How do the Government changes to Hospital funding impact my premiums?
BF&M manages two of the three components of your premium - the SHB and the supplemental benefits. We utilise various claims management practices to help to reduce costs, facilitate data analytics, and serve as an important check and balance to the health system. Some of these practices include: monitoring billing practices, tracking diseases, and ensuring treatment is given according to approved standards of practice.
Prior to June 1st, 2019, this allowed BF&M to participate in the management and administration of all on- and off-island health care services. Your premium was based on the overall risk profile and expected claims experience of your group, including both supplemental benefits and mandated Standard Health Benefits, in addition to the costs of administration and claims processing and the Government MRF fee.
Effective June 1st, 2019, the Government change means that basic hospital benefits will no longer be included in the claims experience of your group, or included in your risk-rated premium calculations. Instead, they are now included under the mandated MRF fee, a large portion of your total premium, which is based on the community-rated experience of all insureds in Bermuda.