Proposed amendments to the Health Insurance Law aim to ensure dental coverage is honored for insurance card holders and to prevent healthcare insurers from denying individual coverage.
Speaking before the Legislative Assembly on Feb. 24, Premier Alden McLaughlin said the amendments seek to take immediate action to strengthen comprehensive revisions from 2013.
He proposed amending definitions in the law to avoid loopholes and clear up doubts regarding dental benefits.
“One or more of current health insurance providers are refusing to provide dental health insurance coverage to people residing in the Cayman Islands, and in some cases groups that have less than 20 members,” he said.
An updated definition would establish that a “registered medical practitioner” also refers to registered dentists.
“This updated definition will prevent healthcare providers from refusing to accept insurance cards with dental benefits, as previous to that some dental providers were of the opinion that the law provides coverage for medical care only and not dental, although the standard health insurance contract has a provision for a dental examination included under the wellness benefit,” he said.
Mr. McLaughlin said there have also been cases of insurers denying individual coverage, despite a compulsory insurance requirement for residents.
“The intention of the house when the law was passed was that all approved health insurance providers must provide individual and group health insurance coverage, if every resident is required to have health insurance,” he said.
“It appears that based on the license issued by the Cayman Islands Monetary Authority under the terms and conditions under the license, there is no mandatory requirement to provide individual coverage to the person unless it is legislated.”
Mr. McLaughlin proposed empowering the government health commission to issue one-year insurer certificates and enable it to revoke certificates in cases of non-compliance.
North Side MLA Ezzard Miller questioned whether implementing another certificate requirement would address healthcare needs. He expressed concern that a $1,500 fee would be passed on to the consumer in increased costs.
Mr. Miller suggested placing responsibility on the monetary authority to ensure current certification requirements are being met.
The Legislative Assembly approved the bill’s second reading.