Tokyo securities industry health insurance society privacy policy
Japanese sitemap
Links
Introduction to Kenpo Seach by life stage when you need long-term care when you become sick or injured List of application forms
Additional health insurance information Guide to recreation facilities Health examinations, disease prevention Guide to directly managed clinic Other activities
Pritection of personal information
HOME > Protection of personal information > Purposes of using personal information
Purposes of using personal information


The Tokyo Securities Industry Health Insurance Society (“Society”) uses the personal information provided on various forms, including personal information provided on notifications, applications, and requests submitted by insured persons and dependents (“members”) and employers, personal information on medical cost details and pharmaceutical statement (“rezepts”) used when medical institutions and other such facilities bill the Society for member treatment and examinations, and personal information including numerical results from member health checkups described on result reports, for the following activities: providing insurance benefits for non-occupational illnesses, injuries, death, and childbirth of members as stipulated in the Health Insurance Act; implementing health activities necessary to maintain and promote the health of members; and implementing specific health checkups and specific health guidance pursuant to the Act on Assurance of Medical Care for Elderly People and other regulations.
Personal information obtained by the Society is entered into and managed using operational systems and used in Society activities.
In addition, personal information held by the Society is retained and managed appropriately for the retention periods stipulated in laws and regulations and by the Society, then disposed of or deleted appropriately after the end of the Society’s retention periods.
Provided below is a summary of the activities related to the above purposes of using personal information.




   

Purposes of using personal information held by the Society


(1)

Purposes of use necessary for providing insurance benefits to members

 

[Cases of internal use by the Society]

 

@ Confirming insured persons’ eligibility, certifying dependents, and managing issuance of health insurance cards

 

 

Notifications of Eligibility as Insured Persons submitted by establishments (by insured persons in the case of Notifications of Eligibility as Voluntarily and Continuously Insured Persons) are reviewed and used to grant eligibility as insured persons.

 

 

Dependents are certified using Notifications of Health Insurance Dependents (Change) and other documents necessary for certification (certificates).

 

 

Dependent status confirmation (authorization) is conducted using Dependent Survey Forms.

 

 

Health insurance cards are issued after reviewing Notifications of Eligibility as Insured Persons, Notifications of Health Insurance Dependents (Change), etc.

 

 

Health insurance cards of members who have lost their eligibility are collected and managed for the specified retention period.

 

A Managing issuance of elderly benefits cards, Certificates of Application of Maximum Copayment Amount, and Certificates Issued for Specific Disease Treatment

 

 

Elderly benefits cards are issued after reviewing eligibility data.

 

 

Certificates of Application of Maximum Copayment Amount and Reduced Standard Copayment Certificates are issued after reviewing Requests for Issuance of Maximum Copayment Certificates, Requests for Issuance of Reduced Standard Copayment Certificates, and required documents such as tax exemption certificates.

 

 

Certificates Issued for Specific Disease Treatment are issued after reviewing Application Forms for Certificates Issued for Specific Disease Treatment and required documents.

 

B Providing insurance benefits (statutory and additional benefits)

 

 

Information obtained by the Society, such as member eligibility status, eligibility status for coverage using public funds, and records of past benefits, is used to make decisions on the payment of insurance benefits to ensure appropriate provision of insurance benefits.

 

 

Rezepts and requests for payment of insurance benefits are used to make decisions on and process the payment of insurance benefits.

 

 

Rezepts are used to review claims for insurance benefits such as Injury and Sickness Allowance. In certain cases, benefits decisions may be made based on reviews of the status of treatment and other information obtained from the physician responsible or home-visit interviews.

 

C Operations involving the use of personal information as stipulated in the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures.

       
 

[Cases involving information provision to other operators]

 

@ Automatic payment of High-Cost Medical Care Benefits, patient cost-sharing reimbursements, etc.

 

 

Benefits such as High-Cost Medical Care Benefits (statutory benefits) and patient cost-sharing reimbursements (additional benefits) are calculated by the Society automatically and paid through establishments.

 

 

Notice of the above insurance benefits is distributed to insured persons through their establishments.

 

A Subcontracting translations and calculations involving overseas medical care expenses

 

 

Translations of documents such as the details of medical care costs and calculations of medical care costs for members who have received medical care overseas are subcontracted.

 

B Filing claims with casualty insurers and others in connection with third party actions

 

 

The facts of an accident and copies of rezepts, etc. are submitted to the party responsible (including casualty insurers and others) so that the Society can exercise the subrogated right to demand compensation in cases in which members received insurance medical care due to third party actions, as in traffic accidents.

 

 

In administering demands for compensation due to third party actions, as in traffic accidents, inquiries will be made with the party responsible (including casualty insurers and others) regarding the facts of the matter, details, and so forth.

 

C National Federation of Health Insurance Societies (NFHIS) cooperative enterprise for high-cost medical care benefits

 

 

When applying to the NFHIS cooperative enterprise for high-cost medical care benefits, copies of rezepts, etc. and the application form are sent to the staff in charge of high-cost medical care of the NFHIS High-Cost Medical Care Group. See here for more information.

 

D Implementation of the Tokyo General Health Insurance Society Health Facilities Promotion Association (Toshinkyo)’s loan operations for high-cost medical expenses and childbirth

 

 

When an insured person makes use of the loan program for stopgap funds for high-cost medical expenses and childbirth operated by Toshinkyo, the entire set of application documents is submitted to Toshinkyo.

 

 

Part of the benefits for which payment is granted based on rezepts, etc. and Applications for Childbirth and Childcare Lump-sum Grant (Additional Sum) corresponding to the insured person’s loan is paid to Toshinkyo.

 

E Coordinating information under the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures

 

F Subcontracting processing of data on member eligibility and related matters

 

 

Processing of data and other operations related to member eligibility and related matters are subcontracted.

 

 

Bulk preparation of various Society ledgers and forms, health insurance cards, and Dependent Survey Forms is subcontracted.

 

G Inquiries or responses concerning member eligibility, insurance benefits, etc. (insurers, municipalities, medical care institutions, etc.)

 

 

To process the acquisition and loss of eligibility and to ensure appropriate provision of insurance benefits, inquiries and responses may be exchanged with other insurers, municipalities, medical care institutions, etc.

 
 


(2)

Purposes of use necessary for collecting insurance premiums

 

[Cases involving information provision to other operators]

 

@ Ascertaining standard monthly remuneration and standard bonus amounts

 

 

Notifications of Eligibility as Insured Persons, notices of bases for calculating standard monthly remuneration, and notices of change to monthly remuneration submitted by establishments are reviewed and used to determine the standard monthly remuneration of insured persons.

 

 

Notices of bonus payments submitted by establishments are checked to determine standard bonus amounts of insured persons.

 

 

Establishments are asked to submit documents such as salary and bonus ledgers for use in verifying details on notices.

 

A Collecting health insurance premiums (general insurance premiums and regulation insurance premiums) and long-term care insurance premiums

 

 

Payment notices of health insurance premiums and long-term care insurance premiums are prepared using standard monthly remuneration, etc. Premiums are collected from employers. Premiums for Voluntarily and Continuously Insured Persons are collected from the insured persons directly by sending them payment notices.

 

 

Documents such as applications for maternity leave, applications for waiver of insurance premiums during childcare leave, and applications for exemption from long-term care insurance are used to process waivers and exemptions for health insurance premiums and long-term care insurance premiums for eligible persons.

 

[Cases involving information provision to other operators]

 

@ Subcontracting processing of data on members’ insurance premiums

 

 

The Society subcontracts operations such as the processing of data on member eligibility and insurance premiums and management of operational systems.

 

 

Bulk preparation of various Society ledgers and forms, health insurance cards, and Dependent Survey Forms is subcontracted.

 
 


(3)

Purposes of use necessary for health activities and welfare services

 

[Cases of internal use by the Society]

 

@ Health checkups, health guidance, and health consultations for health maintenance and promotion

 

 

Personal information is used in health checkups provided at the Kenpokaikan examination center.

 

 

Applications for and implementation of health checkups and notification of results are conducted through establishments.

 

 

Results of health checkups provided at the Kenpokaikan examination center and contracted facilities are used as reference information in health management activities and health guidance.

 

 

Member eligibility information is used for checking, communication, and notification vis-a-vis establishments or contracted facilities to facilitate health checkup activities.

 

 

The content of various application forms is checked against health checkup results reports and other materials.

 

 

Information on follow-up exams and secondary exams is provided to members directly or through their establishments based on results of health checkups.

 

 

Personal information is used to provide or administer various courses, interviews, etc.

 

 

Personal information may be used for referrals to medical care institutions.

 

A Implementing specific health checkups and specific health guidance

 

 

Specific health checkups are included as certain examination items in health checkups under the Society’s health management activities. Notification of results is provided through establishments.

 

 

Specific health guidance is provided through stratification of health checkup results into the categories of information provision, motivational support, and proactive support and notifying eligible persons through establishments.

 

B Providing various subsidies

 

 

Eligibility information, past examination records, and other information are used in subsidy payment decisions and payment processing based on various subsidy application (claim) and usage application forms.

 

C Preparation of anonymized information data related to data on health checkups, rezepts, etc. to implement Data Health Plans and collaborative health programs

 

D Implementing vaccination operations

 

 

Personal information is used to confirm eligibility for vaccination and bill vaccination charges.

 

 

Personal information may be used in consultations related to vaccination and in responding to cases of harm to health.

 

E Administering the examination center

 

 

See here concerning the purposes of using personal information in health checkups provided at the examination center.

 

F Administering the Society clinic

 

 

See here concerning the purposes of using personal information at the Society clinic.

 

G Administering health promotion facilities (e.g., lodges)

 

 

Personal information is used to confirm user eligibility and for communications, notifications, and billing for usage charges.

 

 

Personal information is used to make appointments and prepare use tickets for health promotion facilities (e.g., lodges)

 

 

Personal information may be used for sending and receiving applications, notifications, and inquiries regarding use through establishments.

 

[Cases involving information provision to other operators]

 

@ Managing the state of implementation of specific health checkups and specific health guidance and reporting to the Japanese government

 

A Subcontracting checkups to medical care institutions

 

B Subcontracting processing of data on health checkups and related matter

 

 

Preparing and managing data on records of implementing specific health checkups and specific health guidance are subcontracted.

 

 

Preparing checkup tickets for specific health checkups and sending them to eligible persons are subcontracted.

 

C Subcontracting data entry by punching input for computer processing of health checkup data

 

 

Data entry by punching input of results of health checkups provided at facilities other than the examination center is subcontracted.

 

D Shared use of health checkup results with employers

 

 

To advance the health of insured persons, the Society and employers may share judgments and certain results of health checkups. This is necessary to facilitate health checkup activities as stipulated by laws and regulations, to identify those at risk, and to provide health guidance and other follow-up services to control lifestyle-related conditions over the medium to long term. See here for more information

 

E Subcontracting specific health guidance based results of specific health checkups

 

F Subcontracting analysis of anonymized information data and preparation of statistics, etc.

 

G Subcontracting health consultations and mental health counseling

 

 

Telephone health consultation and mental health counseling services are subcontracted.

 

H Subcontracting vaccination operations

 

I Subcontracting operations and management of health promotion facilities (e.g., lodges)

 

 

Certain operations and management of health promotion facilities (e.g., lodges) are subcontracted.

 

J Subcontracting operations for payment of subsidies for use of contracted lodging facilities

 

 

Provision of lodging services at Laforet Club (contracted facility) and administration of settlements of subsidy payments are subcontracted.

 

K Notifying members of medical care costs

 

 

Preparation of medical care cost information using rezepts and other data is subcontracted.

 

 

See here for more information of implied comprehensive consent regarding medical care cost information.

 

L Subcontracting the distribution of PR magazines and other publications

 

M Subcontracting the distribution of home medical supplies

 

N Distribution of medications for overseas travel through establishments

 

 

Medications for overseas travel are distributed to those traveling overseas as requested through their establishments.

 

O Applications for events

 

 

Personal information is used for reservations for and participation in events, classes, and other activities organized by the National Federation of Health Insurance Societies and other organizations.

 

 

Lists of participants in events, classes, and other activities may be provided to participants and others.

 

 

Materials such as photographs and reviews of events, classes, and other activities may be published in PR magazines (including those of related organizations such as the National Federation of Health Insurance Societies).

 

 

Events, classes, and other activities are organized and administered jointly with related organizations.

 

P Subcontracting specimen testing, dental technician work, and other tasks

 
 


(4)

Purposes of use necessary for review and payment of medical fees

 

[Cases of internal use by the Society]

 

@ Inspection and review of medical cost details (rezepts)

 

 

Information such as the billing details of rezepts is inspected and reviewed.

 

 

Request for reexamination of questionable billing details is submitted to the Health Insurance Claims Review & Reimbursement Services (HICRRS).

 

[Cases involving information provision to other operators]

 

@ Subcontracting inspections and reviews of the details of rezept data

 

A Subcontracting data entry by punching input and image scanning for computer processing of rezept data

 

 

Digitalization of rezept data by punching input is subcontracted to the Health Insurance Claims Review & Reimbursement Services (HICRRS).

 

B Subcontracting preparation of data on payment of insurance benefits and (statutory and additional benefits)

 

 

Preparation of data on payment of insurance benefits, details and notices of funds transfer to establishments, and notices of insurance benefits (for individuals), all based on rezept data, is subcontracted.

 

C Subcontracting the preparation of digital data, inspecting its details, review, and reconciliation for claims for judotherapist expenses

 

 

Digitalization of data on claims for judotherapist expenses by punching input, preparation of data on payment of insurance benefits, inspection of claim details, and preparation and sending of notices of confirmation of treatment are subcontracted.

 

[Cases involving information provision to the healthcare bill check and payment organization]

 

@ Provision of member information for transfer of rezepts using the system for online verification of eligibility.

A Inquiring for and providing member information related to request for reexamination for transfer of rezepts using the system for online verification of eligibility.

 
 


(5)

Purposes of use necessary for the stabilization of Health Insurance Society operations

 

[Cases of internal use by the Society]

 

@ Medical care cost analysis and disease analysis

 

 

Data on rezepts, insurance benefits, and health checkups are used in medical care cost analysis, statistical disease analysis, and measures to normalize medical care costs

 

A Reconciliation and analysis of health checkup data, rezept data, and treatment data

 

B Distribution of notices of insurance benefits (statutory and additional benefits) related to rezepts

 

 

See here for more information.

 

[Cases involving information provision to other operators]

 

@ Subcontracting operations such as data processing related to medical care cost analysis and medical care cost information

 

A Subcontracting operations such as data processing and distribution related to notices of price differences for generic drugs

 

 

Analyzing rezept data and preparing and notifying members of price differences for generic drugs are subcontracted.

 
 


(6)

Other

A. General Society operations

 

[Cases of internal use by the Society]

 

@ Basic data for maintenance and improvement of Society management and operations

 

 

Personal information is used to submit data pursuant to notices from regulatory authorities.

 

 

Materials such as lists of persons in charge of operations (health managers) may be used in explanatory meetings held for persons in charge of operations (health managers), public-relations activities, and other business communications.

 

 

Personal information is used for audits of the Society.

 

 

Personal information is used for Society activity statistics and analysis.

 

 

Personal information published in lists of names, etc. is obtained and used within the scope necessary for Society operations.

 

A Responding to requests for disclosure, etc.

 

 

Personal information is used to respond to requests to prepare certificates and other documents and requests for disclosure, etc.

 

B Communicating with and notifying members

 

 

Contact information on notifications and other documents submitted is used to contact, check with, and notify members.

 

[Cases involving information provision to other operators]

 

@ Responding to external auditing

 

A Provision of information under laws and regulations

 

B Consulting with attorneys and other professionals regarding operations in general

 

C Subcontracting retention, management, and disposal of documents, medical waste, etc.

 

D Subcontracting maintenance, management, and other administration of operational systems, etc.

B. Officers, employees, and others

 

Personal information on officers, employees, and others is used in the following cases in addition to the purposes of using personal information indicated above:

 

[Cases of internal use by the Society]

 

@ Employment administration (e.g., salary calculations, tax administration, human-resources and labor management, business communications) for officers and employees
Contacting applicants for employment, operations related to hiring, and labor management for temporary employees

 

A Business communications with Society Committee members, procedures required by laws and regulations

 

[Cases involving information provision to other operators]

 

@ Subcontracting stress checks for officers and employees

 

A Subcontracting corporate pension management, benefits, etc.

 

B Subcontracting preparation of employee IDs, business cards, commendations for long service, etc.

 
 


(7)

Purposes of use related to use of the system for online verification of eligibility

 

[Cases in which the Society provides information for use in administration by other agencies]

 

@ Registration of members’ eligibility information and specific health checkup data

 

[Cases in which the Society receives information from other agencies for use in its own administration]

 

@ Specific health checkup data

     
 
 





Index Top
@
Protection of personal information
@ How the Tokyo Securities Industry Health Insurance Society handles personal information
@ Privacy Policy
@ Purposes of using personal information
@ Handling of specific personal information
@ Purposes of use of personal information at Tokyo Securities Industry Health Insurance Society clinics
@ Provision of information to third parties pursuant to laws and regulations
@ Handling of personal information in health checkup services
@ Preparation and provision to subcontractors of anonymized information
@ Handling of personal information at health maintenance and promotion facilities
@ Provision of personal information to third parties
@ Implied comprehensive consent regarding personal information
@ Joint use of personal information
@ Procedures for making requests such as those for disclosure of personal information
@ Procedures for making requests such as those for disclosure of personal information to Tokyo Securities Industry Health Insurance Society clinics
@ Security measures for personal data held
@ Contact point for matters related to handling of personal information
@ The Society’s accredited personal information protection organization
Index



Copyright© 2004 Tokyo securities industry health insurance society All rights reserved.