Laws of Bermuda

BERMUDA STATUTORY INSTRUMENT

SR&O 8/1971

HEALTH INSURANCE (CERTIFICATE OF ENTITLEMENT) REGULATIONS 1971

[made under sections 38 and 40 of the Health Insurance Act 1970 and brought into operation on 1 April 1971]

ARRANGEMENT OF REGULATIONS

1 Form of application 2 Form of certificate

[NB Formerly the Hospital Insurance (Certificate of Entitlement) Regulations 1971. Title amended, and references to “hospital insurance”, “Hospital Insurance Fund” and “Commission” substituted by “health insurance”, “Health Insurance Fund” and “Council” by 2004:22 s.19 & Sch para 2 effective 1 January 2006; “Director” substituted by “Committee” by 2009:49 s.15(5) effective 15 December 2009. These amendments are not individually noted]

Form of application

1 The form of application for a certificate of entitlement under section 38 of the Health Insurance Act 1970 shall be in accordance with the form set out in the Schedule or as near thereto as circumstances admit. [Regulation 1 amended by 2004:22 effective 1 January 2006]

Form of certificate

2 Where the Committee is satisfied that a person in respect of whom an application is made is entitled to subsidized hospital treatment he shall issue to the applicant a certificate of entitlement in the following form—

HEALTH INSURANCE (CERTIFICATE OF ENTITLEMENT) REGULATIONS 1971

"CERTIFICATE OF ENTITLEMENT

(issued In pursuance of section 38 of the Health Insurance Act 1970) Certificate No. I hereby certify that (full name of person in respect of whom application is made) of (full address) is entitled to subsidized hospital treatment under paragraph ( ) of subsection (1) of section 2 of the Health Insurance Act 1970. (signed) Committee." [Paragraph 2 amended by 2002:26 s.3(3) effective 1 August 2005; and by 2004:22 effective 1 January 2006]

SCHEDULE

Application for a Certificate Entitlement Full Name Present Address Date of Birth Place of Birth Age on Last Birthday Nationality Present Employer (if any) Do you possess Bermudian Status Date of Entry to Bermuda Is Your Home in Bermuda Have you resided in Bermuda for a continuous period of not less than ten years during the period of twenty years immediately preceding the date of application What periods in excess of 3 months have been spent abroad (otherwise than for the purposes of educational or vocational training or on holiday) give details, date of each such absence and reasons therefor. Signature of Applicant Date

Laws of Bermuda

[Amended by: BR 24/1984 BR 38/1987 2002:26 2004:22 2009:49]