Higher benefits

The Health Insurance Commission will recommend to the Ministry of Health the raising of the maximum benefit per episode covered under the Standard Health Insurance Contract.

Currently, the maximum benefit for a single episode covered under the SHIC is $25,000.

Superintendent of Health Insurance Mervyn Conolly was unable to say what the HIC would recommend the maximum benefit be changed to in the Health Insurance Regulations.

‘I regret that until the HIC Board has agreed, I am not able to say what level it will be raised,’ Mr. Conolly said.

The issue was made topical last week when premature Jamaican twin babies died after being born here in Cayman. The Cayman Islands Hospital did not have the sufficient facilities to deal with the three-month premature babies and tried to find adequate care elsewhere for the infants.

Although healthcare facilities in the Bahamas and the United States could have adequately treated the infants, the parents’ health insurance ‘could not cover the exceedingly high cost of transport and care required due to the extreme prematurity of the infants’, according to a statement issued by Cayman Health Services Authority this week.

The parents had the SHIC, which covers post natal care for up to 30 days after birth. However, the air ambulance alone would have cost most of the maximum benefit allowed under the SHIC. Jamaican Honorary Consul Robert Hamaty has said the U.S. and Bahamas healthcare facilities were asking for a surety in the region of $500,000 to cover the cost of treatment.

Just last month at the Cayman Islands Insurance Association’s annual seminar, the issue of the maximum benefit per episode under SHIC was called ‘woefully inadequate’ during the panel discussion period.

Under Cayman’s Health Insurance Law, all employers must effect and maintain at least the Standard Health Insurance Contract for all of their employees, even foreign nationals on temporary work permits. Employers are entitled to deduct half of the premium costs directly from employees’ wages.

Raising the maximum benefit of the SHIC would cause insurance premiums for both the employer and the employee to go up. Mr. Conolly said it was too early to tell how much those premiums will go up.

‘We are hoping that with the overall changes to the plan of benefits that there will not be a significant increase in premium rates,’ he said. ‘The plan would still need to be affordable to the average employee.

‘Of course we will not know the final answer to the question of premium rate until the plan of benefits are approved by the HIC Board and assessed by the actuaries.’

Mr. Conolly said he could not say when the HIC would submit its recommendations to the Ministry of Health.

‘But the Commission does consider the matter to be very significant,’ he said.

After the Ministry receives the recommendation, it would have to recommend to Cabinet the Health Insurance Regulations be changed.

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