JIS News

Although 49,000 pensioners have already registered to receive benefits under the National Insurance Scheme NIGold Health Plan, Director of National Insurance in the Ministry of Labour and Social Security, Denzil Thorpe says the Ministry is still not satisfied with these figures.
He points out that the Ministry is actively targeting the remaining 30 per cent of pensioners who are yet to access the health plan.
Mr. Thorpe tells JIS News that although the Ministry has been unable to identify a specific reason for the shortfall in the number of registered pensioners for the Plan, they are looking at several strategies, including direct mailing to try to boost registration numbers.
He explains that the benefits extended under the NIGold are for persons who are in receipt of a National Insurance pension, and therefore, the Ministry can use its database to identify and directly target those pensioners who have not yet registered.
The National Insurance Director notes that initially, “we actually targeted directly on a wholesale basis. we sent letters and temporary cards to every single NIS pensioner on our database”.
The direct mailing and other public education initiatives resulted in the registration of 70 per cent of the pensioners. “Now that the numbers are smaller, we may again target the 30 per cent directly to see if they probably had not heard or didn’t understand the message that we are trying to convey,” Mr. Thorpe says.
He points out that findings of the Ministry reveal that a majority of unregistered pensioners reside in the Kingston and St. Andrew area, “and we are actually looking at that as well, to see if where persons are living has anything to do with why they are not registering”.
He says that in addition to examining possible causes for low registration, the Ministry has commissioned a study by its consulting actuaries to determine whether or not the National Insurance Fund has the capacity to accommodate increases in the levels of benefits payable under the NIGold. This is in addition to a recent announcement by the Labour and Social Security Minister, Horace Dalley, that the basic rates payable to pensioners would be increased, effective April 3.
The NIGold is a health plan for NIS pensioners funded by the National Insurance Fund and is administered by Blue Cross of Jamaica. The programme came into effect in December 2003. Upon implementation of the plan in 2003, temporary paper health cards were distributed to all pensioners to access benefits. However, effective April 1, 2005 electronic swipe cards were introduced for use by pensioners who have registered at the Electoral Office.
Mr. Thorpe likens the NIGold to other health plans offered by insurance providers, noting that the pensioner now use the swipe cards at pharmacies, medical laboratories, doctor’s offices or any other Blue Cross provider, to access services such as prescription drugs, dental and optical services, or diagnostic services. There are set annual maximum benefit levels for cardholders in three categories: $4,000 per annum for prescription drugs; $3,000 for diagnostic services and $2,000 per annum for dental and optical services. He notes that the NIGold pays $500 for a doctor’s visit and also covers in-hospital care up to $800 per night for room and board and $6,000 for miscellaneous expenses.
“Where a pensioner has to undergo surgery, we pay a surgeon’s fee of up to $30,000, assistant surgeon’s fee, and anaesthetist’s fee of up to $12,000. To access these benefits the beneficiary needs to make a $1,000 co-payment for the surgeon’s fee and a $500 co-payment each for the assistant and the anaesthetist,” Mr. Thorpe explains.
As for plans to improve the existing NIGold Health Plan, he says one of the primary elements of the programme that he would like to refine is the length of time it takes to process the application and to deliver the swipe cards. He notes that currently, the turnaround time for applicants to receive the card varies, and some delays were experienced as a result of the mass registration that took place when the programme began.
Ideally, Mr. Thorpe says he would like to see a maximum turnaround time of four weeks for pensioners to be able to pick up swipe cards at the Electoral Office after they have registered.
To date, approximately $450 million has been expended by the NIGold Plan in utilisation fees.
In the meantime, the National Insurance Director is advising pensioners that their benefits under NIGold will be renewed on April 1 this year.
“All the annual benefits will be renewed on April 1. I want to point out to the pensioners as well, that if they already have a swipe card, it is that same card that they should use after April 1 to access their benefits. Therefore, they don’t need to get a new swipe card nor do they have to go back to the Electoral Office to register again. What will happen is that the balances will be automatically reset,” Mr. Thorpe informs.
In respect of persons who have not yet registered for the programme, he says such persons need to visit the Electoral Office nearest to them to do so. If the pensioner is infirmed and thus unable to go to the Electoral Office, he/she or an agent can contact the nearest Electoral Office or the Ministry of Labour and Social Security/NIS office in their parish to arrange for a home visit.
“The Electoral Office of Jamaica (EOJ) has actually registered several pensioners in their homes where they are unable to go to the office themselves. That is part of the reason that we opted for the EOJ to carry out the registration process on our behalf, because they do that sort of home visit as a part of their normal activities,” Mr. Thorpe explains.