AS TABLED IN THE HOUSE OF ASSEMBLY

A BILL
entitled
HEALTH INSURANCE (MISCELLANEOUS) AMENDMENT ACT 2015

TABLE OF CONTENTS
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Citation
Amends section 2 of Health Insurance Act 1970
Amends section 3A of Health Insurance Act 1970
Amends section 26 of Health Insurance Act 1970
Amends Health Insurance (Standard Hospital Benefit) Regulations 1971
Amends Health Insurance (Mutual Re-Insurance Fund) (Prescribed Sum) Order
2014
Amends Health Insurance (Artificial Limbs and Appliances) Regulations 1971
Amends Health Insurance (Approved Scheme) Regulations 1971
General amendment of Acts
General amendment of statutory instruments

WHEREAS it is expedient to amend the Health Insurance Act 1970 and various
statutory instruments made pursuant to that Act, and to make general amendments to
effect the renaming of the standard hospital benefit as the standard health benefit;
Be it enacted by The Queens Most Excellent Majesty, by and with the advice and
consent of the Senate and the House of Assembly of Bermuda, and by the authority of the
same, as follows:
Citation
This Act may be cited as the Health Insurance (Miscellaneous) Amendment Act
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2015.
Amends section 2 of Health Insurance Act 1970
Section 2 of the Health Insurance Act 1970 is amended
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(a) in the heading, by deleting hospital treatment of;
(b) in subsection (1)
(i) by after paid to the Board inserting (and to an approved health care
provider); and

HEALTH INSURANCE (MISCELLANEOUS) AMENDMENT ACT 2015

(ii) in paragraphs (a), (b) and (bb) by, in each case, after general hospital
inserting or from an approved health care provider (as the case may
be);
(iii) in paragraph (c)(ii), by deleting hospital treatment received by that
person as may be agreed between the Minister and the Board and
substituting hospital treatment (or health care provided by an
approved health care provider) received by that person as may be
agreed between the Minister and the Board or, in respect of an approved
health care provider, the Committee;
(c) in subsection (3), by after hospital treatment, both times it appears,
inserting (or health care provided by an approved health care provider);
(d) in subsection (5), by after paid inserting to the Board; and
(e) by inserting after subsection (6)
(7) In this section, approved health care provider means
(a) a residential care home or nursing home within the meaning of the
Residential Care Homes and Nursing Homes Act 1999;
(b) a person providing hospice care; or
(c) a person providing post-acute care at the patients, or a caregivers,
home,
that is approved in writing by the Committee and qualifies under subsection (8) for
payment of the subsidy referred in subsection (1).
(8) To qualify for the payment of subsidy, the health care provider must
provide such health care as is approved by the Committee, to a person, and at such
fees, as are approved by the Committee..
Amends section 3A of Health Insurance Act 1970
Section 3A of the Health Insurance Act 1970 is amended
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(a) in subsection (2A)
(i) in paragraph (b), by deleting or; and
(ii) in paragraph (c), by deleting the comma and substituting ; or; and
(iii) by inserting after paragraph (c)
(d) the Board,; and
(b) by inserting after subsection (2B)
(2C) The Committee may

HEALTH INSURANCE (MISCELLANEOUS) AMENDMENT ACT 2015

(a) establish and supervise a primary care programme for the
treatment of chronic, noncommunicable diseases; and
(b) determine the programmes eligibility criteria and benefits,
and there shall be paid out of the Mutual Re-Insurance Fund claims, approved by
the Committee, in respect of the programme..
Amends section 26 of Health Insurance Act 1970
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Section 26 of the Health Insurance Act 1970 is amended
(a) in subsection (1) by deleting An employer and substituting Subject to
subsection (5), an employer;
(b) in subsection (2)
(i) by deleting who proposes and substituting with an approved scheme
who wishes to continue;
(ii) by, after approved scheme shall, inserting annually, in the
prescribed form with the prescribed fee,;
(iii) by deleting proposed both times it appears; and
(iv) by deleting give its approval thereto and substituting renew its
approval of the scheme;
(c) in subsection (3) by deleting approve any proposed scheme and
substituting renew its approval of a scheme; and
(d) by inserting after subsection (4)
(5) After the coming into operation of the Health Insurance
(Miscellaneous) Amendment Act 2015, the Council shall not approve any new
(proposed) scheme, but may renew its approval of an existing approved scheme..
Amends Health Insurance (Standard Hospital Benefit) Regulations 1971
The Health Insurance (Standard Hospital Benefit) Regulations 1971 are
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amended
(a) in the title and generally throughout the text by deleting standard hospital
benefit and substituting standard health benefit;
(b) in regulation 3
(i) in paragraph (iii), by deleting necessary for the initial treatment of
accidental injuries suffered within forty-eight hours preceding the time
of treatment or of acute illness;
(ii) in paragraph (vi), by deleting Health Insurance; and
(iii) in paragraph (xiv)(bb), by deleting Health Insurance;
(c) in regulation 5 by inserting after paragraph (vii)

HEALTH INSURANCE (MISCELLANEOUS) AMENDMENT ACT 2015

(viiA) screening mammograms that do not adhere to Recommendations
A or B of the United States Preventive Services Task Force
(USPSTF) Guidelines, unless there is a referral from a registered
medical practitioner;;
(d) in regulation 9 by
(i) deleting $301.85 and substituting $338.07;
(ii) deleting $69.66 and substituting $78.02;
(iii) deleting $29.18 and substituting $63.74; and
(iv) deleting $6.73 and substituting $14.71;
(e) in regulation 10 by
(i) deleting $1,207.40 and substituting $1,352.28;
(ii) deleting $278.63 and substituting $312.06;
(iii) deleting $29.18 and substituting $63.74; and
(iv) deleting $6.73 and substituting $14.71;
(f) in regulation 11
(i) in paragraph (1)(a)(i), by deleting $150.93 and substituting $169.04;
(ii) in paragraph (1)(a)(ii), by deleting $34.83 and substituting $39.01;
(iii) in paragraph (1)(b)(i), by deleting $603.70 and substituting $676.14;
and
(iv) in paragraph (1)(b)(ii), by deleting $139.32 and substituting
$156.03; and
(g) in regulation 12
(i) in paragraph (1)(a), by deleting $34.83 and substituting $39.01; and
(ii) in paragraph (1)(b), by deleting $139.32 and substituting $156.03.
Amends Health Insurance (Mutual Re-Insurance Fund) (Prescribed Sum) Order 2014
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Paragraph 2 of the Health Insurance (Mutual Re-Insurance Fund) (Prescribed Sum)
Order 2014 is amended
(a) in paragraph (a), by deleting $14.00 and substituting $18.40;
(b) in paragraph (b), by deleting and;
(c) in paragraph (c), by deleting $0.67 per month. and substituting $1.00
per month; and; and
(d) by inserting after paragraph (c)
(d) to the Board, the sum of $23.64 per month..

HEALTH INSURANCE (MISCELLANEOUS) AMENDMENT ACT 2015

Amends Health Insurance (Artificial Limbs and Appliances) Regulations 1971
Regulation 3(2) of the Health Insurance (Artificial Limbs and Appliances)
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Regulations 1971 is amended by deleting $15,000 both times it occurs and, each time,
substituting 30,000.
Amends Health Insurance (Approved Scheme) Regulations 1971
The Health Insurance (Approved Scheme) Regulations 1971 are amended
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(a) in regulation 2(2), by deleting approve a proposed and substituting
renew approval of a;
(b) in regulation 3, by deleting grant or and proposed; and
(c) in the Schedule
(i) in the first line, by deleting Proposed;
(ii) by deleting paragraph 1 of the Notes; and
(iii) in paragraph 2(f) of the Notes, after surety, by inserting , required by
section 26(3) of the Act,.
General amendment of Acts
The following Acts
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(a) Bermuda Hospitals Board Act 1970;
(b) Government Employees (Health Insurance) Act 1986; and
(c) Health Insurance Act 1970,
are amended generally throughout the text by deleting standard hospital benefit or
standard hospital benefits and, in each case, substituting standard health benefit.
General amendment of statutory instruments
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The following statutory instruments
(a) Bermuda Hospitals Board (Hospital Fees) Regulations 2014;
(b) Government Employees (Health Insurance) (Benefits) Order 1997;
(c) Government Employees (Health Insurance) (Rates) Order 2001;
(d) Health Insurance (Approved Scheme) Regulations 1971;
(e) Health Insurance (Artificial Limbs and Appliances) Regulations 1971;
(f) Health Insurance (Double Cover) Regulations 1971;
(g) Health Insurance (Exemption) Regulations 1971;
(h) Health Insurance (Licensing of Insurers) Regulations 1971;
(i) Health Insurance (Mental Illness, Alcohol and Drug Abuse) Regulations
1973; and

HEALTH INSURANCE (MISCELLANEOUS) AMENDMENT ACT 2015

(j) Health Insurance (Plans) Regulations 1987,
are amended generally throughout the text by deleting standard hospital benefit and
substituting standard health benefit.

HEALTH INSURANCE (MISCELLANEOUS) AMENDMENT BILL 2015

EXPLANATORY MEMORANDUM
This Bill seeks to amend the Health Insurance Act 1970 and various statutory
instruments made pursuant to that Act, and to make general amendments to effect the
renaming of the standard hospital benefit as the standard health benefit.
Clause 1 is self-explanatory.
Clause 2 amends section 2 of the Health Insurance Act 1970. Currently, section 2 limits
subsidy coverage to services provided by the Bermuda Hospitals Board. The amendments
allow subsidy payments also to be made in certain circumstances to health care providers
approved by the Health Insurance Committee. This would allow flexibility for subsidy funds
to be used to pay for services in clinically appropriate, lower cost settings than the general
hospital such as in residential care or nursing homes or in a patients home.
Clause 3 amends section 3A of the Health Insurance Act 1970 by inserting a new
subsection (2C). This new subsection allows the Committee to establish and supervise a
primary care programme for the treatment of chronic, noncommunicable diseases, and
provides that claims shall be paid out of the Mutual Re-insurance Fund.
Clause 4 amends section 26 of the Health Insurance Act 1970 to provide that whilst
existing approved schemes may continue to be approved on an annual basis, no new
schemes will be approved.
Clause 5 amends the Health Insurance (Standard Hospital Benefit) Regulations 1971
to increase the standard premiums and deductions as set out. Regulation 3(iii) is amended
to clarify that outpatient surgery provided at the general hospital is covered by the standard
health benefit and, in regulation 5, a new exemption is added for screening mammograms
that do not adhere to Recommendations A and B of the United States Preventive Services
Task Force Guidelines.
Clause 6 amends the Health Insurance (Mutual Re-Insurance Fund) (Prescribed Sum)
Order 2014 to increase payments made out of the Mutual Reinsurance Fund as set out.
Clause 7 amends Health Insurance (Artificial Limbs and Appliances) Regulations 1971
to increase the maximum liability for an artificial limb or appliance from $15,000 to
$30,000.
Clause 8 amends the Health Insurance (Approved Scheme) Regulations 1971 in
consequence of the amendment of section 26 of the Health Insurance Act 1971 in clause 4.
Clause 9 amends the specified Acts to change all references to standard hospital
benefit to the new terminology standard health benefit.
Clause 10 amends the specified statutory instruments to change all references to
standard hospital benefit to the new terminology standard health benefit.