Muscat, July 26 (ONA) – The Executive Chairman of the Capital Market Authority, Abdullah bin Salem al-Salmi, has said that issuing licensing requirements for third-party administrators (TPAs) is an important step to improve the health regulations. insurance sector in Oman. TPAs play an important role in the ecosystem, providing outsourced after-sales administrative services to insurance companies by facilitating profitable claims operations with high efficiency and quality while ensuring a smooth and enjoyable customer experience for policyholders. , when seeking covered treatment from health service providers.

CMA Executive Chairman said that the publication of regulatory requirements for the exercise of TPA activities in accordance with Decision No. 34/2020 will contribute to the preparation of the infrastructure of the insurance sector in the Omani market, improve the quality of services linked to health insurance. and complete the legislative and regulatory framework of the health insurance scheme for private sector employees, expatriates residing in Oman and visitors.

He added that the publication of the regulations responds to the growing health insurance market in the Sultanate. In 2019, health insurance leads insurance products, accounting for 35% of the total insurance market. This represented 170 million Omani rials of the health insurance market. The industry has experienced tremendous growth over the past five years with over 25% year-over-year growth, and we expect health insurance products to see greater uptake, thanks to awareness raising. Increased public to the role of insurance private sector employees, following government policy to provide insurance coverage for this category.

The Executive Chairman of CMA spoke about the main features of the regulation, pointing out that it is flexible in specifying license requirements to carry out the activity in accordance with global best practices and the needs of the Omani market. The regulations authorized the licensee to render the service for more than one insurance company and described the framework for the outsourcing of health service providers. The requirements took into account the ease of investment by nationals, the promotion of Omanization and investment in human resources by opening up opportunities for new graduates from local colleges and universities. In addition, it will promote workforce development through structured training and development to meet industry demands with the required combination of medical insurance and finance knowledge.

Al-Salmi added that the main features include the need to explicitly face the advanced technology required to improve the internal systems that will be integrated into the CMA’s health insurance portal while ensuring data privacy and security. and information. The CMA Dhamani portal will be the centralized health insurance exchange platform that will integrate and link the regulator (s), insurers, TPAs, private health facilities, policyholders and all other relevant stakeholders to interact transparently and perform all transactions electronically, improving efficiency. and reduce administrative overheads.

The regulations include the requirements for licensees to comply with the regulatory procedures of the CMA, such as guaranteeing the minimum capital requirement which is 200,000 Omani Rials and streamlining the company’s goal of being focus only on third party administrative services with minimal overlap with broker and agent functions. TPAs must have a full-time manager with a university degree in medicine, health care or insurance with no less than 5 years of post-graduation experience, in addition to having a full-time physician with no less than 5 years of experience. .

It should be noted that the regulations were published after consultation with all market stakeholders, including government entities, insurance companies and private health facilities. The draft regulations have been posted for consultation and feedback on the CMA website for professionals, academics, law firms, investors and the public to complete the consultation process. .

—- End / KH



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