Rather, health insurance is a relationship involving three major players; patients, healthcare providers and HMOs, with each operating under different responsibilities and expectations. He also noted that many enrollees do not fully understand the limitations of their health insurance packages, particularly exclusions and exemptions. The authority said the increase was driven by stronger collaboration with state social health insurance agencies, government ministries, organised labour, employers and the private sector, as well as the gradual implementation of mandatory health insurance provisions. A patient who has paid for health insurance should not have to become an expert in insurance contracts before receiving care. That is the promise Nigeria’s health insurance system must deliver if the country is to move from simply expanding coverage to achieving meaningful universal health coverage.