Employer Obligations Elisabeth Kast Compliance Officer 24 th - PowerPoint PPT Presentation

Health Insurance & Employer Obligations Elisabeth Kast Compliance Officer 24 th January 2018

Overview 1. What is the Bermuda Health Council? 2. Compliance Quiz 3. Relevant Legislation 4. Monitoring and Enforcing Compliance 5. Employer Liability 6. Penalties for Non-Compliance 7. Case Example

What is the Bermuda Health Council?  Quasi-Autonomous Non-Governmental Organisation (QUANGO)  Established by Bermuda Health Council Act 2004. Operational since 2006.  Mission: To regulate, coordinate, and enhance the delivery of health services  Vision: Achieving a quality, equitable and sustainable health system  Activities are focused on health economics and regulation  Structure:  Board – 15 members  Secretariat - 10 staff

Compliance Quiz  Yourself, as an employee of the company?  A consultant you hire for four weeks?  Someone who works three days or 21 hours per week?  The non-employed spouse of an employee?  Child(ren) of an employee?

Relevant Legislation  Health Insurance Act 1970  Compulsory health insurance for employees and non-employed spouse  Licensed insurer reporting to BHeC of non-compliant employers  Lawful deductions of no more than half premium amount  Employee obligations to inform employer of spouse employment status  Recovery of damages for medical bills during period of non-coverage  Duty of employer to provide information to employee regarding status of health insurance policy

Relevant Legislation Continued  Health Insurance (Inspection of Records) Regulations 2015  Power of Inspectors  Maintenance of records of employment and wages  Policy information for employees  Start and end dates of employment  Information on spouse  Wage deductions  Payments to insurer  Health Insurance (Exemption) Regulations 1971  Less than 15 hours per week  Less that 2 months per year  Full-time student

Monitoring and Enforcing Compliance Sources of Information:  Insurer reports (monthly)  Public Inquiry  Government Legislated Authorities Actions:  Calls to employers  Warning letters  Website List  Inspections  Court

Employer Liability  An employer:  is liable for the total cost of health insurance premium  may deduct half of the premium amount from employee wages for employee and non-employed spouse  must promptly provide employees with insurance information in writing  must pay medical bills during periods of non-coverage

Penalties for Non-Compliance  Offences include:  Unlawful deductions  No active health insurance policy  Not informing employees  Failure to provide records  Penalties include:  Fines  Imprisonment Employers are responsible for all medical expenses incurred by employees during period of non- coverage

Case Example  Employee initiated complaint  No deductions from employees pay  Employees never informed about health insurance  Employee involved in serious accident, Employer fined $1,500 in criminal court  Employee to recoup up to $800,000 in damages

Questions?