General insurance How Contributor Programme works

[Mataracy]

An employer registers itself and employees with the scheme. Thereafter, the employer affiliates itself with NHIS approved Health Maintenance Organisation(s), who now provides (s) the employees with a list of NHIS approved health care provider (public and private).

The employee registers himself or herself and dependants with such provider of his/her choice. Upon registration, a contributor presents his identity card to his chosen Primary health care provider for treatment. The contributor will be able to access care after a waiting period of thirty-five (35) days.
This will enable the completion of all administrative processes.
A contributor had the right yo change his Primary Health Care Provider after a minimum period of six (6) months if he is not satisfied with his services.
Payment for services rendered yo him will be made to the Health Care Provider by the Health Maintenance Organisation (HMO).
A contributor may, however, be asked to make a small co-payment, where applicable, at the point of services.

PAYMENT METHOD(SYSTEM)
Health Care Providers under this programme will either be paid by capitation or fee-for-service.

(a) Capitation:- This is the payment to a Primary Health Care Provider by HMOs on behalf of a contributor, for services rendered by the provider.
This payment is made regularly in advance for services to be rendered.

(b) Fee-for-Service:- This payment is made by HMO to non-capitation receiving Health Care Providers who render services on referral from other approved providers.

 

[btaliat]

I think your explanation on this contributor effect on insurance is more clear here. What happens if the employee is actively under a particular insurance and maybe his employer also wants to insure him let say on the same insurance policy with a new insurance company? Will he cancel the old one or he can do the two?

 

[Mataracy]

I think your explanation on this contributor effect on insurance is more clear here. What happens if the employee is actively under a particular insurance and maybe his employer also wants to insure him let say on the same insurance policy with a new insurance company? Will he cancel the old one or he can do the two?

For the issue of cancelation I believe that in the policy taken it will started as an agreement between the person that take up the policy whether their agreement is flexible or fixed. In the sense that if their agreement is bendable it possible for the insured to determine to change its policy of quit.
The employer can still insure his/her property somewhere else consider that he did not violate or breach any contract rules in the formal place.

 

[Mandy96]

The contributor has a lot to handle according to what you wrote up there, he takes a very important role in the national health insurance scheme, making lists is not a work to be seen as a little work. One has to take it as a vital work that it is

 

[Jamoflondon]

If you ask me, I’ll say this contributor of a thing needs to be analyzed very clearly probably by the agent or the broker, because I used to think insurance is all about the policy and the limitations but now I see the real job it entails. I think the client needs to make some research