Employers face stiff fines over health insurance

| 25/08/2010

(CNS): Government plans to significantly increase fines for firms not providing health insurance as well as improving the cover of basic health insurance under new legislation. The Health Insurance (Amendment) Bill, 2010 is expected to come before the Legislative Assembly next month when the country’s parliament sits again. The law will also provide for the Health Insurance Commission to issue fines directly to employers who don’t get health insurance for their staff. Employers failing to provide mandatory health care benefits could be fined as much $30,000 under the new law, while fines for companies that are not approved insurers who issue policies will be as much $100,000. The law also intends to addresses the problem of the poor coverage provided by the basic package.

Employers who take more from their employees than is allowable under the law for health cover could be fined up to $40,000 and bosses who fail to provide workers with details about their health insurance can be fined up to $15,000 with daily penalties of as much as $1,000.

Things should also improve for employees as they will be getting more health care cover from the basic package. Currently there is a cap of $25,000 cover for each bout of illness or injury, which in many cases is far from adequate.  The Health Insurance Commission has recommended that this cap be removed. Health Minister Mark Scotland has announced the government’s plan to address the myriad issues with the country’s mandatory health cover, which he says will improve health cover for everyone.
“This new plan has benefits for maternity care that are not in the insurance plan now; it has benefits for mental health care and it has benefits for dialysis,” Scotland told News 27.
The law will also ensure that health insurance companies cannot refuse to insure employees who have existing medical conditions.
The introduction of a mandatory improved benefit package as well as better enforcement should have a knock on effect to the Cayman Islands Hospital and its financial health. Much of the past short fall in the Health Service Authority’s budget is as a result of inadequate cover. When patients can’t afford to meet the gap between what their health insurers pays for medical care and the actual cost of that medical care the hospital has been left to cover the shortfall.
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  1. John Evans says:

    Sounds like another enforceable law to me unless you beef up the powers of the HIC and gove them more staff. Are they going to remove the paper chase that gives employers up to 6 months to fend off HIC and let investigators just turn up unannounced or give HIC powers to shut companies down that ignore the penalties?

    The insurance companies also need to get their act together over this. My partner and I were victims of employers who failed to pay medical insurance. In both cases the insurers simply accepted payment of the arrears (in the full knowledge that any risk had passed) and denied that there had ever been a problem.

    Problems like this seem to always go back to easy solutions – tying the processing of work permits and/or Trade & Business Licenses in with simple verification of compliance with the health insurance, pensions and employment laws could have made an impact on this problem years ago.

    • Concerned Caymanian says:

      John – they are already tied up. It is just that the immigration Boards are refusing to follow the Law.Read s.44 – they are supposed to consider "other matters arising from the application" etc. They have all the power they need to say, "if you are not paying health and pension for your existing employees, the last thing we will do is grant you more permits". It is cheap and easy and effective. As they do not do it they appear either incompetent or corrupt, and whilst I would prefer the former, I fear the latter.

  2. Beachboi says:

    "while fines for companies that are not approved insurers who issue policies will be as much $100,000."   WHAT??????  A fine for an company that issues insurance policies that is not licensed as an insurance company????   Okay sure a fine, but about 20 years in prison should round out that punishment just "fine"!  Pun intended.

    How many more people have to die from lack of coverage of this basic policy before the law is changed?  Do we easily forget the lady that died after she was shipped off to Honduras once her basic $25,000 coverage ran out at GT hospital?  I am also on this policy and I pray that if something happens that I do not have to die for our politicians to figure out that something has to be done.  I am sure that they will get around to it when they have time since they have the best coverage that OUR money can buy.

  3. Anonymous says:

    Don’t make me laugh…Another unenforced law that means nothing until someone is actually charge and fined.

    And the courts actually get money from one of these scum bag employers.

    Pass all the feel good laws you want it, the real news would be the law is being enforced.

  4. noname says:

    This is somthing that needs to be done as all employees need Health Insurance.  I know of one helper her employer obtained two temp. permits and now on a yearly permit, but has no Health Insurance.  While on the last temp permit she was admitted to the hospital and has a bill over $4000.00 which she alone is paying monthly out of her hunble wages.  Last week she fell at her job and hurt her ankle.  The employer who still does not have any insurance for her said she would have to take time off out of her vacation.  Her ankle got worse, she went to the Hospital about four days later (she had no money) and found out that the ankle is broken.  This is so awful when helpers are treated like this and they contunie to get work permits over and over again. 

    I wonder which Department in Government is going to inforce this law?  I will hope that this come about soon. 

    • Beachboi says:

      You need to convince your friend or associate to go to the police.  This employer should be jailed!!!

      • Anonymous says:

        But that’s just it – that friend/associate presumably needs the job – so can’t go and complain about the employer because she would lose her job/permit.  I know a helper looking after an elderly Caymanian lady in a similar position.  The lady’s family employ her.  She has no healthcare, no pension, no annual leave and no sick leave entitlement at all and considering she has to work 24/7 looking after this bedridden and incontinent lady, she’s only paid $350 a week – that’s $50 a day for 24/7 care – disgusting.

    • Anonymous says:

      Private health insurance does not work, period. Simply look at the U.S., we are going down the same road.

    • Anonymous says:

      absolutely…..DO SOMETHING about this.

      Why can this not be detected at the hospital??!! 

  5. Anonymous says:

    Umm… this only makes a difference if you prosecute…which you will not.



  6. Anonymous says:

    The buck doesn’t stop with the employers.  The insurance companies are ripping us off big time and use every excuse in the book not to pay, sometimes putting us to ridiculous expense appealing their decisions and obtaining reports to prove how unreasonable their decisions are.  And don’t get me started on the unreasonable exclusions they try to force on people.  You end up in a catch 22 situation, gotta be insured to be legal but gotta accept unreasonable exclusions (that would not be enforced upon you elsewhere, just herein Cayman) if you want to be insured.  But then of course, when you try to get insured elsewhere after this, you have to declare the exclusion and thus end up being screwed on every policy you take out thereafter.

    • Anonymous says:

      This catch 22 situation is a result of privatized health care.

      Health care, other insurances, electricity, phone and water should be a governmental thing. You can not allow to have a company making money on the health problems of people. They benefit by keeping you sick.

      Unfortunately this country is based on money (like the US), so it will only get worse.


      • Anonymous Realist says:

        Absolutely – "Wealthcare" is no care at all.

        As small business owners we are being sucked dry by government already and cannot afford health insurance for ourselves let alone an employee, not that we could afford one in any case. The fees and red tape associated with hiring even a part time employee are a nightmare.

        It’s a sad state of affairs when decent hard working members of any society cannot even have the security of knowing that if anything befalls them they can at least expect a modicum of healthcare.

        Private health systems positively encourage abuse by the multi billion dollar industry that is wealthcare from drug companies through insurance companies to doctors and everyone in between.

        (I had to pay over US$570.00 at GT hospital just for testing of blood samples ordered by a doctor who had already billed over CI$300 for sticking a needle in an arm. God knows what happens to those of us who can’t pay when it comes to the crunch – eternal debt and the stigma of being "without insurance" and therefore a lesser human being I suppose).