Accenture Health
Insurance Society

Application forms

List of Locations where application forms should be obtained from and be submitted

Form (A4) Applications obtained from Applications submitted to
  • Notice of dependent transfer
  • accenture, IMJ
    • Regular Employees :
      AEE Dalian HR (DL from ES)
    • SP Employees :
      AEE Dalian HR (Request by e-mail)
    • Fixed-Term Employees :
      AEE Dalian HR (Request by e-mail)
  • avanade : HR
  • Voluntary Continual Coverage : AHIS
  • accenture, IMJ
    • Regular Employees :
      HR Operations
    • SP Employees :
      HR Supervisor for "SP Employees"
    • Fixed-Term Employees :
      HR Supervisor for "Fixed-Term Employees"
  • avanade : HR
  • Voluntary Continual Coverage : AHIS
  • Dependent charge sheet
  • Insured Person (Family Member) Name Change Notice
  • Maternity Lump Sum Allowance/ Additional Maternity Lump Sum Allowance Application
  • Example
  • Request for Payment of Maternity Allowance
  • Example
  • Request for Payment of Burial Fees (Costs)
  • Example
  • Injury and Sickness Benefits Application
  • Example
AHIS
AHIS
AHIS
AHIS
AHIS
AHIS

We’re sorry, but the electronic application service is only available in Japanese. To apply in English, please mail a paper application form to Accenture Health Insurance Society.

AHIS
Application Forms for Overseas Medical Care Expenses AHIS
Application Form for Transportation Expenses AHIS
Application for In-home Care Support AHIS
(Advance) Maternity Lump Sum Allowance/ Additional Maternity Lump Sum Allowance Application AHIS
Notice of accident involving bodily injury due to the actions of a third party AHIS
Application for certificate to receive treatment for specific diseases and disorders AHIS

Contact

accenture, IMJ

AEE Dalian HR Employee Support (ES)
APSSC.HR.SUPPORT@accenture.com

045-330-8333(Ext.8333)

HR Supervisor
for "SP Employees"

APSSC.HR.SUPPORT@accenture.com

045-330-8333(Ext.8333)

HR Supervisor
for "Fixed-Term Employees"

APSSC.HR.SUPPORT@accenture.com

045-330-8333(Ext.8333)

avanade

HR japanhr@avanade.com Tel. 03-6234-0155

Accenture Health Insurance Society,
Health Insurance Business Center, Value HR Co.,Ltd.

  Level 4 A-PLACE Yoyogi, 5-23-15 Sendagaya, Shibuya-ku, Tokyo 151-0051
info-bpo-acc@valuehr.com
Tel. 03-6709-8028
(Weekdays 9:30-12:00 / 13:00-16:00) *Japanese only

AHIS (Accenture Health Insurance Society)

  5-21-14 Sendagaya, Shibuya-ku, Tokyo Postcode:151-0051
kenpo@accenture-kenpo.jp
Tel. 03-6380-1601
*Japanese only
Voice guidance will begin.
About Health checkups and Cafeteria plan⇒“1”.
About voluntary continuation, insurance cards, adding dependents, and various benefits (excIuding sickness benefits)⇒“ 2”.
About others ⇒“3”.
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