Civil servants balk at healthcare co-pays

The organization representing Cayman Islands government workers has informed the deputy governor that it would accept requirements for civil servants to pay a portion of their healthcare only if that policy is made “optional.”

In a two-page letter to Deputy Governor Franz Manderson sent on May 20, the Cayman Islands Civil Service Association said it was “reiterating” an earlier position that payment for healthcare should come with choice in providers.

“The civil service will not be taxed to further subsidize the health system utilized by the entire country,” the letter, signed by association President James Watler, stated. “[We] are willing to consider co-pay or other changes provided it is (1) with choice, (2) optional, (3) fair.”

Essentially, the organization takes the position that, if government workers are required to pay certain monthly allotments for healthcare coverage, they want to go somewhere other than the Health Services Authority for care or keep the option to continue receiving free healthcare from the government.

At the moment, neither retired civil servants nor active government workers are required to make any payments toward their healthcare, and monthly premiums are funded entirely by taxpayers.

Retiree rates under the Cayman Islands National Insurance Company plans are $870 per month for non-married individuals, $1,306 for non-married people with children, $1,741 for married couples, and $2,176 for the CINICO family plan. Similar rates for working civil servants are $416 per month for single adults, $832 for married couples and the same for single adults with children, and $1,242 for families. Finance Minister Marco Archer said last year that the projected liability in Cayman’s public healthcare system was estimated over a 20-year period at $1.18 billion and that something would have to be done to decrease that figure in the medium term.

Mr. Archer said instituting civil servant co-pays is only one option available to government. Among other changes proposed are increasing the government’s mandatory retirement age from 60 to 65; reducing the current “lifetime” healthcare benefits cap for civil servants from the current $5 million; and considering a “graduated scale” of health benefits for retirees based on their years of service in government.

The retirement age increase is expected to be approved later this year, Mr. Archer said. Mr. Watler said the civil service had no problem with that as long as government workers could receive a draft proposal to consider. He said uncertainty around retirement age issues was causing “unnecessary fear, uncertainty, doubt and distrust” among civil servants.

Lowering the $5 million lifetime cap on healthcare benefits seemed likely to meet with some resistance.

“We look forward to … learning what projected healthcare costs have gone down since the last round of negotiations that will allow the government to now consider reducing the coverage,” Mr. Watler’s letter read.

Minister Archer said in December that the $5 million lifetime cap was more than double what many high-ranking private sector workers receive, including partners in law firms and accounting firm managers, whose plans are typically capped around $2 million to $2.5 million.

The graduated coverage plan for retirees in the government sector was worth exploring, but Mr. Watler indicated that other options to reduce healthcare costs should also be considered.

“[These include] spouses of civil servants working in the private sector having to use their private sector insurance as their primary coverage,” he suggested. Now, spouses of civil servants are eligible for full coverage under CINICO plans in the same way as government workers, regardless of whether they are employed or not.

Mr. Watler also said the Civil Service Association expected to be participating in whatever government group is to consider adding co-payments or deductibles to the current healthcare plans.

“If the civil service is not directly represented at the beginning … we will again end up with unworkable, anti-social proposals that do not progress because of their unintended negative consequences to the Cayman Islands.”



  1. Of course they will balk at paying a co-pay when they are all used to it being free. The statement about it being fair caught my eye as well. I guess it’s fair that they get free healthcare when every other taxpayer has to pay for heathcare as well as contribute to the cost of heathcare for the civil service. He made it clear that this is something the civil service is not willing to do in his comment "the civil service will not be taxed to further subsidize the health system utilized by the entire country."

    Now how fair is that ?

  2. Didn’t we have a big story about CINICO last year? This looks like CINICO is getting back in business. Look at the $2,176 CINICO family plan. Why can’t we have a proper healthcare system in place ?