On Nov. 28, the Social Security Board started suspending National Health Insurance benefits for workers whose employers are behind in their NHI payments.
This move, however, violates the law.
“It’s a strategy we’re using,” said Roy Barry, the head of the SSB’s NHI Division, explaining that the SSB has been threatening to suspend benefits to employees in an attempt to pressure their bosses to pay up.
Knowing your rightsBesides protecting workers whose employers fall behind in National Health Insurance payments, NHI legislation gives residents other rights, too. For instance, businesses are required to maintain records showing the date and amount of the wages they’ve paid to workers, as well as the amount they’ve contributed to NHI. By law, workers are allowed to inspect those records once every three months. Moreover, employers are required to provide each worker with a certificate within 30 days from the end of each year, showing how much of the worker’s wages has been contributed to NHI; how much has been deducted from the worker; and the number of weeks of the year in which the worker was insured, according to the NHI regulations. SSB Deputy Director Jeanette Scatliffe Boynes said that it’s important for residents to know their rights, and that anyone with questions should contact the SSB. “They should check the contribution status,” she said. “They should call the NHI office or come in, or they can ask their employer what their status is.” However, the fear of employer retaliation is putting a chilling effect on the willingness of some workers to speak up, she said. “A number of employees are hesitant to do that, and those calling in are saying, ‘Please don’t let my employer know that I called,’ because they feel that there would be some sort of kickback from the employer,” she said. “So we’re telling them to save their pay stubs. And once they can prove they’re being deducted, we’re telling them that we’ll honour your claim.” |
To a certain extent, the strategy has proven successful: SSB Deputy Director Jeanette Scatliffe Boynes said some 250 of about 1,000 delinquent employers are now current on their payments.
Nevertheless, the SSB’s actions appear to be outside the scope of its lawful authority, and may be misleading residents about what rights they have when it comes to health care.
Threats
On Nov. 16, the SSB announced a new policy intended to curtail delinquency.
“To avoid suspension of their employees’ NHI benefits, employers must make the full outstanding contribution payment no later than November 28,” the SSB’s announcement warned. “Suspended benefits will only be reinstated when full payment of the outstanding amount is made.”
But according to the regulations governing the NHI, employees’ coverage shouldn’t be affected because their employers fall behind in paying their taxes.
“The failure of an employer to pay contributions in respect of an employee … shall in no way affect the benefits that an employee is entitled to under the NHI System,” states NHI Regulation 31.
Moreover, delinquent businesses are liable for any health care expenses incurred by their employees, according to the 2014 amendment to the Social Security Act that established the NHI fund.
Shortly before NHI took effect at the start of this year, government also assured the public that employees wouldn’t be affected if their bosses are in arrears.
“If an employer has not paid any contribution that he is liable to pay for any particular month, he shall be liable to pay a surcharge equivalent to 10 percent of the amount of the contributions he was liable to pay,” Petrona Davies, the permanent secretary for the Ministry of Health and Social Development, stated in a September 2015 e-mail response to a Beacon inquiry. “The failure of an employer to pay contributions in respect of an employee as prescribed shall in no way affect the benefits that an employee is entitled to under the NHI system.”
Neither Ms. Scatliffe Boynes nor Mr. Barry provided any provisions in the law that give the SSB power to contravene this rule.
Suspension
Nevertheless, some employees’ NHI has been suspended, according to those officials.
Ms. Scatliffe Boynes said she received three phone calls on Dec. 13 from people whose claims weren’t processing.
“One was at the dentist and the [NHI] card wasn’t working, and two were at the doctor. And what happened is that they were told their card wasn’t going through,” Ms. Scatliffe Boynes said.
The SSB deputy director added that those employees can still receive benefits, but will have to pay their claims up front and then be refunded by NHI.
“What I told them is that if they could pay the bill and file the claim, the refund would be granted to them,” she said.
It is unclear what would happen if those employees aren’t able to pay their claims up front.
“That’s what I’m trying to find out now: I don’t know,” Ms. Scatliffe Boynes said.
The courts
While the SSB may be on tenuous legal grounds in implementing the suspensions, Ms. Scatliffe Boynes explained that the mere threat of suspension has resulted in many businesses coming current on their NHI payments.
Other possible avenues for collecting from delinquent employers include taking them to court. However, Ms. Scatliffe Boynes said litigation could take years, which is why officials are pursuing the current suspension strategy.
But if those businesses know the SSB can’t actually suspend benefits, that threat loses its teeth — something the deputy director acknowledged.
“Probably 90-plus percent of [delinquent employers] have deducted the money [from their workers] — I’m sure, I’m certain — and they have not paid it in,” she said. “And we don’t want to put them in a relaxed mode that, ‘Hey, I’m not coming in to pay because they can’t suspend and my employee is going to be fine.’”
Whether the SSB will continue its suspension policy remains to be seen. Ms. Scatliffe Boynes said her agency is consulting with a private law firm — it turned to the private sector because the Attorney General’s Chambers might take a while in returning with advice — and hopes to receive advice for moving forward by the end of this week.
“In terms of the legal logistics of that, we are working with our attorneys to see where the loopholes are and what we need to tighten up,” she said. “Maybe when the lawyer gets back to us, she would indicate that the regulations need to be amended, and we’ll have to do the amendments if [suspension is] the way we want to go.”
Ms. Scatliffe Boynes added that she would like the SSB to take alternative measures besides suspending benefits.
“I personally don’t like that way, and I’m hoping they’ll come up with something that gives us more force to get the employers to pay,” she said. “Suspension is not the way to go.”
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