The following Healthcare Newsletter was issued by ACA Employee Benefits – 2019
The table below provides a snapshot of important data which should provide an indication of a scheme’s ability to provide competitive benefits on a sustainable basis.
ACA Employee Benefits - Healthcare regularly monitors key data of the most prominent schemes in order to early detect risks and to better understand the benefit changes and increases announced year on year.
| Scheme |
Principal members |
Net Health Care result 2017
R000 |
Claims ratio |
Average
age |
Solvency |
Net non-h/c expenses pbpm |
Ave past 3 years increase |
| Bestmed |
94 705 |
135 457 |
87.2 |
37.1 |
29.4% |
R170.50
(9.66%) |
9.4% |
| Bonitas |
338 649 |
345 845 |
88.3 |
33.3 |
24.5% |
R158.90
(9.4%) |
9.8% |
| Discovery |
1 323 427 |
967 953 |
85.7 |
34.6 |
27.4% |
R181.50
(12.3%) |
9.1% |
| Fedhealth |
71 980 |
27 985 |
86.9 |
38.0 |
32.1% |
R209.60
(12.2%) |
9.9% |
| Medihelp |
92 358 |
8 110 |
90.7 |
37.0 |
29.6% |
R159.90
(9.2%) |
9.5% |
| Medshield |
78 827 |
(256 764) |
97.8 |
37.6 |
44.6%
|
R168.50
(10.9%) |
11.6% |
| Momentum |
154 181
|
(18 454) |
86 |
32.8 |
25.7% |
R171.90
(14.4) |
10.0% |
| Sizwe |
47 218 |
(4 081) |
88 |
33.2 |
54.9% |
R206.10
(12.2%) |
6.7% |
| Topmed |
20 650 |
(81 161) |
99.7 |
37.9 |
72.6 |
R166.70
(11.7%) |
10.2 |
While the number of principal members, net healthcare result and average age, solvency and other indicators provide for interesting reading, the average increases for the past 3 years provide some insights into the fierce competition between schemes to announce low increases. The announced increases should be seen against the background of benefit increases/reductions. For a number of years we have published the increases, but warned against observing these in isolation, as often a low increase can be very misleading and should be considered together with the benefit reductions or increases of the schemes.
Reference: CMS Report 2018
DISCLAIMER
Although this document has been prepared with due care and in good faith, the interpretations and opinions are those of the authors and are subject to change without notice. As such, the contents do not constitute definitive advice and should not be accepted as such. Neither ACA Employee Benefits (Pty) Ltd and Simeka Health (Pty) Ltd nor the authors accept liability for any damage whatsoever or however it may arise, including but not limited to, direct, indirect or consequential loss that may arise as a result of sole reliance on the information herein. Competent professional advice should be sought when dealing with any contentious issue. ACA Employee Benefits (Pty) Ltd and Simeka Health (Pty) Ltd is a duly authorised financial services provider.