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Another reprieve for insurers that provide primary healthcare policies

Insurers that issue primary health insurance policies have been given another reprieve after the Council for Medical Schemes (CMS) extended the exemption for another two years, from 1 April 2022 to 31 March 2024.

Insurers and their respective FSPs who wanted to renew their exemption had to apply to the CMS by close of business today (14 February). Only providers that were granted an exemption in 2019 could apply.

The extension, once again, of the exemption means some five years have lapsed without the development of a low-cost benefit option (LCBO) that is supposed to replace primary healthcare insurance policies.

The Demarcation Regulations, published in 2016, prohibited insurers from providing these policies.

In March 2017, the CMS (after consultations with National Treasury, the Department of Health and the FSB) issued the Exemption Framework as a transitional arrangement to allow insurers to continue to provide healthcare policies. The Exemption Framework set out the exemption criteria for insurers conducting the business of a medical scheme.

Although the Exemption Framework was supposed to run until 31 March 2019, it was extended to 31 March 2021. Then the CMS extended the exemption by another year to 31 March 2022, because the lockdown prevented the CMS from holding workshops with the insurance industry.

The CMS has established advisory committees tasked with developing a framework for the affected insurers to transition into the medical schemes environment and the LCBO guideline.

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