$1,000 fines for health insurance offences

(CNS Business): Starting next month, the Health Insurance Commission will have the power to impose fines up to $1,000 for both employers and insurance companies for infractions of the health insurance law, though the accused person or company can still opt to take the matter to court instead of paying the fines and they will end up in the dock anyway if the matter is not resolved administratively. However, the fines will, it is hoped, reduce overall court time for such offences.

The recently gazetted Code of Practice for Administrative Fines for Health Insurance Offences lays out how the Commission will apply the fines for certain offences under the Health Insurance Law (2013). On top of a maximum of $1,000 fine, offenders could be liable to pay an additional $100 for each day the offence continues.

Employers who fail to provide employees with health insurance coverage or with up-to-date information about their approved insurer are among those targeted, however, the HIC will also be able to levy fines on insurance companies for not filing the required documents with the Commission, as well as wrongful termination of health insurance contracts or the reduction of the level of benefits.

The company or person 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, they 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, they will have an opportunity to provide any supporting documents for further consideration in relation to the alleged offence.  However, 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.

Health Minister Osbourne Bodden said, “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 hic@gov.ky  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.

Tags: Health Insurance Commission

Category: Government, Insurance, Local Business