Kenya’s National Health Insurance Fund (Amendment) Act, 2022 (NHIF) which took effect on 22 January 2022, expands healthcare coverage and requires employers to pay matching NHIF contributions for their employees, unless they offer equal or better private medical coverage. Previously, employers were only required to deduct the employee’s contribution from their salary and pay it into the fund.
All residents aged 18 or older must participate in the fund (the contribution amount depends on their salary band), and all employers must pay matching contributions for all employees with whom they have a “contract of service.” Employers do not have to pay additional contributions for employees who elect enhanced medical benefits. The Cabinet Secretary for Health is expected to issue regulations on employers’ matching contributions.
Employers offering private medical coverage to their employees that is equal or better than the NHIF are exempt from paying matching NHIF contributions. Employers must apply to the NHIF Management Board for an exemption and include a certificate from the Insurance Regulatory Authority certifying their workforce has private medical insurance, the benefits provided, and the validity period. The NHIF will only pay medical costs for individuals with private health insurance once the coverage is exhausted (treatment costs will be capped at the applicable NHIF limit).
Significantly increased financial and criminal penalties now apply to employers’ NHIF breaches.