Health Insurance Amendment (No. 2) Act 2009
BERMUDA
2009 : 49
HEALTH INSURANCE AMENDMENT (NO. 2) ACT 2009
Assent Date: 15 December 2009
Operative Date: 15 December 2009
ARRANGEMENT OF SECTIONS
1 Short title
2 Amends section 1
3 Amends heading of Part II
4 Inserts sections 11A to 11D
5 Amends section 13
6 Amends section 13B
7 Inserts section 13D
8 Amends Parts I and II
generally
9 Amends section 20
10 Amends section 20A
11 Amends section 25
12 Amends section 38
CONSEQUENTIAL AMENDMENTS
13 Amends section 5 of Bermuda
Health Council Act 2004
14 Amends section 57 of
Insurance Act 1978
15 Amends statutory instruments
WHEREAS it is expedient to amend the Health Insurance Act
1970;
Be it enacted by The Queen's Most Excellent Majesty, by and
with the advice and consent of the Senate and the House of Assembly of
Bermuda, and by the authority of the same, as follows:
Short title
1 This Act, which amends the Health Insurance Act 1970 (the
“principal Act”), may be cited as the Health Insurance Amendment (No.
2) Act 2009.
Amends section 1
2 Section 1 of the principal Act is amended by—
HEALTH INSURANCE AMENDMENT (NO. 2) ACT 2009
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(a) inserting, in its correct alphabetical place, the
following—
“ “Committee” means the Health Insurance Committee
established under section 11A;”; and
(b) repealing the definition of “Director”.
Amends heading of Part II
3 The principal Act is amended in the heading of Part II by deleting
“BERMUDA HEALTH COUNCIL” and substituting “HEALTH INSURANCE
COMMITTEE”.
Inserts sections 11A to 11D
4 The principal Act is amended by, immediately after the heading
of Part II, inserting the following sections—
“Establishment of Committee
11A (1) There is established a Committee to be known as the
Health Insurance Committee which shall, subject to any general
directions of the Minister, have the powers conferred, and
discharge the duties imposed, upon it by or under this Act.
(2) The Committee shall consist of—
(a) the Permanent Secretary with responsibility for
health who shall be the Chairperson;
(b) the Financial Secretary who shall be the Deputy
Chairperson;
(c) the Permanent Secretary with responsibility for
financial assistance;
(d) the Chief Executive Officer of the Bermuda Health
Council;
(e) the public officer responsible for health insurance
who is designated as such by the Minister; and
(f) two persons (who are not public officers)
appointed by the Minister—
(i) one who has experience and good
standing in the medical profession in
Bermuda; and
(ii) the other who has experience and good
standing in the health insurance sector of
the insurance industry in Bermuda.
HEALTH INSURANCE AMENDMENT (NO. 2) ACT 2009
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(3) A member referred to in subsections (2)(a), (2)(b) or
(2)(c) may designate a public officer to attend a meeting on his
behalf.
(4) A person appointed under subsection (2)(f) shall be
appointed for a term of three years and is eligible for
reappointment.
(5) In the case of absence or inability of a person
appointed under subsection (2)(f) to act, the Minister may
appoint a person to act temporarily in his place.
(6) A person appointed under subsection (2)(f) may at
any time resign his office by instrument in writing addressed and
transmitted through the Chairperson to the Minister and from
the date of receipt by the Minister of the instrument that
member shall cease to be a member.
(7) The Committee shall be deemed to be properly
constituted notwithstanding that there is a vacancy in the office
of the Chairperson or any other member.
(8) The validity of any proceedings of the Committee shall
not be affected by any defect in the appointment of a member.
(9) No act done or proceeding taken under this Act by
the Committee shall be questioned on the ground of any
omission, defect, or irregularity not affecting the merits of the
case.
(10) No action, suit, prosecution or other proceedings
shall be brought or instituted personally against any member of
the Committee in respect of any act done bona fide in pursuance
or execution or intended execution of this Act.
(11) Fees shall be paid to members of the Committee in
accordance with the Government Authorities (Fees) Act 1971.
Meetings of Committee
11B (1) The Committee shall meet as often as may be
necessary or expedient for the performance of its functions.
(2) The Chairperson may at any time call a meeting of
the Committee and shall call a meeting to be held within five
days of a written request for that purpose addressed to him by
any three members.
(3) At any meeting of the Committee three members shall
constitute a quorum.
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(4) At any meeting of the Committee, in the absence of
the Chairperson the Deputy Chairperson shall take the chair
and in the absence of both the Chairperson and the Deputy
Chairperson the members present shall elect one of their
number to take the chair.
(5) At any meeting of the Committee, every member (or
his designate referred to in section 11A(3)) shall have one vote
but, in the event of an equality of votes, the chair of the meeting
shall have a second or casting vote.
(6) Subject to subsection (5), the decisions of the
Committee shall be by a majority vote.
(7) The Committee shall have power to co-opt persons for
the purpose of any particular meeting if such persons are
considered by it to be competent to assist in any special area of
the Committee's deliberations, but any such persons shall not be
entitled to vote at the meeting.
(8) Minutes of each meeting of the Committee shall be
kept in proper form.
(9) Subject to this section, the Committee may regulate
its own proceedings.
Functions of the Committee
11C (1) The functions of the Committee are—
(a) to manage the health insurance plan and the
FutureCare plan;
(b) to receive claims submitted by or on behalf of
insured persons in respect of payments to be
made out of the Health Insurance Fund, the
FutureCare Fund and the Mutual Re-Insurance
Fund (“the Funds”);
(c) to investigate and decide on such claims;
(d) to authorize the payment of claims which have
been approved by it;
(e) to manage and keep under constant review the
state of the Funds;
(f) to keep under constant review, and advise the
Minister regarding, the payment of subsidies
under sections 2 and 3;
(g) to make recommendations to the Minister in
respect of matters concerning the Funds; and
HEALTH INSURANCE AMENDMENT (NO. 2) ACT 2009
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(h) to perform such other functions as may be
assigned to it by or under this Act or by the
Minister.
(2) The Committee shall make an annual report to the
Minister containing such information as the Minister may
require.
Minister may consult Committee
11D In the exercise of his functions under this Act the Minister
may consult the Committee on any matter but, notwithstanding
that the Minister has consulted the Committee on any matter, he
may act in his discretion in that matter.”.
Amends section 13
5 Section 13 of the principal Act is amended by—
(a) in subsection (1), deleting the words “for persons under
the age of 65 years”; and
(b) repealing subsection (4).
Amends section 13B
6 Section 13B(4) of the principal Act is repealed.
Inserts section 13D
7 The principal Act is amended by, immediately after section 13C,
inserting the following—
“Committee to offer only health insurance plan or
FutureCare plan
13D The Committee shall not offer to the public any contract or
plan of insurance other than the health insurance plan or the
FutureCare plan.”.
Amends Parts I and II generally
8 The principal Act is amended by deleting the word “Council”
wherever it appears in Parts I and II (other than in the definition of “the
Council” in section 1(1)) and, in each case, substituting the word
“Committee”.
Amends section 20
9 Section 20(2) of the principal Act is amended by deleting the
word “Director” wherever it appears and, in each case, substituting the
word “Council”.
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Amends section 20A
10 Section 20A(1) of the principal Act is amended by deleting the
words “section 18(1)” and substituting the words “section 20(1)”.
Amends section 25
11 Section 25 of the principal Act is amended by, in subsections (3)
and (7), deleting the word “Director” and, in each case, substituting the
word “Council”.
Amends section 38
12 Section 38 of the principal Act is amended by—
(a) deleting the word “Director” wherever it appears in the
section and, in each case, substituting the word
“Committee”; and
(b) in subsection (3), deleting the word “he” and substituting
the words “the Committee”.
Amends section 40
12A Section 40 of the principal Act is amended—
(a) in subsection (1)—
(i) by repealing paragraphs (c), (ca), (k) and (ka);
and
(ii) by, in paragraph (m), deleting the word “provide”
and substituting the words “subject to
subsection (1A), provide”; and
(b) by, immediately after subsection (1), inserting the
following—
“(1A) The Minister may, acting on the
recommendations of the Committee, make regulations—
(a) prescribing the terms and conditions of
the health insurance plan or the
FutureCare plan, including allowable
exclusions, and provisions as to
cancellation, automatic renewal and cover
on termination of employment;
(b) prescribing the conditions subject to
which benefit under the health insurance
plan or the FutureCare plan shall be
payable for treatment of insured persons
provided in a hospital outside Bermuda;
and
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(c) under sections 2(4), 3(3) or 38(2) of this
Act.”.
CONSEQUENTIAL AMENDMENTS
Amends section 5 of Bermuda Health Council Act 2004
13 Section 5(e) of the Bermuda Health Council Act 2004 is amended
by deleting the following words—
“to manage the health insurance plan and the FutureCare plan
established under the Health Insurance Act 1970 and”.
Amends section 57 of Insurance Act 1978
14 Section 57(1)(b) of the Insurance Act 1978 is amended by
deleting the words “Bermuda Health Council (established under the
Bermuda Health Council Act 2004)” and substituting the words “Health
Insurance Committee”.
Amends statutory instruments
15 (1) The following statutory instruments are amended by
deleting the word “Council” wherever it appears in the statutory
instrument and, in each case, substituting the word “Committee”—
(a) Health Insurance (Audit of Accounts) Regulations 1971;
(b) Health Insurance (Cover) Regulations 1971;
(c) Health Insurance (FutureCare Plan) (Premium) Order
2009;
(d) Health Insurance (Health Insurance Plan) (Additional
Benefits) Order 1988;
(e) Health Insurance (Health Insurance Plan) (Premium)
Order 1987;
(f) Health Insurance (Portability of Subsidy) Regulations
1973.
(2) The Health Insurance (Plans) Regulations 1987 are
amended by—
(a) deleting the words “Bermuda Health Council” wherever
they appear and, in each case, substituting the words
“Health Insurance Committee”;
(b) deleting the word “Council” wherever it appears and, in
each case, substituting the word “Committee”; and
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(c) deleting the word “Director” wherever it appears and, in
each case, substituting the word “Committee”.
(3) The Health Insurance (FutureCare Plan) (Additional
Benefits) Order 2009 is amended by—
(a) in paragraph 2, repealing the definition of “Council” and
inserting, in its correct alphabetical place, the
following—
“ “Committee” means the Health Insurance Committee
established under section 11A of the Health
Insurance Act 1970;”; and
(b) in the Schedule thereto, deleting the word “Council”
wherever it appears and, in each case, substituting the
word “Committee”.
(4) The Health Insurance (Approved Scheme) Regulations 1971
are amended, in the Schedule thereto, by—
(a) deleting the word “Director” and substituting the word
“Council”; and
(b) deleting the words “section 28(3)” and substituting the
words “section 26(3)”.
(5) The Health Insurance (Certificate of Entitlement)
Regulations 1971 are amended by deleting the word “Director” wherever
it appears and, in each case, substituting the word “Committee”.
(6) The Health Insurance (Exemption) Regulations 1971 are
amended by—
(a) deleting the word “Director” wherever it appears and, in
each case, substituting the word “Council”; and
(b) in regulation 2(2), deleting the words “he may issue” and
substituting the words “the Council may issue”.
(7) The Health Insurance (Health Insurance Plan) (Enrolment)
Rules 1987 are amended by—
(a) in the definition of “enrolment” in paragraph 2(1),
deleting the words “Council under section 11” and
substituting the words “Committee under section 13”;
(b) in the definition of “enrolment period” in paragraph 2(1),
deleting the word “Council” and substituting the word
“Committee”; and
(c) in paragraph 5(1), deleting the word “Director” and
substituting the word “Committee”.
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(8) The Health Insurance (Inspection of Records) Regulations
1971 are amended by, in regulation 3(4), deleting the words “the Director
or someone duly authorized by him” and substituting the words “a
person duly authorized by the Council”.
(9) The Health Insurance (Licensing of Insurers) Regulations
1971 are amended, in the Schedule thereto, by deleting the word
“Director” and substituting the word “Council”.
(10) The Health Insurance (Portability) Regulations 1971 are
amended by—
(a) deleting the word “Council” wherever it appears and, in
each case, substituting the word “Committee”; and
(b) deleting the word “Director” wherever it appears and, in
each case, substituting the word “Committee”.
(11) The Health Insurance (Procedure for Subsidy Payments)
Regulations 1971 are amended by—
(a) deleting the word “Council” wherever it appears and, in
each case, substituting the word “Committee”; and
(b) in regulation 3(3), deleting the words “the Director and
one other member of”.
