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HEALTH INSURANCE PREMIUMS ACT

HEALTH INSURANCE PREMIUMS ACT

Chapter H‑6

Table of Contents

                1      Definitions

                2      Regulations

                3      Liability for premiums

                4      Exemption

                6      Remittance of premium

                7      Agents

                8      Employers groups

                9      Designated groups

              10      Employee groups

              11      Employers liability unaffected

              12      Collection of premiums from non‑group members

              13      Payroll deductions

              14      Waiver of premium

              15      Uncollectible premiums

              16      Offence and penalty

              17      Inspection of agents records

              18      Interest and penalties

              19      Order for payment of premium

              20      Premium arrears

              21      Regulations

              22      Registration

              23      Registration by Minister

              24      Offences re certificate of registration

              25      Opting out of Plans

              26      Forms

              27      Agreements


              28      General penalty

HER MAJESTY, by and with the advice and consent of the Legislative Assembly of Alberta, enacts as follows:

Definitions

1   In this Act,

                           (a)    “agent” means a local authority, employer or other person or unincorporated group of persons designated as an agent and who, under this Act, is authorized or required to collect premiums;

                           (b)    “benefit period” means a period that is designated in the regulations as a benefit period;

                           (c)    “Blue Cross agreement” means the agreement made pursuant to section 41 of the Alberta Health Care Insurance Act between the Minister responsible for that Act and the ABC Benefits Corporation continued under the ABC Benefits Corporation Act;

                           (d)    “dependant” means a dependant as defined in the regulations;

                           (e)    “employee” means an employee as defined in the regulations;

                            (f)    “employer” means an employer as defined in the regulations;

                           (g)    “insured hospital services” means insured services within the meaning of Part 3 of the Hospitals Act;

                           (h)    “local authority” means

                                  (i)    a city, town, village or municipal district,

                                (ii)    the Minister responsible for the Municipal Government Act in respect of an improvement district,

                               (iii)    the Minister responsible for the Special Areas Act in respect of a special area, or

                               (iv)    the board of trustees of a school district in a national park;

                            (i)    “Minister” means the Minister determined under section 16 of the Government Organization Act as the Minister responsible for this Act;

                            (j)    “premium” means an amount of money payable to the Minister under this Act;

                           (k)    “registrant” means a resident who is registered under this Act,  but does not include a resident who is registered as a dependant under this Act;

                            (l)    “resident” or “resident of Alberta” means resident as defined in the Alberta Health Care Insurance Act;

                          (m)    “subsidy” means the amount prescribed in the regulations by which a premium is reduced;

                           (n)    “wages” includes any salary, pay, holiday pay, overtime pay and any other remuneration for work or services however computed, but does not include tips or other gratuities.

RSA 1980 cH‑5 s1;1984 c26 s2;1989 cD‑21.5 s13;
1994 cM‑26.1 s642(26);1995 c24 s99(39);
1996 cA‑0.5 s15;1996 c6 s13

Regulations

2(1)  The Lieutenant Governor in Council may make regulations

                           (a)    designating benefit periods;

                           (b)    respecting the amount of premiums to be paid by persons liable for the premiums and designating the times and methods for the payment, collection and remittance of premiums;

                           (c)    prescribing penalties for the purposes of section 8(9);

                           (d)    authorizing the Minister to grant subsidies;

                           (e)    respecting the amounts of and the bases for calculating subsidies;

                            (f)    prescribing the conditions as to eligibility of persons for subsidies;

                           (g)    governing the waiver of premiums under section 14;

                           (h)    prescribing the times when and the manner in which employers who are agents shall deduct and remit to the Minister the amounts of the premiums payable by them;

                            (i)    designating the employees in respect of whom employers are not required to remit premiums;

                            (j)    prescribing the circumstances under which the Minister may withhold overpayments of premiums under section 6;

                           (k)    fixing the remuneration, if any, to be paid to agents;

                            (l)    prescribing the duties of agents in addition to those set out in this Act;

                          (m)    requiring bonds to be given by agents and their officers or employees and respecting the amounts, form, nature and contents of the bonds;

                           (n)    defining “dependant”, “employer” and “employee” for the purposes of this Act or any provisions of this Act;

                           (o)    prescribing the premiums payable to the Minister for the purposes of the receipt of goods and services under the Blue Cross agreement;

                           (p)    providing, as to any provision of the regulations, that its contravention is an offence;

                           (q)    conferring powers or duties on the Minister not otherwise given by this Act for the purpose of carrying out and administering this Act;

                            (r)    generally, providing for any matter considered necessary for the purpose of administration and operation of this Act or to meet cases that may arise and for which no provision is made by this Act.

(2)  Not less frequently than once in each year and at any other times the Treasury Board requests, the Minister shall give detailed consideration to the amount of the premiums from time to time fixed under subsection (1)(b).

RSA 2000 cH‑6 s2;2004 c5 s4

Liability for premiums

3(1)  Except as otherwise provided in this Act, every resident other than

                           (a)    a dependant,

                           (b)    a member of the Canadian Forces who has no dependants in Alberta, or

                           (c)    repealed 2013 c4 s2,

                           (d)    a person serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada) who has no dependants resident in Alberta,

is liable to the Minister for and shall, subject to this Act and the regulations and according to whether the resident is a person with or without dependants, pay to the Minister in advance on behalf of the resident and the resident’s dependants, if any, the amount of the premium prescribed in the regulations.

(2)  The regulations may prescribe different rates of premiums according to whether the registrant liable for payment is a person with or without dependants and, in the case of persons with dependants, according to the number of dependants.

(3)  Persons of the following classes, namely,

                           (a)    members of the Canadian Forces, or

                           (b)    repealed 2013 c4 s2,

                           (c)    persons serving a term of imprisonment in a penitentiary as defined in the Corrections and Conditional Release Act (Canada)

shall pay, in respect of their dependants, the premiums prescribed by the regulations, but are not liable for the payment of premiums in respect of themselves.

(4)  This section does not apply to premiums prescribed pursuant to section 2(1)(o).

RSA 2000 cH‑6 s3;2013 c4 s2

Exemption

4(1)  If a registrant or the registrant’s spouse or adult interdependent partner is receiving a benefit under the Seniors Benefit Act, the registrant is not liable for the payment of premiums on behalf of the registrant, the registrant’s spouse or adult interdependent partner or the registrant’s dependants.

(2)  Subsection (1) does not apply to premiums that have become due or become due during a period of time when the registrant or the registrant’s spouse or adult interdependent partner is not receiving a benefit under the Seniors Benefit Act.

RSA 2000 cH‑6 s4;2002 cA‑4.5 s40

5   Repealed 2003 cI‑0.5 s55.

Remittance of premium

6(1)  Every person who is liable to pay premiums shall, at the times fixed and in the manner prescribed in the regulations, pay to the Minister or to the Minister’s agent the amount of the premium payable by the person on behalf of the person and the person’s dependants, if any, in respect of each such subsequent benefit period as may be designated in the regulations, together with a statement in the form and containing the information prescribed by the Minister.

(2)  The Minister may make other arrangements for the collection of premiums in any part of Alberta designated by the Minister in any case in which the Minister considers it advisable to do so.

(3)  Subject to the regulations, the Minister shall refund any overpayment of premium to the person who paid it or the person lawfully entitled to receive it.

RSA 1980 cH‑5 s5

Agents

7(1)  Every agent to whom premiums are paid shall, at the times fixed in the regulations, remit to the Minister the amount of the premiums so received by the agent, together with a statement in the form and containing the information prescribed by the Minister.

(2)  When any person has paid a premium in respect of a benefit period to an agent, the premium so paid is deemed to have been paid in advance in respect of that benefit period as required by section 3(1), but nothing in this subsection relieves the agent from any liability to remit the amount of the premium to the Minister.

RSA 1980 cH‑5 s6

Employers groups

8(1)  The employees of an employer are a group for the purposes of this Act if the number of employees and those persons counted as employees pursuant to the regulations for the purposes of this subsection, is equal to or exceeds the prescribed number.

(2)  A group under this section shall be called an “employer’s group”.

(3)  The Lieutenant Governor in Council may make regulations for the purposes of this section

                           (a)    specifying a number as the “prescribed number”;

                           (b)    specifying the persons or classes of persons to be counted as employees for the purposes of determining whether a group qualifies as an employer’s group;

                           (c)    prescribing the circumstances under which an employer is not to be considered as liable for the payment of a premium in relation to an employee in the employer’s group.

(4)  In addition to the employees, the following persons are included in an employer’s group:

                           (a)    the employer himself or herself, if the employer is a resident;

                           (b)    if the employer is a partnership, each member of the partnership who is a resident.

(5)  The employer is an agent of the Minister with respect to an employer’s group.

(6)  An employer whose employees are an employer’s group shall,

                           (a)    subject to any agreement made with an employee or with a certified bargaining agent on the employee’s behalf under which the employer undertakes to pay all or part of the premiums, deduct from the wages payable to each of the employer’s employees in the group the premium payable by that employee, and

                           (b)    whether or not the employer makes a deduction pursuant to clause (a), remit to the Minister the premium payable by or on behalf of that employee in accordance with the regulations.

(7)  On remitting the premiums payable by the employer’s employee as provided in subsection (6), each employer shall, at the same time, send to the Minister a statement with respect to it in the form and containing the information prescribed by the Minister.

(8)  When an employer has

                           (a)    pursuant to an agreement under subsection (6) agreed to pay premiums on behalf of an employee, or

                           (b)    deducted premiums from the wages of an employee,

the premiums payable on behalf of the employee are, in relation to the employee concerned, deemed to have been paid by the employee to the Minister but nothing in this subsection relieves the employer from the employer’s liability to remit those premiums to the Minister.

(9)  If an employer fails to comply with subsection (6), the employer shall, on being notified by the Minister to do so, in addition to the premiums the employer is liable to remit, pay to the Minister the penalty prescribed by the regulations.

RSA 1980 cH‑5 s7;1984 c26 s2

Designated groups

9(1)  If the employees of an employer do not qualify as an employer’s group under section 8, the Minister may, at the request of the employer, designate the employees as a group for the purposes of this Act.

(2)  A group under this section shall be called a “designated group”.

(3)  Section 8(3)(c) and (4) to (9) apply to a designated group to the same extent as though it were an employer’s group.

(4)  Notwithstanding section 8(1), a group does not cease to be a designated group by reason of the fact that it subsequently is qualified to be an employer’s group until the Minister revokes its designation under this section.

RSA 1980 cH‑5 s8

Employee groups

10(1)  The Minister and a trade union or employee association may enter into an agreement or arrangement whereby, among other things,

                           (a)    some or all of the persons who are from time to time members of the trade union or employee association are constituted as a group for the purposes of this Act, and

                           (b)    the trade union or employee association undertakes to pay to the Minister the premiums otherwise payable by those members pursuant to section 3(1).

(2)  A group constituted by an agreement or arrangement under subsection (1) shall be called an “employee group”.

(3)  The trade union or employee association concerned

                           (a)    is primarily liable for the payment of the premiums that the employees in the employee group would otherwise be liable to pay to the Minister under section 3(1), and

                           (b)    shall remit the premiums to the Minister at the times fixed in the regulations, together with a statement in the form and containing the information prescribed by the Minister,

whether or not the employer or trade union or employee association contributes to the payment of all or part of those premiums and whether or not the employer deducts all or part of the premiums for the remuneration payable to the employer’s employees.

(4)  The trade union or employee association concerned is an agent of the Minister.

RSA 1980 cH‑5 s9

Employers liability unaffected

11(1)  Nothing in this Act shall be construed to affect any agreement or arrangement for contribution by an employer of all or any of the premiums payable under this Act in respect of the employer’s employees and any obligation of the employer under such an agreement or arrangement to pay all or any part of the premium continues in respect of the payment of the premium under this Act.

(2)  When the amount required to be paid by an employer under subsection (1) is greater than the amount the employer is by virtue of subsection (1) required to pay in respect of the premiums under this Act, the employer shall, until the agreement is terminated, pay the amount of the excess to or for the benefit of the employees.

RSA 1980 cH‑5 s10

Collection of premiums from non‑group members

12(1)  The Minister may make arrangements with any organization having 5 or more members who are residents of Alberta whereby a member of the organization is appointed to collect the premiums payable by its members and remit them to the Minister at the times fixed in the regulations, together with a statement in the form and containing the information prescribed by the Minister.

(2)  The members of an organization under subsection (1) are to be called a “collector’s group” and the member of the organization who collects or remits the premiums is an agent of the Minister for that purpose.

(3)  Membership in a collector’s group does not affect the liability of the members of the group to pay premiums.

(4)  Persons who are members of an employer’s group, a designated group or an employee group are not eligible to be members of a collector’s group.

RSA 1980 cH‑5 s11

Payroll deductions

13(1)  When a person who has failed to pay arrears of premiums is or becomes a member of an employer’s group, designated group or employee group, the employer or group shall, when notified by the Minister to do so, and in the manner prescribed in the regulations, cause to be deducted from the person’s wages the premium arrears owing and shall remit those premiums to the Minister.

(2)  Any employee, employer or employee group who contravenes subsection (1) is guilty of an offence.

RSA 1980 cH‑5 s12

Waiver of premium

14   Subject to the regulations, the Minister may waive the payment of the whole or any part of the premiums of a registrant who applies for a waiver of premiums for reasons of financial hardship.

RSA 1980 cH‑5 s13

Uncollectible premiums

15   When the Minister is satisfied that a premium payable by or on behalf of any person is uncollectible or is collectible only with expense or effect that is unreasonable in the circumstances, the Minister may cause the amount of the premium to be written off in the Minister’s books, but that action by the Minister does not affect the liability of the person by whom the premium is payable in respect of that premium.

RSA 1980 cH‑5 s14

Offence and penalty

16(1)  An agent who fails or refuses to remit to the Minister as required in the regulations the amount of premiums paid to or deducted by the agent or which the agent is otherwise liable to remit, is guilty of an offence and liable to a fine not exceeding $500.

(2)  If an agent to which subsection (1) applies is a corporation, an officer, director or agent of the corporation who directed, authorized, assented to, acquiesced in or participated in the failure or refusal to remit is a party to and guilty of the offence to which subsection (1) applies and is liable to a fine as stated in subsection (1) whether or not the corporation has been prosecuted or convicted.

(3)  A person, other than an agent or local authority, who fails to pay the premium or any part of it as required by this Act and the regulations is guilty of an offence and liable to a fine not exceeding $25.

RSA 1980 cH‑5 s15

Inspection of agents records

17(1)  When directed by the Minister for the purpose of the administration of this Act, any person authorized by the Minister, at any reasonable time

                           (a)    is entitled to inspect any books, documents and records kept by or on behalf of an agent for the purpose of or in connection with or pertaining to this Act or the regulations, and

                           (b)    is entitled to enter into any building, premises or place used by or on behalf of an agent for or in connection with the keeping of any books, documents and records referred to in clause (a).

(2)  Any person who is in charge of any place or record mentioned in subsection (1) shall permit and assist any person authorized by the Minister in the inspection or entry.

(3)  A person who prevents, hinders, obstructs or fails to permit or assist any person authorized by the Minister in the exercise of the powers conferred by subsection (1) is guilty of an offence.

RSA 1980 cH‑5 s16

Interest and penalties

18(1)  The Minister may impose interest or a penalty, or both, in respect of any amounts that remain unpaid under this Act.

(2)  The Minister may, by regulation, prescribe the interest rates and the penalties for the purposes of this section.

1984 c26 s2;1985 c32 s3

Order for payment of premium

19(1)  An amount payable under this Act by a registrant or agent to the Minister that has not been paid or any part of an amount payable under this Act by a person that has not been paid may be certified by the Minister on the expiration of 30 days after the mailing of a premium notice to the person who is in arrears of premiums at the person’s last known address.

(2)  A premium notice given under subsection (1) shall be endorsed with or accompanied with a statement indicating the possible consequences on default of payment and the rights of the addressee to file a notice of objection under subsection (5).

(3)  Subject to subsection (5), on production of a certificate under subsection (1) to the clerk of the Court of Queen’s Bench at the judicial centre closest to the place where the registrant or agent resides or has an office according to the records of the Minister’s Department, it shall be registered in the Court as a judgment of the Court and when registered has the same force and effect, and all proceedings may be taken on it, as if the certificate were a judgment obtained in the Court for a debt of the amount specified in the certificate.

(4)  No costs or charges shall be charged by a clerk of the Court on the registration of a certificate and no costs or charges shall be charged by the Registrar of Land Titles under the Land Titles Act on the filing of a writ of enforcement.

(5)  When a person to whom a premium notice is given files with the Minister within the 30‑day period referred to in subsection (1) a notice of objection denying the person’s liability for the premium or disputing the amount of premium owing, the Minister may afterwards proceed against that person only by action for the amount owing and not under this section.

RSA 2000 cH‑6 s19;2006 c21 s26;2009 c53 s78

Premium arrears

20   In addition to any other remedies provided in this Act, when any money is payable by the Minister directly to a person while that person is indebted to the Minister, the Minister may withhold from the money payable the amount by which the person is indebted, or any part of the indebtedness, and apply the amount withheld in reduction or extinguishment of the indebtedness.

RSA 1980 cH‑5 s18

Regulations

21   The Lieutenant Governor in Council may make regulations

                           (a)    governing the registration of residents with the Minister generally;

                           (b)    prescribing the classes of dependants that a resident is required to register;

                           (c)    prescribing the classes of persons exempted from registration;

                           (d)    providing for any matter pertaining to declarations under section 25 not otherwise provided for in that section;

                           (e)    providing for any matter relating to registration of residents under section 23, including the duties of hospital boards in connection with the registration of unregistered residents receiving hospital services;

                            (f)    imposing on any person the duty of registering a resident or residents;

                           (g)    respecting the imposition of penalties on persons who have not registered within the times prescribed under the regulations.

1984 c26 s2

Registration

22(1)  Subject to this section and the regulations, every resident shall register with the Minister.

(2)  A resident is not required to register with the Minister if

                           (a)    the resident is exempted from registration by the regulations, or

                           (b)    the duty to register is imposed by the regulations on some other person.

(3)  When the regulations impose a duty on a person to register a resident or residents with the Minister, that person shall fulfil that duty in accordance with the regulations.

(4)  When a person is required to register himself or herself or to register other persons with the Minister under this section or the regulations, the person shall do so at the place and in the manner and form and at the times prescribed in the regulations.

1984 c26 s2

Registration by Minister

23(1)  If

                           (a)    a claim for benefits is made under the Alberta Health Care Insurance Act by or on behalf of a resident who is not registered with the Minister under this Act, or

                           (b)    insured hospital services are provided to a resident who is not registered with the Minister under this Act,

the Minister may register that resident on being furnished with evidence satisfactory to the Minister that the resident is a resident of Alberta.

(2)  When the Minister registers a resident pursuant to subsection (1), the Minister may also register

                           (a)    the dependants of that resident, or

                           (b)    if that resident is himself or herself a dependant, the person on whom that resident is dependent and that person’s other dependants.

1984 c26 s2

Offences re certificate of registration

24(1)  Every person who produces to a practitioner or a member of the practitioner’s staff a certificate of registration issued under this Act

                           (a)    knowing that the person named in it is not, at the time of its production, a resident of Alberta, or

                           (b)    knowing that the person on behalf of whom, and to facilitate whose treatment, it is produced is not the person named in it or a dependant of that person,

is guilty of an offence.

(2)  In this section, “certificate of registration” means

                           (a)    a certificate of registration issued under this Act, or

                           (b)    any other document prescribed by the regulations as being a certificate of registration for the purposes of this Act or the Alberta Health Care Insurance Act.

1984 c26 s2

Opting out of Plans

25(1)  A registrant may, for the registrant and the registrant’s dependants, file with the Minister a declaration stating that the registrant elects to be outside the Plan and the Hospitalization Benefits Plan under Part 3 of the Hospitals Act.

(2)  A declaration under subsection (1) shall be in the form prescribed by the Minister and shall indicate the consequences of filing the declaration mentioned in subsection (6) and the effect of subsection (7).

(3)  A declaration under subsection (1) is invalid unless at the time it is filed with the Minister the person making it

                           (a)    is registered under this Act together with the person’s dependants, and

                           (b)    is not liable to the Minister for any premiums.

(4)  A declaration under subsection (1) takes effect on the day on which it is filed with the Minister and remains in effect

                           (a)    for 36 months, or

                           (b)    until a revocation of the declaration takes effect under subsection (6.2).

(5)  Repealed 2007 c18 s3.

(6)  If a registrant files a valid declaration under subsection (1), then, notwithstanding anything in this Act, the Alberta Health Care Insurance Act or the Hospitals Act,

                           (a)    neither the registrant nor the registrant’s dependants are entitled to benefits under the Alberta Health Care Insurance Act in respect of health services provided to them while the declaration is in effect,

                           (b)    the registrant is personally and solely liable for the payment to a hospital of the entire cost of insured hospital services provided to the registrant and the registrant’s dependants while the declaration is in effect,

                           (c)    neither the registrant nor any of the registrant’s dependants are entitled to receive goods and services under the Blue Cross agreement, and

                           (d)    the registrant is not liable for payment of premiums that become due while the declaration is in effect.

(6.1)  A registrant may revoke a declaration under subsection (1) by filing a revocation in the form prescribed by the Minister stating that the registrant revokes the declaration.

(6.2)  A revocation under subsection (6.1) takes effect 90 days after the day on which it is filed with the Minister.

(7)  Notwithstanding subsections (1) and (6),

                           (a)    the spouse or adult interdependent partner of the registrant who filed a declaration may file with the Minister an election to have the spouse or adult interdependent partner and the dependants excluded from the declaration, and

                           (b)    a dependant other than the spouse or adult interdependent partner of that registrant may file with the Minister an election to have that dependant excluded from the declaration, if no election has been filed under clause (a),

and an election so filed takes effect on the day on which it is filed with the Minister.

(8)  If a spouse or adult interdependent partner files an election under subsection (7)(a),

                           (a)    the declaration does not extend to or apply to the spouse or adult interdependent partner and dependants of the registrant during the period that the election is in effect, and

                           (b)    the spouse or adult interdependent partner is liable for the payment of premiums in respect of the spouse or adult interdependent partner and his or her dependants during the period that the election is in effect.

(9)  If a dependant files an election under subsection (7)(b),

                           (a)    the declaration does not extend to or apply to the dependant during the period that the election is in effect, and

                           (b)    the dependant is liable for the payment of premiums in respect of the dependant unless the registrant agrees to be liable for the payment of those premiums.

(10)  A person who makes an election under subsection (7) may revoke the election by filing a revocation in the form prescribed by the Minister stating that the person revokes the election.

(11)  A revocation under subsection (10) takes effect on the day on which it is filed with the Minister.

(12)  An election under subsection (7) remains in effect until

                           (a)    the declaration ceases to be in effect, or

                           (b)    the day on which a revocation of the election takes effect.

RSA 2000 cH‑6 s25;2002 cA‑4.5 s40;2004 c5 s4;
2007 c18 s3

Forms

26   The Minister may prescribe any forms to be used under this Act or the regulations that the Minister considers necessary.

RSA 1980 cH‑5 s19

Agreements

27   The Minister may enter into agreements with any government, person or unincorporated group of persons

                           (a)    respecting any matter relating to the administration or operation of this Act, or

                           (b)    providing for any matter for which no provision is made elsewhere in this Act or in the regulations that the Minister considers necessary,

and the Minister may implement any agreement so made.

RSA 1980 cH‑5 s20

General penalty

28(1)  Every person who is guilty of an offence under the regulations or under this Act and for which no penalty is specifically provided, is liable

                           (a)    for a first offence, to a fine of not more than $500 and in default of payment to imprisonment for a term of not more than 30 days,

                           (b)    for a 2nd offence, to a fine of not more than $1000 and in default of payment to imprisonment for a term of not more than 60 days, and

                           (c)    for a 3rd or subsequent offence, to imprisonment for a term of not more than 6 months without the option of a fine.

(2)  A prosecution for an offence under this Act or the regulations may be commenced within 2 years from the date of the commission of the offence, but not afterwards.

RSA 1980 cH‑5 s21