After you leave your employer
Individuals are eligible for health insurance coverage until their retirement date. If you retire and lose eligibility for insurance coverage, please promptly return your insurance card, Eligibility Confirmation Document, etc., to the office.
When being examined by a healthcare provider after losing eligibility, be sure to inform the provider that you are no longer covered by the Works Applications Group Health Insurance Society, and present your insurance card, Eligibility Confirmation Document, etc., for your new insurance coverage. If it is discovered that you used the Health Insurance Society qualifications despite having lost them, you will be billed for those expenses.
When an individual has retired
After retiring from the company at the mandatory retirement age, etc., you can select "start new employment," "become the dependent of a child, etc.," or "be an insured individual for two years under optional continued insurance," etc. If none of those is the case, the individual will enroll in National Health Insurance.
If you retire and lose eligibility for insurance coverage, please return your insurance card, Eligibility Confirmation Document, etc., to the human resources department of your company within five days after losing eligibility.
- Health Insurance Card, Eligibility Confirmation Document, etc., (for the insured individual and all dependents)
* There is no need to return your Individual Number Insurance Card.
If you wish to remain a member of the Health Insurance Society
Such persons will receive insurance benefits similar to those that were available while employed. However, injury and illness allowance and maternity allowance will not be paid.
(The allowances will be paid if the requirements for continued benefits had been met by the person at the time of retirement.)
Precautions related to subscription
- This is a qualification that is acquired voluntarily by an insured person when he/she looks to continue coverage when losing his/her qualification. For this reason, the obligation to submit notices, pay insurance premiums, etc., become the responsibility of the insured person. (Health insurance does not do reminders.)
- Voluntarily and continuously insured persons cannot withdraw his/her subscription for reasons such as switching over to the National Health Insurance or becoming a dependent family member.
Please consider subscription only with an advance understanding of the following points.
All insurance premiums are the responsibility of the individual.
The insurance premiums for individuals covered by optional continued insurance are calculated by multiplying the standard monthlycompensation by the insurance premium rate, in the same manner as when they were insured individuals.
The "standard monthly compensation" of individuals covered by optional continued insurance
The lower of the following items.
- The standard monthly compensation at the time the individual retired
- The average standard monthly compensation of the Health Insurance Society
In addition, because the business operator will no longer pay part of the insurance premium, you will be responsible for the entire amount. Individuals age 40 or older and under age 65 are also responsible for the entire amount of nursing care insurance premiums.
* Please contact the Health Insurance Society for information on the standard monthly compensation and your actual premiums.
After completing the procedures, you will be issued an Eligibility Notification, an Eligibility Confirmation Document, etc., as an individual covered by optional continued insurance. (Your insurance code and number will also be changed.)
- Application for Eligibility for Optional Continued Insurance
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Payment Method and Deadlines
As a rule, insurance premiums are paid through deposit into an account designated by the Health Insurance Society. The Society will send "payment slips" directly to individuals covered by optional continued insurance.
When you will receive medical treatment before an Eligibility Notification is issued by the our Health Insurance Society, please notify a medical institution that you are in the process of applying for optional continued insurance. Once you receive your an Eligibility Notification, an Eligibility Confirmation Document, etc. , please present it to the healthcare provider.
| First Insurance Premium Payment |
Please pay your insurance premium by the deadline specified by the health insurance society (the deadline date is shown on the statement of payment). If the insurance premium is not deposited by the deadline, it will be deemed that no application had been made for the voluntary continuation of health insurance. |
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| Insurance premiums from the second time on(Monthly payment) |
Please deposit the health insurance premium for the month by the 10th of that month. (Because notification of payment of premium is not performed every month, please be careful.) |
| Insurance premiums from the second time on(half-year payment/half-year prepayment) |
Method of paying insurance premiums for half a year in a single lump sum
(Discount rate: 4% annually, with the compound present value method) First half: April through September portion Second half: October through March portion When individuals enroll after the beginning of the period, it is necessary to pay, in one lump sum, the insurance premiums for the period from the month after the month of enrollment to the upcoming September or March. * Under the system, there is no discount on the amount for the month of enrollment.
* If the payment deadline for the first half has passed, payment will be switched to monthly payment.
* If the payment deadline for the first half has passed, payment will be switched to monthly payment.
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| Insurance premiums from the second time on(annual payment/lump-sum prepayment) |
Method of paying insurance premiums for one year in a single lump sum
(Discount rate: 4% annually, with the compound present value method) When individuals enroll after the beginning of the period, it is necessary to pay, in one lump sum, the insurance premiums for the period from the month after the month of enrollment to March of the following year. * Under the system, there is no discount on the amount for the month of enrollment.
* If the payment deadline for the first half has passed, payment will be switched to monthly payment.
* During the pre-paid period, individuals cannot withdraw except with beginning new employment.
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Loss of Qualifications
Qualifications will be lost if any of the following conditions apply.
- When the subscription period expires(2 years)
- When the health insurance premium is not paid by the deadline
- When the insured person is re-employed and becomes insured under a different health insurance.*
- When the voluntarily and continuously insured person dies
- When the insured person reaches age 75 (shift to the medical insurance system for the elderly aged 75 or over)
An individual who has lost eligibility as an insured person with optional continued insurance needs the procedures for losing eligibility and needs to return the Health Insurance Card or the Eligibility Confirmation Document, etc. if you have it. After an indiviidual loses eligibilty as an insured person with optional continued insurance, if the individual mistakenly uses our Health Insurance Society's insurance to receive medical treatment, the individual must reimburse the us for the full amount of medical expenses and other benefits paid by the Health Insurance Society.
- Health Insurance Card or the Eligibility Confirmation Document (If you have it)
(If you have been issued an "Elderly Beneficiary Health Insurance Card," a "Specified Disease Medical Treatment Certificate," or a "Certificate of Eligibility for Ceiling-amount Application," etc., return them as well.)
- Notification of Loss of Eligibility for Optional Continued Insurance
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* There is no need to return your Individual Number Insurance Card.
Benefits that can be received after retirement
Individuals who can receive benefits
- Individuals who were insured individuals for one year or more continuously prior to retirement
The statutory benefit amount can be received
- The illness and injury allowance, birth allowance, lump-sum birth/childcare benefit, and burial fees (expenses) are paid in the amounts legally stipulated for each. No additional benefits are paid.
This can be received in the following cases
In the case of the illness and injury allowance
| Payment conditions | If you are receiving an illness and injury allowance at the time of retirement, and continue to be unable to work due to treatment for that illness or injury |
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| Payment period |
Until the end of the illness and injury allowance reception period
* This is not paid if you are receiving an old-age welfare annuity, but if the old-age welfare annuity is less than the illness and injury allowance, you will be paid the difference.
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In the case of the birth allowance
| Payment conditions | If an individual is receiving a birth allowance at the time of retirement |
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| Payment period | Until the end of the birth allowance reception period |
Lump-sum birth/childcare benefit
| Payment conditions | If an individual gives birth within six months after losing eligibility |
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Burial fees (expenses)
| Payment conditions |
* Individuals who die within three months after losing eligibility receive payment even if they had not been insured for at least one year.
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Using the Health Insurance website
Notifications from the Health Insurance Society and the use of healthcare business are done on the website.
To continue using the services after retirement, be sure to change your registered e-mail address from the address assigned by the company to your private e-mail address.