medical service under health insuranceとは 意味・読み方・使い方

(3) If the ratio between the amount of the insurance benefits pertaining to employment injury provided for in the Industrial Accident Insurance Act (excluding the lump sum compensation for surviving family paid in case of Article 16-6, paragraph (1), item (ii) of the Industrial Accident Insurance Act, the insurance benefits pertaining to persons afflicted with a disease caused as a result of having been engaged in a specific job or occupation for a long period which is specified by the Ordinance of the Ministry of Health, Labour and Welfare (limited to the persons specified by the Ordinance of the Ministry of Health, Labour and Welfare for each type of the businesses specified by the Ordinance of the Ministry of Health, Labour and Welfare, taking into consideration of the service period in respect of such business, etc.) (hereinafter referred to as the "insurance benefits pertaining to persons afflicted with a specific disease" in this paragraph and in Article 20, paragraph (1)), and the insurance benefits pertaining to persons deemed as entitled to receive the insurance benefit pursuant to the provision of Article 36, paragraph (1) of the Industrial Accident Insurance Act (hereinafter referred to as the "insured of Class III special enrollment")) in respect of any business falling under any of the following items during each insurance year of three consecutive insurance years and in respect of which business three years or more have passed, since the establishment of the insurance relation of industrial accident insurance, as of March 31 of the last insurance year of such consecutive three insurance years (hereinafter referred to as the "reference date" in this paragraph), the payment of which has been made during such consecutive three insurance years (or, in case of insurance benefits paid as pension or otherwise specified by the Ordinance of the Ministry of Health, Labour and Welfare, the amount thereof shall be calculated pursuant to the provisions of the Ordinance of the Ministry of Health, Labour and Welfare; the same shall apply in Article 20, paragraph (1)), plus the amount of the payments made as the services listed in Article 29, paragraph (1), item (ii) of the Industrial Accident Insurance Act which pertain to employment injury and which are specified by the Ordinance of the Ministry of Health, Labour and Welfare (or, in case of payments other than those paid as lump sum payments, the amount thereof shall be calculated pursuant to the provisions of the Ordinance of the Ministry of Health, Labour and Welfare) on one hand, and the amount obtained by multiplying the aggregate of the amount of the general insurance premiums (or, in case of the businesses set forth in paragraph (1), item (i), the amount of the portion corresponding to the industrial accident insurance rate prescribed in the preceding paragraph (or, if such rate has been increased or decreased pursuant to the provision of such paragraph, such increased or decreased rate)) after deducting the amount of the portion corresponding to the off-the-job injury rate (meaning the rate prescribed by the Minister of Health, Labour and Welfare by taking into consideration of the injury rate pertaining to commuting injury and the amount of the costs required for the benefit for second medical examination, etc. during the past three years in respect of all businesses to which the Industrial Accident Insurance Act is applied, and other circumstances; hereinafter the same shall apply in this paragraph and in Article 20, paragraph (1)) plus the amount of the Class I special enrollment insurance premiums after deducting the amount of the portion corresponding to the special enrollment off-the-job injury rate (meaning the off-the-job injury rate after deducting the rate determined by the Minister of Health, Labour and Welfare set forth in Article 13; the same shall apply in each item of Article 20, paragraph (1) and in Article 20, paragraph (2)), by the rate specified by the Ordinance of the Ministry of Health, Labour and Welfare by taking into consideration of the costs required for the insurance benefits paid as pension concerning employment injury, the costs required for the insurance benefits pertaining to persons afflicted with a specific disease, and other circumstances (in Article 20, paragraph (1), item (i) referred to as the "Class I adjustment rate") on the other hand, exceeds eighty-five one-hundredth (85/100), or is seventy-five one-hundredth (75/100) or less, then the Minister of Health, Labour and Welfare may acknowledge the rate calculated by increasing or decreasing the industrial accident insurance rate prescribed in the preceding paragraph in respect of such business less the off-the-job injury rate, by the rate specified by the Ordinance of the Ministry of Health, Labour and Welfare within the scope of forty one-hundredth (40/100), as the industrial accident insurance rate for the insurance year two years following the insurance year in which the reference date of such business is included.発音を聞く 例文帳に追加

３　厚生労働大臣は、連続する三保険年度中の各保険年度において次の各号のいずれかに該当する事業であつて当該連続する三保険年度中の最後の保険年度に属する三月三十一日（以下この項において「基準日」という。）において労災保険に係る保険関係が成立した後三年以上経過したものについての当該連続する三保険年度の間における労災保険法の規定による業務災害に関する保険給付（労災保険法第十六条の六第一項第二号の場合に支給される遺族補償一時金、特定の業務に長期間従事することにより発生する疾病であつて厚生労働省令で定めるものにかかつた者（厚生労働省令で定める事業の種類ごとに、当該事業における就労期間等を考慮して厚生労働省令で定める者に限る。）に係る保険給付（以下この項及び第二十条第一項において「特定疾病にかかつた者に係る保険給付」という。）及び労災保険法第三十六条第一項の規定により保険給付を受けることができることとされた者（以下「第三種特別加入者」という。）に係る保険給付を除く。）の額（年金たる保険給付その他厚生労働省令で定める保険給付については、その額は、厚生労働省令で定めるところにより算定するものとする。第二十条第一項において同じ。）に労災保険法第二十九条第一項第二号に掲げる事業として支給が行われた給付金のうち業務災害に係るもので厚生労働省令で定めるものの額（一時金として支給された給付金以外のものについては、その額は、厚生労働省令で定めるところにより算定するものとする。）を加えた額と一般保険料の額（第一項第一号の事業については、前項の規定による労災保険率（その率がこの項の規定により引き上げ又は引き下げられたときは、その引き上げ又は引き下げられた率）に応ずる部分の額）から非業務災害率（労災保険法の適用を受けるすべての事業の過去三年間の通勤災害に係る災害率及び二次健康診断等給付に要した費用の額その他の事情を考慮して厚生労働大臣の定める率をいう。以下この項及び第二十条第一項において同じ。）に応ずる部分の額を減じた額に第一種特別加入保険料の額から特別加入非業務災害率（非業務災害率から第十三条の厚生労働大臣の定める率を減じた率をいう。第二十条第一項各号及び第二項において同じ。）に応ずる部分の額を減じた額を加えた額に業務災害に関する年金たる保険給付に要する費用、特定疾病にかかつた者に係る保険給付に要する費用その他の事情を考慮して厚生労働省令で定める率（第二十条第一項第一号において「第一種調整率」という。）を乗じて得た額との割合が百分の八十五を超え、又は百分の七十五以下である場合には、当該事業についての前項の規定による労災保険率から非業務災害率を減じた率を百分の四十の範囲内において厚生労働省令で定める率だけ引き上げ又は引き下げた率に非業務災害率を加えた率を、当該事業についての基準日の属する保険年度の次の次の保険年度の労災保険率とすることができる。 - 日本法令外国語訳データベースシステム