OBJECTIVES: To identify the socio-economic factors that influence the non renewal decision of National Health Insurance Policy Holders METHODS: An analytical cross sectional survey was conducted. Four hundred and fifty-four (454) subjects from the non renewal list at the Bekwai Mutual Health Insurance Scheme were randomly selected and interviewed using validated structured and pre-tested questionnaires. A hand delivered questionnaire was used to collect data with the help of three trained research assistants after consenting process had been completed. The data was entered analyzed using SPSS version 16 and analysis was done for the various study variables. All statistical tests were run at 95% confidence interval and at 5% significance level. RESULTS: Two hundred two (44.5%) of the respondents reside in the urban setting while 252 (55.5%) of respondents was from the rural area.  Eighty-seven out of the 454 respondents representing 19.2% were traders while 84 (18.5%), 80 (17.6%), 54(11.9%) and 16(3.5%) respectively.  Most respondents were married suggesting that decoupling the exemption of children under 18 years old from parents has served as a disincentive to the registration of parents. Urban respondents who had no formal education and primary school level were 3.15 times and  2.32 times more likely not to renew their health insurance, as compared with rural respondents. Artisans, clericals and students were 0.80 times, 0.95 times, and 0.79 times less likely not to renew their health insurance respectively.  Respondents who fall within income brackets 1-100, 101-200 and 201-300 were 0.54 times, 0.72 times and 0.78 times less likely not to renew health insurance. CONCLUSIONS: Socio-economic factors, such as education, income, marital status and employment had influence on the retention decisions. Implementing pro-poor social interventions and conducting further studies to access the influence of beliefs, knowledge and status of health insurance on  healthcare utilization could be helpful.