s.5Compulsory health insurance
5
Section 5Part 0 —

Compulsory health insurance

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Every person resident in the Islands shall, unless that person is —
covered by a contract of insurance effected by an employer under subsection (2);
covered by a contract of insurance effected by Government under subsection (3), or where Government does not effect such a contract, medical services are provided to that person by Government in accordance with the Personnel Regulations (2019 Revision); or
an uninsurable person,
Subject to this section, every employer shall effect and continue on behalf of —
themselves;
the employer’s dependants;
each of the employer’s employees; and
the dependants of each of the employer’s employees,
Government may effect and continue on behalf of —
each officer in a pensionable office or on probation to such an office;
each officer serving under a local or an overseas contract;
Repealed by section 4 of the Health Insurance (Amendment) Act, 2010 [Law 34 of 2010];
each officer in a temporary office;
each public office pensioner;
each indigent person;
each elected member of the Cayman Islands Parliament and, where the Speaker is not a member of the Cayman Islands Parliament, the Speaker;
each past Speaker who was not a member of the Cayman Islands Parliament;
each past elected member of the Cayman Islands Parliament who is a public office pensioner; and
the dependants of any person specified in paragraphs (a) to (h),
Government may, on written application to it by or on behalf of —
a seaman fifty-five years of age or older and that seaman’s dependants;
a widow of a seaman;
a veteran and the veteran’s dependants;
a widow of a veteran;
a surviving civil partner of a seaman or veteran; or
any other person approved by the Cabinet,
Government may, on written application to it by or on behalf of a partially uninsurable person or an underinsured person, agree to pay for health care services provided to that person at a government health care facility in respect of any medical condition of that person which is the subject of an exclusion or limitation in that person’s standard health insurance contract, and that person shall, unless that person is indigent, repay the cost of such health services to the Government.
If a spouse or civil partner ceases to be the unemployed spouse or unemployed civil partner of an employee within the meaning of section 2, the obligation imposed on the employer shall, subject to subsection (7), cease to have effect.
Where an employee and the employee’s spouse or civil partner are employed by different employers, each employee may, subject to their employer’s agreement, elect which employer shall insure both of them or whether they shall be insured separately by each employer.
Subsection (1) shall not require more than one health insurance contract to be effected in respect of any person and, accordingly, if a person is employed by more than one employer, insurance must be effected on that person’s behalf and on behalf of that person’s dependants by that person’s principal employer.
Where a person is employed by two or more employers, the principal employer of that person shall be deemed to be the employer who employs that person for the most hours each week.
Where a person is employed by two or more employers and each employer employs the person for a similar amount of hours a week, the principal employer shall be that employer who first retained the services of the employee.
The children of two employees and who are employed by different employers who are spouses or civil partners of each other shall be covered under only one insurance contract which shall be determined by the employees.
The employer who is liable in accordance with subsection (11) to provide health insurance for the children of an employee shall provide health insurance for children born after such health insurance has been provided and the insurance shall cover post-natal care for a period of not less than one month after birth in those cases where the children are Caymanian or where the children are entitled to reside in the Islands in accordance with the Immigration (Transition) Act (2021 Revision).
The employer of a child shall not be required to effect a contract of health insurance in respect of a child where that child is employed on a part-time basis or only during school holidays.
Subsection (1) shall apply to every self-employed person, and every partner in a partnership shall be regarded as self-employed.
Where, after the 22nd September, 2003, an employee applies for health insurance for that employee’s spouse or civil partner as defined in paragraph (b) of the definition under this Act, that person shall provide to that person’s employer an affidavit stating that the person’s spouse falls within the definition.
Except as permitted by regulations prescribed under section 25, no underwriting is permitted under the standard health insurance contract.
A person who fails to comply with subsection (1) or (2) commits an offence and is liable on summary conviction to a fine of thirty thousand dollars, and on conviction on indictment to a fine of forty thousand dollars.

Cross References