EY Japan
Health Insurance Society
Procedures

Resignation / Retirement

An individual loses their certification as an insured person with the EY Japan Health Insurance Society on the day of resignation or retirement. If you lose your insured status due to resignation or retirement, please promptly return your health insurance card or Eligibility Confirmation Document, if you have one.
When being examined by a medical institution after losing eligibility, be sure to inform the institution that you are no longer covered by the EY Japan Health Insurance Society, and receive medical care using your new health insurance. If an individual who has mistakenly used the EY Japan Health Insurance Society's insurance after losing his/her eligibility as an insured person, The EY Japan Health Insurance Society will bill him/her any medical expenses.

Health Insurance System after Resignation or Retirement

An individual who has left the company due to resignation or retirement at the mandatory age can choose to be re-employed, become a dependent of their child or another family member, or become an insured person with optional continued insurance for two years. If none of the above are suitable for the individual, he/she may enroll in National Health Insurance.

Procedures
Required Documents

Please always submit the notification within five days after losing eligibility as an insured person.

  • Health Insurance Card or Eligibility Confirmation Document of insured person and all dependents (If they have it)
  • Elderly Beneficiary Health Insurance Cards (if issued)
  • Eligibility Certificate for Ceiling-Amount Application (if issued)

* There is no need to return your Individual Number Insurance Card.

Optional Continued Health Insurance System

The Optional Continued Health Insurance System enables individuals who have been an insured person for two or more months before their resignation or retirement to stay enrolled as an insured person of the EY Japan Health Insurance Society for up to 2 years after losing eligibility.
Insured persons with optional continued insurance receive insurance benefits similar to those that were available while employed. However, these individuals are not eligible to receive injury and illness or childbirth allowance benefits.
(Allowances are paid if the requirements for optional and continued benefits have been met by the person at the time of resignation or retirement.)

Notes on Enrollment

  • Insured persons qualify to enroll in optional continued insurance upon loss of their eligibility as a regular insured person. Thereafter, the enrollee is responsible for submitting notifications, paying insurance premiums, and any other such obligations. (The EY Japan Health Insurance Society does not provide any reminders about these obligations.)
  • National Health Insurance premiums (taxes) may cost less than optional continued insurance if an individual has lost their job due to company circumstances.*
*The EY Japan Health Insurance Society does not have details about these health insurance programs and premiums. Please contact the National Health Insurance section of your local municipality.

*Please consider enrolling only after reviewing all of the information above.

All Insurance Premiums are the Responsibility of the Individual

The insurance premiums for individuals covered by optional continued insurance are calculated by multiplying standard monthly remuneration by the insurance premium rate, in the same manner as the premiums when the individual was a regular insured person.

Standard monthly remuneration of insured persons with optional continued insurance

The lower of the items below.

  • The standard monthly remuneration of the individual at the time of resignation or retirement
  • The average standard monthly remuneration of the EY Japan Health Insurance Society as of September 30 of the previous fiscal year

In addition, insured persons with optional continued insurance are responsible for paying the entire premium because employers no longer pay a portion of insurance premiums. Moreover, individuals age 40 or older but under age 65 are also responsible for the entire amount of long-term care insurance premiums.

*Please contact the EY Japan Health Insurance Society for information about the standard monthly remuneration and actual insurance premiums.

Procedures

Enter the required information on the “Application Form for Certification as Voluntarily and Continuously Insured Person” and submit it directly to the health insurance society “within 20 days” after losing qualification (starting on the day after your retirement date).
The EY Japan Health Insurance Society issues an Eligibility Notification, an Eligibility Confirmation Document, etc. to individuals as insured persons with optional continued insurance after they have completed the filing procedures. (The health insurance code and number also changed.)

Required Documents
  • Application Form for Certification as Voluntarily and Continuously Insured Person
    PDF

Payment Method and Deadlines

As a general rule, insured persons with optional continued insurance transfer insurance premium payments to an account designated by the EY Japan Health Insurance Society. (Statements of payment include account details for the wire transfer)

*Please note that EY Japan Health Insurance Society cannot accept the direct delivery of cash payments or issue an Eligibility Notification, an Eligibility Confirmation Document, etc. on the spot.

When you will receive medical treatment before an Eligibility Notification is issued by the EY Japan 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 medical institution.

Please note that you will not be able to receive medical treatment at a medical institution by presenting only the Eligibility Notification. You will need to present it along with your Individual Number Card.

If your health insurance eligibility can be confirmed with your Individual Number Insurance Card, you do not need to present your Eligibility Notification.

First insurance premium payment Please pay your insurance premium by the date specified by the EY Japan Health Insurance Society (shown on the statement of payment).
If the first insurance premium is not paid by the payment deadline without a valid reason, the individual loses their qualification as an insured person with optional continued insurance.
Second and subsequent insurance premium payments Please pay the monthly health insurance premiums by the 10th of each month.
The EY Japan Health Insurance Society also has a prepayment system which offers a discount on health insurance premiums paid in six-month or twelve-month installments. If an insured person with optional continued insurance withdraws after prepayment, the EY Japan Health Insurance Society will reimburse any remaining insurance premiums.
About the Prepayment System
The prepayment system applies a discount to lump-sum insurance premiums wired in advance. Please contact the EY Japan Health Insurance Society if you would like to use the prepayment system.

Payment Method

Six-month payment Payments in a six-month installment from April to September and October to March of the following year
Twelve-month payment Payments in a twelve-month installment from April to March of the following year
Payment Deadline Prepayments are due by the end of the month before start of the first month
*Prepayment discounts do not apply if a payment arrives in the EY Japan Health Insurance Society account after the payment deadline.
*The EY Japan Health Insurance Society reimburses insurance premiums to an insured person with optional continued insurance who enroll in a different health insurance plan through an employer for payments made from the month of enrollment in the new health insurance plan. (Notification required)
*In the case of withdrawal by request, the EY Japan Health Insurance Society will reimburse premiums to an insured person with optional continued insurance from the month following the month of the request up to the period for which the premiums were paid. (Notification required)
If Health Insurance Premiums Not Paid by the Deadline
An individual who does not pay the health insurance premiums by the deadline with a valid reason such as a natural disaster or transportation strike loses their eligibility as an insured person with optional continued insurance.

Loss of Qualifications

Individuals lose their eligibility as insured persons with optional continued insurance if any of the items below apply.

  • When the insured person with optional continued insurance makes an application for withdrawal by request (by submitting the Application for Forfeiture of Status as an Insured Person with Optional Continued Insurance)
    *The date of loss of eligibility will be the first day of the following month after the application is received by the EY Japan Health Insurance Society.
  • When the enrollment period expires (maximum of two 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 insured person with optional continued insurance dies
  • When the insured person reaches age 75 (shift to the medical insurance system for the elderly age 75 or older)

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 individual loses eligibility as an insured person with optional continued insurance, if the individual mistakenly uses the EY Japan Health Insurance Society's insurance to receive medical treatment, the individual must reimburse the EY Japan Health Insurance Society for the full amount of medical expenses and other benefits paid by the EY Japan Health Insurance Society.

Procedures
Required Documents

Please submit the necessary materials within five days after losing eligibility as an insured person with optional continued insurance.

  • Health Insurance Card or Eligibility Confirmation Document (If you have it)
    (Return any Elderly Beneficiary Health Insurance Card, Certificate of Medical Treatment for Specified Diseases, or Eligibility Certificate for Ceiling-Amount Application issued by the EY Japan Health Insurance Society)
  • Application for Forfeiture of Status as an Insured Person with Optional Continued Insurance
    PDF

* There is no need to return your Individual Number Insurance Card.

Benefits Received After Resignation or Retirement

An individual who has lost eligibility as an insured person with optional continued insurance can still receive illness and injury, childbirth, lump-sum childbirth and childcare, and funeral expense allowance benefits from the EY Japan Health Insurance Society if certain requirements are met.

Individuals Receiving Benefits

  • Individuals who were insured persons for one year or more continuously prior to resignation or retirement

Individuals Eligible to Receive Statutory Benefits

  • The EY Japan Health Insurance Society pays the illness and injury, childbirth, lump-sum childbirth and childcare, and funeral expense (fee) allowance benefits in the amounts that are legally mandated. No additional benefits are paid.

Various Benefits Available

Illness and Injury Allowance

Payment requirements Individuals receiving an illness and injury allowance at the time of resignation or retirement who continue to be unable to work due to treatment for that illness or injury
Payment requirements Until the end of the payment period for the illness and injury allowance
*Individuals receiving an old-age welfare annuity are not eligible for the illness and injury allowance unless the old-age welfare annuity is less than the illness and injury allowance. In this case, the EY Japan Health Insurance Society pays the difference.

Childbirth Allowance

Payment requirements Individuals receiving a childbirth allowance at the time of resignation or retirement
Payment requirements Until the end of the payment period for the childbirth allowance

Childbirth/Childcare Lump-sum Allowance

Payment requirements Individuals giving birth within six months after losing eligibility

Funeral Expenses (Fees)

Payment requirements
  • Insured persons who die within three months after losing eligibility
  • Insured persons who die while receiving an illness and injury allowance or a childbirth allowance after losing eligibility, or within three months after the payment period ends
*Individuals who die within three months after losing eligibility receive payment even if they have not been insured for one year or more.
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