Claims its announcement on planned contribution and benefit changes is 'fully in accordance with the requirements of the Medical Schemes Act'.
SA’s largest administrator of medical schemes, Discovery Health, has lodged an appeal against a Council for Medical Schemes directive “to cease and retract all communication to members” regarding its proposed changes to its contributions and benefits for 2024.
However, Noach said the process DHMS followed in communicating its 2024 contribution increases and benefit changes to members “is fully in accordance with the requirements of the Medical Schemes Act ”. “Such an appeal is not an unusual occurrence across the medical schemes industry, and is not an adversarial step,” Noach pointed out.
The CMS referred to its circular to medical schemes, dated 31 July 2023, about guidance to medical schemes on contribution increases and benefits changes for next year. “Against this backdrop, the action imposed by CMS also seeks to protect medical schemes from investing into benefits or benefits options that are not approved or yet to be approved by the regulator,” it said. ADVERTISEMENT CONTINUE READING BELOW Read: Mastering the world of medical aid
The CMS circular to medical schemes in July this year “advised” schemes to limit their 2024 contribution increases to 5% in line with inflation and the current difficult economic environment. Noach said on Thursday that it is a long-standing practice spanning more than 25 years for medical schemes to initiate communication with financial advisors and thereafter with members in September every year to provide product updates in respect of contribution and benefit changes for the year ahead.
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