JAKARTA. National health insurance program (JKN), which is run by the Social Security Agency (BPJS), will take effect January 1, 2015. Any company operating in Indonesia must pay JKN premiums for employees starting next year. Although the deadline is near, employers and insurance companies still objected to the program.   The problem is that the insurance company and BPJS has not yet reached agreement on the scheme of coordination of benefits (COB). COB principle is to align the benefits when BPJS participants buy health insurance from private insurance. COB is important because many companies already use private insurance for their employees health insurance program.

Initially, many insurance companies are interested in the scheme so that private insurance participants can automatically become participants of BPJS program. There are about 30 insurance companies that have signed the coordination of benefits with BPJS. The problem, BPJS adding new provisions. This led to protests from the insurance company. Ahmad Fauzie Dervish, Chairman of the Indonesia General Insurance Association(AAUI), mentions several controversial provisions.

First, COB scheme only allowed for collective enterprise customers. As a result, private insurance can not take advantage of this COB scheme to attract individual customers. As a matter fact, there are large number of customers who want to obtain the services of both: private insurance and basic services of BPJS.

Second, the flow of health care. Commercial health insurance customers should follow the flow of health services BPJS. For example, the customer must request a referral to a BPJS health facility partner, before going to a hospital that is a partner to the insurance company. It is certainly inconvenient for customers.

Fourth, there is no clarity dependent portion between the administering body and private insurance. "We were asked to lower premiums, but we also ask the proportional portion of the claim," said Ahmad to KONTAN, yesterday. AAUI will be sent a letter to the president with a request to defer the obligation for companies running JKN to 2017

Shinta Widjaja Kamdani, Chairman of the Indonesian Employers Association (Apindo) also asked for a delay until there is clarity about the benefits of coordination mechanisms. Without COB, the benefits received by workers is lower. Employers also lose money because they have to pay two health insurance premiums for workers.   If the government continues to impose, APINDO will ignore the Presidential Decree (Perpres) No. 111/2013 on Health Insurance Program. "We chose to respect the collective labor agreement with the workers," said Shinta. Purnawarman Basundoro, Legal Director of Communication and Interpersonal BPJS said it still refers to the regulation. It could be postponed if the regulation is revised. "We are still communicating with insurance company on COB matter," he said.

Editor: Amal Ihsan