•NHIF has been offering the cover for almost eight years and insiders said it was fairly better.
•NPS Principal Administrative Secretary Bernice Lemedeket said NHIF quoted Sh9.3 billion whereas the winners quoted Sh8.6 billion hence lost.
There are concerns within the National Police Service and Kenya Prisons Service after the state medical insurer lost a bid to renew a contract to provide comprehensive medical cover.
The National Hospital Insurance Fund (NHIF) was on December 16 informed it had lost the tender to a consortium of private insurance firms.
The firms are led by CIC General Insurance Led (Leader of the Consortium), Old Mutual General Insurance Kenya Limited and Britam General Insurance Company (K) Limited.
This is a big loss for NHIF given the two agencies were seen as some of the biggest clients.
NPS Principal Administrative Secretary Bernice Lemedeket said NHIF quoted Sh9.3 billion whereas the winners quoted Sh8.6 billion hence lost.
“We regret to inform you that your bid was unsuccessful for the reasons that it was not the lowest technically responsive bid in the financial evaluation,” she said.
NHIF has been offering the cover for almost eight years and insiders said it was fairly better.
Chief Executive Officer Dr Peter Kamunyo wrote an internal memo on December 30 saying their contract for provision of comprehensive medical cover to members of police and prisons will expire on Saturday, December 31 2022 since the client will be transitioning to another medical insurance cover provider.
“We should therefore ensure that NHIF's liability for beneficiaries of the scheme in regard to enhanced medical scheme ends at midnight, 31s December 2022 after which all beneficiaries of the scheme should be transitioned to the National Health Scheme,” he said.
Kamunyo said officials there should liaise and ensure the transition takes place smoothly and efficiently by having the system programed appropriately for an automatic transition.
“For patients on overseas treatment the Guarantees of Payment (GOP) should also be revised in liaison with the client to reflect the transition,” he said.
He told regional and branch managers to inform all healthcare providers within their jurisdictions of the transition and advise the healthcare personnel to notify beneficiaries of the NPS/KPS on ongoing treatment accordingly.
In addition, all other service providers such as those offering emergency evacuation services should also be adequately notified by the relevant departments.
“We should all liaise and consult as necessary to ensure beneficiaries on ongoing treatment are not inconvenienced.”
“In that regard all notifications to healthcare providers and other service providers should be done by close of business today, 30th December 2022,” he added.
The police and prisons officers were later supplied with a form instructing them how they will join the new scheme.
The insurers further listed the medical facilities that accept to offer services across the country.
There were concerns the transition may affect service provision for many.
The NHIF contract had expired in September but was extended up to December 31, 2022.
The government entered a contract for the provision of a comprehensive cover for employees of the agencies through NHIF.
It covers up to five children or legally adopted children from zero to 21 years of age.
Children from 22 years to 25 years were covered if fully dependent on the principal member and enrolled in full-time post-secondary education.
Children or dependents with disability wholly dependent on or living with the principal member, registered with the National Council of Persons with Disability, shall not have an age limit.
The move was part of the state’s systematic efforts to institutionalise a welfare and protection programme for the officers who have to contend with life-changing situations through the course of their duties.
Officials said entities were strictly guided by the existing public procurement procedures.
The agreement was a culmination of lengthy deliberations and consultations among the key stakeholders, who settled on the intra-government contracting model.
This was with a view to addressing the escalating claims of unpaid life insurance and annuity benefits to service members or their designated beneficiaries.
The ultimate goal was to harmonise the insurance policy benefits of the officers with those of other civil servants and tailor them to address the vulnerabilities of the surviving families of those who lose their lives in the line of duty.
To further cushion officers, the state will launch a Trust Fund for the welfare of the families of police officers killed on duty.
The government had in June 2022 set aside Sh200 million to offset hospital bills for police officers who had exhausted their annual NHIF cover limits.
Under the arrangement, police officers who exhaust their yearly benefits but still need medical services are required to make ex gratia claims through a committee constituted by the Inspector General.