James Reilly (Dublin North, Fine Gael) | Oireachtas source

I move amendment Nos. 13:

In page 17, line 3, to delete "11F" and substitute "11G".

Section 15 is an amendment to the principal Act and inserts a new section 11A to 11F. Section 11A provides for a risk equalisation scheme for the purposes of assisting in the achievement of the principal objective. Section 11B sets out to whom the scheme will and will not apply. Section 11C includes a provision taken in conjunction with Schedules 3 and 4 to make payments from the fund of credits in respect of a hospital utilisation charge and the amount of premium to be paid from the fund in respect of age, sex and type of cover. The rate of risk equalisation credit for 2013 to apply in respect of the amount of premium to be paid from the fund in respect age, sex and type of cover will also be inserted into Schedule 4 on Report Stage.

Section 11D empowers the HIA to establish a fund as well as setting out what will be paid into and out of the fund. It also provides that for the purpose of maintaining a sufficient amount of moneys, the Minister for Finance may advance funding to the HIA through a special account. Section 11E requires the HIA to categorise each type of health insurance contract to allow for appropriate risk equalisation credits and stamp duty payments which will apply in respect of advanced and non-advanced levels of types of contracts. The HIA will make regulations accordingly and enter the particulars in the register of health insurance contracts.

Section 11F provides that the Minister will make regulations relating to the making of claims for risk equalisation credits under the scheme. Provisions for a risk equalisation scheme are set out in this section as well as who it applies to, how it will operate and how an insurer can make a claim for risk equalisation credits. The section provides the HIA with powers to establish and operate the risk equalisation fund as well as power to make regulations specifying which products it determines to be non-advanced cover.