Care Shield Life and Long-Term Care (Elder Shield Scheme) Regulations 2021

the Board finds that the insurance cover in respect of the individual has been issued in error (including because the individual dies on or before the date of commencement of the insurance cover, and the Board is notified of the individual’s death only after that date), and no claim has been accepted by the Administrator under section 16 of the Act in respect of the individual;

the Board finds that the individual was severely disabled before the commencement of the individual’s insurance cover under the ESH Scheme; or

the individual opts out of the ESH Scheme within 60 days beginning on the commencement of the individual’s insurance cover under the ESH Scheme, or within any other period as the Board may allow.

the individual —

fails to make the required premium payment for the individual’s insurance cover at the expiry of 75 days after the renewal date of the individual’s insurance cover (called in this Part the grace period); and

has not made the minimum number of premium payments under the ESH Scheme such that the individual’s insurance cover under the ESH Scheme does not terminate by reason of the individual’s failure to pay the premium for any insurance period;

the individual dies;

the individual has fully claimed the benefits under the ESH Scheme;

the individual has requested to terminate his or her insurance cover under the ESH Scheme; (e)the individual’s insurance cover under the CSHL Scheme has commenced; (f)the Board, with the Minister’s approval, considers that the exceptional circumstances for the reinstatement of the individual’s insurance cover under regulation 8(1)(c) no longer apply; (g)the individual ceases to be a citizen of Singapore on or after 1 April 2024 and does not immediately become a permanent resident of Singapore; or

the individual ceases to be a permanent resident of Singapore on or after 1 April 2024 and does not immediately become a citizen of Singapore.

where sub-paragraph (a) of that paragraph applies — on the date immediately after the last insurance period in which the individual has made the required premium payment;

where sub-paragraph (b) of that paragraph applies —

on the date immediately after the date on which the individual dies, if the individual has not made a successful claim under the ESH Scheme in accordance with section 16 of the Act; or

on the date immediately after the date on which the Board is notified of the individual’s death if the individual has made a successful claim under the ESH Scheme in accordance with section 16 of the Act;

where sub-paragraph (c) of that paragraph applies —

if the month in which the last payout was made is not the same month in which the insurance period is to end — on the date immediately after the last day of the month in which the last payout was made; or

if the month in which the last payout was made is the same month in which the insurance period is to end — on the date immediately after the last day of the insurance period in which the last payout was made;

in the circumstances set out in sub‑paragraph (d) of that paragraph — on the date immediately after the last day of the last insurance period in which the individual has made the required premium payment; (e)in the circumstances set out in sub‑paragraph (e) of that paragraph — on the day of the commencement of the individual’s insurance cover under the CSHL Scheme;

in the circumstances set out in sub-paragraph (g) of that paragraph — on the date immediately after the date on which the individual ceases to be a citizen of Singapore and does not immediately become a permanent resident of Singapore; and

in the circumstances set out in sub-paragraph (h) of that paragraph — on the date immediately after the date on which the individual ceases to be a permanent resident of Singapore and does not immediately become a citizen of Singapore.

in the event the termination was in accordance with regulation 7(1)(a) — the individual applies to reinstate his or her insurance cover within 180 days after the expiry of the grace period or a longer period that the Board may allow;

in the event the termination was in accordance with regulation 7(1)(e) — the individual’s insurance cover under the CSHL Scheme is subsequently cancelled; (ba)in the event the termination (whether before, on or after 30 October 2024) was in accordance with regulation 7(1)(g) or (h) — the individual is reinstated as a citizen of Singapore or a permanent resident of Singapore; or

the Board, with the Minister’s approval, considers that there are exceptional circumstances for the reinstatement of the individual’s insurance cover.

who, on or after 1 April 2024, ceases to be a citizen of Singapore and does not immediately become a permanent resident of Singapore, or who ceases to be a permanent resident of Singapore and does not immediately become a citizen of Singapore;

whose insurance cover under the ESH Scheme was not issued in error, but was terminated (whether before, on or after 30 October 2024) under regulation 7(1)(g) or (h); and

who is a severely disabled individual whose claim under section 16 of the Act has been accepted by the Administrator (whether before, on or after 30 October 2024).

the individual; or

an approved payee nominated by the individual, or by the authorised applicant for the individual.

the Board is unable to make the payment because of insufficient information provided by the individual or the approved payee for such payment; or

in the case of payment to an approved payee, the approved payee lacks mental capacity or has died, and no new approved payee was nominated by the individual, or by the authorised applicant for the individual, as the case may be.

the whole amount of the goodwill sum is treated as the payment of the number of monthly insured sums which corresponds to that whole amount (called the relevant insured sums); and

the payment of any other insured sum under section 18(2) of the Act resumes only after the relevant insured sums are treated as paid under sub-paragraph (a).

if the insured person became entitled to the payment of an insured sum in any month during the insurance period immediately before P, unless paragraph (2) applies;

where the insured person is required to pay a single lump sum premium or premiums for 10 insurance periods — the insured person has paid the single lump sum premium or premiums in respect of all the 10 insurance periods, as the case may be;

the insured person has paid the premium in respect of the insurance period that commences after the individual’s 65th birthday;

the insured person has made the minimum number of premium payments under the ESH Scheme such that the insured person’s insurance cover under the ESH Scheme does not terminate by reason of the insured person’s failure to pay the premium for any insurance period;

the termination of insurance cover under regulation 7.

his or her obligation to pay the premium has ended because of paragraph (1)(b), (c), (d) or (e); or

the insured person subsequently becomes entitled to the payment of an insured sum during the insurance period immediately before P.

a reference to a premium paid under paragraph (1)(b), (c) or (d) includes a premium paid for the insured person’s insurance cover under the former ElderShield Scheme; and

P does not include the first insurance period of the insured person’s insurance cover under the ESH Scheme.

there is any shortfall in the premium in respect of an insurance period paid under section 14(4) of the Act by an insured person, or by a relevant CPF member under Division 2 of this Part; and

the insured person or the relevant CPF member has paid moneys to an approved insurer in respect of the whole or any part of a supplement premium for a supplementary disability insurance policy under the CareShield Life and Long‑Term Care (Supplement Scheme) Regulations 2020 (G.N. No. S 850/2020).

a reference to a shortfall in the premium payable in paragraph (1)(a) includes a shortfall in the premium payable for the insured person’s insurance cover under the former ElderShield Scheme; (b)a reference to moneys paid to an approved insurer in paragraph (1)(b) includes money paid to the approved insurer in respect of the whole or any part of a premium for a severe disability insurance policy taken out with the approved insurer under the former ElderShield Supplement Scheme;

“approved insurer”, “supplementary disability insurance policy” and “supplement premium” have the meanings given by regulation 2 of the CareShield Life and Long‑Term Care (Supplement Scheme) Regulations 2020; and

“former ElderShield Supplement Scheme” means an insurance scheme established and maintained by the Ministry of Health before the transfer date for the purposes of allowing an individual insured under the former ElderShield Scheme to purchase a supplementary severe disability insurance policy from an approved insurer to provide additional severe disability insurance benefits over and above the former ElderShield Scheme.

in any form and manner required by the Board; and

supported by any document or information required by the Board.

the relevant CPF member has paid the whole or any part of the insured person’s premium in respect of a previous insurance period, including an insurance period of the insured person’s insurance cover under the former ElderShield Scheme; or

the relevant CPF member has, before the transfer date, authorised the Board to withdraw moneys standing to his or her credit in his or her medisave account for the payment of any premium under any severe disability insurance policy taken out with an approved insurer under the former ElderShield Scheme by the insured person.

in any form and manner required by the Board; and

supported by any document or information required by the Board.

refund to the relevant CPF member’s medisave account, the whole or any part, as the Board may determine, of any amount deducted from the relevant CPF member’s medisave account to pay for any premium of an insured person;

pay into the medisave account of the relevant CPF member, the whole or any part, as the Board may determine, of the interest that would have been payable on the amount of the refund under sub‑paragraph (a) if that amount had not been deducted from the relevant CPF member’s medisave account; and

require payment of the resulting shortfall in the premiums under section 22(1) of the Act or in accordance with the other provisions of this Division.

the deduction from the relevant CPF member’s medisave account is in contravention of these Regulations; or

the insured person or the relevant CPF member made a false or an inaccurate representation to the Board, or provided the Board with any inaccurate, incorrect or misleading information, in connection with the application for payment of a premium for the insurance cover of an insured person under any of the following insurance schemes to be deducted from the relevant CPF member’s medisave account:

the CSHL Scheme;

the ESH Scheme;

a Supplement Scheme.

deduct from the relevant CPF member’s medisave account an amount not exceeding the amount standing to the credit of the relevant CPF member in the medisave account to pay any part of the premium; and

permit any deficiency to be paid in any manner that the Board thinks fit, subject to any condition that the Board may impose.

the relevant CPF member must, if required by the Board, refund to the relevant CPF member’s medisave account the amount withdrawn from that account, which would not have been withdrawn without the earlier approval or appointment (called the affected amount); or

the Board may —

refund from the Fund to the relevant CPF member’s medisave account the affected amount paid as premiums for the insured person’s insurance cover under the ESH Scheme; and

require payment of the resulting shortfall in the premiums under section 22(1) of the Act or in accordance with the other provisions of this Division.

no claim was accepted by the Administrator under section 16 of the Act before the date of termination; and

the insurance cover was terminated because of the death of the individual concerned, which occurred within a period of 60 days starting on the commencement date of the insurance cover.

the individual’s insurance cover under the former ElderShield Scheme was renewed; or

the individual’s insurance cover under the ESH Scheme commenced or was renewed.

no claim was accepted by the Administrator under section 16 of the Act before the date of termination; and

the Board is satisfied that there are extenuating circumstances for making such refund.

into the medisave account of the individual who paid the premium, or in cash or any cash equivalent to that individual, as the Board considers fit; or (b)into the medisave account of the insured person or in cash or any cash equivalent to the insured person, as the Board considers fit.

for an individual whose insurance coverage under the former ElderShield Scheme commenced on or after 30 September 2007 (called in this regulation the ESH 400 Scheme) —

if the individual is required to pay premiums until the insurance period that commences after the individual’s 65th birthday — the insured sum specified in the First Schedule applicable to the individual;

if the individual is required to pay premiums for 10 insurance periods — the insured sum specified in the Second Schedule applicable to the individual; and (iii)if the individual is required to pay a single lump sum premium — $400; (b)for an individual whose insurance coverage under the former ElderShield Scheme commenced on or after 30 September 2002 and before 30 September 2007 (called in this regulation the ESH 300 Scheme) —

if the individual is required to pay premiums until the insurance period that commences after the individual’s 65th birthday — the insured sum specified in the Third Schedule applicable to the individual;

if the individual is required to pay premiums for 10 insurance periods — the insured sum specified in the Fourth Schedule applicable to the individual; and

if the individual is required to pay a single lump sum premium — $300; and

for an individual under the ESH 300 Scheme who upgraded to the ESH 400 Scheme on or after 30 September 2007, an amount calculated using the formula:

A is the number of insurance periods for which the individual has paid additional premiums to upgrade from the ESH 300 Scheme to the ESH 400 Scheme;

B is the total number of insurance periods for which the individual is required to pay additional premiums to upgrade from the ESH 300 Scheme to the ESH 400 Scheme; and

C is the number of months for which an insured person received payouts under the former ElderShield Scheme and the ESH Scheme.