Westfield Health Scheme (FOI)

​Request 

The Westfield Scheme:

A

What are the total premiums paid? 

B

What is the total refund paid? 

C

Analysis of claims for example how many in the bands: 0 to £50, £50 to £100, £100 to £200, £200 to £300, £300 to £400, £400 to £500 

Response

The figures presented in response to this request relate to the Jersey 65+ Health Plan as it is currently structured. However, the Minister for Social Security has published draft regulations which, if approved by the States Assembly, will see the current plan replaced by a new, revised scheme at the beginning of 2017.

Administration of the new scheme will differ from what is currently in place and this may impact on future expenditure in the areas covered by this request. In particular, administration of the new scheme will be undertaken by the Department of Social Security itself and there will consequently be no need for the department to pay premiums in the way it does presently. At present, the department pays a monthly premium on behalf of each member of the plan, with the premium to cover both the benefit and the administrative costs incurred by Westfield Health. 

Instead, the department will retain the funding and pay the benefits directly to dentists, opticians and chiropodists on behalf of customers once services have been provided, rather than customers being reimbursed after they have themselves paid for the services provided, as happens currently. A link to the Draft Regulations is attached. They will be debated by the Assembly at its sitting of 12 July 2016.

Download Draft Social Security (Health Bonus Scheme) (Jersey) regulations 201- (size 433kb)

A

In 2015, the Social Security Department paid a total of £472,500 in premiums.

B

The total payment of benefits under the Jersey 65+ Health Plan in 2015 was £251,693.37.

Premiums also cover the fee to Westfield Health, which currently administers the plan. Any unspent premiums, beyond what is spent on the benefits and administration, are returned to the Department. In that regard, in 2015 a surplus of £164,568 was generated for the year. 

These figures differ from those presented in the report P.61/2016 in the link above. That report was produced prior to finalisation of the 2015 accounts and figures were taken from initial reporting by Westfield Health. The figures presented in this response reflect the final, confirmed position, as per the Department’s accounts.

C

 In 2015, the breakdown of payment of the benefits to members of the plan was as follows:

The largest single payment of benefit that may be paid under the plan is £500.