The Bermuda Heath Council has recommended several reforms to overhaul private health insurance companies.

In a report released yesterday the council said the reforms would "protect the public, promote equality and promote cost efficiency".

They are seeking the public's input on the reforms, some of which will be ready to launch next year.

l Create a more "robust" standard hospital benefit plan

The goal is to transform the current basic standard benefits to cover health care beyond hospitalisation. The review of the current system will also "identify mechanisms to ensure equitable reimbursement for providers of the standard hospital benefit". It would be available to the entire population as a stand-alone health plan. Work is currently underway on this proposal and a timeline will be established during the current fiscal year.

• Insurers have to accept anyone in their standard hospital benefit plan

Private companies would no longer be able to deny coverage based on age or pre-existing conditions. The council hopes to implement this by April 2011.

It added: "New regulations that establish system-wide lifetime coverage limits are also being contemplated." The council hopes to implement this by April 2012.

• The standard hospital benefit plan must be the same price across the board

The report proposed the plan be "sold to everyone at the same price, regardless whether they are covered under an individual or group health plan". It added: "We will investigate mechanisms to enable proportional premium contributions for the package based on a fixed percentage of an insured's salary."

A timeline for these developments will be established this fiscal year.

l Ensuring transparency in health care policies

This initiative would require insurers disclose all benefits, exclusions, requirements, limits, and costs of a health insurance policy to policy holders "in plain English" both in print and on their websites. The council hopes to implement this by April 2011.

l Tightening oversight to ensure companies are solvent

The report noted the demise of British American Insurance Company in 2009 underscored the need for companies to be solvent. It added that other local insurance companies saw their profits reduced due to lost investments in the stock market during the turbulent economic recession.

The council worked with the Bermuda Monetary Authority to look at the risk management policies local insurers are subject to under the Insurance Act 1978. It was decided that the Act, which established regulations that set capital adequacy, solvency, and liquidity standards, would have to be updated to meet European Union regulations for solvency. These changes are expected to be in place by the end of 2012.

• Increasing the reporting requirements of private insurance companies

The council and Bermuda Monetary Authority will now require additional information from companies before granting licences.

This includes audited financial statements and a list of the company's assets, including common stock, preferred shares, government bonds, corporate bonds, asset-backed securities, mortgages and real estate.

They would also require copies of the company's policy forms in respect of group policy holders and individual policy holders as well as the number of people they ensure and total yearly claims data, including claims for hospitalisation, physician, dental, prescription drug and overseas treatment.

l Companies will have to reimburse claims within 30 days

"This reform was commenced recently as the council introduced a standardised health claims form that will eventually be mandated for use system wide," the report stated. "Also planned are mandates fixing 30 days (as a starting point) as the maximum allowable time frame for the reimbursement of a 'clean' and complete claim from the day received.

By April 2012 the council would like companies to reimburse clients within 15 days.

l Companies will have to have a fully automated claims system

The objective is to move the health system toward a fully electronic claims submission, processing, and reimbursement system, the report said. It added: "International evidence has demonstrated that shrinking the footprint of the administrative costs of the health system, especially the cost of record keeping, makes health systems less expensive and more efficient."

Legislation will be tabled in 2011.