The child and childcare support levy — how does it affect payroll from 2026?

In short: The child and childcare support levy is a new charge collected on top of medical insurance premiums from April 2026 (Reiwa 8) to fund measures against the falling birthrate. Under employees' insurance, the company and the employee split it, and the premiums withheld from pay rise. The first thing a business must do is reflect the new rate shown by its health insurer in its payroll system and check the deduction amount and payslip display.

We hear more and more from businesses, "I've heard a new premium is going up — what does the company have to do?" The child and childcare support levy is a newly created charge, separate from existing social insurance premiums, and under employees' insurance it is withheld from pay together with health insurance premiums. The system itself is national policy, but how it is reflected in payroll is the company's job. First, pin down "from when, by whom, and where in pay it applies."

What is the child and childcare support levy, and when does collection start?

The child and childcare support levy is a system created by the Act to Partially Amend the Child and Childcare Support Act and Others (Act No. 47 of 12 June 2024) to fund measures against the falling birthrate, such as expanding the child allowance. Medical insurers (the Japan Health Insurance Association, health insurance societies, National Health Insurance, and so on) collect the levy portion together with the medical insurance premiums they levy on the insured, and pay it to the state as a support contribution through the Social Insurance Medical Fee Payment Fund.

Item	Content
Basis	Act to Partially Amend the Child and Childcare Support Act and Others (Act No. 47 of 12 June 2024)
Effective	The support-levy provisions take effect on 1 April 2026
Start of collection	From the April 2026 (Reiwa 8) premium. Under employees' insurance, roughly from pay paid in May 2026 (the April premium is withheld then)
How collected	The medical insurer adds the levy to medical insurance premiums and pays it to the state as a support contribution
Use	Expanding the child allowance, childbirth and childcare benefits, etc. (measures against the falling birthrate)

The key point is that the levy is collected not as a stand-alone new premium but "on top of" the current medical insurance premium. For a company, the practical reality is less "a new filing appears" and more "the rate shown by its health insurer changes."

Who bears it, and where does it show up in pay?

Under employees' insurance (the health insurance that company employees join), the levy is split between the company and the employee. The state sets a uniform support-levy rate for employees' insurance, and the rate for Reiwa 8 (FY2026) is 0.23%. Since the company basically bears half of the levy, the employee's share is half of that (roughly equivalent to 0.115%).

In the Reiwa 8 estimate published by the Children and Families Agency on 26 December 2025, the average monthly amount per person is as follows (company share and employee share combined).

Type of medical insurance	Average monthly amount (estimate)
Employees' insurance (overall)	About 500 yen per insured person
— Japan Health Insurance Association	About 450 yen
— Health insurance societies	About 550 yen
— Mutual aid associations	About 650 yen
National Health Insurance	About 300 yen per household
Medical care for the latter-stage elderly	About 200 yen per insured person

Under employees' insurance, the actual amount is set by a rate, so the higher the remuneration, the larger the levy. The figures above are only averages; for each individual's pay, the levy is calculated by applying the rate to the standard monthly remuneration and so on. On the payslip, this levy is withheld alongside health and pension premiums (or shown included in the health insurance premium), and the display follows the insurer's guidance.

Note that this is a different system from the existing "child and childcare contribution." That contribution is borne entirely by the company and paid together with employees' pension premiums; the contribution rate for Reiwa 8 is held at 3.6 per 1,000. The levy differs in that it is split between employer and employee and added on top of medical insurance premiums, so do not confuse the two. Sorting out whether an employee's share rises can be checked together with what employers should do when the 1.06-million-yen income wall is abolished and the 1.3-million-yen wall and proof of a temporary rise in income, which makes explaining it to employees easier.

How does adding it to medical insurance premiums change payroll practice?

There are broadly three things for the company to do.

What to do	Content
Reflect the rate	Set, in the payroll system, the new rate including the levy shown by your health insurer (the Association or a society)
Check deductions and payslip	From the April 2026 premium (pay paid in May), confirm the employee's share is correctly withheld and shown on the payslip
Inform employees	Explain in advance why take-home pay changes, together with the purpose of the system

In cloud payroll such as freee or Money Forward, rates are usually updated in line with the insurer's announcement, but always confirm before the payroll run for the effective month that your own setting reflects the latest rate. If a manual or outdated setting is left in place, the employee's share becomes over- or under-withheld and a later adjustment is needed. Even where payroll is outsourced, the company makes the final decision and approval of the deduction and payment amounts. How the scope of payroll and the company's checks work is summarized in how much does it cost to have a Shakai Hoken Roumushi do payroll.

Because bonuses, treatment during childcare leave, and the standard monthly remuneration move in the same framework as health insurance premiums, the realistic way to run it is to picture the levy as an add-on layered on existing social insurance practice. Detailed treatment is settled by each insurer's guidance, so confirm the latest with your health insurer, the Japan Pension Service, and the Children and Families Agency.

What is the schedule for the staged increases?

The levy is introduced in stages from FY2026 to FY2028, and the total contribution for each year is set by law. The projected average monthly amount per person across all medical insurance enrollees rises year by year as follows.

Fiscal year	Projected average monthly amount per enrollee
Reiwa 8 (FY2026)	About 250 yen
Reiwa 9 (FY2027)	About 350 yen
Reiwa 10 (FY2028)	About 450 yen

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These averages are figures per enrollee across employees' insurance, National Health Insurance, and medical care for the latter-stage elderly combined. Because the denominator differs from the employees'-insurance-only average (about 500 yen above), the levels do not match.

The employees'-insurance rate for Reiwa 8 is shown as 0.23%, but the specific rates for Reiwa 9 and Reiwa 10 are to be shown afresh in line with each year's total. As of the time of writing (21 September 2026), the fixed rates for Reiwa 9 onward have not been published, so confirm the announcements from the Children and Families Agency and your health insurer as the effective date approaches (we leave this unverified and do not state fixed figures).

Who handles the payroll setting and the tax?

Because the child and childcare support levy moves within the social insurance framework, reflecting it in payroll is labor practice. The design of the system and the tax system itself is the realm of national policy, which a business or professional cannot move.

What to do	Main person in charge
Setting the rate including the levy, checking deductions, social insurance procedures, payroll	Shakai Hoken Roumushi (our office)
Year-end income tax adjustment, preparing tax documents for a fee	Tax accountant
Design of the system and the tax system	National policy (not something a professional performs on your behalf)

The levy is a social insurance charge added on top of medical insurance premiums, and it is a separate matter from the year-end income tax adjustment. Settling the over- or under-payment of income tax, as with year-end adjustment, becomes a tax accountant's work when done for a fee. That even if you have a Shakai Hoken Roumushi do payroll, year-end adjustment is not included is set out in whose job is freee's year-end adjustment. Our office and a tax accountant are separate, independent entities, and Shakai Hoken Roumushi work and tax work are contracted separately (we do not take them on under one engagement). Our office does not receive referral fees.

四葉社会保険労務士事務所 can advise on reflecting the new rate including the levy in payroll, checking the deduction amount and payslip, and how to inform employees. Fees are summarized in the fee schedule.

Frequently asked questions

Q. From which pay is the child and childcare support levy withheld?
A. Under employees' insurance, collection begins with the April 2026 (Reiwa 8) premium. Since premiums are generally withheld from the following month's pay, in practice the employee's share is withheld roughly from pay paid in May 2026. Before the payroll run for the effective month, confirm that the new rate including the levy is reflected in your system.

Q. Do the company or the employee bear the levy?
A. Under employees' insurance, the company and the employee split it. The uniform support-levy rate the state sets for Reiwa 8 is 0.23%, of which the company basically bears half and the employee the rest. Because it is calculated by applying the rate to remuneration, the higher the pay, the larger the amount. The level of the amount varies by the health insurer you join (the Association, a society, and so on).

Q. Is it the same as the existing "child and childcare contribution"?
A. It is a different system. The child and childcare contribution is borne entirely by the company and paid together with employees' pension premiums; the rate for Reiwa 8 is held at 3.6 per 1,000. The child and childcare support levy, by contrast, is split between the company and the employee and collected on top of medical insurance premiums. The two differ in who bears them and how they are paid, so payroll treats them separately.

Q. I hear it rises in stages. How far will it increase?
A. It is raised in stages from FY2026 to FY2028. The projected average monthly amount per enrollee across all medical insurance is about 250 yen in FY2026, about 350 yen in FY2027, and about 450 yen in FY2028. The specific employees'-insurance rate for FY2027 onward is to be shown afresh in line with each year's total, so confirm the fixed figures with your health insurer and the Children and Families Agency.

Sources

• Act to Partially Amend the Child and Childcare Support Act and Others (Act No. 47 of 12 June 2024): creates the child and childcare support levy, provides that medical insurers include the levy in the premiums they collect, and sets the amount and collection method of the support contribution and the collection work by the Social Insurance Medical Fee Payment Fund; the support-levy provisions take effect on 1 April 2026
• Children and Families Agency, "About the child and childcare support levy system": start of collection (under employees' insurance, from the April 2026 premium, i.e. withheld from May pay), the uniform employees'-insurance rate of 0.23% for Reiwa 8, and "the company basically bears half of the levy" (accessed 21 September 2026)
• Children and Families Agency, "Estimate of the Reiwa 8 child and childcare support levy" (published 26 December 2025): employees' insurance about 500 yen per insured person (Association about 450 yen, society about 550 yen, mutual aid about 650 yen); National Health Insurance about 300 yen per household; latter-stage elderly medical care about 200 yen per insured person (accessed 21 September 2026)
• Projected average monthly amount per enrollee across all medical insurance: about 250 yen for Reiwa 8, about 350 yen for Reiwa 9, about 450 yen for Reiwa 10 (Children and Families Agency published materials; staged introduction FY2026–FY2028)
• Child and childcare contribution rate: held at 3.6 per 1,000 for Reiwa 8 (borne entirely by the employer, paid together with employees' pension premiums; a system separate from the levy)
• Rates and amounts are set each year; the specific employees'-insurance rate for Reiwa 9 onward could not be confirmed as a fixed published figure at the time of writing (21 September 2026), so it is left unverified and no fixed figure is stated. Confirm the latest with the Children and Families Agency and your health insurer

This article does not decide whom to consult. Reflecting the rate including the levy in payroll, checking the deduction amount, and social insurance procedures are the work of a Shakai Hoken Roumushi. Year-end income tax adjustment goes to a tax accountant — each contracted separately as separate, independent entities. Our office does not receive referral fees. For fees when consulting 四葉社会保険労務士事務所, see the fee schedule; for frequently asked questions, see the FAQ.

This article is general information. Individual judgments, such as the appropriateness of your own rate setting or the deduction amount, are made by a qualified professional after a consultation. Written by Joji Uramatsu (Shakai Hoken Roumushi, Gyoseishoshi, Registered Real Estate Transaction Specialist).