Exclusive: How teachers were forsaken by SHA leaders
The Social Health Authority (SHA) rejected a proposal to insure roughly 400,000 teachers, citing insufficient structures, according to the Teachers Service Commission (TSC).
Members of Parliament (MPs) learned that the SHA system would have billed the TSC Sh37 billion.
SHA was clear that even if the commission had provided that amount, it would take a full year to implement, TSC chief executive Nancy Macharia informed MPs.
Similar to SHA, Macharia noted that teachers were also not insured under the now-defunct NHIF, as it too presented hefty figures that the TSC could not afford.
No frameworks
Macharia was answering a query posed by Mandera South MP Abdul Haro, who asked why the TSC had not transitioned teachers to SHA.
Macharia stated: “When we encountered problems with Minet last year, we aimed to shift our teachers to SHA, so we held a meeting with SHA and were told that SHA lacked sufficient structures for this. ”
She continued: “We indeed had a meeting with them and aside from stating they did not have frameworks, they requested Sh37 billion to onboard teachers, and even then, they indicated that they were not prepared to onboard them this year. Our [Minet] scheme operates on a budget of approximately Sh20 billion. ”
Macharia testified before the Education Committee, chaired by Tinderet MP Julius Melly, to address inquiries about teachers’ health insurance.
Although the Minet cover – provided for a three-year duration, expiring on November 30 – has issues, she stated that the TSC has struggled to find another insurance provider for the substantial number of teachers.
Macharia mentioned that the TSC had put out a tender, but no insurance companies had submitted proposals to provide insurance services.
Treasury delays
While the TSC had completely settled the contract for the second-year policy, concluding on November 30, 2024, she indicated that treasury delays had resulted in non-payment for the first and second quarters of the third-year policy, which commenced on December 1, 2024, and March 1, with the outstanding bill at Sh11. 2 billion.
She added that the TSC will be unable to offer group life insurance to teachers once the current coverage lapses in November, as the agency requires Sh1. 5 billion for it.
Under the Minet scheme, teachers receive inpatient and outpatient services ranging from Sh1 million to Sh2. 5 million, dental coverage of Sh45,000, optical services of Sh60,000, maternity coverage ranging from Sh120,000 to Sh300,000, evacuation allocations, and international and travel referral allocations of Sh2 million and Sh200,000 respectively, as well as funeral expenses for principal members and transport for immediate family members up to a maximum of 10 people at Sh300,000.
However, MPs dismissed the teachers’ insurance scheme, claiming it had failed the teachers and urged the TSC to develop a more effective cover.
Several MPs recounted personal experiences of needing to support teachers receiving treatment in hospitals after the insurance scheme declined to settle their accounts.
Lawmakers pointed out flaws in the scheme, stating that it had left teachers to endure hardships alone.
They mentioned late approvals for treatment, delays in the authorization and pre-authorization processes, patients being denied access to hospitals, and the failure to pay final benefits for teachers who have passed away.
Melly indicated he needed to talk with Minet representatives after a patient was reportedly held at Upper Hill Hospital for over 90 days due to the scheme failing to cover the bills.
Melly stated: “We want a reliable insurance scheme for teachers. You must either split these teachers into groups and provide them with a decent scheme or give us a clear path forward, because what is happening is not acceptable. “The existing scheme is merely a mishmash of insurance providers, which is quite an absurd scheme. ”
Amorphous’scheme
Joseph Makilap (Baringo North) described the scheme as amorphous and ineffective for teachers. “As TSC, you mentioned you are facing budget constraints, and it is evident that teachers will continue to suffer because of this amalgamation of insurance companies.
We are urging you as TSC to sit down and group teachers to determine how they can benefit. If not, let’s enroll all teachers into SHA and from that point, we’ll say God help us. ”
Julius Taitum (Igembe North) questioned why the final benefits had not been paid promptly: “Currently, teachers are unable to access their funds to take care of their deceased loved ones. What’s going on? ”
Dick Maungu (Luanda) remarked that the approval process for treatment requests from teachers was excessively prolonged.
He expressed: “This insurance matter is one that is challenging to resolve. It is an issue that began in 2015 and cannot be fixed overnight. Let TSC figure out how to group the teachers so they can be insured differently. Otherwise, this is simply a consortium of vague firms that is quite absurd; it isn’t an insurance company at all. ”
Jerusha Momanyi (Nyamira woman rep) asserted that teachers were lamenting over inadequate services provided by SHA, while Peter Orero (Kibra) inquired why teachers received treatment at hospitals but were not provided with medications. “When teachers visit hospitals … they receive treatment but are not given medications. They are compelled to purchase their own. ”
Mary Emase (Teso South) mentioned that she had to rescue teachers from hospitals after the current scheme refused to pay their bills. “There are issues within this scheme. Our teachers are in distress. If you want our teachers to remain in the classroom, please tackle these problems. ”
Emase recounted how she was also compelled to assist teachers hospitalized as the scheme declined to cover their bills, highlighting that they are forced to buy medications.
She stated: “There are issues within this scheme, our teachers are in distress. If you want our teachers to stay in the classroom, please tackle these problems. ”
