How much will an employee contribute to benefit from the National Health Insurance Scheme? 

The Health and Managed Care Association of Nigeria (HMCAN) claimed every worker will part with 15 per cent of his/her salary as health tax.

But, the National Health Insurance Authority (NHIA) said the association got its facts wrong as no portion in the NHIA Act mandates employers to so tax their employees.

In a press statement, the HMCAN said it has over the years clamoured for the implementation of a holistic law that seeks to make health insurance mandatory in Nigeria and has worked extensively with the defunct NHIS, several state schemes and the organised private sector.

The statement reads: “HMCAN acknowledges the clarity provided by the NHIA Act 2022 which now provides mandatory health insurance across the country and the clearly defined roles of HMOs in the provision of health insurance in addition to supporting the social schemes for federal MDAs and state social schemes.

“HMCAN supports the NHIA Act’s focus to promote, regulate and integrate health insurance schemes across the country and to harness private sector participation.

“Without prejudice to the anticipated operational guidelines to be issued by the NHIA, HMCAN wishes to provide the following clarifications for the general public and all stakeholders in respect of the provisions of the NHIA Act.

“The NHIA is vested with the regulatory responsibility for all participants under the health insurance arrangement including state health insurance agencies, healthcare providers, HMOs, TPAs and even banks and insurance companies that wish to participate in the health insurance sector.

“The NHIA is responsible for managing the Federal Public Service Scheme which had always been managed by the erstwhile NHIS. The NHIA may choose to appoint HMOs (as TPAs) or TPAs to administer the scheme for them or may choose to create an in-house team to do so.

“Only the State Health Insurance Agencies are authorised to establish Basic Health Care packages in the states. The BHCP are to be defined by each state and they may appoint HMOs/TPAs to assist them with the administration of their schemes. Participation is mandatory for residents of the relevant states and payments for subscription is expected to be paid directly to the state HIA by the individual or employer.

“The State HIAs are also expected to define and create Vulnerable Person schemes or arrangement to ensure that such persons are properly catered for. This is a significant milestone which must not be overlooked.

“HMOs are empowered to operate private plans. Licensed HMOs can create and offer their plans to all Nigerians provided that the people also have a BHCP. Payments for private plans are to be made to the HMOs directly and HMOs must pay providers for care that has been rendered to their beneficiaries”.

But the NHIA debunked the HMCAN claims that employers and employees will be mandated to make contributions of 15 per cent of basic salary to the new NHIA) scheme.

The NHIA stressed that the ACT contained no such clause, described the claim as a ploy to confuse the people.

It explained that the law does not prescribe a percentage that federal civil servants would pay, as their premium is being paid by the Federal Government.

However, for others not under the Federal Civil Service, they can come into the programme through the Group, Individual and Family Social Health Insurance Programme(GIFSHIP), where they either pay N45,000 as an individual or N15,000 per person as a group.

The NHIA explained: “The new law recognises state health insurance agencies. So, Nigerians can either choose their states’ health insurance scheme which is limited in coverage to the state or belong to the NHIA scheme which covers them in every state of the federation.

NHIA’s Director-General Prof. Mohammed Sambo, said: “It is not true, and there is nowhere such kind of thing is mentioned. They are saying 15 per cent as health tax for what? The HMCAN is confused. I know that they will not be happy, but it is inevitable. When they had their field days, they didn’t do the right thing, and they have allowed many petitions to go to the National Assembly.

“If the National Assembly took a decision on the strength of the level of petition, they wouldn’t have even made them to be operating.

“Therefore, their statement is a misinformation. In the NHIA law, there is no pronouncement by the government that this is going to be so.

“They are confused and they want to muddle up everything. But it won’t be possible because people are not ignorant. That is why we have swung into action to educate people about the law so that they would know and act on the right information.”