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Insurance News: The Health Insurance law of 2013

Laarni Talavera – Dimatulac – Asst. Manager – Employee Benefits

Being a part of Dubai Strategic Planning, it was 2013 when His Highness Sheikh Mohammad Bin Rashid Al Maktoum, UAE Vice – President and Prime Minister and Ruler of Dubai approved the Health Insurance Law which stipulates rules and regulations for all parties involved with the provision and implementation of health insurance in DUBAI.

The law aims to ensure that every national, resident and visitor in Dubai has essential health coverage and access to essential health services. Dr. Haidar Al Yousuf of Health Funding at DHA said that the law shall continue to have access to all current healthcare services provided by DHA and various private healthcare providers.

The law has framework for Insurance Companies to abide by as per the law and only registered Companies are allowed to deliver insurance schemes and packages to ensure that every insurance company follows high standards as well as the provisions that are compliant with DHA.

DHA set a cost for providing Essential Benefits Plan at the range of AED 500 to AED 700 per insured member per year for 2014.

For ENHANCED DHA PLANS – there are no restrictions at present on the premiums but DHA will be issuing rules in 2015 to meet the objectives that the premium pricing regulations will ensure stability in the market, to prevent premium “price wars” and to protect the insured population from unjustifiably excessive increases to renewal premiums.

Knowing that health insurance is a form of security, we as a Broker play a vital part in educating our clientele about the DHAs new law.

About 3 million people reside in Dubai. The implementation timeline has started on 2014 and all 3 million residents are expected to have coverage by June 2016.  From a sales and marketing perspective, and collaboration with our financial consultants covering 300,000 members from the lower salary bracket will invoke premiums of AED 195,000,000/-.

Similarly with residents falling under the High Salary Bracket touching 1,000,000 lives, we can see a an estimate ranging from AED 5,000,000,000/- worth of Insurance Business throughout the implementation timeline that is up for grabs, a great opportunity for Insurers and brokers to take advantage of.

Minimum Benefits that are mandated to any health insurance plan to be marketed in Emirate of Dubai shall cover the following:

  • Annual Benefit Level of AED 150,000/-
  • Area of Cover: Emirate of Dubai (and other Emirate or countries at the discretion of the Insurer). Emergency medical treatment shall cover Within All Emirates of the UAE.
  • Network: Limited Network – must provide reasonable geographic access
  • Pre – Existing conditions – included after (6 months of first scheme membership)
  • Benefits shall cover Basic Inpatient and Outpatient Services, Companion Accommodation, Preventive Services, vaccines and immunizations
  • Maternity Services from day 1.

All NEW Schemes/ Policies established from 01 January 2015 must comply with the EBP benefits standards even if established before the deadline.

Indeed, DUBAI is a beautiful place to live and work in and it’s our job as Insurers to secure this life for people!

Laarni Talavera is an asst manager in the employee benefits department, she specializes in client servicing, liaison and processing insurance cases for individual and group medical.

 

 

 

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