(CNS): One of the Cayman Islands’ leading health insurance companies, Coralisle Medical Company Ltd, which operates locally as CG BritCay, is proposing to increase rates for the basic Standard Health Insurance Contract (SHIC) plan by around 25%, effective 1 July.
However, the Health Insurance Commission (HIC) has the power to stop the increase if it determines that it is excessive, inadequate, unfairly discriminatory or unreasonable, and Health Minister Katherine Ebanks-Wilks has indicated that the NCFC government will resist the change.
According to a release from the Ministry of Health, the proposed adjustment would increase premiums across all SHIC categories. Justifying the increase at this time, BritCay has pointed to the claims experience, healthcare cost trends and increased use of advanced medical services now available locally and that it is the first adjustment to its SHIC rates since 2013.
However, the release noted the potential impact of this increase on the 12,200 employees and dependents currently enrolled under BritCay’s SHIC policies, and said the commission is aware of the significant implications of the proposal.
As such, the increase is under review by the ministry and the Department of Health Regulatory Services (DHRS), which monitors and regulates the health insurance and healthcare industry in the Cayman Islands.
Ebanks-Wilks said that the government recognises the concern that the proposed increase has generated among workers, families and employers.
“Government is acutely aware of the cost-of-living pressures facing Caymanian families, workers and businesses. 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,” the minister said.
“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,” Ebanks-Wilks added.
The release notes that under Sections 6(2) and 6(3) of the Health Insurance Regulations (2017 Revision), approved insurers are required to provide the commission with detailed information supporting any proposed increase to SHIC premium rates, including claims history, loss ratios and projection assumptions.
The regulations further provide that if the HIC determines 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 fifteen working days.
DHRS Director and Superintendent of Health Insurance Mervyn Conolly said that the HIC is “conducting 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 noted that Regulation 6(3) provides the HIC “with 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 DHRS and the commission are currently reviewing CG BritCay’s submission and all relevant supporting information. The HIC and the ministry are also in communication with the company about the proposed increase and its impact on policyholders, the release said.
Acting Chief Officer Exie Tomlinson-Panton said the health ministry remains focused on ensuring that healthcare coverage remains accessible and affordable for residents. “We recognise the importance of affordable health insurance to families and businesses in Cayman. The ministry will continue working with all relevant stakeholders to ensure that residents’ interests remain at the forefront of this process,” she said.
The ministry said it will provide updates as the review process progresses.
