S.I. No. 223/1946 - National Health Insurance (Arrears) Regulations, 1946.

STATUTORY RULES AND ORDERS. 1946. No. 223.

NATIONAL HEALTH INSURANCE (ARREARS) REGULATIONS, 1946.

The Minister for Local Government and Public Health in exercise of the powers conferred on him by the National Health Insurance Acts, 1911 to 1942, and of every and any other power him in this behalf enabling, by this, his Order, makes the following Regulations :—

1 ..

1. These Regulations may be cited as the National Health Insurance (Arrears) Regulations, 1946.

2 ..

2. In these Regulations, unless the context otherwise requires :—

the expression " the Minister " means the Minister for Local Government and Public Health ;

the expression " the Society " means Cumann an Árachais Náisiúnta ar Shláinte ;

the expression " the Act of 1918 " means the National Health Insurance Act, 1918 ;

the expression " the Acts " means the National Health Insurance Acts, 1911 to 1942, as amended by any subsequent enactment ;

the expression " contribution year " means any period commencing on the 27th Monday in any year and terminating on the day preceding the 27th Monday in the next year ;

the expression " employed " means employed within the meaning of the Acts and " employment and " unemployed " shall be construed accordingly.

3 ..

3. These Regulations relate only to insured persons who are members of the Society.

4 Arrears not to accrue during periods of sickness, etc.

4.—(1) For the purpose of calculating under these Regulations the number of contributions paid by or in respect of an insured person, a contribution shall be deemed to have been paid in respect of each complete week comprised in any period during which, under section 3 of the National Insurance (Part I. Amendment) Act, 1917, or under sub-section (3) of section 18 af the Act of 1918, or under sub-paragraph (d) of paragraph (1) of Article 16 of Emergency Powers (No. 381) Order, 1946, no account is to be taken of arrears accruing :

Provided that—

(i) if that period exceeds one or more complete weeks four days or more, such days shall be treated as a week ; and

(ii) if that period commences on a Monday and terminates on the following Saturday, it shall be deemed to comprise a complete week.

(2) For the purposes of paragraph (a) of sub-section (3) of section 18 aforesaid—

(a) notice shall be deemed to have been given within the prescribed time in respect of any period for which sickness or disablement benefit has been paid or is payable ; and

(b) in the case of any period in respect of which no benefit has been paid or is payable, the prescribed time for giving notice shall be up to and including the 30th day of November next after the end of the contribution year in which the insured person was incapable of work or such later date as the Minister may in any particular case fix.

5 Benefit year.

5. The period within which the reduction or suspension of benefits shall take effect (in these Regulations referred to as the " benefit year ") shall be a period from the first Monday in January in any year to the Sunday immediately before the first Monday in January in the succeeding year, both days inclusive.

6 Contributions of person entering insurance in course of year.

6. In the case of a person becoming an insured person after the commencement of a contribution year, contributions shall, for the purpose of ascertaining his position with respect to arrears at the end of the contribution year, be deemed to have been paid in respect of the period between the commencement of the contribution year and the end of the week immediately preceding his entry into insurance.

7 Application to year of 53 weeks.

7. In the application of these Regulations to a contribution year comprising 53 weeks every reference in the Regulations or in the Schedules thereto to a number of contributions paid or payable for the contribution year shall be read and have effect as if the number were increased by 1.

8 Reduction of benefits of employed contributors.

8.—(1) If the number of contributions paid by or in respect of an employed contributor for any contribution year is more than sixteen, the rate of any sickness benefit payable to him during the succeeding benefit year shall be reduced by the amount appearing in column (2), or (4), as the case may be, in Part I of the First Schedule to these Regulations opposite to the group of numbers in column (1), which comprises the number of contributions paid by or in respect of him for the contribution year, and the rate of any disablement benefit payable during the same period shall be reduced by the amount appearing in column (6) opposite to the said group of numbers :

Provided that if the number of contributions paid is less than 48, he shall be entitled, within the period specified in Regulation 12 of these Regulations (hereinafter referred to as the " period of grace ") to pay to the Society by way of cancelling arrears a sum (in this Regulation referred to as the " appropriate sum ") ascertained in manner hereinafter mentioned or any less sum being 1s. or a multiple of 1s. ; and if the appropriate sum is so paid, the rates of sickness and disablement benefits payable to him shall be the same as if 48 or more contributions had been paid by or in respect of him for the contribution year, or, if any such less sum is so paid, the benefits shall be reduced by the amounts appearing in columns (2), (4) and (6) of the said Part I opposite to the amount in column (7) or (8), as the case may be, which is equal to the difference between the appropriate sum and the amount actually paid.

The appropriate sum in respect of any particular number of contributions paid for a contribution year shall be the sum appearing in column (7) (or, in the case of a woman, column (8)) of the said Part I opposite to the group of numbers which comprises the number of contributions paid for the contribution year.

(2) (i) If the number of contributions paid by or in respect of an employed contributor for a contribution year is more than 16 and less than 26 the amount of maternity benefit payable shall, during the succeeding benefit year, be 20 shillings ;

(ii) if the employed contributor is the husband of a woman who is herself an employed contributor the amount of any maternity benefit which would have been payable in respect of the woman's insurance if the husband's maternity benefit had been suspended on account of arrears shall be reduced by 20 shillings.

(3) If the number of contributions paid by or in respect of an employed contributor for any contribution year is 16 or less he shall be suspended from sickness, disablement and maternity benefits during the succeeding benefit year :

Provided that—

(a) upon payment by him to the Society during the period of grace of the sum of 12s. (or in the case of a woman, 9s.) no suspension or reduction of benefits shall be made ;

(b) upon payment of any such less sum as would reduce the sum of 12s. (or in the case of a woman, 9s.) to one of the amounts appearing in columns (7) or (8) of the said Part I as the case may be, sickness and disablement benefits shall be reduced by the amounts appearing in columns (2), (4) and (6) of Part I aforesaid opposite to the amount in columns (7) or (8) to which the sum of 12s. or 9s. has been so reduced ;

(c) if, on payment of any such less sum, the sum of 12s. (or in the case of a woman, 9s.) is reduced

(i) to 9s. (or in the case of a woman, 7s.) the amount of maternity benefit payable shall be 20 shillings ;

(ii) to 7s. or less (or in the case of a woman, to 5s. or less) maternity benefit shall be payable at the full rate.

(4) The foregoing provisions of this Regulation, so far as they relate to sickness benefit, shall apply to an employed contributor who by reason of the fact that 104 weeks have not elapsed since his entry into insurance and less than 104 contributions have been paid by or in respect of him, is entitled to a lower rate of sickness benefit, with the substitution of the amounts appearing in columns (3) and (5) for those appearing in columns (2) and (4) of the said Part I.

9 Surrender of contribution cards.

9. Save as otherwise provided in these Regulations, a contribution shall not be treated as having been paid by or in respect of an employed contributor whose contributions are payable by means of affixing stamps to contribution cards until a contribution card to which a stamp has been duly affixed has been surrendered to the Society but the contributor shall not be entitled to make any payment by way of cancelling arrears, until contribution cards to which stamps have been duly affixed in respect of any period of employment comprised in the relevant contribution year have been surrendered to the Society.

10 Reduction of benefits of voluntary contributors.

10.—(1) If the number of contributions paid by a voluntary contributor for any contribution year is more than 33, the rate of any sickness benefit payable to him during the succeeding benefit year shall be reduced by the amount appearing in column (2) or (4) as the case may be, of Part II of the First Schedule to these Regulations, opposite to the group of numbers which comprises the number of contributions paid by him for the contribution year, and the rate of any disablement benefit payable during the same period shall be reduced by the amount appearing in column (6) opposite to the said group of numbers, and if the number of contributions paid is 33 or less, he shall be suspended from sickness, disablement and maternity benefits :

Provided that he shall be entitled to cancel arrears by paying to the Society within the period of grace, any number of contributions required to make up his contributions for the contribution year to at least 39, and if arrears are so paid, sickness and disablement benefits shall be payable at the rate which would have been applicable if the arrears had been paid as contributions for that contribution year.

(2) (i) If the number of contributions paid by a voluntary contributor for a contribution year is more than 33 and less than 39 the amount of maternity benefit payable shall, during the succeeding benefit year, be 20 shillings ;

(ii) if the voluntary contributor is the husband of a woman who is herself an employed contributor the amount of any maternity benefit which would have been payable in respect of the woman's insurance if the husband's maternity benefit had been suspended on account of arrears shall be reduced by 20 shillings.

(3) The foregoing provisions of this Regulation so far as they relate to sickness benefit shall apply to a voluntary contributor who by reason of the fact that 104 weeks had not elapsed since his entry into insurance under the Acts and less than 104 contributions have been paid by or in respect of him, is entitled to a lower rate of sickness benefit with the substitution of the amounts appearing in columns (3) and (5) for those appearing in columns (2) and (4) of the said Part II of the First Schedule.

11 Allocation of contributions.

11. All contributions (including contributions paid by way of cancelling arrears) paid in respect of a contribution year by a voluntary contributor who is in arrears shall, for the purpose of determining the period for which he is entitled to remain an insured person, be allocated to, and be deemed to have been paid in respect of, consecutive weeks in that contribution year commencing with the first week of the contribution year, excluding any period of incapacity in respect of which contributions are not payable.

12 Period of grace.

12.—(1) The period of grace within which payment of a sum of money or of arrears of contributions may be made by way of cancelling arrears under these Regulations shall be the period up to and including the 30th day of November next after the end of the contribution year, or, such longer period as the Minister may in any particular case determine.

(2) If under the provisions of this Regulation the period of grace is extended, any revision of the calculation of arrears consequent upon a payment by way of cancelling arrears, or in the case of a voluntary contributor a payment of arrears of contributions, during the period of extension shall take effect on the expiration of four weeks from the date of payment or the surrender of the contribution card, as the case may be, or on such earlier date, not being prior to the date of payment, as the Minister may in any particular case determine.

13 Duty of Society to give notice of arrears.

13. The Society shall, before the 1st day of October, send or deliver to each member of the Society, being an employed contributor by or in respect of whom less than 48 contributions have been paid for the previous contribution year, and to each member, being a voluntary contributor by whom less than 50 contributions have been paid for that period, a notice containing such particulars as the Minister may approve with regard to

(a) the rates of benefits to which the member will be entitled during the next benefit year ;

(b) the amount of the payment necessary to cancel arrears ; and

(c) the effect of failure to cancel such arrears; but

except in cases where the Minister otherwise determines, no member shall be entitled by reason of the failure of the Society to send or deliver any such notice as aforesaid within the above-mentioned time, or by reason of any error therein, to any extension of the period within which such payment may be made or to any benefit or right to which he would not otherwise have been entitled :

Provided that if in the case of an employed contributor the Society sends him a notice containing particulars relating to an employed contributor, the benefits payable to the member during the succeeding benefit year shall be calculated in accordance with the terms of the notice and shall not be affected by reason that it may subsequently be ascertained that the member should, under the provisions of the next succeeding Regulation, have been deemed for the purposes of these Regulations to be a voluntary contributor.

14 Period of 40 weeks under section 18 (2) of the Act of 1918.

14. A person (including a married woman) who has not been employed for at least 40 weeks in each of two consecutive contribution years which have elapsed since the date of his entry into insurance, and who for a substantial part of the period during which he was unemployed in each such year was not employed for some reason other than incapacity for work due to some specific disease or bodily or mental disablement of which due notice has been given or inability to obtain employment shall for the purposes of these Regulations be deemed to be a voluntary contributor.

Any period of which no account is taken in calculating arrears of contributions under paragraph (2) of Regulation 4 of these Regulations shall be deemed to be a period in respect of which due notice has been given for the purposes of this Regulation.

15 Time limit for notice of incapacity under section 13 (4) of the Act of 1918.

15. For the purposes of sub-section (4) of section 13 of the Act of 1918—

(1) any period of which no account is taken in calculating arrears of contributions under paragraph (2) of Regulation 4 of these Regulations shall be deemed to be a period in respect of which notice has been given within the prescribed time ;

(2) the prescribed time shall, in the case of a person (including a deceased person), by or in respect of whom it is proved that he is or was incapable of work owing to some specific disease or bodily or mental disablement for a period in respect of which no benefit has been paid or is payable, be the period from the commencement of the incapacity to the expiration of three months after the end of the incapacity or such longer period as the Minister may in any particular case determine.

16 Recalculation of arrears in certain cases.

16.—(1) If after the expiration of any period of grace—

(a) a contribution card to which stamps have been affixed in respect of any period of employment during the contribution year to which the period of grace relates, is surrendered to the Society; or

(b) contributions are recovered by or delivered to the Minister in respect of any period of employment during that year,

the calculation of the rates of benefits payable to the contributor during the relevant benefit year shall, as from the appropriate date be revised and the benefits shall be payable from that date as if the contribution card to which stamps have been affixed as aforesaid had been surrendered to the Society or the contributions had been paid within the period of grace.

(2) For the purposes of this Regulation the expression " the appropriate date " means the date determined in the manner following:—

(a) if a card has been lost or destroyed and the contributions are credited to the Society by means of a second card issued by the Minister for the purpose, and the Minister is satisfied that the loss or destruction of the first card has not been due to any default or neglect on the part of the contributor, the appropriate date shall be such date as the Minister may direct, not being earlier than the date on which notice of the loss or destruction of the said card was given to the Minister or to the Society, or, in the case of a card lost in the post, the date on which it was posted ;

(b) if the contributions have been recovered by or delivered to the Minister, the appropriate date shall be the date of such recovery or delivery ;

(c) if a card has been delivered to the Minister, the appropriate date shall be such date, not being earlier than the date of such delivery or later than four weeks from the date on which the card is received by the Society, as the Minister may determine ;

(d) in any other case the appropriate date shall be the date of expiration of the fourth week from the date on which the stamped contribution card is surrendered to the Society :

Provided that the Minister may in special circumstances direct that the appropriate date shall be a date earlier than that specified in the relevant sub-paragraph of this paragraph.

(3) The foregoing provisions of this Regulation shall, subject to the necessary modifications, apply in the case of a card stamped by virtue of the provisions of sub-section (2) of section 13 of the Act of 1918.

17 Application to seamen.

17.—(1) The provisions of these Regulations shall apply to masters, seamen and apprentices (in this Regulation referred to as " seamen ") subject to the following modifications:—

(a) if a seaman serving on a foreign-going ship or on a ship engaged in regular trade on foreign stations (in this Regulation referred to as a " foreign-going seaman ") is employed on a voyage at the end of a contribution year, the period of grace shall in his case be the period up to the expiration of the fourth week after the termination of the voyage or the 30th day of November next ensuing after the end of that contribution year, whichever is the later date, and the relative benefit year shall not commence before the expiration of the sixth week after the termination of the voyage, the benefit year relative to the last contribution year ended before the commencement of the voyage being, if necessary, extended to the date of commencement of the first-mentioned benefit year ;

(b) if a foreign-going seaman who is in arrears is employed on a voyage on the date of the issue to him by the Society of the notice of arrears referred to in Regulation 13 of these Regulations, the period of grace applicable to him shall not in any case end before the expiration of four weeks after the date of his return to the State on the termination of that voyage, and the payment of arrears, if made, shall have effect from the commencement of the relative benefit year.

(2) In the case of foreign-going seamen the period in which under sub-section (2) of section 48 of the National Insurance Act, 1911, as amended by paragraph (b) of sub-section (1) of section 27 of the Act of 1918, four weekly contributions are, for the purpose of calculating arrears, to be treated as five such contributions shall be the period of a contribution year.

(3) In calculating for the purposes of Regulation 14 of these Regulations the number of weeks of employment of a foreign-going seaman four weeks of employment shall be treated as five.

18 Soldiers.

18. The arrears of an insured person who is in arrears at the date on which he becomes a person to whom sub-section (2) of section 13 of the National Health Insurance and Widows' and Orphans' Pensions Act, 1936 (No. 12 of 1936) applies shall be cancelled.

19 Transition from voluntary to employed insurance.

19. An insured person who, having been a voluntary contributor at the beginning of a contribution year, becomes during that year an employed contributor shall be treated for the purposes of arrears as if he had remained a voluntary contributor throughout the contribution year, unless, having become an employed contributor during the first 26 weeks of the contribution year, he satisfies the Society that he has been employed during the remainder of the contribution year, or that, if he has not been employed for any part of that period, he was unemployed by reason of incapacity for work due to some specific disease or bodily or mental disablement or to inability to obtain employment.

20 Transition from employed to voluntary insurance.

20.—(1) An insured person who, having been an employed contributor, ceases to be employed and subsequently gives notice of his desire to be a voluntary contributor shall be deemed for the purposes of these Regulations to have become a voluntary contributor at the end of the last week in which he was employed.

(2) If such notice is given after the end of the contribution year in which he ceased to be employed, but before the beginning of the ensuing benefit year, it shall be the duty of the Society forthwith to send to him a notice in accordance with Regulation 13 of these Regulations as though he was a voluntary contributor at the end of the contribution year, and he shall be entitled to pay contributions by way of cancelling arrears in accordance with the provisions of these Regulations relating to voluntary contributors before the expiration of the period of grace or of two weeks after the date of such notice, whichever date is later :

Provided that where any sum has been paid by the insured person under the provisions of these Regulations relating to employed contributors by way of cancelling arrears within the period of grace the number of contributions payable under the said provisions relating to voluntary contributors shall be reduced by the number of contributions corresponding to the sum so paid, any fraction of a contribution remaining over being treated as a contribution.

(3) If such notice is given after the beginning of the said benefit year and if less than 48 contributions are paid by or in respect of him for that contribution year, he shall be entitled during that benefit year to such benefits as he would have been entitled to if he had not become a voluntary contributor :

Provided that it shall be the duty of the Society, on receiving notice from the member of his desire to become a voluntary contributor, to send to him a notice in writing specifying the amount required to be paid by him (calculated in the manner set out in the next succeeding paragraph hereof) and the time within which such amount is payable, and, if within 14 days after the receipt of such notice the member pays to the Society the said amount, he shall continue during the remainder of the benefit year to be entitled to the benefits at the rates which would have been applicable to him if he had continued to be an employed contributor.

(4) The amount required to be paid by a voluntary contributor under the last paragraph shall be calculated as follows :—

There shall be ascertained

(i) the rates of benefit (as calculated at the end of the period of grace) to which he would have been entitled during the succeeding benefit year if he had not elected to become a voluntary contributor ; and

(ii) the number of arrears of contributions which would have been payable by him during the period of grace as a voluntary contributor in order to make up the contributions paid for the contribution year to the number required to provide benefits at those rates ; and

the sum required to be paid shall be the amount of money representing such arrears of contributions, less a number of contributions corresponding to any sum paid by the insured person during the period of grace by way of cancelling arrears, any fraction of a contribution remaining over being treated as a contribution :

Provided that if the rate of sickness benefit to which the insured person would have been entitled if he had continued to be an employed contributor is not one of the rates of sickness benefit specified in the scale contained in Part II of the First Schedule to these Regulations, it shall be treated for the purposes of this Regulation as though it were the next higher rate in the said scale, and the required sum shall be calculated accordingly.

21 Section 8 of Act of 1911 and section 12 (2) of Act of 1913.

21. Any period of incapacity during which sickness benefit has been reduced or suspended by reason of arrears shall, for the purposes of paragraph (c) of sub-section (1) of section 8 and sub-section (5) of section 8 of the National Insurance Act, 1911, as amended by sub-section (2) of section 12 of the National Insurance Act, 1913, be treated as a period during which the benefit has been paid at a rate at which it would, but for the arrears, have been paid.

22 Penalty on failure to pay levy, etc.

22. For the purposes of paragraph (b) of section 17 of the Act of 1918 the time within which a levy imposed by the Society on a member must be paid shall be the period of four weeks from the date of the issue by the Society to him of a notice in writing requiring him to pay, and, if he fails to pay such levy within that period, the rate of any sickness benefit payable to him for the benefit year commencing next after the expiration of such period shall be reduced by the sum of 6d. for each 6d. or part of 6d. comprised in the amount of the levy, and the rate of any disablement benefit payable to him for the period aforesaid shall be reduced by the sum of 3d. for each such 6d. or part of 6d.

23 Date of operation and revocation of existing Regulations.

23.—(1) These Regulations shall come into operation and have effect as on and from the 8th day of July, 1946.

(2) The National Health Insurance (Arrears) Regulations specified in the Second Schedule to these Regulations are hereby revoked with effect as on and from the 8th day of July, 1946, but without prejudice to any right or privilege acquired or accrued or any penalty, obligation or liability incurred under them prior to that date.

FIRST SCHEDULE.

PART I.

EMPLOYED CONTRIBUTORS.

PART II.

VOLUNTARY CONTRIBUTORS.

SECOND SCHEDULE.

REGULATIONS REVOKED.

GIVEN under the Official Seal of the Minister for Local Government and Public Health this sixth day of July, one thousand nine hundred and forty-six.

SEÁN MACENTEE,

Minister for Local Government and

Public Health.