Insurance company CG BritCay plans to increase premiums for its Standard Health Insurance Contract plan by 25%, a move that has prompted a review by regulators.
The increase in the cost of the SHIC plan, the cheapest of the plans offered by insurers, could affect up to 12,000 residents, according to the Ministry of Health and the Department of Health Regulatory Services, which say they are “actively reviewing” the proposed hike.
The proposed adjustment, which was submitted to the regulator by Coralisle Medical Company Ltd., known as CG BritCay, is scheduled to take effect on 1 July.
“According to the insurer, the increase is the first adjustment to SHIC rates since 2013 and is attributed to claims experience, healthcare cost trends and increased use of advanced medical services now available locally,” the health ministry said in a statement issued on 5 June.
The release noted that the Health Insurance Commission was “aware of the significant implications of this proposed increase and its potential impact on the 12,200 employees and dependents currently enrolled under CG BritCay’s SHIC policies”.
SHIC plans are the minimum level of prescribed healthcare coverage mandated by legislation in Cayman.
Minister for Health Katherine Ebanks-Wilks said in the release government recognised the concern that the proposed increase had generated among workers, families and employers.
“Government is acutely aware of the cost-of-living pressures facing Caymanian families, workers and businesses,” she said. “An increase of this magnitude would have a direct impact on more than 12,000 people who rely on SHIC coverage, and we understand the concern this announcement has generated.”
She added, “Affordable healthcare coverage is not a luxury; it is a necessity. At a time when many households are already facing increasing costs, Government cannot simply stand by while a proposal of this scale is considered. My ministry will continue working closely with the Health Insurance Commission and the Department of Health Regulatory Services to ensure that the interests of policyholders remain at the centre of this process.”
Cayman’s health regulations require insurers to provide the Health Insurance Commission with detailed information supporting any proposed increase to SHIC premium rates, including claims history, loss ratios and projection assumptions.
If the commission finds that a proposed standard premium rate is “excessive, inadequate, unfairly discriminatory or unreasonable”, it must notify the insurer and, following an inquiry, may order an adjustment to the proposed rate within 15 working days, according to the regulations.
In the release issued by the ministry, the director of the Department of Health Regulatory Services and superintendent of health insurance, Mervyn Conolly, said the commission was carrying out a “detailed assessment of the actuarial data, claims experience, healthcare utilisation trends and other supporting information provided by the insurer to determine whether the proposed rates satisfy the requirements established under the Health Insurance Act and Regulations”.
He added that under Section 6(3) of the regulations, the commission has clear authority to intervene, “and it is our responsibility to ensure that any proposed increase is evidence-based, justified and consistent with the legislative framework designed to protect policyholders”.
The Compass has contacted CG BritCay for comment.
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