Here are some insights on the benefits for a company – small or large – joining a medical aid as a ‘group/collective,’ versus employees making individual choices regarding their own medical scheme.

There are 17 open medical schemes in South Africa, each with their own set of plans and benefits. This can be confusing when trying to decide on what is best for you, your family and your employees in terms of making sure you have healthcare cover and that you can afford it. 

Consulting a broker will help you navigate through the various options and plans before a final decision and commitment is made, especially if the medical aid is going to be offered as part of an employee’s remuneration.

Companies which join a medical aid as a collective and subsidise the medical aid contributions, as part of the remuneration package, show that they value the health and wellness of their employees. This goes a long way to position the organisation as caring and an ‘employer of choice.’  It contributes towards a higher degree of employee engagement, including lower absenteeism, increased presenteeism and the productivity of the company.

This is particularly true for the total rewards model where additional benefits, such as medical aid, are part of the total package – a package which is often more attractive to employees. 

Compulsory medical aid membership also assures the employer that their employees will have access to private healthcare in the event of major life-threatening medical events. 

However, it’s important to make sure that the medical aid you are considering offers additional services when joining as a collective, rather than an individual. Ensure that your company and employees benefit from: 

• Favourable underwriting concessions, usually for groups of 10 or more 
• A dedicated Key Accounts Manager allocated to your group 
• An integrated billing system to ensure ease of administration for you and your employees
• One-on-one ongoing member support through an on-site help desk
• That during the ‘open season’ at the end of the year (when you make decisions about the year ahead in terms of any changes to plans), your group benefits from education and option change assistance 
• Access to a mid-year concession (where applicable). This relates to assisting with changing plans during the year  
• Ongoing member education and option benefits aligned to the annual Health Calendar (Cancer awareness, heart disease, diabetes, lifestyle diseases and mental health)
• That a Wellness Day screening is offered as part of the plan, as well as individual, confidential employee health profile reports to allow employees to take charge of and manage their health 
• Compulsory membership ensures employees have access to private healthcare and, in the event of major life-threatening medical events, they will not have to take out a loan or ask for a salary advancement to cover medical expenses

In the case of Bonitas, small, medium and large companies benefit from Wellness Day screenings offered on site. These consist of carefully selected tests to help employees get a clear picture of their health and are the first steps in detecting serious chronic conditions such as hypertension, heart disease and diabetes.

The free wellness screening is offered for each member, once a year, across all its plans. This includes:

• A blood pressure test
• A blood glucose test
• A cholesterol test
• A BMI test
• A waist-to-hip ratio measurement

Different plans for different needs

Everyone has different healthcare needs and to accommodate these medical schemes offer a variety of plans. The decision on which works best for your employees will be based on what they need in terms of medical cover. For example: Younger employees need to consider an option that will have added maternity benefits and cover childhood immunisation; someone older might want to look for added screening options whereas a healthy employee might be happy to be on a hospital plan that covers them for in-hospital procedures and medical emergencies.

We believe ‘one size doesn’t fit all’ so we offer members a choice of cover from 15 plans – in five categories – which include:

• Traditional options
• Savings options
• Hospital options
• Network options
• Newly introduced Edge options 

Added benefits

Often schemes include additional benefits and these need to be taken into consideration as they help stretch the medical benefits and save on costs. For example, this year we introduced the Benefit Booster, which anyone can access once they have completed a wellness screening or wellness questionnaire. This ranges from an additional R940 to R2 739 – depending on the plan – that can be used to pay for out-of-hospital day-to-day services, such as blood tests, over the counter medicine and GP consultations or a programme to stop smoking.

Preventative care

Prevention is definitely better than cure – especially when it comes to health. Make sure the scheme or plan you choose offers a preventative care benefit that will help detect serious illnesses early so that the necessary steps can be implemented to help employees stay healthy. These can include flu vaccines, HIV tests, lipograms, mammograms, pap smears, prostrate screenings, pneumococcal vaccines, bone density screenings and stool tests for colon cancer. 

Our members are from all walks of life – they are go-getting entrepreneurs, SMMEs, chief executive officers, newlyweds, young couples with children, retirees and minimum wage earners. 

There is a great deal of choice when it comes to selecting a plan best suited to your employees needs and that is within the budget. It’s not always easy. Which is why we highly recommend consulting a broker who will offer advice about what is best suited to your company’s needs. Brokers are accredited by the Council of Medical Schemes, so they are qualified to offer advice and support and there is no extra charge for this service

Lee Callakoppen is the Principal Officer of Bonitas Medical Fund.