Health Insurance Amendment Act 2009
HEALTH INSURANCE AMENDMENT ACT 2009
1
BERMUDA
2009 : 10
HEALTH INSURANCE AMENDMENT ACT 2009
[Date of assent: 25 March 2009]
[Operative Date: 1 April 2009]
ARRANGEMENT OF SECTIONS
1 Short title
2 Amends section 1
3 Amends section 3A
4 Amends section 12
5 Amends section 13
6 Inserts sections 13A, 13B and
13C
7 Amends section 14
8 Amends section 15
9 Amends section 16
10 Amends section 17
11 Amends section 18
12 Amends section 19
13 Amends section 25
14 Amends section 31
15 Amends section 33
16 Amends section 40
CONSEQUENTIAL AMENDMENTS
17 Amends section 5 of Bermuda
Health Council Act 2004
18 Amends section 4 of Public
Funds Act 1954
19 Amends Health Insurance
(Audit of Accounts)
Regulations 1971
20 Amends Health Insurance
(Portability) Regulations 1971
21 Amends Health Insurance
(Cover) Regulations 1971
22 Amends Health Insurance
(Health Insurance Plan)
Regulations 1987
23 Amends Health Insurance
(Mutual Re-insurance Fund)
(Prescribed Sum) Order 2006
24 Amends Health Insurance
(Health Insurance Plan)
(Additional Benefits) Order
1988
25 Commencement
HEALTH INSURANCE AMENDMENT ACT 2009
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WHEREAS it is expedient to amend the Health Insurance Act
1970 to provide for the establishment of an insurance plan for seniors:
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 Act
2009.
Amends section 1
2 Section 1 of the principal Act is amended—
(a) by inserting the following definitions in their correct
alphabetical order—
“ “FutureCare Fund” means the fund established under
section 13A;
"FutureCare plan" means a plan issued by the Council
under section 13B to persons who are over the age
of 65 years, providing standard hospital benefit and
such other additional benefits as the Minister may
by order made under section 13B specify;”; and
(b) in the definition of “health insurance plan” by inserting,
immediately after the words “section 13”, the words “to
persons under the age of 65 years,”.
Amends section 3A
3 Section 3A of the principal Act is amended by—
(a) in subsection (1), deleting the word “specified” and
substituting the word “prescribed”; and
(b) in subsection (2A), immediately after the words “the
Fund”, inserting the words “or the FutureCare Fund”.
Amends section 12
4 Section 12(1) of the principal Act is amended by deleting the
words “under this Part” and substituting the words “in respect of the
health insurance plan”.
Amends section 13
5 Section 13 of the principal Act is amended by—
(a) in subsection (1), immediately after the words “health
insurance plan”, inserting the words “for persons under
the age of 65 years”; and
HEALTH INSURANCE AMENDMENT ACT 2009
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(b) in subsection (4), deleting the words “the public” and
substituting the words “a person who is under the age of
65 years”.
Inserts sections 13A, 13B and 13C
6 The principal Act is amended by inserting, immediately after
section 13, the following sections—
“FutureCare Fund
13A (1) There is established under the control and
management of the Council, a FutureCare Fund into which shall
be paid all premiums payable to the Council in respect of the
FutureCare plan and out of which shall be paid all claims for
benefit in respect of the FutureCare plan and any other expenses
incurred by the Council in carrying out its functions in respect of
the FutureCare plan.
(2) There shall be paid to the credit of the FutureCare
Fund an initial sum of ten million dollars which shall be paid out
of the Consolidated Fund at such times and in such amounts as
the Council, with the approval of the Minister, may require.
(3) Subject to the approval of the House of Assembly
signified by resolution, the initial sum paid under subsection (2)
may from time to time be increased by resolution of the Council
and any increase of that sum, approved as aforesaid, shall be
charged on the Consolidated Fund.
FutureCare plan
13B (1) Subject to this section and section 13C, the Council
shall offer to the public a FutureCare plan for persons who are
over the age of 65 years.
(2) The Minister shall make an order under this section
specifying—
(a) the premium (including the standard premium)
to be paid to the Council in respect of each
FutureCare plan effected with the Council under
subsection (1) during the subsistence of that
plan;
(b) the additional benefits (including the items of
treatment) covered by the FutureCare plan,
and may amend any such order from time to time as the
circumstances warrant.
(3) A FutureCare plan may be effected with the Council
in respect of more than one person and in that event the
HEALTH INSURANCE AMENDMENT ACT 2009
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corresponding multiple of the premium payable under an order
made under subsection (2) shall be charged accordingly.
(4) The Council shall not offer to a person who is over the
age of 65 years any contract or plan of insurance other than the
FutureCare plan.
(5) Section 6 of the Statutory Instruments Act 1977 shall
not apply to an order made under this section.”.
Enrolment under FutureCare plan
13C (1) A person who, on 31 March 2009, is enrolled under
the health insurance plan and is, on that date, over the age of 65
years shall be transferred by the Council to the FutureCare plan
with effect from 1 April 2009.
(2) A person who, on 31 March 2009, is not enrolled
under the health insurance plan, is eligible to be enrolled in the
FutureCare plan if, and only if—
(a) the person attains the age of 65 years after 1
January 2009; or
(b) in the case of an indigent person, at the time the
person seeks enrolment, the person is over the
age of 65 years.
(3) Notwithstanding subsections (1) and (2), the Minister
may by order declare a period of time to be a period during
which any person who is over the age of 65 years may be
enrolled in the FutureCare plan.
(4) The negative resolution procedure shall apply to an
order made under this section.
Amends section 14
7 Section 14 of the principal Act is amended—
(a) in the section heading, by deleting the words “under
standard contract”;
(b) by, in subsection (1), immediately after the words
“health insurance plan”, inserting the words “or the
FutureCare plan”; and
(c) by, in subsection (2), immediately after the words
“health insurance plan”, inserting the words “or the
FutureCare plan, as the case may be,”.
HEALTH INSURANCE AMENDMENT ACT 2009
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Amends section 15
8 Section 15 of the principal Act is amended in subsection (1) by,
immediately after the words “health insurance plan”, inserting the words
“or the FutureCare plan”.
Amends section 16
9 Section 16 of the principal Act is amended by—
(a) in subsection (1), immediately after the words “the
Fund”, inserting the words “, the FutureCare Fund”; and
(b) in subsection (2), immediately after the words “the
Fund”, inserting the words “, the FutureCare Fund”.
Amends section 17
10 Section 17 of the principal Act is amended by—
(a) in subsection (1)(b), immediately after the words “the
Fund”, inserting the words “, the FutureCare Fund”; and
(b) in subsection (3), immediately after the words “the
Fund”, inserting the words “, the FutureCare Fund”.
Amends section 18
11 Section 18(1) of the principal Act is amended by—
(a) immediately after paragraph (a), inserting the following
paragraph—
“(aa) prescribing the form and manner in which
applications for enrolment for the FutureCare plan
shall be made;”;
(b) immediately after paragraph (b), inserting the following
paragraph—
“(ba) specifying the periods during which applications
for enrolment for the FutureCare plan shall be
made and providing for the enrolment of certain
persons or classes of persons outside those
periods;” and
(c) immediately after paragraph (c), inserting the following
paragraph—
“(ca) providing for the payment of benefits and the
collection of premiums in respect of the
FutureCare plan;”.
Amends section 19
12 Section 19 of the principal Act is amended in the definition of
“an employee” by deleting the words—
HEALTH INSURANCE AMENDMENT ACT 2009
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“, but does not include a person over the age of 65 in respect of
whom subsidy is not payable under section 2(1)(b)”.
Amends section 25
13 Section 25(3) of the principal Act is amended by deleting the
words “standard contract” and substituting the words “contract of health
insurance”.
Amends section 31
14 Section 31(4) of the principal Act is amended by deleting the
words “for the standard contract may be made” and substituting the
following words—
“without evidence of insurability for the health insurance plan
may be made by the insured person”.
Amends section 33
15 Section 33 of the principal Act is amended by deleting the words
“the standard contract” and substituting the words “a contract of health
insurance”.
Amends section 40
16 Section 40(1) of the principal Act is amended—
(a) by inserting, immediately after paragraph (c), the
following paragraph—
“(ca) prescribe the terms and conditions of the
FutureCare plan, including allowable exclusions,
and provisions as to cancellation, automatic
renewal and cover on termination of employment;”
and
(b) by inserting, immediately after paragraph (k), the
following paragraph—
“(ka) prescribe the conditions subject to which benefit
under the FutureCare plan shall be payable for
treatment of insured persons provided in a
hospital outside Bermuda;”.
CONSEQUENTIAL AMENDMENTS
Amends section 5 of Bermuda Health Council Act 2004
17 Section 5 of the Bermuda Health Council Act 2004 is amended
in section 5(e) by—
(a) immediately after the words “health insurance plan”,
inserting the words “and the FutureCare plan”; and
HEALTH INSURANCE AMENDMENT ACT 2009
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(b) deleting the word “Hospital” and substituting the word
“Health”.
Amends section 4 of Public Funds Act 1954
18 Section 4(5) of the Public Funds Act 1954 is amended by
repealing subparagraph (v) of paragraph (c).
Amends Health Insurance (Audit of Accounts) Regulations 1971
19 The Health Insurance (Audit of Accounts) Regulations 1971 are
amended—
(a) by revoking regulation 1 and substituting the following—
“Powers of Auditor
1 The Audit Act 1990 shall apply to the audit and
inspection of the accounts of the Fund, the Mutual Re-
insurance Fund and the FutureCare Fund (hereinafter
referred to as “the Funds”) and the Auditor shall in
relation thereto have the powers conferred on him by
section 14 of that Act.”; and
(b) in regulation 2, by deleting the words “the Fund”
wherever they appear and substituting, in each case, the
words “the Funds”.
Amends Health Insurance (Portability) Regulations 1971
20 The Health Insurance (Portability) Regulations 1971 are
amended by—
(a) in regulation 2—
(i) immediately after the words “under the health
insurance plan” inserting the words “or the
FutureCare plan”; and
(ii) immediately after the words “by the health
insurance plan” inserting the words “or the
FutureCare plan, as the case may be”;
(b) in regulation 4(aa), deleting the words “section 11” and
substituting the words “section 13 or 13B, as the case
may be,”; and
(c) in regulation 5(1), immediately after the words “health
insurance plan” inserting the words “or the FutureCare
plan, as the case may be,”.
Amends Health Insurance (Cover) Regulations 1971
21 The Health Insurance (Cover) Regulations 1971 are amended in
regulation 6 by deleting the words “under a standard contract and the
HEALTH INSURANCE AMENDMENT ACT 2009
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Council shall, subject to the terms and conditions of the standard
contract, conclude a standard contract” and substituting the following
words—
“and the Council may conclude a health insurance plan or a
FutureCare plan (as the case may be)”.
Amends Health Insurance (Health Insurance Plan) Regulations 1987
22 The Health Insurance (Health Insurance Plan) Regulations 1987
are amended—
(a) by deleting the words “Health Insurance Plan”, in the
title and in regulation 1, and in each case substituting
the word “Plans”;
(b) by, immediately after regulation 1, inserting the
following regulation—
“Interpretation
1A In these regulations “plans” means the health
insurance plan or the FutureCare plan, as the case
may be.”;
(c) by deleting the words “health insurance plan” or “health
insurance plans” wherever they appear in the
regulations and substituting, in each case, the word
“plans”;
(d) by deleting the words “Health Insurance Council”
wherever they appear in the regulations and
substituting, in each case, the words “Bermuda Health
Council”;
(e) by deleting the words “section 11” wherever they appear
in the regulations and substituting, in each case, the
words “sections 13 or 13B, as the case may be,”;
(f) by deleting the words “section 12” where they appear in
regulations 9 and 12 and substituting, in each case, the
words “section 14”; and
(g) by deleting the words “section 23” where they appear in
regulation 5 and substituting the words “section 25”.
Amends Health Insurance (Mutual Re-insurance Fund) (Prescribed
Sum) Order 2006
23 The Health Insurance (Mutual Re-insurance Fund) (Prescribed
Sum) Order 2006 is amended in paragraph 2 by deleting the words
“Health Insurance Fund” and substituting the words “FutureCare Fund”.
HEALTH INSURANCE AMENDMENT ACT 2009
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Amends Health Insurance (Health Insurance Plan) (Additional
Benefits) Order 1988
24 The Health Insurance (Health Insurance Plan) (Additional
Benefits) Order 1988 is amended by revoking paragraph 7 of the
Schedule thereto.
Commencement
25 This Act shall come into operation on 1 April 2009.
