Lifetime Community Rating, Children and Spouses – clarification

Wednesday, 18 March 2015 – The HIA wishes to clarify the treatment of periods of cover for children and adults where health insurance premiums are paid on their behalf by either their parents or another adult (including a spouse).

Lifetime community rating takes effect from 30th April this year. It will introduce age-related loadings on health insurance premium for those aged over 34 years who take out health insurance for the first time after this date. A loading of 2% per year of age over 34 years will apply. However, periods of previous cover, where an adult rate of premium was paid for an individual, will be taken into account in calculating the amount of age-related loadings that may apply after 30th April.

Currently health insurers apply a reduced level of health insurance premium in respect of children and full time dependant students. These periods of cover where reduced health insurance premiums apply, are not taken into account for the purposes of lifetime community rating and the calculation of age related loadings.

When a full adult premium is paid in respect of anyone, including a dependant student, such periods of cover are taken into account for the purposes of Lifetime Community Rating.

Similarly in the case of an individual where a full adult premium rate is being paid for them by their spouse, such periods of cover are also taken into account for the purposes of Lifetime Community Rating.

Example 1

Adult child aged 29 years with full adult premium being paid on their behalf by their parents since age 24.

This period of 5 years of cover will be taken into account for the purposes of Lifetime Community Rating and any subsequent age-related loading that may apply if that individual takes out private health insurance after age 34 years and after 30th April next.

Example 2

An individual aged 62 years has had her health insurance premiums paid for by their spouse who is recently deceased since they married at age 30 years. This 32 year period of cover will be taken into account for the purpose of lifetime community rating. If effect, provided the individual continues in cover following the death of their spouse, no age related loadings will apply to their health insurance premiums.

For media queries, please contact

Jim Devlin, FTI Consulting, e. jim.devlin@fticonsulting.com; m. 087 2631057; t. 01 66 33 600

The above information was sourced with the permission of the Health Insurance Authority from their website www.hia.ie. Our thanks to them for their assistance.