By Lilian Okoro
The Ultimate Health HMO has introduced the Group, Individual and Family Social Health Insurance Programme (GIFSHIP) as its core coverage plan, aiming to expand insurance access to Nigeria’s informal sector and private workforce.
Otunba Lekan Ewenla, Managing Director and Chief Executive Officer of Ultimate Health HMO, announced the initiative at a media briefing in Lagos on Tuesday.
He stated that the decision to adopt GIFSHIP was part of a broader strategy to increase enrollment and align with the National Health Insurance Authority (NHIA) Act 2022.
The plan is designed to serve individuals, families, associations, and small and medium-sized enterprises (SMEs), alongside workers in the informal economy.
Ewenla said: “The essence of being here is basically for us to set the right agenda.
“This is because we’ve seen that for a very long time, the low uptake of the organised private sector on the health insurance programme was basically due to a lot of misgivings, misinterpretation, and the wrong footing at which we commenced the health insurance programme in this country.”
He noted that previous laws only encouraged participation, leading to poor compliance.
“But the reason why the formal sector or the organised private sector didn’t really enrol then was because the law does not make it mandatory for the organised private sector to comply.
“ The NHIA law now has made it mandatory for everyone.”
According to Ewenla, GIFSHIP will address existing gaps by standardising pricing and eliminating arbitrary negotiations.
“What we are trying to do is to set the agenda for this to be implemented across the nation,” he added.
The Managing Director also linked low uptake to weak awareness among employers regarding their statutory obligations.
“It is their statutory responsibility to pay medical allowance to their workers and convert the medical allowance of their workforce to health insurance premium.”
The GIFSHIP plan features a fixed annual premium of N38,718.00 per person.
Ewenla said: “The adoption of GIFSHIP as the basic benefit package is a strategic step to strongly focus on the objectives of making healthcare affordable, accessible and equitable.
“It is time to shift from assumptions to what the NHIA Act says. We need to shift from merely treating illness to creating health.”
He noted that the products were developed via actuarial analysis to meet the needs of high-income clients while remaining within regulatory guidelines.
Also, Mr Austine Aipoh, National President of the Healthcare Providers Association of Nigeria (HCPAN), said successful implementation required synergy between governments, HMOs, and industry bodies.
He noted that 60 percent of Nigerians remain in the informal sector.
“Sixty percent of Nigerians are in the informal sector, very informal small workers, vulcanisers, the bricklayers, and all that and we have not tapped into that,” Aipoh said.
He further raised concerns over weak enforcement within the organised private sector.
“The organised private sector, yes, they are well organised, but enforcement has not been forthcoming.
“The government has just left them without coming heavily on them and I’m happy that you are adopting GIFSHIP.
“It will help to meet up with the basic premium package for health service, where you will need to draw from the basic health care provision fund.”
Aipoh said that proper implementation would improve funding and enable providers to deliver higher quality healthcare services.
He also noted that the programme’s ultimate success would require sustained public awareness and enforcement of the NHIA Act. (NAN)www.nannews.ng
Edited by Vivian Ihechu
