NHIMA administers Zambia's National Health Insurance Scheme. Both employer and employee contribute 1% of gross salary each. NHIMA benefits cover inpatient and outpatient care at accredited facilities.
The National Health Insurance Management Authority is established under the National Health Insurance Act No. 2 of 2018. NHIMA manages the National Health Insurance Scheme, which provides health coverage to workers and their dependants. Contributions: both employer and employee pay 1% of the employee's gross monthly salary, remitted by the employer to NHIMA by the 10th of the following month. Employers who fail to remit face penalties. Beneficiaries: contributor, spouse (one registered spouse), and up to five children under 18. Benefits cover inpatient and outpatient services at accredited public and private health facilities. A member must present their NHIMA card and national ID to access services. To register, employers submit a form to the nearest NHIMA office and register all employees. Individual members can also verify their contributions via the NHIMA member portal. Complaints about denied claims can be referred to the NHIMA dispute resolution mechanism.
An employee is taken to hospital and presents her NHIMA card, but is told her employer has not remitted contributions. She reports to NHIMA, which investigates the employer for non-remittance and ensures she receives treatment.
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