Arrangement

SCHEDULE   4

THE STATES, in pursuance of Articles 9 and 36 of the Health Insurance (Jersey) Law 1967[1], have made the following Regulations –

“SCHEDULE 1

(Regulation 3(1))

assessment of eligibility for different rate of medical benefit

1        Income limits

(1)     For the purposes of Regulation 3(1)(c) the weekly income limits are –

(a)     if the person is over the age of 21 and single, £145.50;

(b)     if the person is over the age of 17 but under the age of 21 and does not live with a parent or guardian or in a hostel, £119.05;

(c)     if the person is married, £241.35; and

(d)     if the person is not within clauses (a) to (c) and has sole responsibility for a person under full age, £241.35.

(2)     If the person is maintaining a dependent child or young person the applicable income limit set out in sub-paragraph (1) shall be increased by adding to it the following amounts for each such child or young person –

(a)     for a young person aged 18, 19 or 20 years, £71.20;

(b)     for a child aged 16 or 17 years, £55.70;

(c)     for a child under the age of 16, £44.95.

(3)     However, in the case of a person mentioned in sub-paragraph (1)(d), the first child shall be disregarded.

(4)     The applicable income limit set out in sub-paragraph (1) shall be increased by adding to it the following –

(a)     the total of any amount paid by the person in rent;

(b)     one third of any amount paid by the person by way of board and lodging;

(c)     in the case of a person who is an owner occupier, an amount equivalent to the minimum that would be charged by the Minister for Housing by way of rent if the person were a States tenant; and

(d)     25% of any fee paid by an insured person –

(i)      to a hospital or care home for which the Health and Social Services Department is responsible, or

(ii)      to a home to which the Nursing and Residential Homes (Jersey) Law 1994[3] applies.

2        Income assessment

(1)     Subject to sub-paragraph (2), the following sources of income are to be included when assessing the weekly income of an insured person –

(a)     earnings;

(b)     an amount in respect of income from savings of –

(i)      £1 in respect of savings of up to £7,298 in the case of a single person and up to £12,114 in the case of a married person, and

(ii)      25 pence for each £50 of savings over and above the amounts specified in clause (i);

(c)     social security benefits;

(d)     pensions;

(e)     any deed or gift;

(f)      maintenance payments for the insured person or a dependent child;

(g)     parish welfare;

(h)     income from lodgers; and

(i)      income from letting of property.

(2)     The following are to be disregarded when assessing weekly income –

(a)     in the case of the earnings of an insured person who is a single parent or a pensioner who works less than 25 hours a week, the first £20 earned and half of the amount earned over £20 and under £40;

(b)     in the case of any training allowance paid by an employer training scheme administered by the States, the same amount as described in clause (a) plus a quarter of any allowance exceeding £40;

(c)     income from Therapeutic Work Scheme employment;

(d)     15% of any allowance payable under the Family Allowances (Jersey) Law 1972[4] or £8, whichever is the greater;

(e)     disability transport allowance (within the meaning of Article 2 of the Disability Transport Allowance (Jersey) Law 1997[5]), attendance allowance (payable under the Attendance Allowances (Jersey) Law 1973[6]) and any allowance payable under the Invalid Care and Disability Allowances (Jersey) Law 1978[7];

(f)      the first £21.45 of any maternity allowance or long term incapacity benefit payable under the 1974 Law[8];

(g)     in the case of an insured person in receipt of an incapacity pension or an old age pension under the 1974 Law –

(i)      £23.75 in the case of a single person, and

(ii)      £39.40 in the case of a married person;

(h)     survivor’s benefit under Article 24 of the 1974 Law;

(i)      educational grants and grants from charitable organisations;

(j)      in the case of income from lodgers –

(i)      if the lodger lives as a member of the family, £40.30,

(ii)      if the lodger is not provided with food, £32.28,

(iii)     if the lodger is provided with food, £36.70; and

(k)     in the case of income from immovable property, 20% of the cost of exterior repairs and 40% of the cost of all other repairs.”.