Lifetime Community Rating (LCR) Regulations, S.I. No. 312 of 2014, became applicable with effect from 1 May 2015. Under LCR, community rating is modified to reflect the age at which a person takes out private health insurance. Late entry loadings are applied to the premiums of those who join the health insurance market at age 35 or over. The LCR Regulations stipulate that no loading is applied to an insured person if, on 1st May 2015, the person had a continuous period of cover in an in-patient indemnity health insurance scheme prior to that date. The primary purpose of introducing LCR is to encourage people to purchase health insurance at a younger age.
The regulation governing the LCR loadings applies equally to all citizens of the State irrespective of the nature of any health care provided by their employer. Many employers provide a range of health benefits to employees and not necessarily as part of a regulated healthcare insurance product. It is a matter, therefore, for each citizen to decide whether they wish to take out private health insurance in order to avoid additional loadings for taking out insurance after the age of 34.
Commissioned Officers are currently provided with private health care by the State, i.e. they can be referred by the Defence Forces for private/semi-private treatment in civilian hospitals or private consultant’s rooms, where it is deemed necessary.
The position of members of the Defence Forces with regard to the LCR Regulations has been raised with the Department of Health, both at official and Ministerial level. Meetings have been held between officials from the Department of Defence and the Department of Health on 30th April 2015 and 8th January 2016 to discuss the issue.
The Department of Health stated that the Irish private health insurance regulatory system is based on the key principles of community rating, open enrolment, lifetime cover and minimum benefit. Community-rated insurance markets depend on a continuing entry of younger people to help keep premium prices down for everybody. The Department of Health considered that the arrangements in place for Defence Forces personnel do not comply with health insurance legislation or its key principles. It considered that there has been no impediment to member of the Defence Forces purchasing indemnity health insurance as a means to avoid loadings similar to any other citizen. It stated that no waiver provision exists in the regulations and that any fair and equitable consideration of a waiver for one group requires consideration of other groups whose employers provide similar health benefits separate to indemnity contract arrangements. Even if such an arrangement was deemed appropriate, a waiver provision would require to be enacted in primary legislation. The Department of Health cannot see any basis or mechanism for a waiver to be put in place such that officers could avoid loading when they come to purchase health insurance on retirement from the Defence Forces.
The Department of Health has undertaken to forward to the Health Insurance Authority the concerns of the Defence Forces regarding LCR for consideration as part of a planned independent review of the operation of the LCR Regulations scheduled for 2017.
