Qatar issues Executive Regulations to the new mandatory health insurance scheme

Qatar continues to forge ahead with the rollout of its mandatory healthcare insurance scheme by issuing the long-awaited Executive Regulations, which add to, and form, an integral part of the Law that came into effect in May 2022. The much-anticipated mandatory healthcare scheme will replace an earlier scheme (SEHA) which was launched in 2013 and then withdrawn in 2015. The mandatory healthcare scheme will apply to all expatriates and visitors to Qatar for the duration of their visit. At a time when Qatar is preparing to host the World Cup and see an influx of visitors, we look at the implications for the insurance sector and employers in Qatar.

The Law and the Executive Regulations

The new mandatory healthcare system was created under Law No. 22 of 2021 regulating the health services in Qatar (Law), which came into effect on 4 May 2022.

The eagerly awaited Resolution of Minister of Public Health No. (8) of 2022 Concerning the Issuance of Executive Regulations of Law No. (22) of 2021 Regulating Healthcare Services in the State (Executive Regulations) put flesh on the bones of the Law, providing the details on how the scheme will work. The Executive Regulations were published in the Official Gazette on 1 September 2022 and came into effect on 2 September 2022.

Significant changes to the insurance sector in Qatar

In a significant step, the Executive Regulations stipulate that mandatory health insurance, including basic and additional cover, can only be provided by insurers licensed in compliance with Qatar law and registered with the Ministry of Public Health (MOPH). Fundamentally, this means that international health insurers can no longer provide cover for members in Qatar through licensed intermediaries in the Qatar Financial Centre or the State, as was previously the position.

Consequently, there is a strict prohibition in the Law and the Executive Regulations on unlicensed insurance activities, thereby restricting the provision of insurance coverage to licensed entities in Qatar. This is a seismic change to the regulatory landscape in Qatar.

The Executive Regulations extend to and preclude insurance brokers and claims management companies from participating in the scheme unless they obtain the requisite authorisation to operate in Qatar and register with the MOPH.

The only exception to the strict prohibition is in relation to visitors to Qatar (persons who are not expatriates or residents) who hold a global health insurance policy which includes Qatar and covers basic healthcare comprising emergency and accident services will not be required to obtain cover from a Qatari registered insurer.

With health insurance mandatory to enter the country and the World Cup less than two months away, Qatari licensed insurers are well placed to capitalise on these changes. However, it remains to be seen if and how such entry requirement will be enforced.

Healthcare records

A further momentous change introduced by the Executive Regulations is the requirement to obtain express written consent from each member to disclose their medical records. This means where the insurer contemplates a reinsurance arrangement, it would need to get the express written permission of each member to disclose its medical records to the reinsurer.

These confidentiality obligations also apply to insurance brokers, claim management companies, employers and other healthcare entities operating in the scheme. Since the disclosure of information between parties to an insurance relationship is not excluded from the confidentiality obligations, how express consent will be obtained from each member practically is not contemplated by the Executive Regulations. Presumably, this will need to be considered in the context of Law No. (13) of 2016 Concerning Personal Data Protection Law (Data Protection Law) and the regulatory guidelines issued by the Compliance and Data Protection Department, which govern the processing of personal data in Qatar. Still, there is a question mark as to whether transferring personal data for a reinsurance arrangement would qualify as a lawful purpose.

Coverage and Employers’ responsibility

Qatar’s new mandatory healthcare insurance scheme distinguishes between basic and additional coverage. The list of basic healthcare services is set out in Annex 1 to the Executive Regulations. Additional healthcare services include all other healthcare services not included in the basic list.

Employers will be responsible for arranging basic healthcare insurance from a Qatari-licensed insurer for all their employees and their eligible families (i.e., spouses and up to three children under the age of eighteen) and paying the premiums for the cover.

Employers need to take note of these changes, as an employee’s residence permit will not be renewed unless the employer has implemented basic healthcare cover for its employee.

However, further details on the various plans and the costs are still awaited.

Enforcement

The Executive Regulations came into force immediately on 2 September 2022, with no transition period for the industry to adjust to the new scheme. However, the Law provides an exemption for existing insurance policies to remain in effect until their expiry, subject to approval from the MOPH. It is unclear how the exemption will be applied.

Given the lack of a grace period, there is uncertainty regarding how compliance with the requirements of the Executive Regulations will be enforced early on.

It is also unclear whether there will be a universal application of the scheme or whether it will be rolled out in phases. However, it is expected the rollout will first likely target visitors who will be required to hold basic healthcare cover.

We are still in a holding pattern until further announcements by the MOPH are made.

Action Required  

The insurance sector, employers, and sponsors should closely examine and acquaint themselves with the obligations imposed on them in the new mandatory healthcare scheme. Steps should be taken to implement measures to comply with the Law and the Executive Regulations as and when required.

Insurance policies issued by unlicensed international insurers will remain in effect until expiry. Those policies should be closely monitored. Likewise, employers should be reviewing their health benefit plans and contracts to determine what necessary updates are required to align with the Executive Regulations.

If you would like further information on any issue raised in this article, please contact Peter Hodgins, Emma Higham, Nasteho Muse or Lisa Merod. 

Disclaimer: Please note the English translation of the Executive Regulations is an unofficial translation into English of the original Arabic text, and the government officials in Qatar may interpret the text of the legislation differently. For the purposes of drafting this article Clyde & Co has used its own translation of the Executive Regulations. At the time of drafting this article, no official translation of the Executive Regulations has been published.