Employed Kenyans whose employers fail to remit their Social Health Authority (SHA) deductions by ninth of every month will not access the insurance services. 

SHA acting Chief Executive Robert Ingasira told senators who sit in the Health Committee that the system is configured in such a way that it changes an individual’s eligibility to enjoy the social health insurance services by that date of every month. 

The system, Ingasira disclosed, is so automatic that it blacklists all employees whose remittances have not been made by the required date. 

The CEO also warned that employers who fail to remit contributions on time will face a 2 per cent penalty on the unpaid amounts. 

“Additionally, failing to contribute or making unauthorised deductions from employees could result in fines up to Sh2 million, imprisonment for up to three years, or both,” he warned. 

Thousands of employees have found themselves stranded at various medical facilities after their employers failed to remit the funds on time. 

Ingasira appealed to employers wishing for their workers to enjoy SHA services to fulfil their statutory obligations by the stipulated date. 

Urgent interventions  

Ingasira told the senators that SHA management has engaged employers and notified them of the consequences of failing to remit the deductions within the stipulated timeframe as one way of ensuring that no employee is locked out.  

To check on one’s eligibility to enjoy services of Social Health Insurance Fund (SHIF), contributors can check using a USSD code from their phones. 

Ingasira however told the committee that in the case of a very genuine concern, the fund has on several occasions been able to intervene to ensure that the patients get the services they require. 

He revealed that under SHIF, which is a contributory scheme, they have paid Sh17.8b while under the Primary Healthcare Fund, which is supported by the Exchequer, they have paid Sh12.2b. They are yet to make any payment under the Emergency, Chronic and Critical Illness Fund due to late activations 

He however revealed that the government has enhanced the cover for chronic illnesses requiring dialysis and chemotherapy. 

Ingasira was responding to a question by nominated Senator Tabitha Mutinda who sought to know whether employees would still get services should their respective employers fail to remit funds to SHIF within the stipulated time. 

The Social Health Insurance Act was enacted on October 19, 2023, and took effect on November 22, 2023, replacing the previous NHIF Act. 

The Act requires employers to deduct statutory contributions from their employees’ wages or salaries every month, at the rate prescribed by the Act. 

SHI General Regulations stipulate that salaried employees make a monthly contribution rate that is 2.75 percent of the gross salary with a minimum contribution of Sh300 per month and no maximum contribution. In respect to non-salaried persons, the household is expected to make an annual contribution set at a rate of 2.75 per cent of the household income with a minimum contribution of Sh300 per month within 14 days before the lapse of the annual contribution. 

The move comes barely a week after lawmakers warned that the SHIF could fail if the government fails to address the current contributory scheme by the non-salaried Kenyans. 

The MPs said it is unacceptable that out of 22.2 million Kenyans registered under SHA only 3.9 million are contributing to SHIF, which is not sustainable and thus insisted that there is a need for the ministry to devise ways of making sure the non-salaried Kenyans increase their contributions. 

The Parliamentary Budget Office (PBO), which provides technical support on matters relating to Public Financial Management (PFM) and financial oversight to all MPs, Departmental Committees and Select Committees in its report has also called for clarity on the Means Testing Instruments (MTI) used to determine the household contribution to the fund. 

“The MTI has presented several challenges, including the provision of inaccurate or incomplete information and the adequacy of the MTI in determining proper household contribution,” the report reads.