New SHIC plan in place, but premiums to soar

| 01/03/2013

url_0.jpg(CNS): A new and more comprehensive insurance plan that gives policy holders far more health coverage came into effect today but it will cost people much more. Health insurance premiums will be going up as much as 40% in some cases in order to cover the increase in benefits and both employers and employees will have to dig deeper in order to get access to health and medical care.  The new version of the standard health insurance contract came into effect 1 March as part of changes made to the law by the health minister last year. As a result of the basic plan increasing, all other policies will be going-up as well in a change to the system driven by government’s efforts to shift some of its increasing health care burden back to the private sector.

Around 20% of government's spending goes on healthcare cost, either for indigents, the elderly and retirees, those who the private sector have rejected or where health insurance plans simply don’t cover the needs of the sick and dying.

The new SHIC plan benefits have been increased as a result of the appallingly inadequate coverage offered on the past plans that were still costly for workers on low salaries. While workers are now facing much more comprehensive coverage, they are now faced with the problem of paying for it as health insurance is mandatory.

The new plan will cover 80% of $400 for visits to the doctor, tests and physician referrals for therapy, compared to the current benefit of just $100. It will also cover dental, routine medical check-ups wellness and even mental health and much more coverage for serious medical emergencies.

Under the new law, insurers will also find it difficult to refuse people because an individual has a pre-existing medical condition. Speaking in the Legislative Assembly last year when he brought the final version of the bill, Health Minister Mark Scotland said that there had been “many instances where the approved insurers were refusing to provide coverage for minor medical conditions and ailments which were controlled with medications, including diabetes, hypertension and high cholesterol,” he said but this will no longer be allowed.

“Under this proposed amendment the approved insurers will still be able to underwrite perspective employees or clients with a higher benefit or supplemental plans or other comprehensive plans,” he said. "The objective of this new amendment is that all persons in the Cayman Islands will be eligible for the Standard Health Insurance Contract.”

While the changes addresses some issues, the difficulties government has had in picking up the costly slack from the private sector may not be so easily resolved if employees cannot find the money to meet the much higher premiums.

However, the minister has said that despite the difficulties people may have, the government had to introduce an improved benefits plan. He said too many people did not have access to health care because the benefits of the previous basic health plan were woefully insufficient

Category: Health

Comments (18)

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  1. Anonymous says:

    Wow…first of all, to the person who left that comment about shutting down the insurance companies, tell me how you would employ all those in the insurance industry left without jobs and what you assume the effect of so many more unemployed Caymanians would be on our economy or C.I.G??? Put that in your pipe and smoke it!

    Second of all, how can you expect Mark Scottland to do any better than this? The man knows NOTHING about Health Insurance so he is always taking shots in the dark, unfortunately at the expense of the Cayman public.

    What we should be talking about in conjunction with increased insurance benefits is how to put a cap on what health care providers are charging. Why are the costs so varying between H.S.A. and the private facilities/physician's on this island?! Compare them yourselves AND make the crucial comparison also to the C.I. standard health insurance fees which have not changed since 2003 despite the steady increase in charges and are used by many insurers as a basis for payment of claims. The government should revise the law to include stipulations about what percentage above the standard health fees health care providers are allowed to charge. The Health Isurance Commission must be more actively involved in governing the way practioners work here; their billing methods and their charges. They must be equally as active with the regulation of the health care poviders as they are with regulation of the insurance companies, which I know for certain they do.

    I sincerly hope that this election season the public will ask the important questions, not just listen to what candidates have to say and not fall victim to the hype and empty promises that are sure to fill the air. I also pray that they elect qualified persons to serve as Honorable Ministers of these extremly important portfolios. I am only 25 years old and have a young son, give us a fighting chance to be happy and prosperous and remain in our own country that we love. DON'T SELL OUT 2013!!

  2. Another Epic Failure says:

    Another EPIC FAILURE for Minister Scotland!

     

  3. Anonymous says:

    For the average SHIC customer, who does not face a major medical event, this will result in an annual benefit increase of approximately $220 ((.8*400)-100).  This will come at an annual premium increase of approximately $345 for the low income policy holder, and $888 for a challenger plan holder.  

    • Anonymous says:

      Which Insurance company you insured with? I work for one and our rates are not disgustingly exorbant like that. If you are faced with over $300 whether is CI or US money for the basic SHIC; you seriously need to shop around!

      • Anonymous says:

        The numbers stated are for CINICO’s SHIC-1 plan, the plan that is being revised as per the new law. They are listed in CI dollars. Presently the rates for low income policy holders are $72/mo. and $185/mo for the “challenger” plan (same coverage, just higher risk policy holder).

        My point was, and is, that the new plan does not benefit the customer in any substantive way. But hey what do I know, only a few decades of experience. I am sure this is great Walue for moniey, for somebody, just not thae policy holder.

  4. Anonymous says:

    this government is slowly killing cayman with the ever increasing cost of living….

    • Anonymous says:

      And with the ever increasing cost for business and companies generally. 

  5. Anonymous says:

    Whoever thought that heath care and business made good bedmates was crazy. We need universal health care in Cayman but we won't get it because there's too much money to be made. The U.S. "system"? Give me a break – God knows how many people die every years over there due to a lack of proper preventative care. There should be criminal charges laid against those who profit from the suffering and deaths of others, but there won't be, rest assured. Making money off of sick people is truly sick. Health care, like education, is a human right, not a business "opportunity" for goodness sake. Sure, offer private health care, but only as an alternative to a government run universalhealth care system for everyone, regardless of income (like in the rest of the civilised world go – check it out).

  6. Anonymous says:

    Will this also include the cosmetic surgeries that have been paid through CINICO???

  7. Slowpoke says:

    Universal single payer coverage was the way to go but no, we had to follow the  failed  US "Free Market" model.  Now we whine about how expensive it is?

    • Anonymous says:

      The USA hasn't had anything like a free market in health care for at least 50 years.

  8. Anonymous says:

    I don't blame the Government for trying to remove some of the cost of healthcare. Part of the problem has to be the exorbitant cost of emergency treatments undertaken in the USA .

     

    Anyone who has dealt with the Baptist in Miami was probably more at risk from the shock of the bills than the disease itself. One month in preemie care costs $400,000, enough to maintain a person in a top class rest home in the UK for close to 7.5 years. (I've seen the bills for both.)

     

    I understand Mark Scotland is exploring the possibilities of working with the UK's health system, a good idea. Anyone who gets caught up in the US healthcare system, which amounts to an upwardly spiralling money-dance between the healthcare providers, the insurance companies, the lawyers and the drug companies, faces almost instant bankruptcy, unless their net worth is in the millions. It's wrong that our government should have to pick up the tab for this scandalous and unresonable cost of treatment.

  9. The Thinker says:

    If you want to cut the outrageous costs of healthcare, do away with insurance companies and nationalize healthcare.  Problem solved! 

    • Doc says:

      People just will not learn from history.  The National Health Service was introduced in the UK in 1948 to reduce the cost of health care, and improve the health of all: if everyone were treated early, it would cost less, and all would be healthier. Hah! 

      The NHS cost has risen astronomically ever since, despite Doctor's salaries falling behind the rate of inflation continuously, and the demands on Doctors increasing.  The General Practitioner in the NHS now spends the first five minutes of his eight minute approved consultation collecting statistical data for the government, instead of looking after you.  Want that here too?

      That's why I left the NHS.

  10. Anonymous says:

    CINICO is another mismanged, wasteful corrupt mess that doesn't provide any proper accounts for its spending. That's why CIG's healthcare costs are soaring.

     

    The AG reported "shocking failures" at CINICO nearly a year ago and came as close as he respectably can to saying that millions have gone missing, and nobody at CINICO even bothered to respond (they were probably in Miami with their noses in the breakfast buffet).

     

    So yetagain the rest of us are having to bail out the CIG because of its systemic dysfunction, greed and waste. Except that it's like trying to fill a bucket with holes in the bottom- it doesn't matter how much the rest of us pour in, it'll always be empty. Expect health insurance costs to go up again in another year along with all the other fees.

  11. Anonymous says:

    Oh yay. Now we SERIOUSLY cannot afford health insurance. 

    • Anonymous says:

      This is difinitly going to shut down, the over 1200 small businesses in these Islands. Where are the small business associations voice on this mess. Are they skulling the system and keeping quiet…hoping to to not be checked.

      • Anonymous says:

        well said… what is the chamber of commerce doing as cayman is dying under the huge cost of living and doing business…