Oman Issues Implementation Rules for New Health Insurance Scheme | Mercer

Oman Issues Implementation Rules for New Health Insurance Scheme

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Oman Issues Implementation Rules for New Health Insurance Scheme
Oman Issues Implementation Rules for New Health Insurance Scheme
Calendar10 October 2019

Mandatory health insurance rules (Decision No. 78/2019) issued by Oman’s Capital Market Authority (CMA) establish the regulatory infrastructure for the health system (Dhamani) for private-sector employees, expatriates and foreign visitors announced last March. The CMA developed the rules working with concerned entities, such as the Oman Ministry of Health, Ministry of Manpower, Public Authority for Social Security, Royal Police, Chamber of Commerce and Industry, and Insurance Association.

Highlights

The rules cover four aspects of the mandatory health insurance system:

  • General provisions governing the health insurance market
  • Licensing requirements for insurance companies
  • Obligations of the main parties in the insurance relationship — third-party administrators (TPAs), health services providers, employers and employees
  • Dispute resolution

Licensed insurance companies, health service providers, TPAs and others will have to use the electronic “Dhamani Platform.” The purpose of this platform is to digitalize and enhance monitoring of the private healthcare system and health insurance services in Oman. The CMA is aiming to launch the e-healthcare system by mid-2020.

The regulations also restrict insurance companies from retaining more than 40% of the insurance premiums in Oman.

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