• Currently, contributions to NHIF are voluntary while employees have contributions deducted from their gross pay every month.
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Image: NHIF
If you're at least age 18, not living with a parent or unmarried you would be required to contributed to the National Hospital Insurance Fund under a proposed law.
A new bill seeks to provide for mandatory contributions by that group at rates set by the NHIF board.
The proposal sponsored by Majority leader Amos Kimunya exempts people under 21 years who have no income and are living with a contributor..
Also exempted would be people younger than 25 who are in school and have no income except for scholarship or bursary, which would be exempt.
The proposed law would not apply to mentally or physically handicapped persons who wholly depend on the contributor. A spouse is considered covered by a contributor.
The NHIF Bill, 2021 provides that employers will pay contributions for their staffers and not deduct the same from the employees' pay.
“A person liable to pay a matching contribution shall pay such contributions in their capacity as an employer and shall not deduct such contribution from the salary or other remuneration of the employee,” the Bill reads.
"No sum deducted from the salary of an employee by an employer shall be recoverable from the employer by that person once remitted to the Fund."
Employers failing to remit contributions will be penalised 25 per cent of the contribution.
"The employer will be liable to pay the penalty and costs incurred by the employee when seeking treatment from a contracted healthcare provider during the period when the contribution is due," the Bill reads.
Currently, NHIF contributions are voluntary while employees have contribution deducted from their gross pay every month.
The proposed law is among steps being taken by President Uhuru Kenyatta’s administration to bolster the Big Four agenda of Universal Health Coverage.
NHIF currently has slightly more than eight million members, a number that would likely double, as there are slightly more than 30 million Kenyan above age 18.
The NHIF board shall prescribe the mode of identification of a beneficiary, “taking into account the existing legal framework for national registration".
Persons who seek exemptions will be required to furnish the NHIF board with information on why they should be considered beneficiaries or produce documents proving their status as beneficiaries.
The Bill proposes a Sh1 million fine or one year in jail for those providing false information to escape mandatory contributions.
“A person who knowingly makes any false statement affecting their capacity to contribute to the Fund or refuses to provide information or produce documents without reasonable cause commits an offence,” the Bill reads.
A Sh10 million fine or five years in jail await persons who make false claims to obtain payment of any NHIF benefit.
The same will apply to those impersonate any person, living or dead, anyone who buys, sells, or offers for sale any card or used stamps or any receipt issued by the Fund.
Contributors will be proven to have paid if they have a record of remittance of contributions or a record of their monthly payslips showing the payments by their employers.
The NHIF board will also define benefits in consultation with the Health Cabinet Secretary.
For those with private health cover, the private insurance will cover payment to the limits covered, while the NHIF will pay for the inpatient stay in hospital.
“The Fund shall cover the outstanding bill where private insurance cover’s limits have been exhausted, subject to limits set by the NHIF board,” the proposed rules read.
The board will also have room to invest in the acquisition of essential medical equipment and supportive infrastructure to contracted healthcare providers.
NHIF would thus advance money to the contracted healthcare service providers for improvement of medical and healthcare services, as long as the providers are financially viable and are in an underserved area.
(Edited by V. Graham)