The Tel Aviv Regional Labor Court recently issued a significant decision certifying a class action lawsuit against Israel’s four HMOs: Clalit, Maccabi, Meuhedet, and Leumit. The core of the proceedings concerns the industry-wide policy that exempts families from paying 'supplementary health services' (SHABAN) premiums for their fourth child and onwards. The plaintiffs, four mothers with three or fewer children, allege that this arrangement directly breaches the principle of equality under the National Health Insurance Law.
According to the claim, similarly situated policyholders are required to pay significantly different amounts to their respective funds based solely on the number of siblings born previously. The court emphasized that this is a preliminary stage and it has not yet been definitively determined that the policy is illegal. However, it found a reasonable probability that the plaintiffs’ arguments will be substantiated as the proceedings advance.
Legal grounds for the ruling rested in part on the Ministry of Health's failure to provide legal defense for a 2005 internal document that had once authorized the 'family tariff.' The absence of an official position supporting the legality of the arrangement was interpreted by the court as a lack of established regulatory backing.
Beyond legal aspects, the filing contends that the policy is not purely social in nature, but serves as a competitive marketing tool designed to attract entire families and lower the average age of the insured population. The claim further asserts that the subsidy for this group is effectively funded by other SHABAN members, who bear the full financial burden without having chosen to do so. The Ministry of Health announced the formation of a dedicated team to review the issue, though no timelines for policy changes have been set. At this stage, no operative order has been issued and the exemption remains in effect, while the HMOs prepare their defenses, which are expected to be submitted to the court this coming October. A final ruling in favor of the plaintiffs could lead to the termination of the arrangement, potentially threatening the long-standing economic model of the SHABAN.