What's Happening?

Facebook Twitter Youtube Linkedin

NEED HELP? QUESTIONS@FIA.ORG.ZA

become A FIA member TODAY
member login

Now It’s Personal

ARTICLE BY

  • Leo Dlamini
  • CEO and Principal Officer
  • Bestmed

SHARE THIS POST

What can South Africans and their advisers expect from medical aid schemes this year? Get up to date with the latest industry trends.

The medical aid industry is at a crucial turning point, driven by innovative technologies, and an ever-growing need for inclusive and affordable healthcare solutions. As a result, we are witnessing the emergence of a more collaborative ecosystem, as well as partnerships between tech businesses, insurance companies and healthcare providers – those that offer an integrated experience – to align to shifting consumer demands.

In fact, the consolidated number of medical schemes decreased from 144 in 2000 to 72 in 2022 and while the industry overall experienced a 1.17% growth in the number of principal members and a 1.05% growth in the number of beneficiaries over this period, there are several pressure points that continue to challenge the industry.

Compliance, with its evolving regulations and policies, including those related to data protection and member privacy, is high on the list, along with balancing budgets within a tight economic environment. From the consumer side, rising costs, inflation and understanding plan details are challenges that must be met to ensure that suitable plans – for their current and future anticipated medical needs – are selected.

Brokers and the financial advisory market play a critical role in driving information, helping consumers undertake in-depth risk analyses and health assessments, and proposing relevant medical aid options to meet requirements and budgets.

These advisers are usually independent of the medical scheme and can provide an impartial overview of the options available – providing appropriate advice on plans to consider as well as benefit structures.

So, as a financial adviser, here is what you need to know this year to ensure you can continue to consult correctly:

Increased health costs

The cost of providing healthcare cover is increasing faster than the economic growth rate and the consumer price index (CPI). In 2023, according to The Council for Medical Schemes, the actual average contribution growth rate of 6.8% exceeded the projected average CPI of 6.1% by 0.7%. The difference between the increase in the contribution rate of medical schemes and the average increase in the CPI carries significant ramifications for the ongoing affordability of private health services.

As such, making sure that your members understand the intricacies of their plan, or change it when necessary, while still getting the required cover, is crucial to offering value for money. It is no longer just about affordability – it’s about deriving value beyond price.

Encourage personalised prevention

There is also a growing trend towards preventive healthcare. Medical schemes are, therefore, focusing more on wellness programmes, health screenings and preventive measures to reduce downstream/future costs. This also includes recognising the importance of mental health, and providing broader coverage and services, which include access to counselling, psychiatric treatments and support programmes.

Make sure you understand the preventive benefits available via each scheme and undertake regular health screenings. The more consumers understand what is available to them, the less likely they are to neglect potential risks and can take more control of their health. Committing to this does not only prove to be life-saving, but also ensures that their money is not consumed unnecessarily and that the medical scheme is able to safeguard their contributions (reserves) to cover future medical expenses and ensure financial sustainability.

Retaining control while going digital

Now more than ever, consumers are demanding transparency, simplicity and responsiveness when it comes to their medical aid, which means a focus on more digitally integrated platforms for easier access to service, information and support. This means that much of the administrative work can now be done quickly and more efficiently from both sides – encouraging consumers to be more active participants in their health planning. As a result, by utilising digital tools offered by schemes, advisers can refocus on client needs as they are freed from administrative tasks and rather spend their time on where they can add value.

They can also use sophisticated software to get additional information on clients so that they can explore “what if” scenarios, adding different scenarios to their planning suggestions, and then having those collaborative discussions about what the future will look like and mapping products and providers to those needs.

Embracing technological advancements to create an integrated healthcare ecosystem, as well as focusing on delivering innovative health solutions that are competitively priced, will be key.

There is no doubt that the industry is changing. It is going to be a tough year as economic growth remains flat. Disposable income under sustained pressure from high interest rates and inflation, and so-called value-for-money product offerings, as well as being responsive to consumers’ needs will continue to be critical going forward. It is no longer just about being transactional; it’s about making it personal. The role of the adviser has never been more apt to do so.

Subscriber Terms and Conditions

  1. APPLICATION OF TERMS
    • These terms and conditions (“Subscriber Terms”) apply to the subscription by any qualifying member of the South African Underwriting Managers Association NPC (“SAUMA”) to the services and benefits offered by FIA Services (Pty) Ltd (“FIA Services”) under the SAUMA affiliation arrangement (“Subscription”).

  2. NATURE OF SUBSCRIPTION
    • A Subscription under this arrangement:
      • does not constitute membership of FIA NPC;
      • does not confer any voting rights or governance participation in FIA NPC; and
      • is governed solely by the contractual relationship between the Subscriber and FIA Services.

  1. ELIGIBILITY
    • To qualify for the Subscription, the applicant must, at the time of application, be a current paid-up member of SAUMA.
    • FIA Services will verify the applicant’s SAUMA membership status with SAUMA prior to activation, and may re-verify such status periodically.
    • If a Subscriber ceases to be a paid-up member of SAUMA, the Subscription will correspondingly be terminated.
    • Applicants are required to authorise FIA Services to confirm their SAUMA membership status with SAUMA as part of the application process.

  1. SERVICES
    • The Subscription entitles the Subscriber to the following benefits:
      • Complimentary access to the FIA CPD Platform;
      • Complimentary access to the FIA Insight Magazine (digital edition);
      • Advertising opportunities on FIA platforms at a discounted rate of 15% (fifteen percent) off the prevailing published rates; and
      • Invitations to attend FIA Technical Webinars annually.
    • FIA Services reserves the right to update, vary or substitute the Services from time to time, provided that the overall value and nature of the benefits remain materially the same.

  1. FEES AND PAYMENT
    • The monthly subscription fee is R260.00 (two hundred and sixty rand) for up to seven registered individuals (Key Individuals and Representatives), and R36.00 (thirty-six rand) per additional registered individual thereafter, excluding VAT.
    • The Subscriber shall provide FIA Services with the required details of each individual to be registered under the Subscription for the purposes of activation and billing.
    • All fees are exclusive of VAT, which shall be charged at the prevailing statutory rate.
    • Subscription fees are reviewed annually in March and may be adjusted with effect from 1 April.
    • Any changes to the Subscription, including but not limited to the number of Representatives and Key Individuals registered under the Subscription, may only be effected once annually during the annual review period in March of each year, with such changes taking effect from 1 April.
    • Subscription fees shall be billed monthly in arrears, unless the Subscriber elects an annual billing cycle at the time of application.
    • The Subscriber shall ensure that all billing information (including contact details, authorised signatories and bank account details) is kept accurate and up to date.
    • Non-payment of subscription fees may result in suspension of access to the Services until such fees are brought up to date.
    • The Subscriber acknowledges and agrees that all subscription fees payable under these Subscriber Terms may be collected by way of debit order, which shall be processed by the holding company, FIA NPC (The Financial Intermediary Association of South Africa), on behalf of FIA Services. Payment to FIA NPC shall be deemed to constitute valid and sufficient discharge of the Subscriber’s payment obligations to FIA Services under these Subscriber Terms.

  1. ONBOARDING
    • Onboarding will be conducted as a Subscription with FIA Services under the SAUMA affiliation arrangement.
    • Onboarding will not confer FIA NPC membership status or any associated rights.
    • Onboarding is conditional on confirmation of the Subscriber’s current SAUMA membership at the time of application

  1. DATA PROTECTION
    • FIA Services will process all personal information in accordance with the Protection of Personal Information Act 4 of 2013 (POPIA) as set out in our POPIA policies.
    • By subscribing, the Subscriber authorises FIA Services to confirm their SAUMA membership status with SAUMA and to process personal information for the purposes of fulfilling the Subscription.

  1. TERMINATION
    • The Subscriber may terminate the Subscription by giving FIA Services one calendar month’s written notice.
    • FIA Services may terminate the Subscription on one calendar month’s written notice, or immediately if the Subscriber breaches these Subscriber Terms and fails to remedy such breach within 14 (fourteen) days of receiving written notice.
    • Termination of the SAUMA–FIA Services affiliation agreement shall not automatically terminate these Subscriber Terms.
    • Termination by the Subscriber shall not relieve the Subscriber of liability for any subscription fees accrued up to the effective date of termination.
    • FIA Services may suspend or terminate the Subscription with immediate effect in the event of non-payment of fees by the Subscriber.

  1. GENERAL
    • These Subscriber Terms are governed by the laws of the Republic of South Africa.
    • Any disputes arising under these Subscriber Terms shall be dealt with in accordance with the dispute resolution provisions contained in the FIA NPC membership terms and conditions, as modified to reflect that the contractual relationship is with FIA Services.
    • Any notices required under these Subscriber Terms may be validly delivered by email to the addresses provided in the Subscriber’s application form, and such notices shall be deemed received on the day of transmission if sent during business hours.
    • The Subscriber may not assign, cede or transfer any of its rights or obligations under these Subscriber Terms without the prior written consent of FIA Services.
    • No variation of these Subscriber Terms shall be of any force or effect unless reduced to writing and signed by both FIA Services and the Subscriber.