Job Discussion Forums

[jesszilla]

I've spent the past few hours reading old posts and visiting links regarding the shakai hoken vs. private insurance question. I'm still unclear on a couple of points, and I'd appreciate any clarification that could be provided.

1) My employer offers private insurance and does not inform its recruits of the legal requirement to enroll in shakai hoken. If I talk to them, and they will not comply, is there another way for me to enroll without taking them to court to do it? I know that I could enroll for the national health insurance for self-employed/unemployed, but could I apply for the Employees Health Insurance through a government office and have them make my company pay their share? This is important to me since the benefits differ between the two government plans, but I don't have the stamina or financial resources for a protracted legal battle.

2) It has been mentioned several times that the premiums for shakai hoken rise exponentially in the second year, to the tune of 20,000-40,000 Y/month. Is this solely for the health insurance, or does this figure include the pension payments? If so, it doesn't seem unreasonable to me, because I could claim roughly half of that back if I leave within three years. Am I missing something?

Rignt now, I'm leaning toward enrolling in shakai hoken if possible, since I have a preexisting medical condition - I have respiratory and skin allergies, and I had an incident a few years ago where I had a severe liver reaction and was out on short term disability for six months. The cause of the liver problem was never explained to my satisfaction, and the possibility exists, however slight, that there could be a repeat of this issue. I don't anticipate having another problem of this magnitude, but then again, I wasn't anticipating having that one, either Therefore, good health coverage with minimal hassles is a priority for me, although it may not be for many others. Any input would be greatly appreciated.

[JimDunlop2]

1. Just because your employer doesn't inform recruits of the shakai hoken option doesn't automatically mean you will have to fight to get it. Some companies realize that many teachers don't WANT shakai hoken... This was the case with my previous employer. You COULD apply for it, but it was discourged and for most people it was a more expensive option than private insurance through an outfit like Global. Yet others had extended travel insurance from back home... In any event, it was never really talked about much -- but it was there. The company management just said that in their years of working they had never known a single teacher to take that insurance... which was probably true.

As an aside, enrolling in shakai hoken is NOT compulsory... Japanese law says you must have insurance -- but it doesn't specify what kind.. It is implicitly assumed that it will be one of the two government options because until recently that's all there was, but in recent years the private insurance market has found a nice little niche that loopholes its way past the law... because they are not based in Japan but countries like New Zealand...

But if you are a civil servant (like me) you will have no choice in the matter. I pay 30,000/month whether I like it or not. It was a condition of being hired.

Anyway,

2. That is true. I pay 30,000/mth. It should also be noted that this IS my first year on shakai hoken -- there was no "cheap" year for me... I guess that's a downfall of working for the government. Yes, a lot of this is for pension. I just checked my pay stub. 15,000 yen for health insurance and 25,000 yen for pension.

Bear in mind that even on shakai hoken you are not 100% covered.... Which means, each time you see the doctor, you will pay a fee -- just not such a large one. This is why many Japanese people buy "top-up" insurance from outfits like AFLAC so they can get this back too... I think it's been said that the Japanese are the most "insured" people in the world... And from what I've seen, I don't doubt it. I even have the city in which I live offering me "gaijin insurance." It's only available to foreigners and no one seems to be able to tell me exactly what it's for..... The closest I ever got to an answer was: "Say if you're walking on the street and you slip on a banana peel and crack your skull -- you can get money." Um.. Ok... Whatever. That's a 500yen/month I don't think I'm going to start paying anytime soon.

[jesszilla]

Even if enrolling in shakai hoken is not compulsory, the fact remains for me that the private plan my employer offers does not cover pre-existing conditions. If I should have a recurrence of this mysterious liver illness or some illness related to the past problems, I would be SOL. If I need to get allergy testing or meds, the private insurance won't cover it. In short, the medical problems that I am most likely to encounter are not covered by the insurance plan that they want me to buy, and it is unlikely that many of the private plans that I could sign up for would cover these things.
The 70% versus 100% coverage I don't mind, since with the private insurance I'd have to shell out for all my medical expenses up front anyway. And, in your case, isn't the jump to a second-year payment schedule due to the fact that you had lived and worked previously in Japan? I am coming to Japan next week, so that problem would not exist for me yet.
Thanks for the info, JimDunlop2. I'm still chewing it over.

[JimDunlop2]

Yer right.... If you have pre-existing conditions you WOULD be SOL... I was just pointing out that shakai hoken is not compulsory (because sometimes some companies will tell you that it is)....

Um... As for my premiums... There was no jump... My first year I had no insurance.... And any doctor's visits I paid for cash (out-of-pocket). So there was no justification for charging me 30,000 in my first year of being on shakai hoken, other than the fact that I work for the local gov't... So their rules are different. I never had the "first year is cheap" privilege.... But you probably will...

[inkansai]

Jesszilla premiums for shakai hoken (employee health and pension insurance) are calculated on your salary for that particular month. Therefore, premiums are usually around the same amount.

kokumin kenko hoken (national health insurance) is calculated using your income for the previous year, hence it is very cheap when you first arrive.

kokumin nenkin (national pension) is not included in kokumin kenko hoken. However, the kokumin nenkin premium is not income indexed, and is currently 13,300. It will increase from April 1st.

Just as an example, i work for an eikaiwa, an average eikaiwa salary. My employer doesn't enrol teachers in shakai hoken

kokumin kenko hoken (national health insurance) 44,167 a month
kokumin nenkin (national pension ) 13,300 a month

if i was enrolled in shakai hoken i would pay 32,450 a month, and would get better benefits. i know that not everyone wants shakai hoken but it should be at least offered to people who want it.

[Iwantmyrightsnow]

[JimDunlop2]

[inkansai]

sorry i can't agree....it appears to be an advertisement. Do the mentioned companies advertise in the Kansai Time Out (where the article was first published)?

[JimDunlop2]

No.

I read the article in its original format. This is the only reprint I could find in a pinch. It is not an advertisement as far as I know.

[jesszilla]

Thanks for the responses.

So let me sum up to be sure I'm clear -

Re Q1 : I cannot enroll in shakai hoken myself if my employer won't enroll me, only kokumin kenko hoken.
Re Q2: Payments for shakai hoken are stable because they are based on current rather than past year income, but payments for kokumin kenko hoken rise in the second year due to the increase in documented income from the previous year. Kokumin nenkin is a separate issue.

And now a few more questions:
1. How do benefits differ between shakai hoken and kokumin kenko hoken? Are pre-existing conditions covered by k.k.h.?
2. Is the unemployment insurance coverage part of kokumin kenko hoken, or just shakai hoken?
3. If I were to enroll in kokumin kenko hoken, would I also have to concurrently enroll in kokumin nenkin, or does that only apply with shakai hoken?
4. Is there an agency that I should be calling with all of these questions? If so, do they have English-speaking representatives? I don't think my Japanese is sufficient for the intricacies of this discussion.

Many thanks to all of you for replying.

[inkansai]

And now a few more questions:

1. How do benefits differ between shakai hoken and kokumin kenko hoken? Are pre-existing conditions covered by k.k.h.?

>> if you are unable to work (after a certain period- a couple of days i think), you will receive 60% of your wage if you are enrolled in shakai hoken. The saftey net for the amount of medical expenses payable in one calendar month is much lower. maternity allowances are also available. with both shakai hoken and k.k.h you will be admitted to hospital immediately- you won't need a guarantor. when you have an emergency being admitted to hospital is not as easy as you would think if you don't have shakai hoken or k.k.h

2. Is the unemployment insurance coverage part of kokumin kenko hoken, or just shakai hoken?

>>Koyo Hoken (employment insurance/ unemployment insurance) is a seperate insurance that most eikaiwa schools actually do pay. It is about 2000 yen a month if you are an average salary eikaiwa teacher

3. If I were to enroll in kokumin kenko hoken, would I also have to concurrently enroll in kokumin nenkin, or does that only apply with shakai hoken?

>>In the past you were able to just enroll in Kokumin Kenko Hoken, and the ward office turned a blind eye. However, things are changing and now many ward offices ask you to enroll in both. (it will depend on where you live)

4. Is there an agency that I should be calling with all of these questions? If so, do they have English-speaking representatives? I don't think my Japanese is sufficient for the intricacies of this discussion.

>> There are Shakai Hoken Offices all over the country whether they have guidance in other languages i don't know. They do have information in English on how to get your pension contributions refunded when you leave Japan.

[jesszilla]

[ghostrider]

"1. ...Are pre-existing conditions covered by k.k.h.? " I want to add to that question, is there a difference in coverage between SH and KKH for pre-existing conditions?

[ghostrider]

[cafebleu]

About health insurance DOES have intrinsic bias because it was written by somebody on behalf of Global Health Insurance. Correct me (anybody) if I'm wrong but this company is based in New Zealand.

I have heard good things about this company - and some appalling things. Such as being out of pocket and not being reimbursed for months and months. Some eslcafe posters and posters on other forums (eg letsjapan.org) will have positive experiences to relate, others will dismiss Global Health and the other names it goes under as being tardy to pay out when you have already forked out.

Whatever the situation, the article there was promotional rather than an example of integrity. I'm not a fan of the Japanese National Health Insurance through the ward office/city hall but I knew when I was enrolled during my time in Japan, that no matter what the emergency or other medical situation, I could rush to the nearest hospital and my insurance would be acceptable to it.

Global Health and other private schemes are a lottery there. Many, maybe most hospitals/clinics will refuse to recognise the insurance and make you pay up front if you are not part of the NHI. Do you really want the trauma of calling friends etc to go to your ATM to take out cash to pay up front in case of an unforeseen medical situation, crisis, or accident?

I'd suggest bite the bullet and enrol at your ward/city hall office. I don't know whether you are already in Japan but do it if you go to Japan. That way you won't have to pay back payments if you decide to do it later. Most employers are not upfront about any insurance and will do their best to offload all the responsibility on you.

A trap for the unwary IS having to pay into the pension through your ward office/city hall office. For me that is cynical - 99 percent of foreigners forced to pay this will never live in Japan in their retirement. However, it is worth it if you live in Japan up to about 3 years. Those of us who lived in Japan longer were well and truly cheated by the time we left.

However, I can't stress enough the importance of having health insurance that is recognised in a split second in Japan and will result in your not having to pay upfront for those situations just referred to. Yes, it is too expensive and it is shockingly so combined with 14,000 yen per month pension or whatever the cost is now.

However, you can always do what a friend of mine did. He stopped paying his NHI/pension premiums a year before he left Japan and he could still claim 244,000 or so pension refund when he returned to his home country because of the dates during which he paid into the pension.
He saved a lot of money in his final year by not paying his premiums and still could collect for the time he did.

As for me 244,000 did not represent any value for what I had contributed. Stay about 3 years and it's fine but do your best to keep out of paying it if your ward office/city hall still thinks it's your choice. Many of them are forcing foreigners to join to make up for their own woeful handling of finances for years - the bankrupt state of these bodies is a scandal in itself.