"Linda Jamii, Mwisho wa Mawazo" - A Winning Corporate Health Scheme

Linda Jamii - Mwisho wa Mawazo!

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The noise has not pettered out, the work has only just began for NHIF and, reality sinks in that the so-called "Universal Sufferage", is really only a "Broader Selection". Will the Fund be managed well? What about those who cannot afford KShs 90 (circa Usd 1 per month)? Which hospitals are accredited? Same goes for NSSF, in July 2014 it was reported that 120 private schemes had requested the Regulator to opt-out of the NSSF scheme. One year later, how many private schemes have applied to opt-out?

I'm sure these were the same weighty matters running through Pierre Mwamburi's mind,  Human Resource Manager of Mwanedu BPO, in addition to having a difficult time controlling the agitated of workers amid murmurs and taunts. Claims that the company was not taking care of its staff rent the air. 

He was relieved as he ducked out of the room, given the excuse that he had to report to Madam "Chairlady", at 7pm, after her late evening golf, at Ngong Racecourse. Rumour had it that she was quite adept with a sand-wedge, and knew how to wiggle out of any difficult situation.

The Chair Lady, Wakesho, was keen to sharpen her skills. Perseverance had paid off as she hit the tee repeatedly, and the ball of course! As the coaching session came to an end, she sipped her juice as she allowed herself to drift back to the reality of every-day corporate life. Golf was a way to forget, if only momentarily, the challenges of managing Mwanedu BPO. Her Father had groomed her well and, she continued to build the family's businesses. However, she opted to try out a new venture into the Business Processing and Outsourcing business. The Business Processing and Outsourcing business was yet to break-even but, she was relieved the company had secured a number of contracts. A few more contracts for Mwanedu BPO and she would be able to relax.

The main issue was the "In-House" company-funded medical cover, which covered Outpatient and Inpatient, which operated on a reimbursement basis. It's popularity had worn thin, inspite of its liberal flexibility. 

Wakesho's and her Fiancee were having dinner, at Haandi's, that evening, with long-time friends Gurmukh Singh and his newly-wed wife Jaswinder Kaur.  Wakesho and Jaswinder would always provoke lively debates. The issue of the increasing cost of medical costs came up and Gurmukh volunteered how he had reduced his company's medical costs whilst offering better cover for his workers, by phasing-out their "In-House" company-funded medical scheme.

"We have a solution!", she exclaimed, as the 7 am meeting began. "I've called in First Liberty Insurance Agency ("First Liberty Kenya") to brief us on the Linda Jamii Healthcare Plan at 7:30am. The plan will help reduce our medical costs".

Linda Jamii is a concept developed by Changamka Microinsurance Ltd, underwritten by Britam Insurance and facilitated by Safaricom Ltd.

Linda Jamii will provide your Organisation a means to rationalize expenditure on uninsured and/or insured medical expenses. It will offer Staff a viable alternative to manage unforeseen illness or injury. The end result will be improved staff efficiency and productivity, reduced stress and, reduced operational costs. It may be offered as a “Tiered-Medical Scheme” based on seniority. It may be adapted to extend medical cover to staff with children in university. It may be offered on a “check-off” basis.

Additionally, Corporates may use this plan in their Corporate Social Responsibility Scheme, for example, aiding the bereaved families of former staff members, assisting needy families.

BENEFITS

A. HEALTHCARE BENEFITS

DESCRIPTION	BENEFITS FOR THE ANNUAL HEALTHCARE PLAN (12 MONTHS)	BENEFITS UP PAYMENT OF KSHS 6,000 (PARTIAL BENEFITS FOR 6 MONTHS)
HOSPITALISATION CARE BENEFIT	KShs. 200,000 Per family per year Maternity limit – KShs. 30,000 (within the hospitalisation limit)	KShs. 75,000 per family for 6 months Maternity limit: 15,000/- (within the hospitalisation limit)
OUTPATIENT CARE BENEFIT	KShs. 50,000 Per family per year. KShs.100/-payable per outpatient visit per person Optical limit – KShs. 5,000 (within outpatient care limit) Dental limit – KShs. 5,000 (within outpatient care limit)	KShs. 20,000 per family for 6 months with KShs. 100 co-pay per hospital visit per person Optical limit – KShs. 2,000 (within outpatient care limit) Dental limit – KShs. 2,000 (within outpatient care limit)
DAILY HOSPITAL CASH BENEFIT	KShs. 500 (payable from day 3 of hospitalisation for principal or spouse)	KShs. 500 (payable from day 3 of hospitalisation for principal or spouse)
FUNERAL ASSISTANCE BENEFIT	KShs. 40,000 (Assistance applicable to principal and spouse) No waiting period for accidental death.	KShs. 40,000 (Assistance applicable to principal and spouse) No waiting period for accidental death.
FAMILY SIZE COVERED	Member / Spouse and all biological or legally adopted children under 18 years or 25 years, if in school or college.	Member / Spouse and all biological or legally adopted children under 18 years or 25 years, if in school or college.
HEALTHCARE COST	KShs. 12,000 per year	KShs. 6,000 for the 6 months period
LIMITS	All limits shown are for the whole family and not individual limits.	All limits shown are for the whole family and not individual limits.
HOSPITALS	Britam approved hospitals	Britam approved hospitals
WAITING PERIOD	60 days from insurance commencement date. 9 months for maternity from insurance commencement date. No waiting period for accident related hospitalisation or death (applicable to each individual)	60 days from insurance commencement date. 9 months for maternity from insurance commencement date. No waiting period for accident related hospitalisation or death (applicable to each individual)

B. OTHER BENEFITS

1.     A convenient and easy way to save for health care using your unique number by M-PESA.

2.     Covers a wide range of healthcare services.

3.     Services available from a large number of participating hospitals countrywide.

4.     Principal member and spouse should be 18 years - 75 years old at entry.

5.     Children covered from one month to 18 years or 25 years if in school or college.

6.     Medical card issued immediately upon registration.

The list of Britam-approved hospitals is updated regularly on the Linda Jamii Website.

We hope to hear from you on when we can make a presentation at your offices.

Linda Jamii, “Mwisho wa Mawazo”

Then the questions came in:

1. Do the Staff have to pay Visiting Fee? Yes, there is a reasonable Co-Pay to prevent abusing the product.
2. How many Corporates do you cover? For purposes of this Blog, its growing! 
3. If I don't have my card will I be able to access cover? Oh yes. The mobile voice & data platform supporting Linda Jamii enables your staff and family to be identified by the Healthcare Provider.

In conclusion, if you are a Human Resource professional, you need to consider Linda Jamii in your array of Medical Insurance options. Cover is available from a wide number of providers all over Kenya.