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Position Paper on Revised NHI Framework

Posted by on Nov 4, 2018 in Policy | Comments Off on Position Paper on Revised NHI Framework

Partnership and Collaboration in the Delivery of Universal Healthcare in The Bahamas Overview The National Health Insurance Authority (NHIA) formally issued a policy paper entitled National Health Insurance: A Shared Responsibility on October 23, 2018. The aforementioned policy paper outlines the proposed policy framework for the revamped NHI program. The NHIA has commenced a 45-day consultation period during which it is anticipated that stakeholders will be engaged and feedback obtained. The expectation is that stakeholder feedback will be reviewed and where appropriate, incorporated into the policy paper before it is finalized.   Statement of Purpose The purpose of this Position Paper is to provide feedback to the NHIA with a view to enhancing the proposed framework. This paper acknowledges the significant work that has been done by the NHIA and its consultants to develop a plan for the revamping of the existing NHI scheme. The BIA met with the NHIA on October 30, 2018, to discuss the Policy Paper for the first time and the feedback received during this meeting has been incorporated into this Paper. It is our view that the contributions of stakeholders particularly the general public will be pivotal to the success of an overhauled NHI plan. The BIA has reviewed the Policy Paper in detail and has produced this document in good faith to assist the NHIA fulfill its mandate. For the purposes of this document, we have assumed that all references within the Policy Paper to private insurers are to be interpreted as private health insurers duly licensed by the Insurance Commission of The Bahamas under the Insurance Act, 2005 (as amended).   General Comments The BIA supports the concept of universal health coverage and shares the vision of the NHIA that residents of The Bahamas should not suffer financial hardship in gaining access to quality and affordable healthcare. We believe that universal access to healthcare in The Bahamas is a noble and attainable goal in The Bahamas. We endorse the NHIA’s philosophy of collective and shared responsibility while supporting the notion that NHI should care for those who need it most. It is against this backdrop that the BIA and private health insurers welcome the opportunity to not only comment on the policy paper but also partner with the NHIA in the implementation of a viable and sustainable NHI plan. We have assumed that the NHIA’s request for feedback is genuine and does not constitute tokenistic engagement. Hence, we expect that comments, observations and proposed amendments to the Policy Paper will be considered, scrutinized and if considered prudent, utilized in the enhancement of the document. We believe that it would have been in the NHIA’s best interest to have shared a draft of the Policy Paper with the BIA prior to releasing it for public comment. This would have ensured that any areas requiring clarification or revision within the document were addressed prior to being put in the public domain. Additionally, it would have mitigated against the risk of raising public expectations and subsequently having to temper the same with more realistic targets. Nevertheless, our specific comments are provided in the ensuing paragraphs.   Timeline for Launch of Standard Health Benefit According to the Policy Paper, the Standard Health Benefit (SHB) is scheduled to be launched between April and July of 2019. It...

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Bahamas Insurance Association Calls on Attorney General

Posted by on Nov 10, 2017 in BIA In The News, Press Releases | Comments Off on Bahamas Insurance Association Calls on Attorney General

The Bahamas Insurance Association (BIA) continues to build relationships with and dialogue on issues affecting the sector with the Government of The Bahamas. Most recently, executives of the BIA paid a courtesy call on the office of the Attorney General, The Honourable Carl Bethel. The BIA contingent, led by chairman, Emmanuel O. Komolafe, sought to introduce the Attorney General to the BIA and its objectives. In addition to highlighting the stability of the insurance industry and its consistent contribution to the local economy, the team stressed the need for a liberalized exchange control regime and a number of other legal concerns affecting the industry’s future growth potential and ongoing operations. The meeting also provided the opportunity to discuss the proposed amendments to the AML/CTF framework for the industry via the Financial Transactions Reporting Bill, a priority for both the Attorney General’s office and the industry. Both parties committed to engaging in further dialogue on this matter. Ultimately, the Attorney General acknowledged the significant role of the insurance industry to The Bahamas and its economy and committed to addressing the concerns of the BIA and its members. Pictured L to R  front are Dr. Rhonda Chipman Johnson, Coordinator, BIA; The Hon. Elsworth Johnson, Minister of State, Ministry of Legal Affairs; The Hon. Carl Bethel, Attorney General; Emmanuel Komolafe, Chairman, BIA; Back L-R are Cassandra Nottage, Consultant; Tleca Rolle, Consul; Bede Sands, Orry J Sands, Member of Legislation Committee; Marco Rolle, Permanent Secretary, Ministry of Legal Affairs; DeAndrea Lewis, Colina Insurance; Charlyne Sealy, Summit Insurance, Member of Legislation; Michelle Dean, Assistant Director of Legal Affairs; Tina Roye, Director of Law Reform & Revision. L-R Charlyne Sealy, Summit Insurance, Member of Legislation Committee; Dr. Rhonda Chipman-Johnson, Coordinator, BIA; Emmanuel Komolafe, Chairman, BIA. ABOUT THE BAHAMAS INSURANCE ASSOCIATION: The Bahamas Insurance Association (BIA), formerly known as the Bahamas General Insurance Association (BGIA), is a trade association of insurance companies, brokerages, and agencies licensed by the Insurance Commission of The Bahamas, dealing in all lines of General (property and casualty) and Long Term (life and health) insurance business. Its main purpose is the representation of the interests of the Insurance industry to the Bahamian Government and People, and to other local and international bodies. ### For further information: Leah R. Davis Group Marketing & Communications Manager Bahamas First Corporate Services e LeahD@bahamasfirst.com t 242.302.9000 d 242.302.3989...

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NHI Secretariat may be acting illegally as an Insurance Company

Posted by on Jul 24, 2017 in Press Releases | Comments Off on NHI Secretariat may be acting illegally as an Insurance Company

The Bahamas Insurance Association (BIA) concurs with the Health Minister, Hon. Dr. Duane Sands’ position that in the absence of a National Health Insurance (NHI) Authority Board, actions taken to implement NHI including enrolment and the execution of contracts with medical service providers were unlawful. We also agree with his view that the NHI scheme as it is currently being operated is susceptible to significant fraud; principally because it is operating outside its intended legal framework. We are concerned however that the identified breaches of the NHI Act and Insurance Act are ongoing and have not been addressed to date. One such breach of the NHI Act is that the NHI Secretariat may be acting illegally as an insurance company. The NHI Act anticipated that Regulated Health Administrators (RHAs) would be responsible for the management and administration of NHI benefits. The eligibility and functions of RHAs are addressed in sections 25 and 26 of the NHI Act. We note that an RHA is required under Section 25(2) of the NHI Act to among other things, be a company carrying on long-term insurance business and registered with the Insurance Commission to carry on long-term insurance business for sickness or health insurance in accordance with the Insurance Act (Ch. 347) be certified by the Insurance Commission as an Administrator in accordance with the provisions of the Insurance Act (Ch. 347) enter into an agreement with the Authority in accordance with the provisions of the NHI Act; and satisfy such other requirements as may be determined by the NHI Authority in order to be registered by the NHI Authority for participation in the Plan. It is our understanding that no RHA has been contracted to administer the NHI benefits. Instead, the NHI Secretariat presumably under the guise of purporting to act as the NHI Authority has taken on the functions of an RHA as defined in Section 26 of the NHI Act. It is noteworthy to state that the functions of the NHI Authority are clearly stated in Section 6 of the NHI Act and do not overlap with those of an RHA. The BIA contends that the NHI Secretariat acting on the premise that it can function as the NHI Authority (which has not been formally constituted), may have illegally taken on among other things the following functions of an RHA as defined in Section 26 of the NHI Act: providing beneficiaries with access to benefits paying providers for benefits processing beneficiary claims case management monitoring the provision of health care benefits This would violate the NHI Act and as the Secretariat would be carrying on insurance business, is also a violation of the Insurance Act. The recently reported complaints regarding non-payment of medical providers seems to illustrate one of the practical consequences of violating the law. Had an insurance company failed to make payment, a complaint could have been filed with the Insurance Commission who has the legal power to investigate the complaint and to direct the company to resolve it. The insurer in question could also have been sued for breach of contract. Under these circumstances where the payments themselves violate law, the affected medical providers may not have any legal redress available to them. We submit that it is highly improper for the NHI scheme to be violating...

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BIA Questions Legality Of Actions On National Health Insurance

Posted by on Jul 15, 2017 in Press Releases | Comments Off on BIA Questions Legality Of Actions On National Health Insurance

“Stop, review and make it right” The Bahamas Insurance Association (BIA) concurs wholeheartedly with the position stated by new Health Minister, Dr. Duane Sands, during the recent budget debate. The BIA concurs that the nation now has an opportunity to make right the structure of the Universal Health Care Program to ensure best outcomes for our nation and welcomes the opportunity to meaningfully engage in the process for the good of all.  The BIA therefore feels it necessary to question in the first instance, the legality of actions taken in the haste to implement National Health Insurance (NHI) prior to the 2017 general elections. On April 5, 2017, the government enforced Parts I, II and Section 45 of the National Health Insurance Act (see attached National Health Insurance Act, 2016 (Appointed Day) Notice, 2017).  These parts of the NHI Act provide for the establishment, functions and powers of the NHI Authority, the establishment of the NHI Fund and other financial provisions.  All other aspects of the NHI Act have not yet been given the force of law including the parts that establish the NHI plan, outline the eligibility for NHI, provide for enrolment for NHI and establish the framework as well as functions of regulated health administrators (or health insurers) and health care providers. The fact that NHI was implemented without key elements of the relevant Act enacted, brings into question the actions that were undertaken prior to the general elections.  We were advised by the NHI Secretariat that the Minister responsible for National Health Insurance had delegated specific authorities to the Permanent Secretary for NHI.  It was stated that the PS under the aforesaid delegation could cause the National Health Insurance Authority to enter into contracts with medical providers, begin enrollment for NHI and perform other functions.  We have examined this and find it to be questionable and potentially lacking in legal basis under the empowering legislation. As far as we understand, the Board of the NHIA which pursuant to Section 4(3) of the NHI Act is the governing body of the NHI Authority, has not been appointed. Further, Section 8 of the NHI Act empowers the Board to appoint the Managing Director; hence, in the absence of a board, the recruitment process for the appointment of a Managing Director could not have commenced. This calls into question all acts taken in the name of the NHI Authority in an effort to implement the scheme as they may have been carried out ultra vires of the law. We also note that the NHI Act anticipated that regulated health administrators manage and administer NHI benefits under the NHI Act.  Such Administrators are required by the NHI Act to be companies duly licensed under the Insurance Act (Ch. 347). It appears that no such company was contracted with to administer NHI benefits and that the government via the NHI Secretariat has taken on these responsibilities. NiceEven if the NHI Authority Board had been properly established and a Managing Director appointed, the management and administration of benefits under the NHI Plan by an entity not duly licensed by the Insurance Commission of The Bahamas and in accordance with Part IV of the NHI Act would be unlawful and possibly a violation of both the NHI Act and the Insurance Act. During...

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Traffic Safety System – Approval ‘Nod’ By Bahamas’ Insurance Agents

Posted by on Jul 4, 2017 in BIA In The News, Press Releases | Comments Off on Traffic Safety System – Approval ‘Nod’ By Bahamas’ Insurance Agents

Do you agree that our country needs to do something about the many persons driving at dangerous speeds and running red lights with little regard for other motorists, pedestrians and property? This was one of the questions posed during a recent presentation to 18 members of the Bahamas Insurance Association (BIA) by Intelligent Enforcement Ltd. (IntelEnforce) principal, Donovan Paul, and Chief Information Technology Officer, Michael Arteaga. The presentation was to inform the agents and to access their level of support for the possible implementation of a new traffic public safety system on New Providence roads; one designed to curb road traffic infractions for a reduction in casualties and deaths and vehicle and property damage. With almost 1,000 traffic fatalities on our roads since year 2000, and a staggering 1,000 consecutive hit and run annual reports, topped by reports of thousands of traffic accidents annually causing lifetime bodily injuries, inconveniences and significant vehicle and property damage, IntelEnforce is spearheading the move to have a modern traffic public safety system implemented. Donavan Paul, IntelEnforce CEO said that the new traffic public safety system is a Public-Private Partnership Agreement (PPP), one that enables both the government and the private sector investor a revenue stream. “Considering the revenue projections attached to the one-month pilot test we did on one stretch of road near our office in central New Providence, we believe the government could recover their initial stake or investment in about a year and garner an immediate effect on the traffic public safety system without having to worry about management costs or hardware expansion.” Chief Information Technology Officer, Michael Arteaga, explained that the system is a third generation radar speed meter police tool. “This tool not only records the speed of a vehicle per lane, but also records video of the entire scene taking two still pictures, just seconds apart. Based on the offence, the offender may receive a traffic violation ticket,” Mr. Arteaga said. Attendees learned that the benefits of the new system would include reduced traffic accidents, reduced traffic fatalities, better traffic flow, prevention of property damage, increased revenue for the country, reduced burden on the judicial system, automatic and digital record keeping eliminating warrants being issued for paid tickets, and a more attractive tourism product. Chairman of the BIA, Emmanuel Komolafe agreed with attendees that the proposal, if adopted by the government will benefit the nation: “It seems fair to state that there was a consensus among our members that attended the presentation by IntelEnforce that the proposal if adopted and properly implemented could significantly benefit the country. Apart from the obvious advantages in relation to safety on our roads and an expected reduction in the loss of life and casualties, there are potential benefits to our members and the economy. The likely decline in traffic violations and road crime statistics could result in reduction in insurance claims and potentially lower insurance renewal costs. However, these benefits can only be maximized and the system fully utilized to achieve the set objectives via a public private partnership. In the case of the insurance industry, access to pertinent information and the system will determine how much our members as well as their clients benefit from this new paradigm.” Executive Director of the Bahamas for NAGICO Insurance, Vibert Williams agreed with other...

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Bahamas Insurance Association Calls on Minister of Health

Posted by on Jul 4, 2017 in BIA In The News, Press Releases | Comments Off on Bahamas Insurance Association Calls on Minister of Health

Pledging to be ‘partners in health’ the Minister of Health, the Hon. Duane Sands recently welcomed the Bahamas Insurance Association (BIA) for a courtesy call. Minister Sands described the meeting as positive and productive noting, “Organizations such as the BIA will be key partners for the Ministry of Health as it works to transform and enhance healthcare in The Bahamas.” The Minister also underscored the need for meaningful input from the insurance industry and suggested there were opportunities for the BIA to participate in a significant way and to provide new products. “I look forward to a mutually respectful relationship with the BIA and suggest regular meetings to maintain the dialogue,” said Sands. Executives of the BIA, led by chairman, Emmanuel O. Komolafe, sought to meet the new Minister and introduce the BIA and its objectives. Thanking the Minister for the meeting, Komolafe emphasized the stability of the insurance industry and noted that gross written premiums amounted to about 9% of the nation’s GDP. He remarked that industry has significant interest in the financial health of the country while highlighting the correlation between The Bahamas’ sovereign rating and the credit rating of BIA. The Minister was also advised of a number of outstanding issues including exchange control restrictions which limited insurers’ ability to invest outside The Bahamas and the challenge with asset liability matching for long term insurers. Komolafe expressed, “Overall the BIA is optimistic about working with the Ministry of Health and the NHI Authority once formally constituted and looks forward to collaborating on the refinement of the NHI model and advancement of both the health and insurance industries.” ABOUT THE BAHAMAS INSURANCE ASSOCIATION: The Bahamas Insurance Association (BIA), formerly known as the Bahamas General Insurance Association (BGIA), is a trade association of insurance companies, brokerages, and agencies licensed by the Insurance Commission of The Bahamas, dealing in all lines of General (property and casualty) and Long Term (life and health) insurance business. Its main purpose is the representation of the interests of the Insurance industry to the Bahamian Government and People, and to other local and international...

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Bahamas Insurance Association Calls on Minister of Financial Services

Posted by on Jun 14, 2017 in BIA In The News, Press Releases | Comments Off on Bahamas Insurance Association Calls on Minister of Financial Services

Nassau, The Bahamas – June 14, 2017 – The Bahamas Insurance Association (BIA) recently called on the Minister of Financial Services, Trade and Industry and Immigration, The Hon. Brent Symonette. Having recently held its AGM, the new executive team of the BIA, led by chairman, Emmanuel O. Komolafe, sought to meet the new Minister and introduce the BIA and its objectives. The team also shared updates on a number of industry concerns and opportunities. Komolafe explained, “We believe that our meeting with the Minister of Financial Services and his team was informative and productive. A number of outstanding policy and legislative matters were discussed in an environment that encouraged feedback from the insurance industry. Opportunities for cooperation and collaboration on matters of mutual interest were also discussed during the meeting. Specifically, we explored opportunities for growth within the financial services industry in general and the insurance sector in particular. The Minister expressed his desire to work with the BIA going forward and encouraged ongoing dialogue between the government and the Association. We look forward to a cordial working relationship with the Ministry of Financial Services.” Pictured front row L to R are Rema Martin, J.S. Johnson; LaTonia Tinker, Consultant; Sherrylee Smith, Permanent Secretary; Hon Brent Symonette, Minister of Financial Services, Trade and Industry and Immigration; Brian Self, Security & General Insurance; Dr. Rhonda Chipman-Johnson, Coordinator, BIA; Tina Cambridge, Generali; Timothy Ingraham, Summit Insurance. Back row L-R are Khaliah Brown, Financial Trade Officer; Tanya Murray, Project Manager; Emmanuel Komolafe, Chairman, BIA, Colina; Warren Rolle, Secretary, BIA, NUA Insurance; Cardinal McCardy, Treasurer, BIA, Hope Insurance. ABOUT THE BAHAMAS INSURANCE ASSOCIATION: The Bahamas Insurance Association (BIA), formerly known as the Bahamas General Insurance Association (BGIA), is a trade association of insurance companies, brokerages, and agencies licensed by the Insurance Commission of The Bahamas, dealing in all lines of General (property and casualty) and Long Term (life and health) insurance business. Its main purpose is the representation of the interests of the Insurance industry to the Bahamian Government and People, and to other local and international...

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Bahamas Insurance Association Re-elects Officers

Posted by on May 29, 2017 in BIA In The News, Press Releases | Comments Off on Bahamas Insurance Association Re-elects Officers

Nassau, The Bahamas – May 29, 2017 – The Bahamas Insurance Association (BIA) held its Annual General Meeting (AGM) on May 24, 2017 where Emmanuel Komolafe and Lyrone Burrows were re-elected as Chairman and Deputy Chairman (Life & Health) respectively, for another two-year term. Other BIA executive officers currently serving the second year of their term include Anton Sealy, Senior Account Executive and Director at Insurance Management (Bahamas) Ltd. (Deputy Chairman – Property & Casualty); Warren Rolle, Managing Director of NUA Insurance Agents & Brokers (Secretary); and Cardinal McCardy, President, Hope Insurance Agents & Brokers Limited (Treasurer). This election comes following a change in government in The Bahamas and at a time when the insurance industry is confronted with a myriad of challenges which are expected to impact the business models of BIA members. While thanking the membership for reposing confidence in the leadership team, Mr. Komolafe expressed that the BIA and the insurance industry as a whole stand ready to work with the new government. “We understand that these are serious times for the insurance industry and the nation. It is our firm belief that there is no challenge that is insurmountable if the private sector works in collaboration with the government and civil society to make The Bahamas the best it can be.” The BIA chair outlined that there are a number of systemic and legislative issues and outstanding policy decisions impacting the industry, some dating back to 2010. These include the need for instruments to enable long-term insurers to better match their assets with their long term liabilities, as well as exchange control concessions to enable insurers to diversify their investment portfolios and reduce their concentration risk. There are also proposed amendments to the Insurance Act, 2005 and accompanying regulations that remain outstanding. “We also note that the new government had committed to the removal of Value Added Tax (VAT) from insurance products and healthcare. This policy decision is presumably aimed at making healthcare and insurance more accessible and affordable to the Bahamian people. An increase in insurance penetration across our archipelago of islands will ensure that more businesses and individuals have financial protection thereby reducing dependency on the Government in the event of an insured event,” the BIA Chairman remarked. “The BIA looks forward to building a good working relationship with the new Government to ensure that the concerns of the insurance industry are communicated to the relevant authorities while advocating constructive dialogue,” Komolafe concluded. ABOUT THE BAHAMAS INSURANCE ASSOCIATION: The Bahamas Insurance Association (BIA), formerly known as the Bahamas General Insurance Association (BGIA), is a trade association of insurance companies, brokerages, and agencies licensed by the Insurance Commission of The Bahamas, dealing in all lines of General (property and casualty) and Long Term (life and health) insurance business. Its main purpose is the representation of the interests of the Insurance industry to the Bahamian Government and People, and to other local and international bodies. ### For further information: Leah R. Davis Group Marketing & Communications Manager Bahamas First Corporate Services e LeahD@bahamasfirst.com t 242.302.9000 d 242.302.3989 m...

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BIA responds to KPMG Economic Impact Assessment of NHI Primary Care Phase

Posted by on Jan 25, 2017 in Press Releases | Comments Off on BIA responds to KPMG Economic Impact Assessment of NHI Primary Care Phase

The Bahamas Insurance Association (BIA) remains in full support of Universal Health Coverage (UHC) and welcomes the opportunity to work with the government to expand the existing UHC system within The Bahamas. The KPMG document entitled Investing in health – An economic and qualitative analysis of the impacts of the primary care phase of NHI in The Bahamas makes interesting reading. While the document is quite academic and idealistic, it also contains common sense conclusions based on what can be expected if we commit ourselves to true comprehensive healthcare reform. The caveats in the document which implicitly highlight the correlation between good governance and strengthening of the public primary healthcare system are also noteworthy. There is a school of thought that KPMG is conflicted in conducting an economic impact assessment on an NHI scheme for which it serves as the primary consultant. This viewpoint zeros in on the fact that the firm has received and continues to receive significant fees for extensive services provided vis-à-vis the implementation of NHI. Hence, it is almost unrealistic to expect KPMG to objectively criticize a plan for which it is one the main architects or suggest that the overall impact on the economy will not be extremely positive. In this regard, while the partnership with Cambridge Econometrics is helpful in addressing this concern, a totally independent study would have been preferable. An independent collaborative assessment with the private sector would have also dispelled the notion that KPMG was influenced or pressured by the Government to produce a document which endorses its plans in a politically charged environment and justifies the current approach. Nevertheless, there is some useful information in the document and it seems to confirm that the benefits of primary care will be seen in the medium to long term. The document notes that “over the course of a generation, the primary care phase of NHI will be producing an additional $500 million a year in additional GDP”. It will be helpful if the detailed assumptions used in arriving at the conclusions within the report are shared with experts within the stakeholder community to facilitate a meaningful dialogue. The commentary on Page 2 of the document which suggests that free, accessible and modern primary care services will be offered to residents should be qualified and clarified. This statement suggests that “free” healthcare will be provided to all residents and fails to clarify that individuals with primary care benefits under their private health insurance plan will not receive these “free” services per the legislation. Additionally, the report fails to acknowledge that there are no “modern primary care facilities” in The Bahamas and there is a dire need for the Government to focus on the strengthening and modernization of their 90 plus clinics across our archipelago of islands prior to the rollout of the primary care phase. Per the report, “Firms are also likely to see a slower rate of growth in private health insurance premiums for staff. This commentary seems bold as it assumes that there will be viable private health insurance plans and the risk pool will be healthier in spite of the implications of Section 21 of the NHI Act. KPMG was right in stating that it is difficult to estimate the impact of the primary care phase on government finances...

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BIA Celebrates Insurance Month

Posted by on Nov 28, 2016 in BIA In The News, Gallery | Comments Off on BIA Celebrates Insurance Month

In recognition of the substantial role played by the insurance industry in the Bahamas, Prime Minister Perry Christie designated October Insurance Month. Each year, the Bahamas Insurance Association, the Insurance Institute of the Bahamas, the Bahamas Insurance Brokers & Agents, and the Insurance Commission organise a series of activities to raise public awareness of the importance of insurance. The month’s activities kicked off on October 2 with a special service at St. Matthew’s Church followed by a luncheon at Mosaic in the Atlantis Resort. And October 3 was designated Insurance Day – when these pictures were taken. During the month, industry leaders paid a courtesy call on the governor-general, appeared on a TV talk show, and a reception at the Green Parrot Restaurant. A highlight of the month’s activities was an art competition open to all primary and secondary school students. Winners are pictured from left: first place in the senior school category, Cory Hamilton of C. C. Sweeting; first place in the junior school category, Zia Joos of Windsor Preparatory; and second place in the senior school category, Darjanique Green of CC Sweeting. The BIA is a trade association of 30 licensed insurance companies, brokerages, adjusters and agencies. BIA members deal in property, casualty, long-term life and health insurance. The BIA represents the interests of the insurance industry (which employs thousands of Bahamians) and seeks to uphold ethical business practices. READ MORE...

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