What is the Standard Premium Rate (SPR)?
The SPR, which includes the Standard Health Benefit (SHB) as well as the Mutual Reinsurance Fund Premium (MRF), covers the cost of all local hospital services provided by the BHB as well as certain Community Out-Patient Services.
What is changing?
1. MRF Increase
The Bermuda Government has passed legislation that will increase the total cost of the SPR, as shown below:
Your Health Premium
Cost as of Nov 1, 2021
|Argus Supplementary Premium||Your current rates||No change to your current rates||No changes to your current rate|
While the government reserves the right to change the SPR, both in benefits and price at any time, it is just one component of your total health insurance premium. The other is your Argus Supplementary Premium, which will not increase at this time.
2. Daily Reporting for Health Insurers
As a health insurer, we must provide daily eligibility lists to the BHB, confirming that each insured plan member’s SPR has been paid for the relevant reporting period, including dependent spouses, children and certain retirees.
How does this impact my company and employees?
1. Employee Eligibility for BHB Services
As of November 1, 2021, if you are not up to date with your employee’s premiums, they will be charged out-of-pocket for hospital services, based on pricing set by King Edward VII Memorial Hospital.
2. Census Reporting Requirements for Employers
Employers must provide accurate employee census data for all employees, dependent spouses and children, without delay. This means advising immediately if an employee has been hired or terminated, or if a dependent is added to or removed from the policy. This will ensure the correct SPR, inclusive of MRF premium, is collected for the relevant period.
If a member is listed as active, then their SPR is due for that month. This is mandated by the Government, and it is not possible to retroactively void a member and their associated premium. To avoid paying for members that are no longer on your policy, all terminations must be in synch with our employee census data.
Employee census updates should be immediately emailed to firstname.lastname@example.org and must include the following:
• Employee Name
• Date of start or termination
• Addition or removal of dependent spouses and/or children, if applicable
3. Terminating Employees
Since 1971, legislation has required that all employers continue to provide terminated employees with health insurance equal to no less than the SHB for up to 28 days after termination (regardless of reason for termination). Failure to do so can result in a $500 fine, per offense.
Employers are only required to pay the SPR if there is a gap in insurance coverage between one employer to another.
All employers must alert Argus at least two weeks in advance of an employee’s termination date, specifying if the 28-day extension is required, to ensure the correct SPR for that member is included in the next billing cycle.
We're here to help
Our team is here to guide you through the process. If you have questions, please feel free to contact your Relationship Manager directly or our Customer Service Centre at 298-0888 or email email@example.com.
To learn more about the SPR increase, please visit the Bermuda Health Council at https://bhec.bm/standard-health-benefit/