Dependent eligibility survey (authorization)
Purpose of this survey
Thank you for your understanding and cooperation with regard to the activities of the AZSA Health Insurance Society.
Provided below is information on the 2018 Dependent Eligibility Status Survey.
This survey is intended to confirm that household members listed as dependents continue to meet dependent eligibility criteria. The operations of the AZSA Health Insurance Society are funded by insurance premiums collected from insured persons; this makes it critical to appropriately provide insurance benefits and accurately calculate contributions.
As instructed by the Ministry of Health, Labour and Welfare, we perform this survey each year and request your cooperation.
Content of this survey
Main notes on this survey (changes from last survey)
- * The survey document form and response flow will change significantly.
⇒Introducing a chart for identifying required documents
⇒Discontinuing use of the Removal Notification on the rear side of the survey form (The insured person will be notified of disqualification by email.) - * Certificates for FY2018 (FY2017 income) must be submitted to allow the Society to check the status of income-earning family members.
- * Spouse income status will be checked for households with dependents of both spouses (applicable persons will be notified).
Those subject to the survey
Dependents aged 18 and older (as of December 31, 2016)
Note that this survey excludes those certified as dependents on or after January 1, 2017.
Date of survey form distribution and materials distributed
| Date of distribution | Late August | |
|---|---|---|
| Materials distributed | 1 | (Front) “About the 2018 Dependent Eligibility Status Survey” (Back) “Health Insurance Dependent Survey Form Example” |
| 2 | “Health Insurance Dependent Survey Form” | |
| 3 | “Chart of required documents”(front, back) | |
| 4 | Return envelope | |
| 5 | “Dependent Eligibility Status Survey for dependents of both spouses ” | |
Documents to submit
Health Insurance Dependent Survey Form and specified attachments
- * Regardless of whether the subject dependent earned an income or without income, the documents specified on the list must be submitted as confirmation of income status.
When filling out the Health Insurance Dependent Survey Form, refer to the chart of required documents and fill out as shown in the example.
Deadline for submitting
Wednesday, September 26, 2018
Where to submit
Place the form in the enclosed return envelope and send directly (e.g., by in-house mail) to the AZSA Health Insurance Society or submit to the HR section of your establishment.
Voluntarily and continuously insured persons should mail the documents directly to the AZSA Health Insurance Society. (You are responsible for postage.)
- * If your household has multiple dependents subject to the survey, please remember to submit survey forms for all subject dependents.
Notes
Be sure to submit the “Health Insurance Dependent Survey Form” and other required documents. Failure to do so will result in cancellation of the health insurance card of the relevant dependent. (Article 50, Paragraph 7 of the Ordinance for Enforcement of the Health Insurance Act)
If the form is not submitted, the date of dependent removal certification will be the date specified by the AZSA Health Insurance Society (October 1, 2018).
Following cancellation of a household member’s dependent status, the insured person will be billed for any costs incurred by that individual and paid by the Health Insurance Society on or after the date of such cancellation, including the cost of medical care and examinations.