Health insurance push shows success in increasing coverage

Complaints commissioner cites concerns about lack of staff on Sister Islands

Since the Health Insurance Law was revised in 2013, less than 6 percent of Cayman residents are without health insurance, down from 12 percent in 2010, according to data from the Health Insurance Commission. 

Health insurance for employees has been mandatory in Cayman since 1997. Revisions to the Health Insurance Law in 2013 and efforts by the Health Insurance Commission have proven successful in getting employers, who are responsible for providing most health insurance policies, to comply with the law. 

Complaints Commissioner Nicola Williams, who began looking into the Health Insurance Commission last year, said she is satisfied with the progress the commission has made getting people enrolled in health insurance programs. However, Ms. Williams said she is concerned with staffing levels at the commission and the fact that there are no inspectors on Cayman Brac and Little Cayman to ensure employers there are providing health insurance as required. 

Ms. Williams had a series of meetings with Health Insurance Superintendent Mervyn Conolly last year while examining the organization’s operations, according to Health Insurance Commission meeting minutes provided to the Cayman Compass through a Freedom of Information request. 

Mr. Conolly declined to comment for this story. 

The meeting minutes cite Ms. Williams’s concern about levels of uninsured residents, but she told the Compass recently that she is now satisfied with the progress made toward getting everyone in Cayman enrolled in health insurance. 

The 2013 revision of the Health Insurance Law provided for a one-year grace period to get the population enrolled in health insurance programs. Since that grace period ran out in spring 2014, Ms. Williams said, “there’s been quite a high level of compliance.” 

But just because compliance nears 95 percent, according to data in the meeting minutes, “doesn’t mean there aren’t issues,” Ms. Williams said in an interview. 

The complaints commissioner said her main concern is with the Sister Islands. “There’s no one on the Sister Islands to make sure employers provide insurance,” Ms. Williams said. 

She said resources are an issue for the Health Insurance Commission, “but it’s not the only issue, or the most significant.” 

According to the meeting minutes, the Health Insurance Commission has filled several vacancies this year, but not without difficulty. Staffing levels have been a frequent topic of discussion for the commission. The minutes state that the commission has hired an administrative assistant and a new assistant health insurance inspector in recent months.  

According to meeting minutes, Mr. Conolly has been trying to hire a health insurance inspector for about a year. In the minutes from the January 2014 meeting, Mr. Conolly told board members that a prospective candidate for the post failed a medical test for government employment. According to the minutes, Mr. Conolly “indicated that staff morale had dimmed” last January over the staffing issues.  

The commission made an offer to a candidate over the summer, but that person refused the offer. According to the minutes, the Ministry of Health reappointed the existing officer.  

Ms. Williams’s last day as complaints commissioner is Friday, Jan. 9. She has been appointed as the U.K. Service Complaints Commissioner, the ombudsman for the U.K. Armed Forces. 

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Data from the Cayman Islands Health Insurance Commission shows the number of insured has increased.
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