Mandatory health insurance set for early 2019 roll-out

MUSCAT, SEPT 24 – An estimated 2.09 million Omani and expatriate employees of private sector establishments in the Sultanate will be eligible for Mandatory Health Insurance coverage, which is proposed to be implemented in a series of stages starting from early next year. Details about the keenly anticipated scheme — due to be rolled out for the first time in the Sultanate — were presented at the 12th Middle East Healthcare Insurance Conference that opened at the Sheraton Oman Hotel yesterday under the auspices of Dr Ali bin Masoud al Sunaidy, Minister of Commerce and Industry. The two-day forum, focusing on the theme ‘Evolution Strategies to Make Compulsory Health Insurance Sustainable and Successful’, has been jointly organised by the Capital Market Authority (CMA) and the Middle East Insurance Review.

In his keynote address, Abdullah Salim al Salmi (pictured), Executive President — CMA, said the compulsory health insurance scheme will be rolled out gradually in as many as five stages encompassing Omanis and expatriate employees of private firms. However, for dependants of these employees, health insurance coverage will be the prerogative of the employers concerned and subject to negotiation between the two parties, he said.
Tasked by the Council of Ministers to implement a cost-effective and quality-based mandatory health insurance system for private sector staff, the CMA has taken all necessary steps to develop a roadmap for its rollout after identifying all of the stakeholders and after taking into account international experiences in the conceptualisation of the scheme, said Al Salmi.

“Over the past year, the CMA has been working to prepare the right climate conducive to the growth of a competitive health insurance industry taking root in the Sultanate,” the Executive President said. “We worked with the relevant government authorities and stakeholders to develop a roadmap and identify a timeframe for the implementation of this scheme.” In developing the mandatory health insurance system, the Authority has sought to minimise the resultant cost burden on private sector firms, while at the same time making sure that quality in service delivery was not compromised.

“We seek the cooperation of all stakeholders — private healthcare service providers, insurance firms, and so on — to maximise quality and minimise cost,” said Al Salmi. Additionally, the CMA is working on a ‘Unified Draft Health Insurance Policy’ that ensures basic healthcare, as well as emergency services, coverage for employees. The model policy has been designed to, among other things, eliminate the potential for misinterpretation and confusion, as well as deter potential abuse. Besides, it allows for flexibility in the incorporation of supplementary coverage provided by some employers to their staff. The mandatory health insurance system, he further noted, will be underpinned by a regulatory framework that will be designed to accommodate any changes or modifications to the scheme in the future.

It will espouse transparency in the pricing of policies, as well as healthcare products and services provided by service providers. Besides, it will seek to secure the interests of both insurers and the insured alike. Importantly, the new scheme is designed to stimulate the growth of healthy competition between insurers and service providers, boost efficiency, build capacities within the insurance industry, and incentivise the rollout of innovative products and services. Longer-term, the initiative will drive new investment in private healthcare infrastructure, thereby contributing to job creation and national economic development, he added.

Conrad Prabhu