Further to our letter to you of June 18th 2019, and further
to the Excel Tables attached to a June 19th email from Fardosa Abdi,
we are pleased to send you the attached list of Unashig Members who are ready
for the immediate launch of our Enhanced Health Insurance cover. The list
contains family details of 87 Unashig Members, as well as the benefits and limits
which each family is paying for.
Those included on the list have raised a total of over KES 8,500,000/-.
The final numbers are likely to rise to around KES10 million in premiums
deposited in the bank by between 95 and 100 Members, depending on how Unashig
and NHIF finalize the details of the insurance contract. We wish to have the
launch in very early in August 2019, since a July launch seems impossible now.
This is how we at Unashig have interpreted NHIF’s new Enhanced Health
Insurance policy – and the summary Excel Tables and the ten more disaggregated
tables which actualize the policy: Each family is first classified by the Unashig
Member’s age into two age-groups – as either Below 60 or 60+. The summary and detailed tables are likewise designed,
respectively, for those aged below 60 and those aged 60 or over. We
understand and accept that each family must stick to its age-group, and that
each is required to pay the aggregate premium specified for the age-group in
terms of each Benefit Layer and any of the 5 more specific benefits that it actually
chooses and wishes to enjoy – taking into account its size such as M+0.... or the like).
In the view of Unashig’s Board, the tables are a menu (with each ‘item’ fully-priced) from which each Member/Family is free
to pick what to pay for, and what not to. Thus, a family which is no longer in
the child-bearing age will not see the need to pay for Maternity cover, and
should not be compelled to do so. That is the common view of our Members as
well. Likewise, those who think that they already have adequate Outpatient
cover through NHIF’s mandatory Basic Cover and/or the University’s (or other
employer’s) Staff Clinic – or some other aspect of Universal Health Care –
should not have to pay for it under the Enhanced Cover as well, or to come up
with an alternative benefit or ceiling outside of the set menu. As we
understand it, Dental and Optical covers are for the same reason also optional.
Due to cost implications, about 30 of our Members – each of whom had
prepaid a premium of KES 66,000/- by April 2019 – are hesitant to join the
scheme until there is greater clarity about how a family’s age-group is to be
determined. More specifically, they wait to know whether a family’s age-group
is to be determined by the age of the individual who is officially a Unashig
Member, or by the age of the oldest family member. Our own computations are
based on the age of the Unashig Member in any given family. If NHIF is of
another view, it will affect the number in the Final Version of our list of
Members to be covered.
Some of our members, discouraged by the sudden increase in premium
amounts, now wish to take the opportunity offered by NHIF to join the Enhanced
Health Insurance scheme half-way through the first year of our Enhanced Cover.
We would appreciate knowing how NHIF proposes to compute the prorated premiums
for the half-year.
Finally, we ask you to let us know the specific team at NHIF with which
three or four of us should start meeting to iron out the relevant contract
details and the modalities for launching our Enhanced Cover in early August. We
propose that the first meetings be held later this week and early next week.
(Sgd). Mauri Yambo
Unashig CEO
