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Learn about Kenya's transition to the Social Health Insurance Fund (SHIF), key dates and SHA employer portal guidance for seamless healthcare coverage.

Transition to the Social Health Insurance Fund (SHIF)

Posted on by Tutorials Handbook

In 2023, the Government of Kenya took a significant step toward achieving Universal Health Coverage (UHC) by introducing the Social Health Insurance (SHI) Act 2023. This legislative move was part of the country’s Bottom-Up Economic Transformation Agenda (BETA), which aims to create a more equitable and inclusive economic system. With healthcare being a cornerstone of the BETA plan, the government recognized the need for a comprehensive, modern, and universally accessible healthcare system. As a result, the Social Health Authority (SHA) was established, signaling a new era in healthcare access for all Kenyans.

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This article will provide a detailed explanation of the transition from the National Health Insurance Fund (NHIF) to the Social Health Insurance Fund (SHIF), key dates for employers and employees, and guidance on using the SHA Employer Portal.

Key Milestones in the SHIF Transition

The Social Health Insurance Act 2023 led to the creation of the Social Health Authority (SHA), which will oversee the Social Health Insurance Fund (SHIF). This new system marks a shift from the NHIF, which has served as Kenya’s primary health insurance provider for many years.

As of 1st October 2024, the NHIF will officially transition to the SHA, and every Kenyan, including dependents, will be required by law to register as a member of the SHA. This transition ensures that Kenyans can benefit from broader healthcare services under the new Universal Health Coverage (UHC) framework.

Here are some key dates to note:

  • Last NHIF Admission: The last date for new admissions or renewals under the NHIF is 30th September 2024. After this date, the NHIF will no longer be the country’s health insurance provider.
  • Start of SHA Coverage: SHA coverage will officially commence on 1st October 2024, ushering in a new system of health coverage for Kenyans. Members who were previously covered by NHIF will be transferred to SHA without interruption in services, provided they are registered and payments are up to date.

Important Payment Deadlines

To ensure a seamless transition, it’s crucial for both employers and individuals to be aware of the payment deadlines associated with the switch to SHA:

  • Payments received on or before 9th October 2024: Contributions made by this date will be credited to the NHIF.
  • Payments received from 9th November 2024, onwards: Contributions after this date will be credited to the SHA, and will count toward the Social Health Insurance Fund.

Late or missed payments may result in delays in access to healthcare services, so it is essential to meet these deadlines.

The Role of Employers in the SHA Transition

Employers play a crucial role in ensuring their employees have continued access to healthcare services under the new SHA system. All employers must register their staff members and ensure that contributions to the SHA are remitted accurately and on time.

The SHA Employer Portal has been established to streamline the registration, payment, and management process for employers. This digital tool is designed to help businesses seamlessly transition to the new health insurance system while keeping employee healthcare coverage uninterrupted.

Key Functions of the SHA Employer Portal

The SHA Employer Portal offers a range of functions to assist employers in managing their employees’ contributions and healthcare coverage. Here are the core features of the portal:

  • Employee Registration: Employers can register their employees and their dependents through the portal. It is important that all employees are registered with the SHA before the deadline of 1st October 2024 to ensure that they receive uninterrupted healthcare services.
  • Contribution Remittance: The portal allows employers to make SHI contributions on behalf of their employees. Timely payment of contributions is essential to ensure that healthcare services are available when needed.
  • Generate Reports: Employers can access and download detailed reports regarding contributions, payment history, and other relevant financial records. These reports will help ensure compliance with payment deadlines and give a clear overview of contribution status.
  • Update Employee Information: Employee data, including dependents, can change over time. The portal allows employers to update any changes in employee or dependent information, ensuring that the records remain accurate and up-to-date.

Step-by-Step Guide to Using the SHA Employer Portal

Accessing and using the SHA Employer Portal is straightforward. Here’s a step-by-step guide to getting started:

  1. Create an Account: Visit the SHA website at https://employers.sha.go.ke/ and create an employer account. You will be required to provide key business details, including business registration information, employer identification, and contact details.
  2. Verify Your Account: Once you’ve created an account, follow the instructions sent to your email to verify your employer account. Account verification is necessary for security purposes and to ensure that your business is correctly linked to the SHA system.
  3. Add Employees: After verifying your account, you can start adding employees to the system. You’ll need to provide detailed information about each employee, including their full name, identification number, and details of any dependents. Ensure that all employees are registered with SHA before the 1st October 2024 deadline.
  4. Make Contributions: Once your employees are registered, you can use the portal to remit contributions. The payment system is designed to be user-friendly, and you can choose to make one-time or recurring payments for your employees. Be sure to adhere to the payment deadlines to avoid disruptions in coverage.

Understanding the New Healthcare Coverage under SHA

The transition from NHIF to SHA is more than just a name change—it represents a fundamental shift in how healthcare coverage is provided in Kenya. The SHA will offer more comprehensive benefits, including expanded services, wider coverage for dependents, and enhanced access to both public and private healthcare providers.

Key benefits of SHA membership include:

  • Expanded Coverage: SHA covers a broader range of healthcare services, from primary care to specialized treatments, ensuring that members can access the care they need.
  • Increased Access to Providers: SHA provides access to a larger network of healthcare providers across the country, both public and private, ensuring that members have more options when seeking care.
  • Dependents’ Coverage: Like NHIF, the SHA will cover employees and their registered dependents, ensuring that families are protected under the UHC framework.

Employer Responsibilities and Compliance

Employers are responsible for ensuring that all employees are registered with the SHA and that contributions are made on time. Failure to comply with the SHA requirements could result in penalties, and more importantly, employees may experience disruptions in their healthcare coverage.

To avoid these issues, employers should:

  • Ensure Timely Registration: Register all employees before the 1st October 2024 deadline.
  • Adhere to Payment Deadlines: Ensure that contributions are made on time and credited appropriately to avoid lapses in coverage.
  • Maintain Accurate Employee Records: Keep employee and dependent records up-to-date to ensure accurate billing and contribution tracking.

Support and Assistance

For employers and individuals requiring assistance during the transition, the SHA has set up dedicated support channels to help resolve any issues:

  • Email: For queries, employers can contact [email protected].
  • Toll-Free Number: Employers can also call the toll-free number 0800 720 601 for immediate support.

The SHA is committed to ensuring a smooth transition for both employers and employees as Kenya embarks on this new phase of universal healthcare coverage.

Conclusion

The transition to the Social Health Insurance Fund (SHIF) and the establishment of the Social Health Authority (SHA) mark a critical moment in Kenya’s healthcare history. With the SHA replacing the NHIF, Kenyans will benefit from expanded coverage, greater access to healthcare providers, and a more comprehensive healthcare system under the Universal Health Coverage framework.

Employers play a pivotal role in this transition and must ensure that their employees are registered, contributions are remitted on time, and records are accurately maintained. By doing so, employers will help secure the health and wellbeing of their employees and their dependents.

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As Kenya moves toward a more inclusive healthcare system, the SHA Employer Portal will be an essential tool in ensuring a smooth and efficient transition. Employers should familiarize themselves with the portal and adhere to the guidelines to guarantee uninterrupted healthcare services for their workforce. The SHA and SHIF are poised to revolutionize healthcare in Kenya, bringing the country closer to achieving Universal Health Coverage for all.

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