• 25 January 2023

Cosmopolitan Health Insurance Company

ABOUT

Cosmopolitan Health Insurance (CHI) is a limited liability company which was established under Act 852 of the National Health Insurance Law (2003) and began its operations in 2014 as a private, indigenous health insurance company. Presently, the company has over 400 accredited Health Service Providers in the country.

There are various product options specially designed to cater for all categories of businesses and levels of employees including individual and family packages.

Cosmopolitan Mutual Health Insurance was set up to aid the government in achieving its aim to provide quality healthcare which is cost-effective and reachable to the general public. The company has legal backing to carry out the following activities:

• To provide, administer and manage private mutual health insurance schemes for corporate institutions and private individuals
• To provide Third Party Administration (TPA) and management of healthcare schemes for corporate institutions and private individuals
• To provide healthcare Top-Up services to corporate institutions and private individuals and
• To provide healthcare cover for dependants of residents and non-resident Ghanaians

Vision

Cosmopolitan Health Insurance seeks to transform the health care experience through a culture of excellence, care, quality service and innovation.

Mission

Cosmopolitan’s mission is to provide the highest levels of coverage possible to our clients. We work to ensure that our insurance products are of the highest standard possible and our plans provide high levels of flexibility with comprehensive coverage.

Products and Services

Premium Based Services: Cosmo Ivory, Cosmo Sapphire, Cosmo Emerald and Cosmo Diamond

Third Party Administration

This is where medical services are administered to third parties of corporate bodies and associations with a large membership. There is also the management of Top up medical services for members of the National Health Insurance Scheme (NHIS).

Cosmopolitan Health Insurance:

• Provides third party administration (TPA) to clients who have their own panel of clinics and hospitals.
• Helps corporate institution to negotiate service charges and cost of drugs from health service providers.
• Comprehensively study’s the contract that governs the health service relationship between corporate institution and the health service providers and provides advice.
• Has all claims submitted to its Medical Director for vetting, after which vetted claims will be submitted to corporate institution for payment to health service providers.
• Provides an alternative payment option for clients to make a down payment against which vetted claims will be drawn.
• Has a team of Doctors who will vet all claims on time for onward payment.
• Will go to the extra mile of coming over to client’s office to register the entire staff members.

Cosmopolitan Mutual Health Insurance also provides complete benefit packages to its members, according to the scheme under which they are registered. They include: consultation, medication, laboratory, investigations, medical and surgical procedures, optical and dental services. The benefit packages are not rigid, but can be adjusted to suit the particular health needs or policies of the corporate institutions.

CMHI also works hard at the response time for claims settlement and presently has a track record of settling about 90% of all genuine claims in, at most, 10 working days.