Health Insurance (Miscellaneous Provisions) Act 2009
I mbeagán focal
Is éard atá sa dlí seo ná leasuithe ar dhlíthe éagsúla a bhaineann le hárachas sláinte, cánacha, dleachtanna stampa, agus árachas, go háirithe chun a chinntiú go roinntear costais seirbhísí sláinte idir daoine árachaithe. Déantar é seo chun dlúthpháirtíocht shóisialta agus idirghlúine a chur chun cinn trí fhóirdheontas costais idir daoine óga agus daoine scothaosta.
Cad a rialaíonn sé
- Leasuithe ar an Acht um Árachas Sláinte, 1994.
- Leasuithe ar an Acht Comhdhlúite Cánacha, 1997.
- Leasuithe ar an Acht Comhdhlúite Dleachtanna Stampa, 1999.
- Leasuithe ar an Acht Árachais, 1936.
Cé air a mbaineann sé
- Daoine árachaithe.
- Cuideachtaí árachais sláinte cláraithe.
Príomhphointí
- Is é príomhchuspóir an Aire agus an Údaráis ná rochtain ar chlúdach árachais sláinte a chinntiú do thomhaltóirí seirbhísí sláinte gan aon idirdhealú bunaithe ar aois nó stádas sláinte.
- Ní mór do ghnóthais chláraithe gan cleachtais a dhéanamh nó comhaontuithe a dhéanamh a sheachnaíonn an príomhchuspóir seo.
- Tá sé mar aidhm ag an dlí seo go roinntear ualach costais seirbhísí sláinte idir daoine árachaithe trí fhóirdheontas costais idir daoine óga agus daoine scothaosta.
- Cuirtear foráil ar fáil do chreidmheasanna cánach chun rochtain a thabhairt do dhaoine scothaosta ar chlúdach árachais sláinte.
Legal text
Health Insurance (Miscellaneous Provisions) Act 2009 Skip to content Disclaimer Feedback Helpdesk Gaeilge Léim go dtí an t-ábhar Séanadh Aiseolas Deasc chabhrach English Gaeilge English Produced by the Office of the Attorney General Táirgthe ag Oifig an Ard-Aighne Home Legislation Acts of the Oireachtas Statutory Instruments Pre-1922 Legislation Constitution External Resources Bills (Houses of the Oireachtas) Iris Oifigiúil / Official Gazette Revised Acts (LRC) Classified List of Legislation (LRC) Translations (acts.
- ie)Translations (Houses of the Oireachtas) Government Publications for Sale EU Law (EUR-Lex) FAQ Disclaimer Feedback Helpdesk Search Baile Reachtaíocht Achtanna an Oireachtais Ionstraimí Reachtúla Reachtaíocht Réamh-1922 Bunreacht Acmhainní Seachtracha Billí (Tithe an Oireachtais) Iris Oifigiúil Achtanna Athbhreithnithe (CAD) (An Coimisiún um Athchóiriú an Dlí) Liosta Rangaithe Reachtaíochta Aistriúcháin (achtanna.
- ie)Aistriúcháin (Tithe an Oireachtais) Foilseacháin Rialtais ar Díol Dlí AE (EUR-Lex) CCanna (Ceisteanna Coitianta) Séanadh Aiseolas Deasc chabhrach Cuardach TitleTeideal Year(
- s)or rangeBliain nó blianta nó raon TypeCineál All Legislation Acts Statutory Instruments Advanced SearchCuardach Casta HomeBaile ActsAchtanna 2009 Health Insurance (Miscellaneous Provisions) Act 2009 Health Insurance (Miscellaneous Provisions) Act 2009 Permanent Page URL View by SectionAmharc de réir Ailt View Full ActAmharc ar an Acht Iomlán Bill History Stair Bille Commencement, Amendments, SIs made under the Act Tosach Feidhme, Leasuithe, IRí arna ndéanamh faoin Acht Open PDFOscail PDF Print Full ActPriontáil an tAcht Iomlán Number 24 of 2009 HEALTH INSURANCE (MISCELLANEOUS PROVISIONS) ACT 2009 ARRANGEMENT OF SECTIONS PART 1 PRELIMINARY AND GENERAL Section 1. Short title, collective citation and construction. 2. Definitions. PART 2 AMENDMENT OF HEALTH INSURANCE ACT 1994 3. Principal objective of Minister and Authority in performing respective functions under Act. 4. Amendment of section 2 of Act of 1994. 5. Amendment of section 3 of Act of 1994. 6. Substitution of section 7 of Act of 1994. 7. Amendment of section 7A of Act of 1994. 8. Amendment of Act of 1994. 9. Further amendment of Act of 1994. 10. Amendment of section 12A of Act of 1994. 11. Regulations may specify information to be provided to policy holders and potential policy holders of type of health insurance contract, etc. 12. Amendment of section 14 of Act of 1994. 13. Amendment of section 17 of Act of 1994. 14. Enforcement notices. 15. Amendment of section 20 of Act of 1994. 16. Amendment of section 21 of Act of 1994. 17. Amendment of Schedule to Act of 1994. 18. Insertion of Schedule 2 into Act of 1994. PART 3 AMENDMENT OF TAXES CONSOLIDATION ACT 1997 19. Amendment of section 112A of Act of 1997. 20. Amendment of section 458 of Act of 1997. 21. Amendment of section 470 of Act of 1997. 22. Age-related relief for health insurance premiums. 23. Amendment of section 904E of Act of 1997. 24. Amendment of section 1024 of Act of 1997. 25. Amendment of Schedule 29 to Act of 1997. PART 4 AMENDMENT OF STAMP DUTIES CONSOLIDATION ACT 1999 26. Levy on authorised insurers. PART 5 AMENDMENT OF INSURANCE ACT 1936 27. Amendment of section 3 of Insurance Act 1936. Acts Referred to Health Insurance Act 1994 1994, No. 16 Health Insurance Acts 1994 to 2007 Income Tax Acts Insurance Act 1936 1936, No. 45 Insurance Acts 1909 to 2000 Social Welfare Consolidation Act 2005 2005, No. 26 Stamp Duties Consolidation Act 1999 1999, No. 31 Succession Duty Act 1853 16 & 17 Vict., c. 51 Taxes Consolidation Act 1997 1997, No. 39 Number 24 of 2009 HEALTH INSURANCE (MISCELLANEOUS PROVISIONS) ACT 2009 AN ACT TO AMEND THE HEALTH INSURANCE ACT 1994, THE TAXES CONSOLIDATION ACT 1997, THE STAMP DUTIES CONSOLIDATION ACT 1999 AND THE INSURANCE ACT 1936, IN PARTICULAR TO ENSURE THAT, IN THE INTERESTS OF SOCIETAL AND INTERGENERATIONAL SOLIDARITY, THE BURDEN OF THE COSTS OF HEALTH SERVICES BE SHARED BY INSURED PERSONS BY PROVIDING FOR A COST SUBSIDY BETWEEN THE YOUNG AND THE OLD; TO PROVIDE, HAVING REGARD TO THE PRINCIPAL OBJECTIVE OF THE MINISTER FOR HEALTH AND CHILDREN AND THE HEALTH INSURANCE AUTHORITY IN PERFORMING THEIR RESPECTIVE FUNCTIONS UNDER THE HEALTH INSURANCE ACT 1994, FOR TAX CREDITS TO ENABLE THE OLD TO HAVE ACCESS TO HEALTH INSURANCE COVER AND TO PROVIDE FOR A MEANS WHEREBY ANY OVERCOMPENSATION ARISING FROM SUCH TAX CREDITS MAY BE REPAID; AND TO PROVIDE FOR RELATED MATTERS. [19th July, 2009] BE IT ENACTED BY THE OIREACHTAS AS FOLLOWS: PART 1 PRELIMINARY AND GENERAL Short title, collective citation and construction. 1.—
- a)the fact that the health needs of consumers of health services increase as they approach and enter old age, (
- b)the desirability of ensuring, in the interests of societal and intergenerational solidarity, and regardless of the age range or health status of any particular generation (or any part thereof), that the burden of the costs of health services be shared by insured persons by providing for a cost subsidy between the young and the old and, without prejudice to the generality of that objective, in particular that the old have access to health insurance cover by means of a tax credit, and (
- c)the manner in which the health insurance market operates in respect of health insurance contracts, both in relation to individual registered undertakings and across the market.
- b)by inserting the following definition after the definition of “ day patient service ”: “ ‘ effect ’, in relation to a health insurance contract or other agreement, means to enter into or renew such contract or agreement, as the case may be;”. (
- c)by inserting the following definition after the definition of “ in-patient indemnity payment ”: “ ‘ net premium ’, in relation to a health insurance contract, means the premium payable under the contract in respect of an individual in any year of assessment after— (
- a)the deduction made therefrom to which the individual is entitled, for that year of assessment, by virtue of section 470 of the Taxes Consolidation Act 1997 , and (
- b)the deduction (if any) made therefrom to which the individual is entitled, for that year of assessment, by virtue of section 470B of the Taxes Consolidation Act 1997 ;”, (
- d)in the definition of “ undertaking ”, by substituting “undertaking;” for “undertaking.”, and (
- e)by inserting the following definition after the definition of “undertaking”: “ ‘ year of assessment ’ has the same meaning as in section 2 of the Taxes Consolidation Act 1997 .”. Amendment of section 3 of Act of 1994. 5.— Section 3 of the Act of 1994 is amended, in subsection
- a)and (
- b)to the Authority by the undertaking in respect of that period, and (
- b)the total amount of the stamp duty referred to in section 125A of the Stamp Duties Consolidation Act 1999 recorded in accounts for that undertaking in respect of that period as extracted from accounts furnished pursuant to section 7F
- a)and (
- b)to the Authority by the undertaking in respect of that period; ‘ draft report ’ has the meaning assigned to it by section 7F
- a)of the definition of ‘ cumulative net fin ancial impact ’ exceeds the amount specified in paragraph (
- b)of that definition; ‘ relevant financial provisions ’ means— (
- a)section 470B of the Taxes Consolidation Act 1997 , or (
- b)section 125A of the Stamp Duties Consolidation Act 1999 , or both; ‘ relevant market sector ’, in relation to information returns made to the Authority for any period of 6 months referred to in section 7D
- a)Article 18 of the Community framework for State aid in the form of public service compensation (2005/C297/04) 1 (the text of which is set out for convenience of reference in Schedule 2), and (
- b)any factors that are prescribed as factors that may be taken into account for the purposes of so determining reasonable profit in accordance with the said Article. Prohibition of non-community rated health insurance contracts. 7.—
- a)a registered undertaking shall not make an offer to effect a health insurance contract of a particular type— (
- i)unless the offer is maintained— (I) for a period of not less than 31 consecutive days commencing on the day on which the offer is first made, and (II) throughout that period on the same terms and conditions on which the offer is first made, and (
- ii)unless the offer is to effect that contract for a period of 12 consecutive months except that the offer may be to effect the contract for a shorter or longer period if, and only if— (I) in all the circumstances of the case, there is good and sufficient reason for doing so, and (II) the entering into of the contract by the undertaking does not in any way prejudice the achievement of the principal objective specified in section 1A
- b)the net premium payable for each insured person under any health insurance contract effected by a particular registered undertaking shall be the same as that payable under every other such contract (after due allowance has been made in respect of the payment of any net premium by instalments) that— (
- i)is effected by that undertaking, (
- ii)is in respect of the same period as that to which the first-mentioned contract relates, (iii) relates to the same health services as those to which the first-mentioned contract relates, and (
- iv)provides for the same payments by the undertaking in respect of those services as those provided for by the first-mentioned contract.
- a)the age, sex or sexual orientation or the suffering or prospective suffering of a person from a chronic disease, illness or other medical condition or from a disease, illness or medical condition of a particular kind, (
- b)the frequency of the provision of health services to a person, or (
- c)the amounts of payments or the number of different payments to which a person becomes entitled under such a contract.
- a)shall, in so far as it relates to a person under the age of 18 years, be— (
- i)waived, or (
- ii)reduced, such a net premium being not more than 50 per cent of the net premium in respect of a person other than the persons specified in this subsection under a health insurance contract effected by that undertaking, and (
- b)may be reduced in so far as it relates— (
- i)to a person who is of or over the age of 18 years and under the age of 23 years, is receiving fulltime education and is dependent on the person with whom the contract is effected, such a net premium being not more than 50 per cent of the net premium in respect of a person other than the persons specified in this subsection under a health insurance contract effected by that undertaking, (
- ii)to a person who is a member of a restricted membership undertaking and is in receipt of a pension recognised for the purposes of the undertaking, or (iii) to a person who is a member, for the purposes of health insurance, of a group of persons, such a net premium being, if it is reduced, not less than 90 per cent of the net premium in respect of a person other than the persons specified in this subsection under a health insurance contract effected by that undertaking.
- a)is the spouse, a child or a dependent of a party to the contract, or (
- b)is the spouse, a child or a dependent of another person named in the contract, then the undertaking may aggregate or combine, as it thinks fit, claims in respect of health services, other than in-patient services, for the purposes of calculating payments, other than in-patient indemnity payments, to be made by it pursuant to the contract.”. Amendment of section 7A of Act of 1994. 7.— Section 7A of the Act of 1994 is amended— (
- a)by substituting the following subsection for subsection
- b)is of or over the age of 30 years.”, (
- b)by substituting the following subsections for subsection
- i)in paragraph (c), by substituting “13 weeks” for “12 months”, and (
- ii)by inserting the following paragraph after paragraph (c): “(
- cc)in the period of the 13 weeks preceding the date on which the registered undertaking concerned was requested to effect the health insurance contract, a health insurance contract was in force in respect of which the insured person was a party to or named in the contract and in respect of whom any registered undertaking providing that contract could have required the payment of a net premium that was greater than the unadjusted premium,”, (
- d)in subsection
- i)by substituting “net premium” for “premium”, and (
- ii)by substituting “unadjusted net premium” for “unadjusted premium”, (
- e)in subsection
- a)is on offer by it in the State on that commencement, or (
- b)is no longer on offer by it in the State but in respect of which one or more than one health insurance contract of such type— (
- i)has been effected by it before that commencement, and (
- ii)is in force on that commencement.
- ii)of the Taxes Consolidation Act 1997 , or (
- b)for the purposes of complying with section 125A of the Stamp Duties Consolidation Act 1999 .
- a)the name of the person, (
- b)the sex of the person, (
- c)the date of birth of the person, and (
- d)the Personal Public Service Number (within the meaning of section 262 of the Social Welfare Consolidation Act 2005 ) of the person. Obligation to make information returns to Authority. 7D.—
- a)the total number of persons insured, or a class thereof, with the registered undertaking or former registered undertaking concerned during the relevant period, (
- b)the total number of persons insured, or a class thereof, in each age group and the gender profile of each age group in respect of the relevant period, (
- c)the total number of persons in each age group, or a class thereof, effecting health insurance contracts during the relevant period, (
- d)the in-patient indemnity payments, or a class thereof, made by the registered undertaking or former registered undertaking concerned during the relevant period, (
- e)information relating to the health insurance services provided during the relevant period, and (
- f)such other information relating to the relevant period, other than personal data, which may reasonably be considered to be information which will enable or assist the Minister or the Authority to perform their respective functions under this Act.
- a)evaluate and analyse all information returns made to it and, without limiting the generality of the foregoing, having particular regard to— (
- i)the average insurance claim payment per insured person made by the relevant market sector during the relevant periods for each age group to which the returns relate in respect of the total number of persons insured in that age group, or a class thereof, during the relevant periods, (
- ii)the average insurance claim payment per insured person made by the relevant market sector during the relevant periods in respect of the total number of persons insured, or a class thereof, during the relevant periods, (iii) the age groups for which the average insurance claim payment referred to in subparagraph (
- i)is in excess of the average insurance claim payment referred to in subparagraph (
- ii)in respect of the same relevant periods, (
- iv)in the case of age groups which fall within subparagraph (iii), the extent of the excess referred to in that subparagraph attributable to each such age group, and (
- v)the net financial impact on each registered undertaking or former registered undertaking of the relevant financial provisions during the relevant periods, and (
- b)as soon as may be after the end of each 6 months period, 12 months period, or longer period, as specified by the Minister by notice in writing given to the Authority (in this paragraph referred to as the ‘ specified period ’), prepare and furnish to the Minister a report in relation to— (
- i)such evaluation and analysis in respect of the information returns which relate to the specified period, (
- ii)such matters concerning the carrying on of health insurance business and developments in relation to health insurance generally that the Authority considers ought to be brought to the attention of the Minister (including information in relation to the profitability of any registered undertaking or former registered undertaking where the operation of the relevant financial provisions is expected to result in a positive cumulative net financial impact on the undertaking), (iii) the amounts of the age-related tax credits that the Authority considers, after having regard to such evaluation and analysis, would need to be afforded, under section 470B
- b)the need to facilitate competition between registered undertakings, and (
- c)any report furnished to him or her pursuant to subsection
- a)maintain and furnish to the Authority (before 1 April of the next succeeding year), in such form as may be specified by the Authority, a statement of profit and loss in respect of— (
- i)its health insurance business in the State which falls within paragraph (
- b)of section 7D
- ii)such other health insurance services, provided by the undertaking, as may be prescribed, (
- b)maintain and furnish to the Authority (before 1 April of the next succeeding year), in such form as may be specified by the Authority, a balance sheet in respect of— (
- i)its health insurance business in the State which falls within paragraph (
- b)of section 7D
- ii)such other health insurance services, provided by the undertaking, as may be prescribed, and (
- c)furnish to the Authority (before 1 April of the next succeeding year), such other information relating to the year as may be prescribed and, without limiting the generality of the foregoing, such information may include a statement of profit and loss and a balance sheet in respect of its health insurance business as it relates to those persons receiving age-related tax credits.
- b)Where the Authority determines under paragraph (
- a)that a registered undertaking or former registered undertaking has made a profit which is in excess of a reasonable profit in respect of a period, it shall make a further determination as to the monetary equivalent amount of the profit which is in excess of the corresponding monetary equivalent amount of such reasonable profit in respect of that period.
- b)to be the positive cumulative net financial impact on the undertaking, (
- c)the monetary equivalent amount determined under subsection
- b)to be the profit of the undertaking which is in excess of the corresponding monetary equivalent amount of such reasonable profit, (
- d)the cumulative amount of overcompensation, being the lower of the amounts referred to in paragraphs (
- b)and (c), (
- e)the amount of overcompensation to be paid to the Exchequer by the undertaking, being the cumulative amount of overcompensation referred to in paragraph (
- d)reduced by the total amount of overcompensation paid or due to be paid to the Exchequer pursuant to the operation of subsection
- f)the bases on which it made the determinations, and calculated the amounts, referred to in paragraphs (
- a)to (e).
- a)The Authority shall, as soon as may be after the preparation of the draft report— (
- i)furnish a copy of the draft report to the registered undertaking or former registered undertaking the subject of the report, (
- ii)invite the undertaking to make representations to the Authority in relation to the draft report before the expiration of 21 days (or such longer period as the Authority may permit in its discretion) from the day on which the undertaking received the report, and (iii) take into account any such representations made to it within that period before preparing the final report as soon as is practicable after the expiration of that period of 21 days (or, if applicable, the expiration of the longer period permitted pursuant to subparagraph (ii)). (
- b)The determinations of the Authority contained in its final report shall be final and conclusive (including for the purposes of any proceedings concerning the recovery of an amount referred to in subsection
- a)the policy holder, or (
- b)the person to whom the registered undertaking issues the request for payment of the premium due under the health insurance contract, where that person is not the policy holder, a statement in writing setting out— (
- i)the premium payable under the contract in respect of each insured person before any deduction referred to in the definition of ‘net premium’ in section 2 is made from the premium, and (
- ii)the net premium under the contract in respect of each insured person.”. Amendment of section 12A of Act of 1994. 10.— Section 12A is amended by inserting the following subsection after subsection
- a)the determination of the age-related tax credit referred to in section 470B of the Taxes Consolidation Act 1997 , or (
- b)the determination of the amount of levy referred to in section 125A of the Stamp Duties Consolidation Act 1999 .”. Regulations may specify information to be provided to policy holders and potential policy holders of type of health insurance contract, etc. 11.— The Act of 1994 is amended by substituting the following section for section 13: “13.—
- a)specifying the type of contract and the information, (
- b)requiring registered undertakings which supply the contract to ensure that the information accompanies the contract in the manner and form specified in the regulations, (
- c)regulating or prohibiting the supply by registered undertakings of the contract if any regulation made under paragraph (
- b)is not complied with in so far as the regulation applies to the contract, and (
- d)without prejudice to the generality of paragraph (a), requiring registered undertakings to include a statement in their offers to renew health insurance contracts, or a class of such offers, as to the rights (including open enrolment rights), or a class of such rights, of the policy holders concerned in respect of the contracts.
- a)specifying the type of contract and the information, and (
- b)requiring registered undertakings, the advertising of which relates (whether in whole or in part) to the contract, to ensure that the information accompanies the advertisements in the manner and form specified in the regulations.
- a)the typical policy holder or potential policy holder of the type of health insurance contract concerned would need the information concerned in order to make an informed contract decision, and (
- b)if such information was withheld, omitted or concealed, it would be likely to cause the typical policy holder or potential policy holder of such a contract to make a contract decision that the policy holder or potential policy holder, as the case may be, would not otherwise make.
- a)in relation to information to accompany a health insurance contract— (
- i)includes accompanied by way of being incorporated into or stamped on the contract, and (
- ii)in the case of an offer to renew the contract, includes accompanied by way of being incorporated into or stamped on the offer to renew the contract made prior to the issue of the contract where such offer is accepted, and (
- b)in relation to information to accompany an advertisement which relates (whether in whole or in part) to a health insurance contract, includes accompanied by way of— (
- i)being incorporated into the advertisement, or (
- ii)there being a reference in the advertisement to the means by which the information may be readily obtained; ‘ advertisement ’ includes any form of advertising or marketing; ‘ contract decision ’, in relation to a type of health insurance contract, means— (
- a)a decision on whether or not to enter into a contract of health insurance of that type, or (
- b)if a contract of health insurance of that type has already been entered into, a decision on whether or not to— (
- i)cancel the contract, (
- ii)renew the contract, or (iii) exercise a contractual right under the contract; ‘ supply ’, in relation to a health insurance contract, includes furnish, offer or agree to supply and expose or display for supply.”. Amendment of section 14 of Act of 1994. 12.— Section 14 of the Act of 1994 is amended— (
- a)in subsection
- a)so received in the course of or by way of reinsurance, or (
- b)so paid in respect of a stamp duty under section 125A of the Stamp Duties Consolidation Act 1999 .”. Enforcement notices. 14.— The Act of 1994 is amended by inserting the following Part after Part III: “PART IIIA Enforcement Notices Interpretation of Part IIIA. 18A.— In this Part— ‘ enforcement notice ’ means a notice under section 18B
- a)a provision of this Act, or (
- b)a provision of a regulation under this Act. Issue of enforcement notices. 18B.—
- a)is contravening a relevant provision, or (
- b)has contravened a relevant provision in circumstances that make it likely that the contravention will continue or be repeated, then the Authority may serve on the person a notice in writing, accompanied by a copy of this Part— (
- i)stating that it is of that opinion, (
- ii)specifying the relevant provision as to which it is of that opinion and the reasons why it is of that opinion, (iii) directing the person to take such steps as are specified in the notice to remedy the contravention or, as the case may be, the matters occasioning it, and (
- iv)specifying a period (ending not earlier than the period specified in section 18C
- a)may— (
- i)make the order sought, (
- ii)make the order sought subject to such variations to those steps as may be specified in the order, or (iii) make the order sought subject to such other steps for the like purpose as may be specified in the order, or (
- b)may dismiss the application, and, whether paragraph (
- a)or (
- b)is applicable, may make such order as to costs as it thinks fit in respect of the application. Application for cancellation of direction specified in enforcement notice. 18C.—
- a)cancel the direction, (
- b)confirm the direction, or (
- c)vary the direction, and, whether paragraph (a), (
- b)or (
- c)is applicable, make such order as to costs as it thinks fit in respect of the application.
- a)to manage and administer any schemes prescribed under section 12, and to establish and maintain the fund referred to in that section, (
- b)to maintain The Register of Health Benefits Undertaking and The Register of Health Insurance Contracts, (
- c)to evaluate and analyse information and other returns made to it, (
- d)to take such action as it considers appropriate to increase the awareness of members of the public of their rights as consumers of health insurance and of the health insurance services available to them, (
- e)to advise the Minister either at his or her request or on its own initiative on matters relating to the functions of the Minister under this Act, the functions of the Authority under this Act and health insurance generally, (
- f)without prejudice to the generality of paragraph (e), to advise the Minister either at his or her request or on its own initiative as to whether, in the opinion of the Authority, the principal objective specified in section 1A
- 17.— The Schedule to the Act of 1994 is amended by deleting “SCHEDULE” and substituting “SCHEDULE 1”. Insertion of Schedule 2 into Act of
- 18.— The Act of 1994 is amended by inserting the following new Schedule after the Schedule: “Section 6A
- PURPOSE AND SCOPE
- It is apparent from the case-law of the Court of Justice of the European Communities
- The provisions of this framework apply without prejudice to the stricter specific provisions relating to public service obligations contained in sectoral Community legislation and measures.
- This framework applies without prejudice to the Community provisions in force in the field of public procurement and competition (in particular Articles 81 and 82 of the EC Treaty).
- CONDITIONS GOVERNING THE COMPATIBILITY OF PUBLIC SERVICE COMPENSATION THAT CONSTITUTES STATE AID 2.
- General provisions
- In its judgment in Altmark, the Court laid down the conditions under which public service compensation does not constitute State aid as follows: ‘[...] First, the recipient undertaking must actually have public service obligations to discharge, and the obligations must be clearly defined. [...]. [...] Second, the parameters on the basis of which the compensation is calculated must be established in advance in an objective and transparent manner, to avoid it conferring an economic advantage which may favour the recipient undertaking over competing undertakings. [...] Payment by a Member State of compensation for the loss incurred by an undertaking without the parameters of such compensation having been established beforehand, where it turns out after the event that the operation of certain services in connection with the discharge of public service obligations was not economically viable, therefore constitutes a financial measure which falls within the concept of State aid within the meaning of Article 87
- Genuine service of general economic interest within the meaning of Article 86 of the EC Treaty
- It is apparent from the case-law of the Court of Justice that with the exception of the sectors in which there are Community rules governing the matter, Member States have a wide margin of discretion regarding the nature of services that could be classified as being services of general economic interest. Thus, the Commission's task is to ensure that this margin of discretion is applied without manifest error as regards the definition of services of general economic interest.
- It transpires from Article 86
- Need for an instrument specifying the public service obligations and the methods of calculating compensation
- The concept of service of general economic interest within the meaning of Article 86 of the EC Treaty means that the undertakings in question have been entrusted with a special task by the State
- a)the precise nature and the duration of the public service obligations; (
- b)the undertakings and territory concerned; (
- c)the nature of any exclusive or special rights assigned to the undertaking; (
- d)the parameters for calculating, controlling and reviewing the compensation; (
- e)the arrangements for avoiding and repaying any overcompensation. 13. When defining public service obligations and in assessing whether those obligations are met by the undertakings concerned, Member States are invited to consult widely, with particular emphasis on users. 2.4. Amount of compensation 14. The amount of compensation may not exceed what is necessary to cover the costs incurred in discharging the public service obligations, taking into account the relevant receipts and reasonable profit for discharging those obligations. The amount of compensation includes all the advantages granted by the State or through State resources in any form whatsoever. The reasonable profit may include all or some of the productivity gains achieved by the undertakings concerned during an agreed limited period without reducing the level of quality of the services entrusted to the undertaking by the State. 15. In any event, compensation must be actually used for the operation of the service of general economic interest concerned. Public service compensation granted for the operation of a service of general economic interest, but actually used to operate on other markets is not justified, and consequently constitutes incompatible State aid. The undertaking receiving public service compensation may, however, enjoy a reasonable profit. 16. The costs to be taken into consideration include all the costs incurred in the operation of the service of general economic interest. Where the activities of the undertaking in question are confined to the service of general economic interest, all its costs may be taken into consideration. Where the undertaking also carries out activities falling outside the scope of the service of general economic interest, only the costs associated with the service of general economic interest may be taken into consideration. The costs allocated to the service of general economic interest may cover all the variable costs incurred in providing the service of general economic interest, an appropriate contribution to fixed costs common to both the service of general economic interest and other activities and an adequate return on the own capital assigned to the service of general economic interest
- The revenue to be taken into account must include at least the entire revenue earned from the service of general economic interest. If the undertaking in question holds special or exclusive rights linked to a service of general economic interest that generates profit in excess of the reasonable profit, or benefits from other advantages granted by the State, these must be taken into consideration, irrespective of their classification for the purposes of Article 87 of the EC Treaty, and are added to its revenue. The Member State may also decide that the profits accruing from other activities outside the scope of the service of general economic interest must be allocated in whole or in part to the financing of the service of general economic interest.
- ‘Reasonable profit’ should be taken to mean a rate of return on own capital that takes account of the risk, or absence of risk, incurred by the undertaking by virtue of the intervention by the Member State, particularly if the latter grants exclusive or special rights. This rate must normally not exceed the average rate for the sector concerned in recent years. In sectors where there is no undertaking comparable to the undertaking entrusted with the operation of the service of general economic interest, a comparison may be made with undertakings situated in other Member States, or if necessary, in other sectors, provided that the particular characteristics of each sector are taken into account. In determining what amounts to a reasonable profit, the Member State may introduce incentive criteria relating, among other things, to the quality of service provided and gains in productive efficiency.
- When a company carries out activities falling both inside and outside the scope of the service of general economic interest, the internal accounts must show separately the costs and receipts associated with the service of general economic interest and those associated with other services, as well as the parameters for allocating costs and revenues. Where an undertaking is entrusted with the operation of several services of general economic interest either because the authority assigning the service of general economic interest is different or because the nature of the service of general economic interest is different, the undertaking's internal accounts must make it possible to ensure that there is no over-compensation at the level of each service of general economic interest. These principles are without prejudice to the provisions of Directive 80/723/EEC in cases where that Directive applies.
- OVER-COMPENSATION
- Member States must check regularly, or arrange for checks to be made, to ensure that there has been no over-compensation. Since over-compensation is not necessary for the operation of the service of general economic interest, it constitutes incompatible State aid that must be repaid to the State, and for the future, the parameters for the calculation of the compensation must be updated.
- Where the amount of over-compensation does not exceed 10% of the amount of annual compensation, such over-compensation may be carried forward to the next year. Some services of general economic interest may have costs that vary significantly each year, notably as regards specific investments. In such cases, exceptionally, over-compensation in excess of 10% in certain years may prove necessary for the operation of the service of general economic interest. The specific situation which may justify over-compensation in excess of 10% should be explained in the notification to the Commission. However, the situation should be reviewed at intervals determined on the basis of the situation in each sector which, in any event, should not exceed four years. All over-compensation discovered at the end of that period should be repaid.
- Any over-compensation may be used to finance another service of general economic interest operated by the same undertaking, but such a transfer must be shown in the undertaking's accounts and be carried out in accordance with the rules and principles set out in this framework, notably as regards prior notification. The Member States must ensure that such transfers are subjected to proper control. The transparency rules laid down in Directive 80/723/EEC apply.
- The amount of over-compensation cannot remain available to an undertaking on the ground that it would rank as aid compatible with the Treaty (for example, environmental aid, employment aid and aid for small and medium-sized enterprises). If a Member State wishes to grant such aid, the prior notification procedure laid down in Article 88
- Regulation as amended by the 2003 Act of Accession.
- APPLICATION OF THE FRAMEWORK
- This framework will apply for a period of six years from the date of its publication in the Official Journal of the European Union. The Commission may, after consulting the Member States, amend the framework before it expires, for important reasons linked to the development of the common market. Four years after the date of publication of this framework, the Commission will undertake an impact assessment based on factual information and the results of wide consultations conducted by the Commission on the basis, notably, of data provided by the Member States. The results of the impact assessment will be made available to the European Parliament, the Committee of Regions and the Economic and Social Committee and to the Member States.
- The Commission will apply the provisions of this framework to all aid projects notified to it and will take a decision on those projects after the framework is published in the Official Journal, even if the projects were notified prior to such publication. In the case of non-notified aid, the Commission will apply: (a) the provisions of this framework, if the aid was granted after publication of the framework in the Official Journal; (b) the provisions in force at the time the aid was granted, in all other cases.
- APPROPRIATE MEASURES
- The Commission proposes as appropriate measures for the purposes of Article 88
- a)as respects so much of a payment that qualifies for relief under section 470, ‘ appropriate per centage ’, ‘ authorised insurer ’, ‘ relevant con tract ’ and ‘ relievable amount ’ have the same meanings, respectively, as in section 470, (
- b)as respects so much of a payment that qualifies for relief under section 470B, ‘ authorised insurer ’ and ‘ relevant contract ’ have the same meanings, respectively, as in section 470B, (
- c)‘ employee ’ and ‘ employer ’ have the same meanings, respectively, as in section 983, and (
- d)‘qualifying insurer’ and ‘qualifying long-term care policy ’ have the same meanings, respectively, as in section 470A.”, (
- b)by inserting the following subsection after subsection
- 20.— Section 458 of the Act of 1997 is amended, in the Table to that section, in Part 2, by inserting “section 470B” before “section 472”. Amendment of section 470 of Act of
- 21.— Section 470 of the Act of 1997 is amended, in subsection
- a)subject to paragraph (b), the year of assessment 2009, 2010 or 2011, (
- b)where a payment made to an authorised insurer is a monthly or other instalment towards the payment of the total annual premium due under a relevant contract, and the payment of such an instalment becomes due and is made in the year of assessment 2012, the year of assessment 2012; ‘ relievable amount ’, in relation to a payment to an authorised insurer under a relevant contract, means— (
- a)where the payment covers no benefits other than such reimbursement or discharge as is referred to in the definition of ‘relevant contract’, an amount equal to the full amount of the payment, or (
- b)where the payment covers benefits other than such reimbursement or discharge as is referred to in that definition, an amount equal to so much of the payment as is referable to such reimbursement or discharge; ‘ restricted membership undertaking ’ has the same meaning as in section 2
- a)the payment is in respect of a premium due under the relevant contract and the relevant contract was renewed or entered into on or after 1 January 2009 but before 1 January 2012, and (
- b)the payment or part of the payment, as the case may be, is attributable to an insured person, and only to an insured person, who is aged 50 years or over on the date the relevant contract is renewed or entered into, as the case may be, then the individual shall, for the relevant year of assessment, in respect of so much of the relievable amount of the payment or part of the payment, as the case may be, as is attributable to an insured person referred to in paragraph (b), be entitled to a credit (referred to in this section as ‘age-related tax credit’) equal to the lower of— (
- i)the amount specified in the second column of the Table to this subsection corresponding to the class of insured person mentioned in the first column of that Table or, where the payment made to the authorised insurer is a monthly or other instalment towards the payment of the total annual premium due under the relevant contract, an amount equal to the amount so specified divided by the total number of instalments to be made to pay such total annual premium, and (
- ii)an amount which reduces the income tax to be charged on the individual for the relevant year of assessment, other than in accordance with section 16
- a)The amount of age-related tax credit given for a relevant year of assessment in respect of an insured person shall not exceed the amount of the payment made to an authorised insurer under a relevant contract in respect of the insured person for the relevant year of assessment. (
- b)Where an individual makes a payment to an authorised insurer that entitles the individual to an age-related tax credit or age-related tax credits, as the case may be, for the year of assessment 2012, the aggregate amount of the age-related tax credit given to the individual in respect of an insured person or insured persons, as the case may be, for that year and the year of assessment 2011 shall not exceed the age-related tax credit or age-related tax credits, as the case may be, that the individual would have been entitled to if the total annual premium due under the relevant contract in respect of the insured person or insured persons, as the case may be, had been paid in the year of assessment 2011. (
- c)Where, for any relevant year of assessment, an employer makes a payment of emoluments to an employee consisting of a perquisite in the form of a payment to an authorised insurer under a relevant contract, and— (
- i)the payment qualifies for relief under this section for that relevant year of assessment, and (
- ii)the aggregate of the age-related tax credit or age-related tax credits, as the case may be, and relief under section 470 due in respect of the payment exceeds the amount of the income tax chargeable, in accordance with sections 112 and 112A, in respect of the perquisite (in this paragraph referred to as ‘ the excess ’), the excess may not reduce the income tax chargeable on any other income of the employee for that year of assessment or, if the employee is a married person assessed to tax in accordance with section 1017, the income tax chargeable on any income of the employee’s spouse for that year of assessment.
- a)Where an individual makes a payment to an authorised insurer that entitles the individual to an age-related tax credit or age-related tax credits, as the case may be, for a relevant year of assessment, the individual shall be entitled to deduct and retain out of it— (
- i)if the payment made is the total annual premium due under the relevant contract concerned for the relevant year of assessment, an amount equal to the total amount of the age-related tax credit or age-related tax credits, as the case may be, (
- ii)if the payment made is a monthly or other instalment towards the payment of the total annual premium due under the relevant contract concerned for the relevant year of assessment, an amount equal to the total amount of the age-related tax credit or age-related tax credits, as the case may be, to which the individual would be entitled if all of that total annual premium were paid divided by the total number of such instalments to be made to pay that total annual premium. (
- b)An authorised insurer to which a payment referred to in paragraph (
- a)is made— (
- i)shall accept the amount paid, after the deduction of the age-related tax credit or age-related tax credits, as the case may be, in discharge of the individual’s liability to the same extent as if the deduction had not been made, and (
- ii)may, on making a claim in accordance with regulations, recover from the Revenue Commissioners an amount equal to the amount deducted. (
- c)Where an individual makes a payment referred to in paragraph (
- a)in respect of a premium due under a contract renewed or entered into on or after 1 January 2009 but before the passing of the Health Insurance (Miscellaneous Provisions) Act 2009, the individual shall be deemed to have deducted and retained out of the payment an amount equal to the amount of the age-related tax credit or age-related tax credits, as the case may be, that the individual is entitled to under this section in respect of that payment. (
- d)An amount that an individual is entitled to deduct and retain out of a payment referred to in paragraph (
- a)shall be in addition to the amount that the individual is entitled to deduct and retain out of the payment in accordance with section 470
- a)The Revenue Commissioners shall make regulations providing generally for the administration of this section and those regulations may, in particular and without prejudice to the generality of the foregoing, include provision— (
- i)that a claim under subsection
- ii)by an authorised insurer, which has registered with the Revenue Commissioners for the purposes of making such a claim, shall— (I) be made in such form and manner, (II) be made at such time, (III) be accompanied by such documents, and (IV) be accompanied by such information as respects the amount of premiums paid under relevant contracts in respect of insured persons aged 50 years or over in a relevant year of assessment and the number of such individuals within each class, as provided for in the regulations, (
- ii)for the making of annual information returns by authorised insurers, in such form (including electronic form) and manner as may be provided for in the regulations, and containing specified details in relation to— (I) each individual making payments, to which this section applies, to such insurers under relevant contracts in a relevant year of assessment, (II) each insured person aged 50 years or over, in respect of whom such payments were made in the relevant year of assessment, including— (A) the name of the insured person, (B) the date of birth of the insured person, and (C) the PPS Number of the insured person, (III) the total amount of premiums paid by the individual under a relevant contract in respect of an insured person aged 50 years or over in a relevant year of assessment, and (IV) the total amount deducted under subsection
- a)by the individual making the payments in the relevant year of assessment concerned, and (iii) for the furnishing of any other information that the Revenue Commissioners may reasonably require for the purposes of the regulations. (
- b)Every regulation made under this section shall be laid before Dáil Éireann as soon as may be after it is made and, if a resolution annulling the regulation is passed by Dáil Éireann within the next 21 days on which Dáil Éireann has sat after the regulation is laid before it, the regulation shall be annulled accordingly, but without prejudice to the validity of anything previously done thereunder.
- b)but is an amount to which the authorised insurer is not entitled, that amount shall be repaid by the authorised insurer. (
- b)There shall be made such assessments, adjustments or set-offs as may be required for securing repayment of the amount referred to in paragraph (
- a)and the provisions of the Income Tax Acts relating to the assessment, collection and recovery of income tax shall, in so far as they are applicable and with necessary modification, apply in relation to the recovery of such amount.”. Amendment of section 904E of Act of 1997. 23.— Section 904E of the Act of 1997 is amended— (
- a)in subsection
- a)subject to paragraph (b), has the same meaning as in section 470, (
- b)in relation to a claim made under section 470B
- a)aged less than 18 years— (
- i)on 1 January 2009 in the case of the first accounting period, (
- ii)on 1 January 2010 in the case of the second accounting period, (iii) on 1 January 2011 in the case of the third accounting period, and (
- iv)on 1 August 2011 in the case of the fourth accounting period, and (
- b)aged 18 years or over— (
- i)on 1 January 2009 in the case of the first accounting period, (
- ii)on 1 January 2010 in the case of the second accounting period, (iii) on 1 January 2011 in the case of the third accounting period, and (
- iv)on 1 August 2011 in the case of the fourth accounting period, in respect of whom a relevant contract between the authorised insurer and the insured person, being the individual referred to in the definition of ‘ insured person ’, is renewed, or entered into, during the accounting period concerned.
- a)€53 in respect of each insured person aged less than 18 years, and (
- b)€160 in respect of each insured person aged 18 years or over, included in the statement.
- b)to pay the stamp duty chargeable on any such statement on the delivery of the statement, the authorised insurer shall— (
- i)from that due date until the day on which the stamp duty is paid, be liable to pay, in addition to the duty, interest on the stamp duty calculated in accordance with section 159D, and (
- ii)from that due date, be liable to pay a penalty of €380 for each day the duty remains unpaid.
- b)another person (in this subsection referred to as the ‘ successor ’) acquires the whole, or substantially the whole, of the business, then— (
- i)the authorised insurer is not required to deliver the first-mentioned statement, and (
- ii)the successor shall— (I) if the successor is, apart from this subsection, required to deliver a statement (in this subsection referred to as the ‘second-mentioned statement’ ) pursuant to subsection
- a)a relevant contract is renewed or entered into by an individual referred to in the definition of ‘ insured person ’ during an accounting period (in this subsection referred to as the ‘ initial accounting period ’), and (
- b)the relevant contract is for a period of more than 12 months, then, without prejudice to the treatment to be accorded to the relevant contract and the initial accounting period by subsection
- i)the accounting period which immediately succeeds the initial accounting period if the second 12 months, or lesser period, of the relevant contract commences during such immediately succeeding accounting period, and (
- ii)each further accounting period where any subsequent 12 months, or lesser period, of the relevant contract commences during such further accounting period.”. PART 5 AMENDMENT OF INSURANCE ACT 1936 Amendment of section 3 of Insurance Act 1936. 27.— Section 3 of the Insurance Act 1936 is amended by substituting the following definition for the definition of “ premium ”: “the word ‘ premium ’ means any money or money’s worth payable or paid to any person who carries on an assurance business and who in consideration of such money or money’s worth undertakes any liability under any policy, bond or certificate, except that, for the purposes of— (
- a)calculating the solvency measures of such business (including any solvency margin or solvency ratio thereof), or (
- b)computing such a person’s profits for an accounting period for the purposes of corporation tax within the meaning of the Taxes Consolidation Act 1997 , such word does not include money or money’s worth of an amount equal to the amount payable or paid by such a person in respect of a stamp duty under section 125A of the Stamp Duties Consolidation Act 1999 ;”. 1OJC 297, 29.11.2005, p.4 1OJ No. L228 of 16 August 1973, p.3 2OJ No. L172 of 4 July 1988, p.1 3OJ No. L228 of 11 August 1992, p.1 4OJ No. L228 of 16 August 1973, p.3 5OJ No. L172 of 4 July 1988, p.1 6OJ No. L228 of 11 August 1992, p.1 Privacy Statement Accessibility European Legislation Identifier (PDF) Open Data License Ráiteas Príobháideachais Inrochtaineacht Aitheantóir Eorpach Reachtaíochta (ELI) Ceadúnas Sonraí Oscailte Liosta Fianán © Government of Ireland. Oireachtas Copyright Material is reproduced with the permission of the Houses of the Oireachtas © Rialtas na hÉireann. Atáirgtear ábhar faoi Chóipcheart le cead ó Thithe an Oireachtais