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S Pass medical insurance requirements

You must buy and maintain medical insurance (MI) for each S Pass holder you employ before you can issue or renew an S Pass. The insurance cost cannot be passed on to your workers.

What it should cover

As part of an employer's S Pass medical obligations, you must buy and maintain MI with coverage for inpatient care and day surgery, including hospital bills for conditions that may not be work-related. The coverage for each S Pass holder has to be at least:

  • (For policies with start date effective before 1 July 2023) $15,000 per year
  • (For policies with start date effective on or after 1 July 2023) $60,000 per year

If the MI plan has sub-limits (e.g. inpatient care, day surgery or ‘per disability/medical condition’), each sub-limit needs to meet the minimum annual claim limit as stated above.

Enhanced MI

Since 1 July 2023, we have enhanced the minimum MI required for all new and existing S Pass holders. The enhanced MI will better protect employers against large medical bills incurred by your workers, and will be implemented in two stages as shown in the table below.

Engage insurers offering the enhanced MI early to understand the products available. We encourage you to buy an MI with all the enhanced requirements early for better peace of mind.

To implement for MI policies, renewals or extensions with start date effective from Enhanced MI requirements
1 July 2023 (Stage 1) Higher annual claim limit of at least $60,000, with a co-payment of 75% by insurers and 25% by employers for claim amounts above $15,000.
1 July 2025 (Stage 2)
  • Standardisation of allowable exclusion clauses
  • Introduction of age-differentiated premiums for those aged 50 and below, and those aged above 50
  • Requirement for insurers to reimburse hospitals directly upon the admissibility of the claim

You can have a co-pay arrangement with the S Pass holder for their medical bills, only if all of the following are met:

  • The co-pay amount is reasonable and does not exceed 10% of the worker’s fixed monthly salary.
  • The duration of co-payment does not exceed 6 months (for every 2 years of employment).
  • The co-payment option is explicitly in the employment contract or collective agreement and has the worker’s full consent.