DUBAI HEALTH INSURANCE LAW MANDATORY MEDICAL INSURANCE

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1 Point of View DUBAI HEALTH INSURANCE LAW MANDATORY MEDICAL INSURANCE ESSENTIAL GUIDE TO NEW MEDICAL INSURANCE LAW JULY 2014

2 ESSENTIAL GUIDE TO MANDATORY HEALTH INSURANCE LAW IN DUBAI Medical insurance to become mandatory in Dubai - introduction Mandatory health insurance facts New health insurance law implementation timeline Essential Benefits Plan (EBP) and Enhanced plan comparison Your health insurance checklist i Compulsory Health Insurance Guide

3 MEDICAL INSURANCE TO BECOME MANDATORY IN DUBAI As of 6 April 2014, there were 43 insurance companies who have been awarded Health Insurance Permits (HIP) which allows them to oer health insurance plans. The long awaited law to make health insurance for all Dubai visa holders mandatory has been passed and will be eective beginning of Q This brings Dubai alongside Abu Dhabi, and Saudi Arabia in rolling out a compulsory employer paid health insurance system. With an estimated population of 2 million currently not insured, the Essential Benefits Plan (EBP) package required by the Dubai Health Authority [DHA] will provide the workforce in Dubai with access to good healthcare when they need it. DHA has specified a minimum level of benefits that must be provided in any health insurance plan oered in the Emirate of Dubai. The strategy of DHA is built upon two key pillars. The first pillar is that all nationals and expatriate residents ( Residents ) of Dubai should have access to healthcare. In order for this to happen there must be funding mechanisms in place to ensure that the costs of care are met. The second pillar is that healthcare provision must be of the highest quality relevant to the needs of the population. The Objective of the Law is therefore to ensure that there is a system of funding in place that meets the objectives of access and quality. As of 6 April 2014, there were 43 insurance companies who have been awarded Health Insurance Permits (HIP) which allows them to oer health insurance plans. In order to acquire the HIP, insurance companies are required to meet many requirements covering financial, licensing, customer service and data security as well as meeting many technical requirements in relation to claims processing and reporting via the DHA electronic platform eclaimlink.ae. Out of the 43 insurance companies, 7 insurers have met additional requirements and have been awarded Participating Insurer (PI) status allowing them to sell the EBP. Only these companies can provide health solutions for the workers with a gross salary of AED 4,000/- per month or less. Only those insurance companies granted permission to transact health insurance business in the Emirate of Dubai are allowed to oer health insurance plans to buyers in the Emirate. 2 million (22% of population) CURRENTLY NOT INSURED IN UAE Out of the 43 insurance companies, 7 insurers have met additional requirements and have been awarded Participating Insurer (PI) status allowing them to sell the EBP. 7 out of 43 PARTICIPATING INSURERS (PI) ELIGIBLE TO SELL THE EBP Marsh 1

4 COMPULSORY HEALTH INSURANCE FACTS DUBAI MANDATORY MEDICAL INSURANCE IMPLEMENTATION TIMELINE Employers with more than 1000 employees Employers with employees Employers with less than 100 employees All spouses, dependants and domestic workers PHASE 1 PHASE 2 PHASE 3 Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Employers are responsible for providing health insurance for their employees. Employers must restructure their existing arrangements where necessary to meet the set criteria by the first renewal date (and no later than 12 months) after the implementation deadline that applies to the company based upon its size as described above. Sponsor is responsible for the members under his/her sponsorship who are not insured by the employer The cost of the EBP package is expected to be around AED per year for workers earning less than AED 4,000 per month. This plan can only be purchased only from insurance companies who have qualified as PIs. However for all other employees who earn more than AED 4,000 per month, the employer is free to seek coverage from any insurance company that has been granted a Dubai Health Insurance Permit including the Participating Insurers (PIs). For this segment of population, insurers are free to set whatever benefit levels they choose and will be known as the Enhanced Plan (subject to meeting or exceeding the EBP benefits) to underwrite, to set special conditions and to set their premiums in relation to the risk presented. At present, there are no restrictions on the premiums that insurance companies may charge for enhanced plans. However DHA will be issuing rules on premium pricing which will apply from some date in 2015 which has yet to be announced. The objective of the premium pricing regulations will be to provide stability to the market, to prevent premium price wars and to protect the insured population from unjustifiably excessive increases to renewal premiums. An employer is free to cover all its lower salary and other employees with a PI. It can also cover its lower salary workers only with a PI and cover its other employees with any other insurance company that holds a HIP The EBP will cover emergency services, access to a primary care physician, referral to specialists, tests and investigations, surgical procedures and maternity care. To ensure compliance with the Health Insurance Law, the issue and renewal of employment visas will be conditional upon evidence being provided at time of visa application or renewal that the employer has in place insurance coverage for the employee Workers earning less than AED 4,000 per month will be provided with Essential Benefits Plan (EBP). 2 Compulsory Health Insurance Guide

5 Dubai Government will fund the program for Nationals registered with DHA. This population will normally be part of the Enaya scheme open to all Dubai Government employees or they will be part of other Government employee schemes funded by Dubai Government Failure to comply with the law will result in fines of up to AED 500,000. PLAN ESSENTIAL BENEFITS PLAN (EBP) AED 4,000 Gross salary per month ENHANCED PLAN CHECKLIST Ensure that your employees earning less than AED 4,000 per month are insured with a PI as per the EBP benefits All other employees can be insured with the 43 insurance companies who have been awarded Health Insurance Permits (HIP) with a minimum of EBP benefits An employer is free to cover all its lower salary and other employees with a PI. It can also cover its lower salary workers only with a PI and cover its other employees with any other insurance company that holds a HIP PREMIUM PROVIDER COVERAGE AED PARTICIPATING INSURERS (PI) ONLY Emergency services Primary care physician Referral to specialists Tests and investigations Surgical procedures Maternity leave NO PREMIUM RESTRICTION AT PRESENT PI or ANY OTHER INSURER HOLDING A HEALTH INSURANCE PERMIT (HIP) (EBP or EBP+) Health Authority Abu Dhabi (HAAD) requires that employees working in Abu Dhabi, even if holding an employment visa issued in another emirate, must have health insurance that meets the Abu Dhabi Basic Plan benefits The employer is not compelled to pay for coverage for spouses and dependents but as a matter of good human resource practice, DHA encourages employers to do so VISA REQUIRED FOR ISSUANCE or RENEWAL OF EMPLOYMENT VISAS Tools such as e-prescription and e-claims will be used by the regulators to measure the success of PIs and with an aim to reduce fraud, overutilization and abuse. The new health system will bring into eect strategies to reduce overutilization. There will be a process educating the public about self-defeating results of medical overuse. Some of these strategies will include appropriateness criteria for investigative diagnosis and medical treatment. REQUIRED FOR ISSUANCE or RENEWAL OF EMPLOYMENT VISAS The healthcare insurers and medical providers will have to work in tandem. This will increase commonalty of spirit and both parties need to have a good relationship for this law to work well for all concerned. All these measures should bring down healthcare costs for the employer eventually, though this is not going to happen immediately but is a step in the right direction. Where an employer does not pay for coverage, the spouses and dependents can still be included within the scheme as a separate category with the insurer collecting the premium from the employer and the employer then deducting the premium from the employees pay Where spouses and dependents are not covered within an employer s scheme, it will be the responsibility of the employee to arrange for insurance coverage with an insurance company and to pay the premium directly It is not permissible for employers to deduct premiums from the employee or to reduce salary to mitigate the cost Marsh 3

6 Marsh will be pleased to provide more information on this new law, and support you with an evaluation of your current status and provide appropriate advice. Please feel free to contact us: DUBAI ABU DHABI ARUN DHYANI ADRIAN FISHER QUINTON MENEZES RANDA MAMO SWAPNIL DIKSHIT NAGEEN SATTAR A Limited Liability Company incorporated in the Emirate of Dubai, United Arab Emirates. Paid-up Capital Dh. 1,500,000. Commercial Registry No This document is provided to you on the basis that it is confidential. It may only be used in connection with the RFP to which this document responds, and shall not be disclosed for any reason without our prior written consent. Copyright 2014 Marsh Emirates Insurance Brokerage and Consultancy. All rights reserved.

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