Your Employer’s Health Insurance Responsibility

December 16, 2015

The Bermuda Health Council and Bernews have teamed-up to answer your questions about the island’s health care system. Visit www.bhec.bm to submit your queries and look for our response on Bernews on the last Wednesday of every month on www.bernews.com.

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Question:  I went to the doctor recently and received a bill months later for a service I thought I was insured for.  I get insurance through my job, so I contacted my insurer and they told me that my policy was not active. Why wasn’t I told before?  Whose responsibility is it to inform employees if their health insurance is not active; the employer or the insurance company?

Answer:  The short answer is your employer. That’s because under Section 20 of the Health Insurance Act 1970 employers are required to provide their employees and their non-employed spouses with health insurance. The employer must also provide you, the employee, with information about an active insurance policy when you start work. In addition, Sections 24A [2] and [3] of the Act state that if an employer doesn’t keep an active insurance policy for any reason, he is to ‘promptly’ inform all employees in writing of the change in policy status.  Failing to alert employees or provide this information is an offence and the employer could be subject to a fine or period of imprisonment.

In June 2015, the Bermuda Health Council was granted the right to publish non-compliant employers on our website: Employer Compliance. The listing, which is regularly updated, provides employees another way to check their health insurance status and also encourages employers to be compliant. If you are concerned about your health insurance coverage, contact us at 292-6420 or email: healthcouncil@bhec.bm

BHeC Employers Compliance Bermuda Dec 16 2015

Question: I am 65-years-old and employed as a part-time receptionist. Does my employer have to pay for my health insurance?

Answer: If you are working more than 15 hours a week, your employer is required to provide you with active health insurance of at least the Standard Health Benefit level of coverage, as per Section 20 of the Health Insurance Act 1970. There are a few employees who are exempt from this requirement and these are listed in the Health Insurance Exemption Amendment Act 2015. They include:

  • Any employee who is employed on a part-time or casual for less than 15 hours a week
  • Any employee who is employed on a temporary basis for no more than a two month period in any year; or
  • Being a full-time student referred to in section 1(3) of the Contributory Pensions Act 1970, who is employed on a Saturday, Sunday or other public holiday or a period of vacation, including half term holiday
  • Government employees and their non-employed spouses who receive medical care as a part of their employment

If you should have employer-provided insurance, and as you are over 65-years-old, you should discuss affordable coverage options with your employer particularly if you are a working retiree.

Question: The current economic climate has resulted in financial strain on my business.  I don’t know if I can afford to cover health insurance premiums for all my employees. What should I do in these circumstances?

Answer: The Health Insurance Act mandates that, as an employer, you have to provide an active health insurance policy for yourself, all your employees, and their non-employed spouses.  If you cannot maintain your current health insurance premiums you should contact your insurer or other insurers to find a policy that is more affordable.  In the event that you do end your current policy, be sure to settle all arrears premiums in addition to enacting a new policy with an alternate insurer.

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Answers supplied by: Ian Cameron, Compliance Officer of the Bermuda Health Council. For more information about employers’ responsibilities regarding health insurance, please see our pamphlet ‘Why health insurance?’

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