance: public insurance (social insurance) and private insurance (private insurance). Social insurance includes medical insurance, nursing care insurance, pension insurance, industrial accident insurance, and employment insurance.
Social insurance (narrow)
- medical insurance⇒健康保険、国民健康保険、後期高齢者医療制度
- nursing care insurance
- pension insurance⇒国民年金、厚生年金
Labor insurance.
- industrial accident insurance
- employment insurance.
2, BASICS of PUBLIC MEDICAL INSURANCE
i PUBLIC MEDICAL INSURANCE
Public medical insurance includes health insurance, national health insurance, and medical care system for the latter-stage elderly.
- health insurance：Targets company employees and their families.
- national health insurance：Self-employed persons and their families are eligible.
- medical care system for the latter-stage elderly：For people aged 75 and over.
ii Basic terms of the insurance system.
- Insurer: The operator of the insurance system.保険者
- Insured: A person covered by insurance. 被保険者
- Dependent: In general, an insured person who has an address in Japan and whose annual income is less than 1.3 million yen (60 years old or older, or less than 1.8 million yen for persons with disabilities and less than 1/2 of the insured person’s annual income) dependents. 被扶養者
3,HEALTH INSURANCE
Health insurance is a system that provides insurance benefits (pays insurance claims) to the insured person (company employee) and their dependents (company employee’s family members) for illness, injury, death, and childbirth that are not covered by workers’ compensation insurance. .
i HEALTH INSURANCE INSURER
There are two types of health insurance: the Japan Health Insurance Association-managed health insurance (Kyokai Kenpo), in which the National Health Insurance Association is the insurer, and the union-managed health insurance (Kumiai Kenpo), in which the Health Insurance Association is the insurer.
全国健康保険協会管掌健康保険（協会けんぽ）（By全国健康保険協会)・・・主に中小企業の会社員
組合管掌健康保険（組合健保）(By健康保険組合)・・・主に大企業の会社員
ii INSURANCE FEE
Insurance premiums are calculated by multiplying the standard monthly remuneration and standard bonus amount of the insured person (company employee) by the insurance premium rate, and the company and the insured person pay half of the amount (labor-employee split).労使折半
※Exemption from social insurance premiums during maternity leave During maternity leave, 42 days before childbirth and 56 days after childbirth. Also, social insurance premiums (health insurance premiums, welfare pension insurance, etc.) are exempted for both the insured person and the employer during the childcare leave period (childcare leave period for raising a child up to the age of three). (A request from the business owner is required.)
iii BENEFIT DETAILS
Health insurance benefits.
- (1) Medical benefits, family medical expenses
- (2) High-cost medical expenses.
- (3) Childbirth and Childcare Lump-Sum Grant, Family Childbirth and Childcare Lump-Sum Grant.
- （４）Childbirth allowance.
- （５） Injury and sickness allowance.
- （６） Burial expenses, family burial expenses.
(1) Medical benefits, family medical expenses ①療養の給付、家族療養費
自己負担割合
- 0歳～小学校入学まで：2割
- 小学校入学～70歳まで：3割
- 70歳～75歳未満：貧乏 2割 金持ち3割
(2) High-cost medical expenses.②高額療養費。
- A,自己負担限度額：￥80,100＋（総医療費－￥267,000)×１%
- B,実際病院に支払う金額：総医療費×3割
- 高額医療費として返金される金額：B-A
③出産育児一時金、家族出産育児一時金。
- 一人：50万円
（４）Childbirth allowance. ④出産手当金。
- 出産前42日間＋出産後56日間分のうち仕事を休んだ日数分金額支給
- 標準報酬月額（￥200,000）÷30日×２/3＝1日あたり（\450０）
- \4500×98日＝￥441,000
（５） Injury and sickness allowance.⑤傷病手当金。
- 4日目から1年6か月支給
- 標準報酬月額（￥200,000）÷30日×２/3＝1日あたり（\450０）
- \4500×547日＝￥2,463,750
（６） Burial expenses, family burial expenses.⑥埋葬料、家族埋葬料。
- 葬儀をしたら5万円
iv Voluntarily and continuously insured person of health insurance
任意継続被保険者。
会社を退職した場合でも、退職後２年間は退職前の健康保険に加入することができる。その際は全額負担。 要件：健康保険継続2か月以上加入、退職日20日以内に申請
4,NATIONAL HEALTH INSURANCE
i BENEFIT DETAILS
National Health Insurance is insurance for all people living in municipalities, such as self-employed people and unemployed people who are not covered by health insurance or mutual aid associations. Insurance premiums vary by municipality. There is no Maternity Allowance or Injury and Sickness Allowance.
5,MEDICAL SYSTEM for the LATTER-STAGE ELDERLY
i OVERVIEW
- 75歳以上 医療費自己負担額1割
- 例外：一定以上の所得の人：2割 現役並み所得：3割
ii INSURANCE FEE
- 保険料：年金から天引き（年額18万以上もらってる人）
- 徴収：市町村
6,PUBRIC MEDICAL INSURANCE for RETIREES
i PUBRIC MEDICAL INSURANCE for RETIREES
下記いずれかの公的医療保険に入らなければいけない
- ①健康保険の任意継続被保険者。退職日から20日以内に申込。
- ②国民健康保険。退職日から14日以内に申込。
- ③家族の扶養者
7,PUBLIC LONG-TERM CARE IMSURANCE
i OVERVIEW
Long-term care insurance is a system that provides the necessary benefits when long-term care is recognized as necessary.
- 第１被保険者：65歳以上。保険料：所得に応じて（18万以上年金取得者天引き
- 第2被保険者：40歳以上65歳未満 保険料：1.82％ ※事故はダメ。老化のみ。
- 共通：自己負担 原則1割（※2割3割の人もいる）
8,WORKERS’COMPENSATION INSURANCE
i OVERVIEW
Industrial Accident Compensation Insurance is a system that provides benefits for workers’ illness, injury, death, etc. at work or while commuting.
- 種類：業務災害、複数業務要因災害、通勤災害
- 保険料：事業主が負担
- 給付内容：休業補償給付（休み4日目から給付基礎日額60％）傷病補償年金（1年6か月たっても傷病が治らない場合に支給）
ii Special enrollment system
特別加入制度：タクシー業者や大工さんなど。（労災保険に任意加入できる制度）
Employment insurance.
i OVERVIEW
Employment insurance is a system that provides necessary benefits and supports reemployment when workers lose their jobs.
ii Contents of each benefit.
①Basic Allowance (Job Seeker Benefit).基本手当（求職者給付）
The basic allowance is a benefit for the unemployed (those who have the ability to work but are unemployed) and is generally called unemployment insurance.
- 給付日数：自己都合、定年：90日～150日 倒産、解雇等：90日～330日
- 受給要件：2年間被保険者期間12か月（1年間被保険者期間6か月）
- 待期期間：7日間（自己都合の場合7日＋2か月）
② Continued Employment Benefit. 雇用継続給付。
A system to provide the necessary benefits to the elderly and those who are caring for them and encourage them to continue their employment.
- 高年齢雇用継続給付：被保険者期間5年以上の60歳以上65歳未満の被保険者で60歳に到達時の賃金額と比べ、75％未満の賃金月額で働いている人に対して、各月の賃金の最大15％相当額支給される
- 介護休業給付：介護するために休業した期間、限度93日で3回まで賃金の６７％まで支給
③Educational training benefits. 教育訓練給付
The education and training benefit is paid by the Workers’ Party at their own expense to attend courses designated by the Minister of Health, Labor and Welfare, and when they complete the course, part of the cost is paid.
- 一般教育訓練給付金：被保険者歴3年。受講料の20％相当額（上限10万円）
- 特定一般教育訓練給付金：被保険者歴3年。受講料の４0％相当額（上限２0万円）
- 専門実績教育訓練給付金：被保険者歴3年。受講料の５０％相当額（年間上限40万円×3年）
④Employment promotion benefits. 就職促進給付。
- 再就職手当：再就職した場合
- 就業手当：アルバイト等に主食した場合
⑤Parental leave benefits.育児休業給付。
- 育児休業給付金：満1歳未満の子養育のための育児休暇：賃金の67％（6か月経過後50％）
- 出生時育児休業給付金（産後パパ育休）：子の出生日から2か月の間で1か月育児休暇習得で67％支給
