Private health insurers refund State subsidy scheme €262,000

Report by Health Insurance Authority finds insurers are largely compliant with legislation underpinning Risk Equalisation Scheme

The State-backed subsidy scheme worth hundreds of millions of euro to the health insurance sector has been refunded €262,000 after an inspection found some insurers committed minor breaches where policies were not fully compliant with regulations.

The Health Insurance Authority (HIA) on Monday published the findings of its Risk Equalisation Scheme Inspection of Registered Undertakings, which was carried out in 2021 for the period 2020.

The HIA inspected registered health insurance companies in Ireland and their compliance with the obligations under the Risk Equalisation Fund, which has an annual value in excess of €800 million.

Overall, the HIA’s findings showed that the three health insurance companies that were inspected — VHI Insurance, Elips Versicherungen and Irish Life Health — were “largely compliant” with the Health Insurance Act.

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All three insurers have the appropriate policies, procedures and controls in place in respect to claims made to the fund.

The HIA, however, identified areas where some insurers’ applications of policies “were not fully compliant with regulations”. These findings were issued to the relevant insurers in January 2022.

Recommendations were made by the HIA to the relevant insurers following the inspection results. A resolution is now being put in place regarding two of the findings, and a refund was made to the Risk Equalisation Fund of €262,000.

Regarding the third finding, the HIA is engaging directly with the registered insurers, and a specific timeline for resolution has been agreed upon.

The HIA also published its first-quarter report on the health insurance market. Key findings show the market continues to grow, with 47.5 per cent of the population holding private health insurance. It has grown from 2,365,332 at the end of 2021 to 2,388,860.

Other findings include that the number of plans on the market has increased from 321 to 325, while the average adult premium is €1,450. The first quarter has seen an average price reduction of 1 per cent across like-for-like plans.

Colin Gleeson

Colin Gleeson

Colin Gleeson is an Irish Times reporter