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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

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.



Fedhealth Amalgamation with Topmed Medical SchemeFedhealth Amalgamation with Topmed Medical Scheme, /simekahealth/marketinsights/PublishingImages/fedhealth_banner.jpg4/8/2020 2:15:40 PM097930aspx1145 members will automatically be defaulted into Fedhealth matching options.
Primary healthcare in a South African contextPrimary healthcare in a South African context, /simekahealth/marketinsights/PublishingImages/primary_healthcare_banner.jpg4/8/2020 2:16:31 PM097932aspx149 the growing burden of modern-day diseases and continued financial pressure experienced by employees, South African employers are constantly searching for innovative solutions to address these very real issues.

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