A recent notice published in the Cayman Islands Gazette regarding administrative fines for health insurance offences aims to reduce the length of time that it takes to dispose of these offences in the court system.

The new Code of Practice for Administrative Fines for Health Insurance Offences illustrates how the Health Insurance Commission will apply the fines system.

Offences for which fines are liable include failure to provide employees with compulsory health insurance coverage, or with up-to-date information about their approved insurer.

The legislation also requires health insurance providers to file certain documents with the Commission. Failure to provide the Commission with the information is considered an offence.

Other breaches of the Law which could be processed administratively include wrongful termination of health insurance contracts or the reduction of the level of benefits.

Employers or other stakeholders accused of committing certain offences under the Health Insurance Law (2013) may be liable to pay $1,000 to the Government. In the case of a continuing offence there will be a fine of $100 for each day the offence continues. All fines collected will go towards the Government’s revenue.

The accused will receive notification from the Health Insurance Inspector of the offence and be given 21 days to respond. If there is no response during this time, the accused will receive a follow up letter which requires a response within 10 days of receipt for the matter to be addressed administratively. In their response, the accused will have an opportunity to provide any supporting documents for further consideration in relation to the alleged offence (s). Failure to respond within the time permitted will result in a court proceeding.

At any stage during the investigation the accused may request in writing that the matter be dealt with administratively and the Commission shall consider the request. If there is a disagreement with the facts of the case or the accused refuses to sign the administrative fine agreement form, the matter will proceed to court.

The Gazette notice outlines the procedures for hearings between both parties when these are deemed necessary by the Commission. It also provides the forms required to file the case, indicates how fines should be paid, as well as the right to appeal.

Health Minister Hon. Osbourne Bodden commented that, “The Administrative Fines System will allow the Superintendent of Health Insurance to collect administrative fines for violations in an expeditious manner, thereby reducing the workload of the Court. In addition, the Superintendent of Health Insurance now has more authority to enforce and regulate the Health Insurance Law.”

Praising the work done to implement the Administrative Fines System, the Minister added, “The Health Insurance Commission, in partnership with the Ministry of Health and other stakeholders, have worked hard to enhance the law’s capability to meet the current needs of the sector.”

Commenting on plans to implement the new code of practice, Superintendent of Health Insurance Mervyn Connolly stated, “Over the next few weeks the Commission will conduct a public education campaign regarding the Code of Practice for Administrative Fines for health insurance offences. Implementation of the Code of Practice will commence on 1 October 2014.”

For more information, please contact the Health Insurance Commission at 946-2084, or email [email protected]

A copy of the Code of Practice is available on www.dhrs.gov.ky or on www.gazettes.gov.ky in Extraordinary Gazette #58 dated Friday 8 August 2014.

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