Individuals in Bermuda can arrange health insurance in a variety of different ways depending upon their personal circumstances.
Yet when it comes to making sure you’re covered, navigating your way through the jargon, paperwork and online forms can feel like a minefield.
Here, we summarise the options available with the assistance of two experts from BF&M and Argus: Shakira Warner, head of population health, and Jai-Michael Phillips, head of benefits, insurance and provider relations.
Full-time employees
Pursuant to the Health Insurance Act 1970, employers in Bermuda are legally required to provide at least the Standard Health Benefit— the minimum of health insurance coverage — for their full-time employees and their non-working spouses who are legal residents and reside in Bermuda.
This coverage is typically arranged through either:
- The Government-administered Health Insurance Plan; or
- A plan with a licensed private insurer.
The SHB covers local medical services, primarily services provided by the Bermuda Hospitals Board, which operates:
- King Edward VII Memorial Hospital;
- Lamb Foggo Urgent Care Centre; and
- The Mid-Atlantic Wellness Institute.
These facilities are partially funded through Government budget allocations and hospital fees. Community-based SHB benefits are defined in regulations and include, but are not limited to:
- Diagnostic imaging;
- Clinical nursing care; and
- Dialysis services from approved providers.
Under the Act, employers are liable to pay the full SHB premium. However, they are entitled to recover up to 50 per cent of the premium from the employee, provided:
- The deduction is documented in the employment contract or with written consent; and
- It complies with the Employment Act 2000.
In practice, most employers contract with private insurers offering enhanced benefits above the SHB minimum. Employers often select the level of coverage most appropriate for their employees and their dependents.
Part-time employees
Bermuda law does not require employers to provide health insurance to part-time employees, defined under the Health Insurance (Exemption) Regulations as those working fewer than 15 hours per week, not more than two months in any calendar year, or students under 26.
As a result, part-time employees often must:
- Purchase individual health insurance through the HIP; or
- Obtain coverage through a spouse’s employer-sponsored plan, if eligible.
Self-employed
Under the Act, self-employed persons are required to maintain SHB-level coverage. They can meet this requirement by:
- Enrolling in the HIP;
- Purchasing a plan from a private insurer; or
- Being covered under a spouse’s employers-based plan (if allowed by the insurer).
If a self-employed individual hires staff, they become subject to the same employer obligations under the Act and must provide SHB-compliant coverage to their full-time employees.
Unemployed/retired
There is no legal mandate requiring unemployed or retired persons to maintain health insurance. However:
- Those under age 65 who are temporarily unemployed may:
Enroll in the HIP; or
Obtain private insurance.
- Those aged 65 or older may apply for the FutureCare programme, which offers subsidised insurance for seniors.
Eligible persons may apply for premium subsidies under the Health Insurance (FutureCare Plan) (Eligibility) Regulations 2009, by obtaining a Certificate of Entitlement under section two.
Combination of HIP and private insurance
Bermuda law does allow individuals to maintain multiple insurance policies, including combinations of HIP and private insurance. However, coordination of benefits (per the Insurance Act 1978) ensures that duplicate payments are not made for the same claim.
In practice, maintaining dual coverage may not always be cost-effective due to overlapping benefits. Employees should assess whether the additional financial outlay justifies the enhanced protection.
Group or association plans
Our experts said: “We do have experience with association plans. This arrangement can be beneficial for small businesses in a similar industry to spread risk over a larger pool of individuals.
“However, keep in mind that premiums are based on the risk profile of the entire population of the association group; there is then a risk of higher premiums to all groups in the event that only one group has higher costs. Each group must be mindful of this risk before entering into an association.”
They added: “Typically a ‘group’ of one is the by-product of a business that once consisted of multiple employees and has downsized over time.
“Each insurer will have different risk tolerances for these ‘groups’ and will explore alternatives to coverage with the member as premium increases can be higher than if there are multiple members in a group to offset that risk.”
- For more information, visit: https://www.bfm.bm/forwardtogether.aspx
