By Luke Anami

The much talked of medical scheme for all civil servants is now a reality, The Standard On Sunday can now reveal.

Civil servants will now have to forfeit their monthly medical allowances, which will be pooled to create Sh7 billion Public Service Medical Scheme. Starting August 1, civil servants will enjoy the new medical scheme for the first time.

Last week civil servants countrywide started filling forms indicating their personal details for the scheme to take off. Among the highlights of the scheme is that teachers have been included.The public spat between Public Service Minister Dalmas Otieno and his Medical Services counterpart Anyang’ Nyong’o notwithstanding, the medical scheme has been included in this year’s financial estimates read on June 8, by Deputy PM and Minister for Finance Uhuru Kenyatta.

In the proposed structure, as revealed by Public Service Permanent Secretary Titus Ndambuki, all 475,480 civil servants and teachers would be required to pay monthly premiums to finance the new health insurance scheme similar to those subscribed to by workers in the private sector.

"The new medical scheme has been discussed exhaustively with the Ministry of Finance," Titus Ndambuki, PS, Ministry of Public Service said in an exclusive interview with The Standard On Sunday.

"We will convert the current medical allowances to premiums to be paid to a consortium of five medical insurance companies."The scheme has three phases: In the first phase, the scheme will cover 219,000 civil servants, with effect from August 1.

Second phase

"The first phase will cover civil servants, Kenya Police, Administration Police, the Prisons Service, the National Youth Service, and the Teachers Service Commission staff," Ndambuki explained.

The second phase will cover members of the Kenya Union of Post-Primary Education Teachers (Kuppet) who have signed up following protracted talks with the Government.

"Kuppet had some concerns, but they would be considered for phase two of the scheme, most likely this August," Ndambuki added."Kenya National Union of Teachers (Knut) negotiates their pay and medical allowances under the Collective Bargaining Agreement. Their current CBA end in July 2013. If they would be interested, they would be allowed to join in the third phase, planned for August 2013," the PS said.He reiterated the fact that teachers have been factored into the medical scheme.

The new Constitution, labour laws, and the Employment Act require that every employer make provision for sufficient medical attention to employees."The Cabinet has approved the scheme. Whether teachers want to join the scheme it is upon them to decide. The doors are open to those who will be willing to do so," Ndambuki added. "Those teachers who wish to join and forfeit their medical allowances are welcome."The medical cover has been designed to provide in-patient, outpatient, and critical illness benefits on family shared basis, life insurance, and last expense cover for principal members.Under the plan, the minimum covers for in-patients ranges from Sh500,000 to Sh2 million per year. Outpatient cover ranges from Sh50,000 to 150,000 per year. For outpatient treatment, a patient will be required to pay Sh200 per visit (see details on the table)."The scheme will cater for the father, mother and two children at the beginning. Once we start the scheme, we will review its performance to see whether it can accommodate more than two children," said Ndambuki.Tenders from insurance companies were opened last week and five firms are being identified to offer medical cover."Each insurance firm will not take more than 30 per cent of the risk. Further they would be required to have an administrator to handle their claims and paper work," Ndambuki explained.The successful consortium shall enter into a three-year contract, renewable upon satisfaction. To avoid cases where some insurance companies go under undetected, each of the consortiums would be required to provide annual reports and accounts for the past three years.

"With the Insurance Regulatory Authority assistance, we will seek the consortium that will best deliver," he added.

Under the new scheme, civil servants and teachers would uniformly pay between Sh13,062 and Sh46,968 in annual premiums to finance the scheme.The financing of premiums will be converted from what both civil servants and teachers earn as medical allowances. The Government has abolished the automatic allowances paid as part of salaries in a review of terms of service with effect from July 1.Civil servants are to surrender their monthly medical allowance that ranges between Sh375 for the lowest-paid to Sh2,940 for the highest paid civil servant. Teachers will part with Sh767 for the lowest-paid, to Sh4, 412 for the highest paid employee, a chief principal, if the proposal is approved. Medical allowances paid to both as outlined above create a bank of about Sh7 billion a year. The Government is to supplement the figure through an additional provision of 25 per cent to meet the difference between what civil servants can offer to buy the premiums.

The scheme has been tendered to private insurance companies, who will therefore control about Sh7 billion.

Speaking to the Press separately, Tom Odege, the secretary general of the Kenya Union of Civil Servants said his union has agreed to the arrangements and would encourage members to sign up."This is something we have been looking up for a long time. Now that it is ready, we encourage our members to fill the forms for purposes of administering the scheme," Odege said.

The package was negotiated between the union and the Government.

The scheme for 214,126 civil servants, also covers 2,978 Teachers Service Commission employees, and more than 200,000 teachers, even though Knut members have rejected it.Glance- Public servants are to get a new deal on medical cover, which is expected to begin on August 1.

- The move would also affect 214,126 civil servants and 2,978 Teachers Service Commission employees. Public Service staff likely to benefit from the scheme will include the police.- Kenya Union of Civil servants support the medical scheme.

- Teachers stand to lose their monthly medical allowance of between Sh767 for the lowest paid staff member, and Sh4, 412 for the highest paid should they approve the scheme.- Teachers and civil servants would uniformly pay between Sh13, 062 and Sh46, 968 in annual premiums to fund the scheme.

- Advantages public servants staff could expect from scheme would include coverage for their family members, who would only have to pay Sh200 under the co-pay arrangement, and send an SMS from their cell phones to the scheme administrator.-

This is meant to verify the member’s status and give a reference number, which the medical provider or hospital the member would use to claim payment.