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Time frame set for mandatory health insurance scheme

DHA says smaller companies with staffing between 100 and 999 would be expected to roll out the plan by July 2015.

Companies with more than 1,000 employees will have to provide insurance cover for their staff by next October in the first phase of a mandatory health insurance scheme.

Expanding on the plan they announced last month, the Dubai Health Authority (DHA) also said smaller companies with staffing between 100 and 999 would be expected to roll out the plan by July 2015, while people working at companies with less than 100 staff and all spouses, dependents and domestic workers must be included under the scheme by June 2016.

EHB package This is the minimum insurance cover that every employer/sponsor will have to provide his employees/dependents. EHB covers: • Access to general physician/family physician. • Referral to specialists • Surgical procedures • Laboratory services: Tests and investigations provided to help a doctor diagnose an injury, illness or condition, or to monitor the effectiveness of a particular treatment. • Emergency services: Medical attention required for conditions that could lead to serious disability or death if not treated immediately, such as accidents or sudden illness. Prior authorization is not required for such cases. • Maternity care: Medical care that women receive during pregnancy (prenatal care), throughout labour, delivery and post-delivery.

Each company will have to spend between Dh500 and 700 on one employee per year to ensure each has an essential health benefits package (EHS) that will cover emergency care, access to general physicians, family physicians, referral to specialists, tests and investigations, surgical procedures and maternity care.

Director of Health Funding Dr Haider Al Yousuf said that for employers this would provide a minimum impact to them in terms of cost. “On an average, health insurance costs 1.5 per cent of the monthly salary,” he said.

“For example, if an employer pays Dh10,000 per month in salaries, and if he adds Dh150 per month, it covers the cost of health insurance. This is a minimum impact, adequate benefit plan; clearly the benefits outweigh the minimum costs involved,” he said, during a meeting on Tuesday with insurance companies. “The scheme protects both employers and employees from unforeseen healthcare costs that can arise out of an illness or an emergency.”

Dr Al Yousef said this were deadlines, and companies could choose to start providing cover earlier.

Last month, the DHA announced that resident or entry visas would not be processed for any individual unless a compulsory health insurance plan was submitted.

Roughly, two million people in the Emirate are expected to benefit from this scheme, including blue-collar workers, many of whom are currently without any basic health cover. Nearly a million people in Dubai are already insured and the ruling may not impact them.

While the health cover for UAE nationals will be provided by the government, all other employers will be responsible for resident expatriate workers.

“Those sponsoring their wives and children will have to buy individual health packages separately unless the company decides to provide them with cover too,” said Al Yousef.

During the meeting, the DHA also discussed both the roll out process and the procedure for procuring a health insurance permit, which is mandatory for all those companies that want to provide health insurance services in Dubai.

“The health insurance mandate will provide a significant boost to the health insurance industry, it will attract investment in the healthcare sector and will generate healthy competition between providers as well as health facilities,” said Essa Al Maidoor, Director-General of the DHA.

All healthcare providers will need to obtain a health insurance permit to be eligible to provide insurance cover in Dubai, for which the DHA has laid out a strict list of criteria that must be adhered in order to get the permit.

“Insurance companies interested in providing the EHB package to resident employees with salaries below Dh4,000 will have to undergo further qualifying criteria to ascertain their ability to provide an insurance package at an affordable rate,” Dr Al Yousuf said.

He said the process of obtaining a health insurance permit began in October this year and will be completed by January 2014. The DHA will announce a list of the companies that have obtained these permits.

asmaalizain@khaleejtimes.com