Impact on Employees with Change in Employer-provided Insurer

The following question stood in the name of Dr Tan Wu Meng –

12 To ask the Minister for Manpower what channels of appeal and support are available to workers with employer-provided healthcare insurance when the employer-provided insurer has changed and the affected workers are no longer covered for conditions which the previous insurer covered.

Ms Tin Pei Ling (MacPherson): Question No 12.

The Minister for Manpower (Dr Tan See Leng): Mr Deputy Speaker, Sir, employers may choose to provide health insurance to their employees as an employee benefit. There is currently no statutory requirement for employers to do so. Where such benefits are contractual, any changes should be agreed to by both parties.

Tripartite partners recommend that for employers who wish to provide medical benefits to their employees, they could adopt the Portable Medical Benefits Scheme (PMBS) and provide additional contributions to their employees’ MediSave accounts instead of insurance. These additional contributions can then be used by employees to purchase their own insurance plans. The PMBS makes healthcare costs more predictable and sustainable for employers. As the scheme's name suggests, employees can also enjoy portability of medical benefits where coverage continues with no risk of exclusions even if their employment situation changes.

Regardless of coverage under employer-provided healthcare insurance, all Singapore Citizens and Permanent Residents are covered under MediShield Life. MediShield Life provides lifetime protection against large hospitalisation bills and selected costly outpatient treatments such as dialysis and chemotherapy, without exclusions for pre-existing conditions. Singaporeans who face difficulties in paying for their remaining medical bills after Government subsidies, insurance and MediSave can approach medical social workers at public healthcare institutions for further assistance.

Mr Deputy Speaker: Dr Tan Yia Swam.

Dr Tan Yia Swam (Nominated Member): I thank Dr Tan See Leng for the reply. I would like to ask two supplementary questions. One is, there is some confusion on the ground, among friends, lay people and even some doctors, between insurance plans for Shield plan versus employee-benefit types of plans. Is there a way to better educate our people on what exactly these different insurance covers are?

My second question is: as the Multilateral Healthcare Insurance Committee (MHIC) is reviewing problems with the Shield plan providers and doctors, will there also be a way to relook how third-party administrators of employee-benefit plans could be better regulated?

Dr Tan See Leng: I thank Dr Tan Yia Swam for her questions. Indeed, education is going to be key in terms of how we advise our employees to navigate between the insurance plans as well as the Shield plans. And I believe that is something that we can look into under the auspices of Ministry of Manpower (MOM). However, we should be working with the tripartite partners, namely, the Labour Movement, together with the Singapore National Employers Federation (SNEF), ourselves, and, perhaps, even bringing in the Ministry of Health (MOH) to work together to collectively come up with very clear communication and educational principles and discussion groups, so that we can communicate some of these policies fairly, clearly and effectively.

On plans to look at third-party administrators, again, this cannot just be isolated to one or two Ministries. The third-party administrators have been in existence for quite a number of decades now. To work collectively to make sure that we find a more nuanced approach involves even the trade associations. In this particular setting, we need to involve professional associations, for instance, like the Singapore Medical Association, and if you want, to even extend it to the Primary Care Network, probably the College of Family Physicians and, perhaps, the Academy as well, to get them involved in coming up with a more nuanced and middle-of-the-path kind of approach involving the providers, third-party administrators, payers and also the patients who are, ultimately, the end-user of the entire system.

So, it is not something that we can decide in one Sitting. Perhaps, it is something that the industry should come together and work towards.

Mr Deputy Speaker: Mr Melvin Yong.

Mr Melvin Yong Yik Chye (Radin Mas): Thank you, Mr Deputy Speaker. I thank the Minister for the answers. There are workers whose employer medical benefits come from an insurer. In some instances, the employer's insurer changed and the new insurer no longer covered what the old insurer would cover. For employees who are so affected, how can they get help? Often, they do not know until they submit a claim and they find that the terms and conditions have changed.

Beyond PMBS, which the Minister has cited, are there other best practice recommendations which TAFEP, MOH and the Monetary Authority of Singapore can work on, so that the insurance industry can have a more consistent practice including providing avenues for workers to get help? The NTUC would be happy to work with MOM and SNEF to promulgate these best practices.

Dr Tan See Leng: I thank Mr Yong for his very pertinent question. It is important to note that, today, as I have shared in my earlier reply to the Parliamentary Question, there is no requirement for employers to-date to do so. However, Tripartite Alliance for Dispute Management can step in to offer advice through, for instance, if the Labour Movement has collective agreements signed between the employees whom they represent and the employer. We certainly can step in to see how we can bring the parties together. But, today, there is no legal requirement for them to do so.

We obviously aspire that employers continue to take a very enlightened, engaging approach in terms of dealing with the medical benefits and the coverage for all of their employees, particularly when it comes to collective agreements. And we hope that all parties would come together. But we understand the challenges because we are also in the situation whereby the cost of healthcare continues to increase. And, hence, the Government, on our part, has a slew of different initiatives to help our local Singapore Citizens and the Permanent Residents. But we are happy to work with the union looking at some of these collective agreements, to see how we can step in to advise and bring both parties to a middle ground. I hope that answers the question.

Mr Deputy Speaker: Mr Louis Chua, next question, please.