KENYA: Contents of a Letter Dated July 23rd to NHIF's Acting CEO Referencing the Initial List of Unashig Members Who Have Paid Up for the Recently Revised Enhanced Health Insurance Cover

Further to our letter to you of June 18^th 2019, and further to the Excel Tables attached to a June 19^th 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

UNASHIG: Procedure for Claiming the Refund of an Insurance Premium Prepayment

Subject to terms and conditions specified hereunder, Unashig will proceed to instruct the bank to refund a prepaid Insurance Premium of a specified amount as soon as we receive a signed and dated letter from a Member stating a specific amount. Refunds are allowed only before the relevant cover takes effect for the Member.

The letterhead should show the Member's full postal address and phone number, and should be addressed to Unashig Kenya PLC, P.O. Box 2000-00100, Nairobi. Any approved payment will be made through bank-to-bank transfer (that is, RTGS or SWIFT). Consequently, the body of the letter should include the following bank details from you (the Member):

1) Your Account Name

2) Your Account Number

3) Your Bank and Bank Branch

4) Your Bank's Swift Code

5) The physical address of your place of residence [LR.No, House Number, Residential Estate, Nearest Road, and Town/County]. Note that this is a requirement in the RTGS or Swift form which Unashig must submit to the bank for each payment.

6) The Bank Transfer and/or M-Pesa transaction code(s), amount(s) and date(s) related to the sum(s) claimed. This requirement is important for verification and audit purposes, and is crucial to resolving disputes between claimants and those who might have actually remitted the claimed sums.

You don’t have to send your letter through the Post Office. It is easier for you to send it as an email attachment to unashig.kenya@gmail.com. We will receive it faster that way, as well. A copy of your letter will be attached to our written instruction to the bank to refund the cash directly into your own bank account.

Concerning claims for any other payments to Unashig, you are advised that the following items are non-refundable:

-- Unashig Membership Application Fee

-- Insurance Processing Fee [Remember that receiving the deposits and managing the bank account entails one-off and recurrent bank charges as well as administrative costs]

-- Purchase of Class A Share

-- Purchase of Class B shares.

The cost incurred in purchasing one or more Unashig shares is non-refundable.Share ownership is a form of property or asset ownership. A Member remains a shareholder even after exiting any particular Health Insurance Scheme, or any other venture, which Unashig may spearhead or or offer. However, even though shares once bought cannot simply be returned to the issuing company (Unashig Kenya PLC) for a refund, the Unashig Board is duty-bound to create or enter into an agreement with an over-the-counter exchange or do any such other thing as will facilitate the purchase and/or sale of, or trade in, Unashig Kenya PLC shares. The company is not quite ready to do so just yet, in view of its infancy. Still, this will hopefully happen at some point after the first AGM.

UPDATE:

Members are further advised that, following a Unashig Board Decision in July 2019, it will take 30 working days to process and refund any sum claimed. There is also a service charge for processing the refund. This charge is the sum of the actual bank levy on the amount remitted AND 2% of the gross amount to be remitted. This 2% is meant to cover Unashig's internal (i.e. management) costs incurred in processing the claim, and includes the logistics of reaching the 3 mandatory signatories required for each refund AND the physically delivery of the requisite instructions to the Bank.

Letter to NHIF's CEO Concerning New Tabulations/Options for Enhanced Health Insurance Cover

[Reproduced below is the substance of a letter mailed by the Unashig CEO this afternoon to NHIF's Ag. CEO]

You will recall that two members of the Unashig Board joined me in a meeting in your office in April this year. Our purpose was to find out how soon Unashig Members could launch their Enhanced Health Insurance cover. You advised us that a new policy would be in place by mid-June 2019, and that new contracts reflecting the new policy might be signed to take effect in July 2019.

Unashig Kenya PLC is a company established by current and past academic and non-academic staff of the University of Nairobi, as well as other shareholders who are Kenyan citizens, to leverage our group size to meet enhanced health insurance costs. We believe that  group-funding should bring down the premiums to a more affordable level for every participating family. Some 165 members have already contributed over KES 11 million toward the Enhanced Health Insurance. The money is in the Unashig bank account at KCB awaiting remittance to NHIF depending on the requirements of your new policy. The money was collected on the basis of a premium rate (indicated to us in a draft contract with NHIF in 2017-18) of  KES 66,000/- per family size of up to M+3. Depending on the affordable options available, the number of Unashig members paying tor the cover could easily rise to 350 or more, in response to the continuing breakdown of University Health Services.

Quite obviously, the times have since changed. Consequently, we are interested to know if any of your newly available benefits-packages and related limits and premiums might be attractive, and affordable, to our members within the premium ceiling of KSH 66,000/- per M+3. Alternatively, we would like to consult with our members concerning the package to opt for even if it should

require an additional premium over and above the KES 66,000/- previously set for a family of 4 (that is, or M+3).

An early response from your office would be greatly appreciated. We are not asking for a grant. We simply wish to have NHIF cover fully paid for by us, with the first year of cover beginning in July 2019.

Unashig: Quantitative Update on "The Road to Enhanced Health Insurance"

[This Quantitative Update was first posted here on December 28, 2018 at 12:39 AM. See the Log of Subsequent Updates at the bottom of the page]


1) By mid-2017, 570 UoN academics under the umbrella of Unashig had filled forms signaling the wish (or intention) to participate in a group-funded Enhanced Health Insurance scheme to be brokered with NHIF. The number was subsequently sent to and used by NHIF to compute the average premiums and related benefits and limits applicable to sets of scenarios proposed by Unashig's Board of Directors. It was always understood by both parties, however, that the number actually paying for cover might be noticeably lower than 570. Gross membership size (or nominal roll) has gradually grown since, and now (February 19th 2019) stands at 655; but net membership is down to 548. This reduced number takes into account several deaths which have since occurred, exits from the group (for one reason or another, including the acquisition of broadly similar cover through the spouses' employers) and corrections for the initial double-counting of married couples who had separately applied to join. Out of the net membership of 548 there are 202 women, who represent 36.9% of the total. A total of 170 members have more recently declared a readiness to pay the annual premium as a lump sum. A lump sum requirement, as opposed to various installment payment options, was stated in writing by NHIF only several months ago. NHIF also insisted that members must pay their premiums through their organization -- Unashig. In our drive to launch the scheme as soon as we could, Unashig proceeded to set a new target of 400 (+/- 50) members for the first year of cover. However, concerned by the slow pace of premium subscriptions, and in response to calls by those who had already paid the premium into the Unashig holding account at the bank, the Unashig Board in January 2019 set a deadline of February 28th, 2019 for the payment of the required premium of KES 66,000 per family-size of M+3 or less -- and agreed on a minimum of 100 fully subscribed members for the purpose. The plan was to approach NHIF at the end of February with the much reduced number in order to get the insurance scheme finally started in March 2019. The driving idea was to negotiate the best possible package of benefits in the context of a significantly reduced number of fully paid up members.

2) Comparing actual registration-by-payment with the minimum target of 100, we note the following patterns and shortfalls since Unashig opened two bank accounts for the purpose in November 2018:
a) A total of 229 persons have to-date paid the required membership application fee, compared to 221 at the last reported count on February 6th 2019.
b) One hundred and two members have now paid the set annual premium either in full (95 Members) or in significant part (7 Members). This is a slow but significant increase over the 70 members who had either paid in full (58) or in part (12) as of February 6th, 2019.
c) One hundred and twenty one Members (121) have fully paid the insurance processing fee, compared with 84 on February 6th. It is to be presumed that most, if not all, intend to participate in the group cover by paying the full premium.
d) One hundred and twenty three (123) past and present UoN academics -- compared to 105 on February 6th -- have each bought the one Class A share permitted in Unashig's Memorandum of Association. We take this as an even more definitive affirmation of their intention to stay involved in Unashig's flagship initiative -- the Enhanced Health Insurance scheme -- which was set in motion in March 2017. Class A shares confer voting rights within Unashig.
e) One hundred and three (103) Full and Associate Members have now paid for a total of 259 Class B shares, compared to 82 shareholders who held 205 Class B shares on February 6th. That's more than twice the number of Class A shares so far bought. However, Class B shares average at only 2.52 per holder. While this apparent appetite for Class B shares suggests a robust alignment with Unashig's two-pronged Health+Wealth strategy, the numbers involved in the purchases do not yet constitute a critical mass of enthusiasm. This is particularly so given that the number of authorized Class B shares stands at 6,000. Much persuading remains to be done.
f) A total of KES 6,576,500/- has so far been raised as Enhanced Health Insurance premium from 95 Members (paying in full), 7 Members making significant part payments (ranging from KES 30,000 to KES 46,000/-), and a few others paying even less. This total is to be compared with a gross of KES 5,621,500/- collected as of February 6th, and 4,120,000/- as of January 4th.
g) Unashig's drive to own quoted shares traded on the Nairobi Securities Exchange (NSE) has so far (February 19th) built up a kitty valued at KES 765,000/-. As of February 6th, a total of KES 662,500/- (comprising KES 210,000/- and KES 452,500/-, respectively) had been raised from Class A and Class B share subscriptions). This compared favourably with a sum of KES 500,000/- which had been raised by December 28, 2018. We're working to push the total to KES 1,000,000/- as soon as we can. Our first investments, in Safaricom PLC and Nairobi Securities Exchange (NSE) shares, amounted to just under KES 330,000/-. We subsequently invested in six additional securities, namely: Equity Bank, Home Afrika, Kenya Reinsurance Corporation, Nation Media Group, Stanlib Fahari I-REIT, and Williamson Tea. The underlying goal is, inter alia, to rapidly grow Unashig's portfolio and in the process own a growing piece of Kenya's "growth engine". Another set of purchases is due in the coming days. There will be more Blue Chip and other investments as members continue to support the drive through Class A and B share purchases.




Update Log ~ This post was updated on: December 29, 2018: 12:25 AM, 12:39 AM; December 31: 11:40 PM; January 1, 2019: 7:59 PM; January 4: 10:20 AM, 2:53 PM, 11:55 PM; February 6: 11:06 PM; February 19: 12:32 AM.