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{
    "id": 1589699,
    "url": "https://info.mzalendo.com/api/v0.1/hansard/entries/1589699/?format=api",
    "text_counter": 70,
    "type": "speech",
    "speaker_name": "Nyamira County, JP",
    "speaker_title": "Hon. Jerusha Momanyi",
    "speaker": null,
    "content": "encompasses the teachers' registration, recruitment, assignment, promotion, disciplinary control and the overall well-being of teachers. In fulfilling its mandate in line with the Government's commitment to achieving universal health care coverage. The Commission has established a teachers' medical scheme aimed at providing comprehensive health insurance to all teachers employed by the Commission, along with their immediate dependents. To implement this, the Commission has engaged a consortium led by Minet Insurance Brokers Kenya Limited through a competitive procurement process in accordance with the Public Procurement and Asset Disposal Act, 2015. The consortium was awarded a three-year renewable framework contract effective 1st December 2022 to 30th November 2025, subject to annual performance review and funding availability. The Commission explained that the medical scheme is structured in two parts: 1. The capitation model. Under this model, the Commission stated that a fixed payment per member is made quarterly in advance to health facilities, covering: (a) Outpatient care. (b) Inpatient services. (c) Maternity. (d) Dental and optical services. TSC emphasised that capitation payments are quarterly-based and not annual, and are crucial for enabling facilities to deliver uninterrupted service to teachers and their families. 2. A fully insured model. This component covers: (a) Last expense. (b) Medical evacuation. (c) International treatment and referral services. (d) Excess-of-loss coverage. The Commission indicated that each covered a family consisting of six members: The teacher, who is the principal member, one spouse, and up to four children. Eligibility for the cover is restricted to teachers actively in service and aged between 18 and 65 years. In response to the delays in disbursement of funds to the scheme, the Commission clarified that no monthly deductions are made from teachers’ salaries. So, their salaries are not cut. However, the entire scheme limits the funds through the Exchequer and is based on allocation approved by the National Assembly. The Commission reported that it had successfully remitted all payments due for the first and second policy years, ending 30th November 2024. However, the delay in disbursing funds for the first quarter of the third policy year, 1st December 2024 to 28th February 2025 was due to the late Exchequer release. TSC assured the Committee that once the Supplementary Budget II is approved by Parliament and the funds disbursed by the National Treasury, the outstanding amounts will be settled immediately to ensure continuity of the scheme. On the alleged Ksh18 billion debt to hospitals, the Commission clarified that hospitals are not contracted directly by TSC, but rather by the insurance consortium led by Minet Insurance Brokers Kenya Limited. Therefore, payments to service providers are the responsibility of the consortium. TSC stated that as of the date of reporting, it had fully settled premiums for the second policy year and was awaiting funding to settle the pending Ksh6 billion for the third policy year. On measures to prevent…"
}