Presentation on theme: "Department of Social Insurance: PENSIONS SECTION."— Presentation transcript:
Department of Social Insurance: PENSIONS SECTION
2 Work Responsibilities and Personnel Director, Social Insurance: Karen Daniels Assistant Director – Pensions: Calvin White Manager Compliance: Sherie Wilson Manager Contributions: Belvina Burt Acting Manager Benefits: Joy Joell Supervises: National Pensions Administration National Health Insurance Supervises: Accounting, Computerization Financial Reporting Pension Benefits Compliance Contributions Manages all compliance functions for CPF & HIP Supervises Team of 4 Inspectors Manages all aspects of benefits processing Supervises Team of 3 Benefits Processors Manages all aspects of contributions processing Supervises Team of 5 Contributions Processors & Cashiers
3 The Contributory Pension Fund Who to Call Contributions – Hot Line Ext 1117Contributions – Hot Line Ext 1117 Benefits – Joy Joell Ext 1129Benefits – Joy Joell Ext 1129 Compliance – Sherie Wilson Ext 1787Compliance – Sherie Wilson Ext 1787 Or Go Online
4 The Contributory Pension Fund Contributions Persons working 4 or more hours/weekPersons working 4 or more hours/week Employer/Employee 50/50Employer/Employee 50/50 Only employed persons liableOnly employed persons liable Contribution week Monday - SundayContribution week Monday - Sunday Contribution year 1 st Monday in AugustContribution year 1 st Monday in August One contribution per weekOne contribution per week Deducted at time of paymentDeducted at time of payment Current weekly rate $56.96/$28.48Current weekly rate $56.96/$28.48
5 The Contributory Pension Fund Benefits Contributory old age pensionContributory old age pension Widow’s allowance or widower’s allowanceWidow’s allowance or widower’s allowance Contributory disability benefitContributory disability benefit Credits of contributionsCredits of contributions Old age gratuityOld age gratuity
6 The Contributory Pension Fund Contributory Old Age Pension 65 Years of age65 Years of age Minimum pension =/> 975 totalMinimum pension =/> 975 total contributions contributions Full pension =/> 1,950 total contributionsFull pension =/> 1,950 total contributions Pro rated between 50% - 100%Pro rated between 50% - 100% Benefit month 16 th – 15 thBenefit month 16 th – 15 th Paid in arrearsPaid in arrears Payable for lifePayable for life Payable in currency of choicePayable in currency of choice
7 The Contributory Pension Fund Widow’s/Widower’s Allowance Married longer than 3 yearsMarried longer than 3 years Surviving spouse under 50 years with no children under the age of 16, benefit paid for 26 weeksSurviving spouse under 50 years with no children under the age of 16, benefit paid for 26 weeks Surviving spouse under 50 years with child or children under 16 years, benefit paid until each child is 16 yearsSurviving spouse under 50 years with child or children under 16 years, benefit paid until each child is 16 years A widow or widower who remarries or cohabits with a man/woman as her/his spouse disqualifiedA widow or widower who remarries or cohabits with a man/woman as her/his spouse disqualified
8 The Contributory Pension Fund Widow’s/Widower’s Allowance As each child attains 16 years he/she no longer qualifies for a benefit.As each child attains 16 years he/she no longer qualifies for a benefit. When surviving parent is under 50 the widow’s/widower’s allowance will stop at the end of the school year in which the youngest child is 16.When surviving parent is under 50 the widow’s/widower’s allowance will stop at the end of the school year in which the youngest child is 16.
9 The Contributory Pension Fund Widow’s/Widower’s Allowance Surviving spouse > 50 years when youngest child is 16, the widow’s/widower’s allowance paid until the surviving spouse is 65 years.Surviving spouse > 50 years when youngest child is 16, the widow’s/widower’s allowance paid until the surviving spouse is 65 years. At 65 the surviving must decide whether to retain the allowance or accept her/his pensionAt 65 the surviving must decide whether to retain the allowance or accept her/his pension
10 The Contributory Pension Fund Disability Benefit Unable to work due to physical or mental disabilityUnable to work due to physical or mental disability 18 years/gainfully employed immediately preceding the date of the incapacitation18 years/gainfully employed immediately preceding the date of the incapacitation Persons must be incapacitated for a continuous period of 52 weeksPersons must be incapacitated for a continuous period of 52 weeks
11 The Contributory Pension Fund Disability Benefit The yearly average of contributions paid by the incapacitated person is not less than 25The yearly average of contributions paid by the incapacitated person is not less than 25 Incapacity must be certified by physicianIncapacity must be certified by physician
12 The Contributory Pension Fund Widow’s/Widower’s Gratuity Widow/widower ineligible for widow’s/widower’s allowance,Widow/widower ineligible for widow’s/widower’s allowance, Equal to the total value of all contributions paid by the deceased spouse.Equal to the total value of all contributions paid by the deceased spouse.
13 The Contributory Pension Fund Gratuity Age 65 yearsAge 65 years Person does not qualify for a contributory old age pensionPerson does not qualify for a contributory old age pension A lump sum one time payment of the contributions paid by the employer and employee – without interestA lump sum one time payment of the contributions paid by the employer and employee – without interest
14 The Contributory Pension Fund Disqualification A person receiving any benefit under the Contributory Pensions Act, 1970 is disqualified for continuing to receive such benefit where he/she is undergoing imprisonment or preventive detention in pursuance of a sentence passed on conviction for an offence.
15 How much will my pension be?How much will my pension be? –Based on the average # of contributions. Why haven’t I received my pension?Why haven’t I received my pension? –Pension is paid on the 15 th. Can I take my money when I leave?Can I take my money when I leave? –Pension is payable at 65. Can I receive pension outside Bermuda?Can I receive pension outside Bermuda? –Yes except for non-contributory. Frequently Asked Questions
16 If I die where does my money go?If I die where does my money go? –To your spouse. If no spouse stays in fund. Do I get interest on my money?Do I get interest on my money? –No. Am I eligible for War Veterans Pension?Am I eligible for War Veterans Pension? –Yes, if you are Bermudian and served in the Second World War. Can I receive pension outside Bermuda?Can I receive pension outside Bermuda? –Yes except for non-contributory. Frequently Asked Questions
17 Can I get pension earlier than 65?Can I get pension earlier than 65? –No. What happens if I do not qualify for a pension?What happens if I do not qualify for a pension? –You will receive a gratuity and can then apply for a Non Contributory Pension. Frequently Asked Questions
18 Q & A
Health Insurance Plan Dept. of Social Insurance Senior’s Day Thu. June 12, 2008 Collin J. Anderson
20 Top 10 Questions 1. 1.What benefits does HIP cover? 2. 2.I have always paid my premium, but why has HIP not paid all my bill? 3. 3.Why does my premium increase every year? 4. 4.My Doctor said HIP hasn’t paid yet, why is that? 5. 5.Why does my prescription drug benefit run out?
21 Top 10 Questions (cont.) 6. 6.How do I obtain my prescription drug balance? 7. 7.How do I obtain my HIP policy number or ask general questions? 8. 8.Can I pay my HIP premium online? 9. 9.What is the difference between HIP and GEHI? Does HIP offer Dental coverage?
22 1. What Does HIP Cover? HIP benefits include: a.Standard Hospital Benefits & b.Supplemental Medical Benefits Please collect one of our brochures at the HIP table in the rear
23 A. Standard Hospital Benefits KING EDWARD VII MEMORIAL HOSPITAL In-patient Stay (public ward rate)In-patient Stay (public ward rate) Out-patient treatment:Out-patient treatment: Emergency treatment (ambulance-in)Emergency treatment (ambulance-in) LaboratoryLaboratory Nuclear MedicineNuclear Medicine Diagnostic ImagingDiagnostic Imaging X-ray Ultrasound C.T. Scan M.R.I Rehabilitation Treatment UnitRehabilitation Treatment Unit Home Health CareHome Health Care Kidney Transplants (up to $30,000)Kidney Transplants (up to $30,000) Dental treatment for persons with medical or mental illnessDental treatment for persons with medical or mental illness Artificial Limbs & Appliance (life-time benefit of up to $15,000)Artificial Limbs & Appliance (life-time benefit of up to $15,000)....AND.....BENEFITS ARE PORTABLE OVERSEAS !!!
24 Mid-Atlantic Wellness Institute In-patient treatment (40 days per year) In-patient detoxification (alcohol and heroin) included under Mid-Atlantic per diem. Unlimited out-patient treatment
25 Standard Hospital Benefits (cont.) SERVICES AT PRIVATE FACILITIES DIAGNOSTIC IMAGING Bermuda Tb., Cancer & Health Association Bermuda Healthcare Services Ltd. Bermuda Eye Institute (Dr. L. Teye-Botchway) Dr. Charles Dyer Dr. Alicia Stovell
26 What are SHBs? Standard Hospital Benefits (SHB) = treatment in hospital in Bermuda ( All local insurers must provide SHB at minimum) Additional benefits beyond this are known variously as ‘supplemental’ benefits or ‘major medical’ The Bermuda Health Council (BHeC) has remit over SHB determination HIP = SHB + Supplemental Medial Benefits (SMB)
27 B. Supplemental Medical Benefits Physicians & Specialists Four (4) Office Visits per year (at $42 each) Home Visits (up to 4 visits per month) ($82) Pre-admission consultation ($100) GPs In-patient visits (up to $704) Anesthesia (in hospital) (up to $1,042) Internal Medicine Specialists (up to $1,461) Surgery (in hospital) (up to $1,880) Obstetrics ($3,061) PRESCRIPTION DRUGS up to $1,200 per year up to $1,200 per year (for persons 65 years +)
28 Supplemental Medical (cont.) Private Laboratory Facilities Lab Test Benefits: C&S WestC&S West Central DiagnosticsCentral Diagnostics Family Medical ServicesFamily Medical Services Island Health ServicesIsland Health Services Point Finger Road Medical LabPoint Finger Road Medical Lab Woodbourne Medical LabWoodbourne Medical Lab
29 Supplemental Medical Benefits (cont.) CARDIAC SERVICES Cardiac Investigations and diagnostic services at non- hospital facilities
I paid HIP, shouldn’t HIP pay all my medical bills? HIP is designed to be a basic health insurance plan. HIP is not major medical. Benefits are limited to ensure the premium is affordable.
31 Bermuda’s Health Insurance System STANDARD HOSPITAL BENEFITS (minimum health care required for all working persons HIA 1970) Premium = $164.36/mo App Sche mes self Insure GEHI (major medical benefits) Premiu m = $400+/ mo COMMERCIAL INSURERS (major medical benefits) Premium = $400+/mo HIP Premium = $218.61/mo or $ for o/65 KEY SHB ex MRF= $ MRF = SHB = SMB = to MM = 200+ SHBs paid via Mutual Reinsurance Fund Premium = $22.84 Market Share Depth of Coverage/ Scope of Benefits
32 3. Why does HIP premium increase every year? Premiums increase to cover rising claims costs Medical inflation contributes to increases Hospital rates in Bermuda increase between 4 and 7 % annually In years where claims losses are lower, new benefits are normally added One of HIP’s goals is to be financially prudent
33 HIP Premium 2008 Under 65 = $ Over 65 = $ Over 65 (Non-subsidy) = $ Standard Premium 2008 SHB Premium = $187.21SHB Premium = $ (Inclusive of 2008 MRF Premium of $22.84)(Inclusive of 2008 MRF Premium of $22.84) SHB Non-subsidy, over 65 = $680.32SHB Non-subsidy, over 65 = $ Deductions Regs. = $21.60Deductions Regs. = $21.60
34 4. My Doctor said HIP hasn’t paid yet… Why? HIP has stated publicly that it had administrative problems over the years. In 2007, HIP implemented an aggressive plan to address claims arrears. Most Doctors and service providers have reported improvements in HIP’s claim payments The arrears project is nearing an end in the next two months…
35 HIP hired 15 new staff members in 2007 * = permanent staff
36 Outstanding Claims by Fiscal Year
37 HIF & MRF PAYMENTS
38 Claims Payment Progress CLAIMS TYPE JUNE 2007 JUNE 2008 Hospital (BHB) 3 months arrears Current (since Sep. 2007) PharmacyCurrentCurrent Physicians & Facilities $2 to $2.5M arrears $1 to $1.5M arrears Overseas (Portability) Argus, Colonial, BF&M, LCCA, British American & GEHI (approx. $7.54M) BF&M & LCCA at 50% (approx. $3M)
39 5. Why does my prescription drug benefit run out? HIP provides a prescription drug benefit of $1,200 per annum to Seniors This is an extremely costly benefit for the Fund to sustain This benefit, like all HIP benefits, must be limited to maintain the financial balance of Fund Currently, prescription drugs required beyond the $1,200 limit must be paid out-of-pocket
40 6. How do I obtain my prescription drug balance? A. A.You can obtain this information today at the HIP table in the rear B. B.You can obtain this information any other time by calling: C. C.Also, all local pharmacies receive this information from HIP on a regular basis
41 7. How do I obtain my HIP policy number or ask general questions? You can obtain this information today at the HIP table in the rear Or Call HIP at:
42 8. Can I pay my HIP premium online? Online payments are now possible for HIP premium payments through Easypay and Bank of Bermuda online banking and ATMs. Butterfireld Direct is a payment option that will be available shortly
43 9. What is the difference between HIP and GEHI ? GEHI is health insurance for government employees and retirees only. HIP is the health insurance offered to the public by Bermuda Government as an affordable option to meet your basic healthcare needs.
Does HIP offer Dental coverage? Starting August 1, 2008, HIP will be adding three (3) additional benefits: Basic Dental; Specialist procedures outside the hospital; Increased Kidney Transplant benefit. You can obtain more information at the HIP table…