Voluntary Health Insurance (Amendment) Act, 1996

Schemes of voluntary health insurance.

2.—(1) The Board shall, with the consent of the Minister, make and carry out health insurance schemes and may, with the like consent, make and carry out such health-related insurance schemes as it may think fit.

(2) The Board may, with the consent of the Minister, make and carry out a scheme amending or revoking a scheme under this section including a scheme under this subsection.

(3) (a) For the purpose of facilitating the operation of schemes under this section the Board may enter into such agreements (if any) with such and so many health service providers and other persons as it considers appropriate.

(b) An agreement under paragraph (a) shall contain such terms and conditions as the Board may, in its discretion, determine and different such agreements, whether with the same or different health service providers or other persons and whether in relation to health services or goods of the same kind or of different kinds, may contain different terms and conditions.

(c) Without prejudice to the generality of paragraphs (a) and (b), the Board may, when considering whether to enter into an agreement under paragraph (a) or when determining the terms or conditions of such an agreement, have regard to—

(i) the cost, nature, quality and extent of any health services previously provided or then being provided or offered to be provided, and

(ii) the cost, nature, quality and quantity of any goods previously provided, or then being provided or offered to be provided, for the purposes of a health service,

by the health service provider concerned or any other health service provider or by the other person concerned or any other person.

(d) The Board may refuse to enter, or refrain from entering, into an agreement under paragraph (a) with a health service provider or other person if it considers it appropriate to do so.

(4) Nothing in this Act shall be construed as imposing on the Board either directly or indirectly any duty or liability to a health service provider or any other person the discharge of which is enforceable in a court and to which it would not otherwise be subject.

(5) The Board shall so fix the amounts of subscriptions, premiums or other charges payable by or in respect of beneficiaries under schemes under this section that taking one year with another the revenue of the Board therefrom together with its other revenues (if any) shall be sufficient, but only sufficient (as nearly as may be), after the Board has made such allowance as it thinks proper for reserves, depreciation and other like purposes, to meet the charges properly chargeable to revenue.

(6) A scheme under section 4 of the Principal Act that was in force immediately before the passing of this Act shall continue in force after such passing as if made under this section and may be amended or revoked accordingly under this section.

(7) In this section—

“health insurance scheme” means a scheme of voluntary insurance the sole or principal purpose of which is to provide for the making of payments by the Board, whether or not in conjunction with other payments, specifically for the reimbursement or discharge in whole or in part of the amounts of fees or charges in respect of the provision of health services paid or payable by persons, such reimbursement or discharge being in consideration of the payment by or on behalf of the persons to the Board of subscriptions, premiums or other charges, but does not include such a scheme of insurance the sole purpose of which is to provide for the making of payments by the Board in respect of sickness, injury or disease of amounts calculated by reference only to the duration of the sickness, injury or disease concerned;

“health-related insurance scheme” means—

(a) a scheme of voluntary insurance the purpose of which is to provide for either or both of the following, that is to say:

(i) the making of payments by the Board to persons in respect of sickness, injury or disease of amounts that are either specified in the scheme or calculated in such manner and by reference to such matters as may be so specified,

(ii) the procurement by the Board of the provision of health services to persons either without charge to them by the health service providers concerned or upon payment by them to such providers of part of the cost of the services,

in consideration of the payment by or on behalf of the persons to the Board of subscriptions, premiums or other charges, or

(b) a scheme for the procurement by the Board of the provision to persons of services related to the prevention of sickness or disease either without charge to them by the providers of the services or upon payment by them to such providers of part of the cost of the services in consideration of the payment by or on behalf of the persons to the Board of subscriptions, premiums or other charges;

“premium” has the meaning assigned to it by the Act of 1994.