Health Insurance Act 1994

11C

F96[Payment from Fund of risk equalisation credits.

11C.(1) (a) Where a registered undertaking effects, before 31 March 2013, a relevant contract for any period commencing on or after 1 January 2013, it shall, in respect of each insured person who falls within a class of insured person specified in column 1 of Table 1 set out in Schedule 4, not collect from the policy holder such part of the premium payable (or, if that premium is payable by instalments, not so collect pro rata from the instalments) in respect of the provision of health insurance cover under that contract to that person—

(i) as is equal to the amount (if any) specified in column 2 of that Table opposite that class of insured person, and

(ii) on the basis that that part of the premium payable is payable from the Fund.

(b) Where a registered undertaking effects, on or after F97[1 April 2023], a relevant contract for any period commencing on or after that date, it shall, in respect of each insured person who falls within a class of insured person specified in column 1 of Table 2 set out in Schedule 4, not collect from the policy holder such part of the premium payable (or, if that premium is payable by instalments, not so collect pro rata from the instalments) in respect of the provision of health insurance cover under that contract to that person—

(i) as is equal to the amount (if any) specified in column 2 of that Table opposite that class of insured person, and

(ii) on the basis that that part of the premium payable is payable from the Fund.

(2) F98[Subject to subsection (2A), a registered undertaking or former registered undertaking may] in accordance with the regulations under section 11F, make a claim to the Authority to be paid an amount equal to its risk equalisation credits for the period to which the claim relates.

F99[(2A) A claim (or a part thereof) for a payment shall not be made to the Authority by a registered undertaking or former registered undertaking under subsection (2) if entitlement to the risk equalisation credits to which the claim (or a part thereof) relates arose more than 6 years before 31 March in the period of 12 months prior to the date of the making of the claim.]

(3) Where the Authority receives a claim referred to in subsection (2) from a registered undertaking or former registered undertaking, it shall, in accordance with the regulations under section 11F, pay out of the Fund to the undertaking that amount that the Authority is satisfied is so payable, in accordance with the Risk Equalisation Scheme, in respect of the risk equalisation credits to which the claim relates.

(4) Information concerning the amounts of stamp duty paid by registered undertakings or former registered undertakings pursuant to section 125A of the Stamp Duties Consolidation Act 1999 shall, at the request of the Authority, be disclosed to the Authority by the Revenue Commissioners or a Revenue officer (within the meaning of section 851A of the Taxes Consolidation Act 1997) for the purposes of assisting the Authority in performing its functions under this Act.]

Annotations:

Amendments:

F96

Inserted (26.12.2012) by Health Insurance (Amendment) Act 2012 (45/2012), s. 15, commenced on enactment.

F97

Substituted (1.04.2023) by Health Insurance (Amendment) Act 2022 (49/2022), s. 3, commenced as per s. 8(2)(b).

F98

Substituted (1.04.2023) by Health Insurance (Amendment) Act 2021 (47/2021), s. 5(b), S.I. No. 112 of 2022.

F99

Inserted (1.04.2023) by Health Insurance (Amendment) Act 2021 (47/2021), s. 5(c), S.I. No. 112 of 2023.

Editorial Notes:

E70

Previous affecting provision: subs. (1)()b) amended (1.04.2022) by Health Insurance (Amendment) Act 2021 (47/2021), s. 5(a), S.I. No. 145 of 2022; amendment substituted (1.04.2023) as per F-note above.

E71

Previous affecting provision: date in subs. (1)(b) substituted (1.04.2021) by Health Insurance (Amendment) Act 2020 (24/2020), s. 2, commenced as per s. 6(2)(b); substituted (1.04.2022) as per F-note above.

E72

Previous affecting provision: date in subs. (1)(b) substituted (1.04.2020) by Health Insurance (Amendment) Act 2019 (49/2019), s. 2, commenced as per s. 6(2)(b); substituted (1.04.2021) as per E-note above.

E73

Previous affecting provision: date in subs. (1)(b) substituted (1.04.2019) by Health Insurance (Amendment) Act 2018 (35/2018), s. 2, commenced as per s. 8(3); substituted (1.04.2020) as per E-note above.

E74

Previous affecting provision: date in subs. (1)(b) substituted (1.04.2018) by Health Insurance (Amendment) Act 2017 (37/2017), s. 3, commenced as per s. 7(2)(b); substituted (1.04.2019) as per E-note above.

E75

Previous affecting provision: date in subs. (1)(b) substituted (1.04.2017) by Health Insurance (Amendment) Act 2016 (19/2016), s. 6, commenced as per s. 9(b); substituted (1.04.2018) as per E-note above.

E76

Previous affecting provision: date in subs. (1)(b) substituted (1.03.2016) by Health Insurance (Amendment) Act 2015 (54/2015), s. 3, commenced as per s. 7(2); substituted (26.12.2016) as per E-note above.

E77

Previous affecting provision: date in subs. (1)(b) substituted (1.03.2015) by Health Insurance (Amendment) Act 2014 (42/2014), s. 6(1), commenced as per s. 6(2), substituted (1.03.2016) as per E-note above.

E78

Previous affecting provision: date in subs. (1)(b) substituted (1.03.2014)) by Health Insurance (Amendment) Act 2013 (48/2013), s. 7(1), commenced as per s. 7(2); substituted (1.03.2015) as per E-note above.