HEALTH INSURANCE PREMIUMS REGULATION

Transcription

1 Province of Alberta HEALTH INSURANCE PREMIUMS ACT HEALTH INSURANCE PREMIUMS REGULATION Alberta Regulation 217/1981 With amendments up to and including Alberta Regulation 6/2016 Office Consolidation Published by Alberta Queen s Printer Alberta Queen s Printer 7 th Floor, Park Plaza Avenue Edmonton, AB T5K 2P7 Phone: Fax: qp@gov.ab.ca Shop on-line at

2 Copyright and Permission Statement Alberta Queen's Printer holds copyright on behalf of the Government of Alberta in right of Her Majesty the Queen for all Government of Alberta legislation. Alberta Queen's Printer permits any person to reproduce Alberta s statutes and regulations without seeking permission and without charge, provided due diligence is exercised to ensure the accuracy of the materials produced, and Crown copyright is acknowledged in the following format: Alberta Queen's Printer, 20.* *The year of first publication of the legal materials is to be completed. Note All persons making use of this consolidation are reminded that it has no legislative sanction, that amendments have been embodied for convenience of reference only. The official Statutes and Regulations should be consulted for all purposes of interpreting and applying the law.

3 (Consolidated up to 6/2016) ALBERTA REGULATION 217/81 Health Insurance Premiums Act HEALTH INSURANCE PREMIUMS REGULATION 1(1) Except where a term is defined in subsection (2), a term defined in the Alberta Health Care Insurance Act or the Alberta Health Care Insurance Regulation has the same meaning in this Regulation. (2) In this Regulation (a) Act means the Health Insurance Premiums Act; (a.01) benefit period means a period of 12 consecutive months commencing on April 1 in each year; (a.1) certificate of registration has the same meaning as certificate of registration in section 24 of the Act; (b) collector s group means a group formed pursuant to section 12 of the Act; (b.1) dependant means, in relation to any person, (i) the spouse or adult interdependent partner of that person, (ii) each unmarried child under the age of 21 years who is wholly dependent on that person for support, (iii) each unmarried child less than 25 years of age who is in full-time attendance at an accredited educational institute, and (iv) each unmarried child 21 years of age or more who is wholly dependent on that person by reason of mental or physical infirmity; (c) designated group means a group designated by the Minister as such pursuant to section 9 of the Act; (d) employee means a person employed by an employer to do work or provide services of any nature and who is in receipt of or entitled to wages;

4 Section 1.1 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (e) employee group means a group formed pursuant to section 10 of the Act; (f) employer in relation to an employee, means the person from whom the employee receives his or her wages; (g) employer s group means a group required to be formed pursuant to section 8 of the Act; (h) group means a collector s group, a designated group, an employee group or an employer s group; (i) premium notice means a notice sent by the Minister to a person or group liable to pay a premium under the Act showing the amount of the premium or instalment of the premium payable by that person or group; (j) prescribed means prescribed by the Minister; (k) taxable income means, in sections 3, 6 and 7, the taxable income from line 260 of the income tax return filed under the Income Tax Act (Canada). (3) In sections 3 and 6 the expression preceding taxation year means the taxation year under the Income Tax Act (Canada) immediately preceding the taxation year in force at the commencement of a benefit period but for the purpose of determining eligibility for subsidized premiums under section 8(2)(c) of a person who becomes a registrant on moving to Alberta from outside Canada, the preceding taxation year shall be the taxation year immediately preceding the taxation year in force on the date the first 12 consecutive months of residence in Alberta is completed. (4) Repealed AR 39/87 s2. AR 217/81 s1;215/83;225/84;39/87;71/89;63/2002;263/2002;109/2003;7/2011 Part 1 Premiums 1.1 Notwithstanding anything in this Regulation, the monthly premium payable for basic health services and insured hospital services for January, 2009 and subsequent months is $0.00. AR 204/2008 s2 2 The monthly premium payable for basic health services and insured hospital services (a) by a registrant with no dependants or by a member of the Canadian Forces with one dependant or by a person 2

5 Section 3 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada) who has one dependant shall be the premium shown in section 1 of the Schedule, and (b) by a registrant with dependants, or by a member of the Canadian Forces with more than one dependant, or by a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada) who has more than one dependant, shall be the premium shown in section 2 of the Schedule, unless section 3, 3.1 or 12 of this Regulation or section 4 or 5 of the Act applies. AR 217/81 s2;215/83;225/84;37/97;39/99;263/2002; 207/2004;173/2014 3(1) A registrant to whom section 7(2), (3) or (4) does not apply is eligible, if his or her taxable income falls within any of the categories specified in subsection (2), to apply in the prescribed form for a subsidized premium for basic health services and insured hospital services in respect of a benefit period. (1.1) Notwithstanding subsection (1), a person whose ordinary place of residence is outside Canada and who is in full-time attendance as a student at an accredited educational institute in Alberta is not eligible to apply under subsection (1). (2) An application for a subsidy may be approved by the Minister and, for that purpose, (a) if the registrant (i) has no dependants, or (ii) is a member of the Canadian Forces and has one dependant who is a child, or is a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada) and has one dependant who is a child and the taxable income of the registrant for the preceding taxation year is $ or more but less than $20 970, the monthly subsidized premium that the registrant is liable to pay is determined by taking 15% of the difference between the taxable income and $ and dividing that amount by 12; (b) if the registrant 3

6 Section 3 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (i) has one dependant, who is the registrant s spouse or adult interdependent partner, or (ii) is a member of the Canadian Forces and has one dependant, who is the registrant s spouse or adult interdependent partner, or is a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada) and has one dependant, who is the registrant s spouse or adult interdependent partner and the combined taxable income of the registrant and the registrant s spouse or adult interdependent partner for the preceding taxation year is $ or more but less than $33 240, the monthly subsidized premium that the registrant is liable to pay is determined by taking 15% of the difference between the combined taxable income and $ and dividing that amount by 12; (c) if the registrant (i) has one or more dependants, at least one of whom is a child, or (ii) is a member of the Canadian Forces and has more than one dependant, at least one of whom is a child, or is a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada) and has more than one dependant, at least one of whom is a child and the taxable income of the registrant, or the combined taxable income of the registrant and the registrant s spouse or adult interdependent partner, where applicable, for the preceding taxation year is $ or more but less than $39 250, the monthly subsidized premium that the registrant is liable to pay is determined by taking 15% of the difference between the taxable income or combined taxable income and $ and dividing that amount by 12; (d) if the taxable income of the registrant referred to in clause (a) for the preceding taxation year is less than $17 450, no premium is payable; (e) if the combined taxable income of the registrant and the registrant s spouse or adult interdependent partner referred to in clause (b) for the preceding taxation year is less than $26 200, no premium is payable; 4

7 Section 3.1 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (f) if the taxable income of the registrant, or the combined taxable income of the registrant and the registrant s spouse or adult interdependent partner, where applicable, referred to in clause (c) for the preceding taxation year is less than $32 210, no premium is payable. AR 217/81 s3;215/83;225/84;166/87;190/88;308/89;216/93; 214/94;37/97;63/2002;109/2003;70/2006;7/2011;173/ (1) Notwithstanding section 3, if a registrant or the registrant s spouse or adult interdependent partner is 65 years of age or over, the registrant is eligible for a full premium subsidy on behalf of the registrant and the registrant s dependants. (2) Where only the registrant s spouse or adult interdependent partner is 65 years of age or over, subsection (1) only applies if the registrant s spouse or adult interdependent partner is a resident of Alberta. (3) Sections 7(2) and (3) and 8 do not apply to a subsidy under this section. (4) This section is effective with respect to a registrant, (a) who becomes a registrant on or after October 1, 2004, on the date on which the registration becomes effective, where at the time of registration the registrant or the registrant s spouse or adult interdependent partner is 65 years of age or over, (b) on October 1, 2004, where the registrant or the registrant s spouse or adult interdependent partner is 65 years of age or over on that date, (c) on the first day of the first month following the 65th birthday of the registrant or the registrant s spouse or adult interdependent partner, where the birthday occurs after October 1, 2004, or (d) on the 65th birthday of the registrant or the registrant s spouse or adult interdependent partner, where the birthday falls on the first day of a month and occurs after October 1, (5) The subsidy under this section ceases at the end of the 2nd month following the month in which the death occurs, as the case may be, of the registrant or the registrant s spouse or adult interdependent partner who was 65 years of age or over at the time of death. AR 207/2004 s3 5

8 Section 5 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 4 Repealed AR 215/83 s5. 5 The monthly premium payable for Alberta Blue Cross Plan non-group membership (a) by a registrant with no dependants, or by a member of the Canadian Forces with one dependant or by a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada) who has one dependant shall be the premium shown in section 9 of the Schedule, and (b) by a registrant with dependants, or by a member of the Canadian Forces with more than one dependant or by a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada) who has more than one dependant, shall be the premium shown in section 10 of the Schedule, unless section 6 or 8.3 of this Regulation or section 5 of the Act applies. AR 217/81 s5;215/83;225/84;166/87;214/94;37/97; 263/2002;173/2014 6(1) A registrant referred to in section 3(2)(a), (b) or (c) to whom section 7(2), (3) or (4) does not apply is eligible to apply in the prescribed form for a subsidized premium for Alberta Blue Cross Plan non-group membership in respect of a benefit period. (1.1) Notwithstanding subsection (1), a person whose ordinary place of residence is outside Canada and who is in full-time attendance as a student at an accredited educational institute in Alberta is not eligible to apply under subsection (1). (2) An application for a subsidy may be approved by the Minister and (a) in the case of a registrant referred to in section 3(2)(a) or (d), the monthly subsidized premium the registrant is liable to pay is the amount set out in section 11 of the Schedule, and (b) in the case of a registrant referred to in section 3(2)(b), (c), (e) or (f), the monthly subsidized premium the registrant is liable to pay is the amount set out in section 12 of the Schedule. AR 217/81 s6;215/83;225/84;166/87;190/88;308/89;216/93; 214/94;37/97;63/2002 6

9 Section 7 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 7(1) For the purposes of sections 3(2) and 6(2) the reference to the taxable income of a spouse or adult interdependent partner does not apply (a) if the registrant and spouse or adult interdependent partner maintain separate homes and are registered separately, (b) if the registrant and spouse have been granted a decree absolute of divorce, or (c) if the registrant or spouse or adult interdependent partner dies. (2) A registrant is not eligible to apply for or receive a subsidized premium if the registrant is exempt from paying income tax under the Income Tax Act (Canada) because (a) the registrant belongs to or is a member of a religious or charitable society, order or community, or (b) the provisions of an international tax agreement, convention or treaty apply to the registrant. (3) A person who becomes a registrant on moving to Alberta from outside Canada is not eligible for a subsidized premium during the first 12 consecutive months of residence in Alberta. (4) Repealed AR 7/2011 s3. AR 217/81 s7;308/89;216/93;63/2002;109/2003;7/2011 8(1) When the application of a registrant for a subsidized premium is approved by the Minister, the approval applies to the current benefit period and, subject to subsection (1.1), to any succeeding benefit period in which the registrant remains eligible under section 3 for a subsidized premium. (1.1) If in a succeeding benefit period the registrant remains eligible for a subsidized premium under a different clause in section 3(2), the amount of the premium that the registrant is liable to pay shall be adjusted in accordance with that clause. (2) An application for a subsidized premium by a registrant made during a benefit period will not be approved by the Minister where the registrant was not eligible for the subsidized premium at the commencement of the benefit period, except where (a) a condition described in section 7(1) occurs during the benefit period, 7

10 Section 8.01 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (b) a person becomes a registrant on moving to Alberta from another province or territory of Canada during the benefit period, (c) a person becomes a registrant on moving to Alberta from outside Canada and the 12 month period referred to in section 7(3) ends within the benefit period, (d) the registrant was a dependant during the benefit period, (e) a registrant, who had no dependants at the commencement of the benefit period, acquires a dependant during the period, or (f) the taxable income levels specified in sections 3 and 6 are varied during the benefit period. (3) Where a registrant who is eligible to apply for a subsidized premium at the commencement of a benefit period fails to do so, he or she may apply at any time during the benefit period and the Minister may approve the application and grant a subsidized premium to be effective from the first day of the benefit period. (4) Where an eligible registrant failed to apply for a subsidized premium during a benefit period for which his or her application for a subsidized premium could have been approved by the Minister he or she may subsequently apply in respect of that period and the Minister may approve the application and grant a subsidized premium to the registrant by making the appropriate retroactive adjustment to the registrant s premium. AR 217/81 s8;216/93;37/97;7/ (1) In this section, material change means, with respect to a registrant s account, (a) a change in a registrant s account category from one to another of the following: (i) single; (ii) family with no children; (iii) family with children; (b) a change in the amount of taxable income arising out of the loss or acquisition by the registrant of a spouse or adult interdependent partner. (2) Notwithstanding section 8, where at any time during a benefit period a registrant who is receiving a subsidized premium experiences a material change that could affect the registrant s 8

11 Section 8.1 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 eligibility with respect to a subsidized premium or the amount of the subsidy, the Minister may reassess the subsidized premium based on the material change. AR 263/2002 s5;109/ Pursuant to section 14 of the Act, the Minister may waive the payment of the whole or a part of the premium of a registrant who is a senior and who applies in a manner satisfactory to the Minister, for a waiver of premiums for reasons of financial hardship. AR 214/94 s5;263/ Repealed AR 207/2004 s4. 8.3(1) A registrant is not liable for the payment of premiums for Alberta Blue Cross Plan non-group membership on behalf of the registrant, the registrant s spouse or adult interdependent partner or the registrant s dependants, if the registrant is (a) 65 years of age or over or the registrant s spouse or adult interdependent partner is 65 years of age or over, or (b) eligible for receipt of benefits under the Widows Pension Act. (2) This section is effective with respect to a registrant, (a) on the date on which the registration becomes effective, where at the time of registration (i) the registrant or the spouse or adult interdependent partner of the registrant is 65 years of age or over, or (ii) the registrant is deemed eligible for benefits under the Widows Pension Act, (b) on the first day of the first month following the 65th birthday of the registrant or the registrant s spouse or adult interdependent partner, where the birthday occurs after the effective date of the registration, (c) on the 65th birthday of the registrant or the registrant s spouse or adult interdependent partner, where the birthday falls on the first day of a month and occurs after the effective date of registration, or (d) on the first day of the month in which a registrant becomes eligible for receipt of benefits under the Widows Pension Act, where eligibility occurs after the effective date of the registration. 9

12 Section 9 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (3) The exemption from liability for the payment of premiums under subsection (1) ceases at the end of the 2nd month following the month in which the death occurs, as the case may be, (a) of the registrant or the registrant s spouse or adult interdependent partner who was 65 years of age or over at the time of death, or (b) of a registrant who is in receipt of benefits under the Widows Pension Act. (4) Where a registrant who is in receipt of benefits under the Widows Pension Act ceases to be eligible to receive those benefits for reasons other than death, the exemption from liability for the payment of premiums under subsection (1) ceases at the end of the same month in which the registrant ceased to be eligible to receive the benefits under the Widows Pension Act. AR 214/94 s5;263/2002;109/2003 9(1) Pursuant to section 14 of the Act, a registrant who is liable to pay premiums but is unable to do so because of financial hardship, may apply to the Minister in the prescribed form for waiver of premiums for basic health services and insured hospital services during the period in which the registrant is unable to pay his or her premiums. (1.1) Notwithstanding subsection (1), (a) a person whose ordinary place of residence is outside Canada and who is in full-time attendance as a student at an accredited educational institute in Alberta, (b) repealed AR 7/2011 s5 is not eligible to apply under subsection (1). (2) Repealed AR 225/84 s3. (3) The Minister may waive the payment of the whole or any part of the premiums of an applicant for basic health services and insured hospital services during the period of financial hardship for a period prescribed by the Minister not exceeding 6 months. (3.1) In making an application for waiver of premiums, (a) an applicant shall disclose in the application the applicant s gross income received from all sources during the 3 calendar months immediately preceding the date of the application, 10

13 Section 9 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (b) an applicant with dependants shall include in the application the gross income received from all sources by the applicant s dependants during the 3 calendar months immediately preceding the date of the application, and (c) an applicant who has rental income or income from self-employment, investment or a business, including a farming operation, shall disclose in the application the applicant s expenses in respect of the self-employment, investment, rental operation or business and the expenses shall be deducted from the applicant s gross income for the purposes of this section. (3.2) For the purposes of this section gross income includes income from employment, self-employment, investment or business, including a farming operation, rental income, commission income, unemployment insurance benefits, workers compensation benefits, veteran s allowance, maintenance or support payments, training allowance, pension benefits, disability benefits, grants, benefits under a policy of insurance or annuity contract and payments received from a union during a labour dispute, but does not include family allowance benefits and proceeds from a student loan. (3.3) The gross income of an applicant for the 3 calendar months immediately preceding the date of the application shall be averaged for the purpose of determining his or her eligibility for waiver of premiums. (3.4) The level of income of an applicant determined under subsection (3.3) shall be compared with the levels of income prescribed by the Minister as the qualifying levels of income for the classes of applicants for waiver of premiums and if the level of income of an applicant is equal to or less than the qualifying level of income for the class of the applicant, the Minister may grant a waiver of premiums to the applicant. (3.5) Notwithstanding subsection (3.4), the Minister may grant an applicant a waiver of premiums if the payment of premiums by the applicant would result in financial hardship, in the opinion of the Minister, having regard to any advice or recommendation the Minister may receive from the Department of Human Services. (3.6) A waiver of premiums shall be effective from the first day of the month in which the application for waiver was dated but in the case of an applicant who in the opinion of the Minister has not paid his or her premiums during the 3 calendar months disclosed in the application, by reason of financial hardship, the Minister may make the waiver of premiums effective from the first day of any of the 3 calendar months disclosed in the application. 11

14 Section 10 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (3.7) If the level of income of an applicant exceeds the qualifying level referred to in subsection (3.4) during the period the applicant has qualified for waiver of premiums, the Minister may terminate the applicant s qualification for waiver of premiums. (3.8) If the information disclosed in an application is incorrect, to the extent that the correct information discloses that the applicant does not qualify for waiver of premiums, the Minister shall terminate the waiver of premiums retroactively and the registrant is liable for the payment of the premiums applicable while the waiver had been in effect. (4) If the Minister has waived the payment of premiums by a registrant for basic health services and insured hospital services under this section, the registrant may apply to the Minister in the prescribed form for renewal of the waiver and the Minister may grant a renewal of the waiver for a further period or periods. (5) A renewal of waiver under subsection (4) is subject to any terms and conditions that the Minister may prescribe and shall be effective from the first day of the month designated by the Minister. (6) A person who becomes a registrant on moving to Alberta from outside Canada is not eligible for waiver of premiums during the first 12 consecutive months of residence in Alberta. AR 217/81 s9;215/83;225/84;44/85;190/88;308/89;37/97; 263/2002;7/2011;31/2012;170/ Repealed AR 225/84 s4. 10(1) The Minister shall send a premium notice at least once every quarter to each registrant who is liable to pay a premium for basic health services and insured hospital services or a premium for Alberta Blue Cross Plan non-group membership specifying the amount of each premium payable by the registrant at the time the notice is sent but no notice need be sent to a registrant with respect to any period during which the registrant is a member of a group unless the registrant is enrolled with the Minister as a non-group member of the Alberta Blue Cross Plan. (1.1) Notwithstanding subsection (1), the Minister is not required to send a premium notice under subsection (1) where the registrant is not in arrears in the payment of premiums and (a) the registrant has entered into an arrangement that is satisfactory to the Minister for the payment of the premiums, or 12

15 Section 10.1 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (b) the registrant does not have Alberta Blue Cross Plan non-group coverage and (i) is receiving full premium assistance, or (ii) any premiums payable by the registrant have been declared as forgone revenue. (2) A registrant is liable for premiums as of the first day of the first month following the date on which his or her registration becomes effective under the Act but when the registration becomes effective on the first day of any month the registrant is liable for premiums as of that day and remains liable for premiums when due so long as the registrant remains eligible for benefits under the Alberta Health Care Insurance Act and is not exempt from the payment of premiums under the Act or the regulations under the Act. (3) Subsections (1) and (2) apply with the appropriate changes to a member of the Canadian Forces with one or more dependants, or to a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada) who has one or more dependants, who are or who become residents of Alberta. (4) Repealed AR 225/84 s5. AR 217/81 s10;350/83;225/84;39/87;37/97;263/2002; 7/2011;173/ The Minister may deem premiums payable by a non-senior registrant as foregone revenue, (a) where that registrant is a directly billed account holder whose quarterly premium billable amount is less than $10, or (b) where, in respect of that registrant, an account is billed through a group plan and the monthly premium payable is $3.33 or less. AR 263/2002 s10 11(1) Where the premium of any registrant becomes subject to a reduction or increase by reason of a change of status or otherwise on a day other than the first day of a month, the reduction or increase shall be calculated as of the first day of the next following month, but where the premium becomes subject to a reduction or increase on the first day of any month, the reduction or increase shall be calculated as of that day. 13

16 Section 12 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (2) Subject to subsection (3), if a registrant has a credit under subsection (1) the Minister shall refund the amount of the credit to the registrant or the person lawfully entitled to it. (3) If the credit referred to in subsection (2) is less than $5 the Minister may withhold the refund until it is requested by the registrant. (4) If a registrant who has paid instalments of his or her premium in advance becomes a member of a group, the Minister shall refund to the registrant the advance instalments that would otherwise be applied after the date on which the registrant became a member of the group. (5) Notwithstanding subsections (2), (3) and (4) the Minister shall not refund an overpayment of premium if the registrant, or the person lawfully entitled to the refund, is otherwise indebted to the Minister. AR 217/81 s11;7/ Subject to any conditions prescribed by the Minister, (a) a registrant is not liable for the payment of a premium under section 3 of the Act while he or she is (i) in receipt of income support or benefits under the Income and Employment Supports Act or benefits under the Assured Income for the Severely Handicapped Act, (ii) a patient for more than 60 days in a facility designated for the purpose of this section by the Minister, (iii) a ward of the Crown under any statute of the Province, (iv) on remand or serving a term of imprisonment in a correctional institution as defined in the Corrections Act, or (v) opted out of the Plan under section 25 of the Health Insurance Premiums Act; (b) the Public Trustee or a committee administering the estate of a person under any statute of the Province is not liable to pay a premium under section 3 of the Act in respect of that person where the estate has no assets; (c) where a registrant or his or her spouse or adult interdependent partner is in receipt of a war veterans 14

17 Section 13 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 allowance or a civilian war allowance from the Department of Veterans Affairs (Canada), the registrant is not liable to pay that portion of his or her premium under section 3 of the Act that is not paid on his or her behalf by the Government of Canada. AR 217/81 s12;215/83;263/2002;109/2003;7/2011 Part 2 Groups 13(1) For the purposes of section 8 of the Act with respect to employer s groups the prescribed number of employees is 5 except where the Minister, in any specific case, directs that the prescribed number of employees be less than 5. (2) For the purposes of subsection (1) an employer need not count as an employee (a) any person who normally attends an accredited educational institute, who is on vacation and whose term of employment does not exceed 5 months; (b) any person whose term of employment is less than 100 hours per month; (c) any person who is temporarily employed for a period of not more than 3 months, where the date of termination of the employment is fixed at the commencement of the employment and shown on the employer s records to occur not later than 3 months after the first day of employment; (d) any person who is a member of a group other than the group from which he or she seeks exemption and whose premiums are remitted by the other group; (e) any person who is a dependant, unless premiums are deducted from his or her salary or otherwise collected in accordance with section 20(3); (f) any person who is not a resident of Alberta; (g) any person who has elected to stay outside the Plan under section 25 of the Act; (h) any person who is an Indian within the meaning of the Indian Act (Canada); 15

18 Section 14 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (i) any person who is 65 years of age or over, or whose spouse or adult interdependent partner is 65 years of age or over; (j) any registrant who is receiving a widow s pension under the Widows Pension Act. (3) The Minister may authorize an exemption in any special case not referred to in subsection (2). (4) Notwithstanding subsection (2), a person referred to in subsection (2)(b) may request to join an employer s group and the person s employer shall comply with the request. (5) While an employer employs any person for a probationary period of 3 months or less, the Minister may authorize the employer to exclude the employee from the employer s group and to exclude the employee s name from any return or documents required to be submitted to the Minister in respect of the group, but the authorization does not exempt the employer from furnishing to the Minister, in respect of the employee, any information required for registration under section 27. AR 217/81 s13;215/83;225/84;263/2002;109/2003;7/ (1) Each employer whose employees qualify as a group under section 13 shall register with the Minister as an employer on the prescribed form, but the employer need not remit any premiums of its employees until notified to do so by the Minister. (2) An employer who fails to register under subsection (1) is guilty of an offence. AR 217/81 s14;7/ (1) Where the Minister (a) is satisfied that the employees of an employer qualify as an employer s group, (b) has designated the employees of an employer as a designated group, or (c) has agreed to the formation of an employee group or a collector s group the Minister shall issue instructions to the agent in respect of the group to enrol as a group, in the form prescribed by the Minister, all persons eligible to be members of the group, and to record in the prescribed form all persons not eligible to be members of the group. 16

19 Section 16 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (2) The agent shall forward the completed forms to the Minister on or before the enrolment completion date assigned by the Minister. (3) Upon completion of enrolment the Minister shall forward to the agent instructions concerning the collection and remittance of premiums which the agent is liable to remit on behalf of its group. (4) An employer who fails to enrol an employer s group in accordance with these Regulations and the Minister s instructions is guilty of an offence. AR 217/81 s15;7/ Premiums and arrears of premiums collected by an employer or other agent from its employees or members of its group on behalf of the Minister are deemed to be held in trust for the Minister. AR 217/81 s16;7/ The premiums payable to the Minister by an agent with respect to a group pursuant to the Act and this Regulation shall be remitted in monthly instalments by the agent within the time set out in the group premium notice. AR 217/81 s17;7/ (1) When notified pursuant to section 13 of the Act, an employer with respect to an employer s group or designated group, or an agent with respect to employee group, shall cause to be deducted from the employee s or member s wages and shall remit to the Minister, in addition to the applicable monthly premiums, the arrears owing to the Minister by the employee or member of the employee group in the manner set out in the notification. (2) The notification from the Minister under subsection (1) shall indicate the total arrears owing by the employee or member and shall specify the minimum monthly payment determined by the Minister to be required in respect of the arrears, and the employer or the agent with respect to an employee group shall deduct or otherwise collect and remit to the Minister at least the specified minimum monthly payment. AR 217/81 s18;215/83;263/ (1) Subject to section 13(5), where a resident becomes an employee of an employer who is an agent of the Minister with respect to a group, or becomes a member of an employee group (a) on a day other than the first working day of any month, the employee shall be deemed to be a member of the group effective from the first day of the first following 17

20 Section 20 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 month and the monthly instalment of the employee s premium shall be calculated as of that day; (b) on the first working day of any month, the monthly instalment of the employee s premium shall be calculated as of that day. (2) For the purposes of this Regulation, where a registrant is a member of an employer s group, a designated group, or an employee group and the registrant s employment ceases or he or she leaves the employee group (a) on a day other than the first working day of any month, the registrant shall be deemed to continue to be a member of the group until the first day of the first following month; (b) on the first day of a month, the registrant shall be deemed to have ceased to be a member of the group as of that day. (3) Within the time prescribed by the Minister (a) an employer shall notify the Minister of the date on which a registrant ceased to be employed, and (b) an agent of the Minister with respect to an employee group shall notify the Minister of the date on which a registrant left the group. AR 217/81 s19;7/ (1) The Minister may issue to agents of the Minister with respect to groups instructions concerning the collection and remittance of premiums and other matters concerning the functioning of groups. (2) The Minister may order the termination of a group, if the group is not being administered in accordance with the Act, this Regulation or the Minister s instructions. (3) If a dependant is employed and is a member of a group, the group may, on the request of the dependant, deduct from the dependant s wages, or otherwise collect from the dependant, and remit to the Minister any premiums payable by the registrant, including arrears. (4) An employer who fails to administer its employer s group in accordance with the Act, this Regulation or the Minister s instructions is guilty of an offence. AR 217/81 s20;7/

21 Section 21 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 Part 3 Registration 21(1) Subject to sections 24 and 30, every resident of Alberta shall register himself or herself and his or her dependants, if any, with the Minister on the prescribed form. (2) Subject to subsection (2.1) and sections 24 and 30, every person who becomes a resident of Alberta on coming from any other province of Canada, including a person who was formerly a resident of Alberta, shall register himself or herself and his or her dependants, if any, with the Minister before the first day of the 4th month following the date of becoming a resident of Alberta, and the person s registration is effective on the first day of the 3rd month following the date the person becomes a resident of Alberta. (2.1) If a person registered under subsection (2) is a dependant of a member of the Canadian Forces, the person s registration is effective on the day the person became a resident of Alberta. (3) Subject to sections 24 and 30, every person who becomes a resident of Alberta on coming from any place outside Canada, including a person who was formerly a resident of Alberta, shall register himself or herself and his or her dependants, if any, with the Minister not later than 3 months after the date of becoming a resident of Alberta, and the person s registration is effective on the day the person became a resident of Alberta. AR 217/81 s21;225/84;7/2011;173/ (1) Subject to subsection (2), if an application by a resident for registration is made under (a) section 21(2) or (3) after the period prescribed in the applicable subsection, or (b) section 25(3)(a), the registration becomes effective (c) 3 months prior to (i) the date of application, or (ii) the date the health service was provided, whichever is the earlier, or (d) on the date determined under section 21, if that date is later than the date determined under clause (c). 19

22 Section 23 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (2) If a resident is an employee of an employer who is an agent at the time he or she applies for registration under section 21(1) or for registration under subsection (1), the registration becomes effective (a) 3 months prior to (i) the date of application, or (ii) the date that a health service was provided, or (b) the first day of the month following 3 complete months of employment with that employer, whichever is the earliest, or (c) on the date determined under section 21, if that date is later than the date determined under clauses (a) or (b). AR 217/81 s22;225/84;7/2011;173/ (1) The person who is primarily responsible for the maintenance and support of the person s family shall be registered as registrant. (2) If circumstances change so that (a) a person registered as registrant under subsection (1) is no longer primarily responsible for the maintenance and support of the person s family, and (b) the person s spouse or adult interdependent partner becomes primarily responsible, the Minister may change the person s registration to that of dependant and change the registration of the person s spouse or adult interdependent partner to that of registrant. AR 225/84 s7;109/2003;7/ A resident is exempt from registering himself or herself while he or she is (a) a member of the Canadian Forces, (b) repealed AR 173/2014 s8, (c) serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada), or 20

23 Section 25 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (d) entitled under any Act of the Parliament of Canada other than the Canada Health Act (Canada) to all insured services. AR 225/84 s7;37/97;7/2011;173/ (1) A person who ceases to be exempt from registration by reason of (a) ceasing to be a member of the Canadian Forces, or (b) repealed AR 173/2014 s9, (c) ceasing to serve a term of imprisonment in a penitentiary (as defined in the Corrections and Conditional Release Act (Canada)) in Alberta, shall register no later than 3 months after ceasing to be exempt from registration. (2) A registration under subsection (1) that occurs within the prescribed period shall become effective on the day the person ceases to be exempt from registration. (3) Where the service of a person who is a member of the Canadian Forces terminates within Alberta, or where a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada), is released within Alberta, and fails to register within the period prescribed in subsection (1) (a) if the person remains a resident of Alberta, his or her subsequent registration shall be in accordance with section 22 or 26, or (b) subject to section 8 of the Alberta Health Care Insurance Regulation (AR 76/2006), if the person leaves Alberta permanently, his or her entitlement to be registered shall be in accordance with section 22 or 26. AR 225/84 s7;37/97;7/2011;173/ (1) When the Minister finds that a resident who is required to be registered is not registered, the Minister may, subject to section 30, register the resident and his or her dependants, if any, and shall notify the resident of the registration and the registration becomes effective (a) 3 months prior to (i) the date he or she is registered by the Minister, or 21

24 Section 27 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (ii) the date the health service is provided, or (b) the first day of the month following 3 full months of employment with an employer who is an agent, whichever is the earliest, or (c) on the date determined under section 21, if that date is later than the date determined under clauses (a) or (b). (2) If a resident or his or her dependant who is required to be registered is not registered with the Minister and (a) makes a claim for benefits for a health service, (b) receives an insured service within the meaning of Part 3 of the Hospitals Act, or (c) becomes employed by an employer whose employees are members of an employer s group or a designated group or becomes a member of an employee group under the Act, the practitioner, hospital board, employer or trade union or employee association, as the case may be, shall furnish the Minister with information regarding the resident and his or her dependants, that may be required by the Minister, in the prescribed form, to enable the Minister to register the resident and his or her dependants, subject to section 30. AR 225/84 s7;7/ (1) Notwithstanding section 26(1) and subject to conditions that may be prescribed by the Minister, the registration of a resident who is not already registered and who is (a) in receipt of income support or benefits under the Income and Employment Supports Act or benefits under the Assured Income for the Severely Handicapped Act, (b) a patient in a mental health care facility designated for the purpose of this section by the Minister after consultation with the Minister of Human Services, (c) a ward of the Crown in right of Alberta, or (d) on remand or serving a term of imprisonment in a correctional institution as defined in the Corrections Act, shall be effective from the date on which he or she became entitled to the income support or benefits, was admitted to the mental health care facility, or became a ward of the Crown or an inmate of the correctional institution, as the case may be. 22

25 Section 28 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (2) If a registrant or a spouse or adult interdependent partner claims to be 65 years of age or older, the Minister may require that the registrant or spouse or adult interdependent partner provide proof of age. AR 225/84 s7;37/97;109/2003;7/2011;31/2012;170/ (1) The Minister may issue a certificate of registration to each registrant in the prescribed form. (2) A resident registered with the Minister who receives a health service from a practitioner or an insured service within the meaning of Part 3 of the Hospitals Act shall present his or her certificate of registration to the practitioner or the appropriate official of the hospital, as the case may be. AR 225/84 s7;7/ If a person, at the time of registration, files a declaration that he or she elects to be outside the Plan in accordance with section 25 of the Act, the declaration shall be effective only during the period commencing on the effective date of the registration and ending on the 30th day of June first following the date on which it is filed. AR 225/84 s7;263/2002;7/2011;173/ (1) Subject to subsections (3) and (3.1), a registrant shall register the name of his or her dependants, if any, on his or her registration form but he or she is not required to register on his or her registration form the name of (a) the registrant s adult interdependent partner, (b) the registrant s spouse or adult interdependent partner, if the registrant and his or her spouse or adult interdependent partner maintain separate homes, whether pursuant to a court order or separation agreement or not, or (c) a dependant who is entitled to all insured services by reason of being entitled to and eligible for the same services under an Act of Parliament other than the Canada Health Act (Canada). (2) Subject to subsection (3), a child of a registrant or person referred to in subsection (1)(a) or (b) shall be registered on the registration form that includes the parent who has custody of the child. (3) A registrant shall not register a dependant who is not resident in Alberta unless the dependant is, 23

26 Section 31 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (a) within Canada on a vacation or visit of not more than 12 months duration, or (b) in full-time attendance as a student at an accredited educational institute, with the intention to become a permanent resident of Alberta on the conclusion of the vacation, visit or attendance. (3.1) A registrant while in receipt of a widow s pension, shall not register his or her adult interdependent partner as his or her dependant. (4) A registrant shall not register that registrant s child if that child was born outside of Alberta except where (a) a parent of the child was, at the time of that child s birth, a resident of Alberta but temporarily absent from Alberta, and (b) it is the intent of the parent who is a resident of Alberta that the child will reside in Alberta when the parent s temporary absence from Alberta ends. (4.1) The coverage under the Plan for a child who is registered under subsection (4) is effective on the date of the child s birth. (5) Subject to subsection (3), if a person referred to in section 24 has dependants who are residents in Alberta, the person shall register those dependants. (6) A registrant shall notify the Minister as soon as a person registered as the registrant s dependant no longer qualifies as the registrant s dependant and where applicable shall furnish to the Minister the latest known address of that person. (7) A person who no longer qualifies as a dependant shall be deleted from registration as a dependant. (8) When a dependant is deleted from a registration for any reason other than the dependant s death, the Minister shall send a notice of deletion, the reason for the deletion and the effective date of the deletion, to the dependant at his or her latest known address. (9) Any person who registers a dependant referred to in section 1(b.1)(iv), shall in respect of that dependant, furnish to the Minister any proof of the dependant s mental or physical infirmity that the Minister may require. AR 225/84 s7;263/84;263/2002;109/2003;7/ (1) A registrant shall notify the Minister when 24

27 Section 31.1 HEALTH INSURANCE PREMIUMS REGULATION AR 217/81 (a) the registrant s address is changed, or (b) any other change occurs in the information shown on the registrant s certificate of registration. (2) On the death of a registrant, the spouse or adult interdependent partner, if any, or the executor, administrator or other person representing the estate of the registrant shall ensure that the Minister is notified of the deceased registrant s (a) name, (b) registration number, (c) date of birth, and (d) date of death. (3) When a registrant leaves Alberta temporarily for a period expected to exceed 6 months, the registrant shall notify the Minister of (a) the registrant s intended date of departure, (b) the registrant s forwarding address, (c) the registrant s intended date of return, and (d) the purpose of the registrant s temporary absence. (4) When a registrant leaves Alberta permanently, the registrant shall notify the Minister of the registrant s (a) date of departure, (b) forwarding address, (c) destination, and (d) intended date of arrival at the registrant s destination. AR 225/84 s7;39/87;26/91;109/2003;7/ Where this Regulation requires that notice of a fact be given to the Minister, the Minister may require the notice to be given in writing and may require the provision of any additional information in connection with the notice that the Minister considers necessary. AR 26/91 s3;7/