Bonitas raises contributions by 8.7% as new service model takes shape

Bonitas Medical Fund will increase its average contribution by 8.7% in 2027, with changes to its product range placing greater emphasis on managed care, health-risk screening, and member engagement.

The announcement comes four months after Bonitas moved its administration from Medscheme to Momentum Health Solutions and its managed care to Private Health Administrators (PHA). The transition caused widespread problems for members and healthcare providers, particularly around claims, hospital authorisations, chronic medication, and communication.

At the product launch on 2 October 2026, principal officer Lee Callakoppen acknowledged the difficulties of the transition.

“The last couple of months have tested us,” he said, adding that the move had required Bonitas to “critically revisit the strength of our foundation”.

He described the change as “one of the largest administration and managed-care transitions that this industry has ever seen” and said it had been “taxing, to say the least”.

Although service levels were starting to normalise, Callakoppen said Bonitas still needed to improve the way it handled claims and escalations.

“An area that we could have done better on in the last couple of weeks,” he said, referring to the handling of escalations. “But we take accountability, we respond, we act, and we deliver.”

With disgruntled members already threatening online to leave, the stakes are high for Bonitas. The 2027 strategy will put both its revised products and care model and its new operating structure under scrutiny: will they deliver the value and service levels Bonitas says it is working to restore?

Bonitas has the highest average increase among the five major schemes

Bonitas’s average increase of 8.7% is higher than the increases announced by the other four major open schemes covered by Moonstone: Discovery Health at 8.2%, Momentum Health at 7.9%, Medihelp at 7.5%, and Bestmed at 7.35%.

The increases across the Bonitas range are:

Bonitas says 60% of its members will receive contribution increases of less than 8%.

The scheme is keeping increases lower on the options it identifies as its main growth plans. BonStart, BonStart Plus, BonFit, and BonSave will increase by an average of 7.3%, while BonEssential Select increases by 7.7%. Together, these five options account for approximately 89% of Bonitas’s new business.

Bonitas says the risk benefits on these plans are, on average, 12% cheaper than those of competitors. This is based on the scheme’s own analysis.

The Standard option will increase by 9.2%. Bonitas describes Standard as particularly relevant to the local government, parastatal, and corporate markets.

The Primary option increases by 8%, while BonPrime, which has more than 50 000 beneficiaries after being introduced in 2026, will increase by 9%. Its risk contribution will rise by 6.4%, with savings on the option increasing to 18%. A family of four will have access to R18 540 in annual savings.

Bonitas’s more comprehensive options carry higher increases. BonComprehensive and BonClassic will increase by 10.2%, while BonComplete increases by 9.7%.

Among the hospital plans, BonCore increases by 7.3%, BonEssential Select by 7.7%, BonEssential by 9.2%, and Hospital Standard by 10.7%. Bonitas says BonCore is aimed at a younger member profile.

The BonCap capitation option will increase by 11.5% across all income bands. Bonitas has adjusted the income bands on the option to align more closely with the mining and manufacturing industries, which it says are the sectors chiefly served by BonCap.

The product mix also reflects where Bonitas has been gaining members. By mid-September 2026, the scheme had enrolled more than 80 000 beneficiaries during the year, with growth across the corporate, local government, mining, and manufacturing sectors. Bonitas says BonSave, BonFit, BonStart, BonStart Plus, and BonCap were particularly popular in these sectors, while BonPrime and BonCore were attracting younger, healthier populations.

Bonitas says its cumulative contribution increases over the past five years have been up to 32% lower than those of competitors. That comparison is also based on the scheme’s own analysis.

Standard Select disappears into Standard

Standard Select was initially introduced as an efficiency-focused, network-based option designed to provide similar value at a lower price. Bonitas says membership grew to a level at which the benefits could no longer be sustained by the pricing structure, resulting in performance below its financial projections.

For 2027, Bonitas will introduce a hospital network on Standard. It says 93% of existing Standard members live within 45 kilometres of a network hospital.

Members requiring emergency stabilisation will still be able to use any private hospital.

Standard will also have a mandatory GP nomination, changes to its chronic medicine formulary, additional chronic conditions, and access to up to R12 000 in extra Benefit Booster benefits.

To access the additional Benefit Booster benefits, members will need to complete a wellness screening, register for B Value and follow the personalised health pathways indicated by the scheme.

BonPrime puts more weight on savings

BonPrime, introduced in 2026, has grown to more than 50 000 beneficiaries.

For 2027, the option’s savings will increase to 18%. Bonitas says a family of four will have access to R18 540 in annual savings.

The Benefit Booster on BonPrime will increase to R8 000, double the 2026 amount. The overall contribution increase on BonPrime will be 9%, while its risk contribution increases by 6.4%.

Bonitas is also introducing a Dental Emergency Benefit on BonSave, BonFit, BonStart, BonStart Plus, and BonPrime. The risk-funded benefit will cover dental emergencies such as a chipped, fractured, or abscessed tooth. Members who undergo an oral screening at a Bonitas Wellness Day will also receive access to educational material on dental care.

Hospital networks will also be adjusted on Primary and BonEssential as part of Bonitas’s strategic purchasing approach. The scheme says it is negotiating network provider rates to manage costs and limit members’ out-of-pocket expenses.

Co-payments of R1 000 on BonEssential Select and R1 240 on BonEssential will apply to non-PMB admissions.

From screening to treatment

Bonitas says wellness assessments increased by 138.6% in 2025 compared with 2024. In 2026, it conducted close to 1 000 wellness days, while its preferred health-risk assessment network has grown to more than 1 245 pharmacies, including Clicks, Dis-Chem, and Medirite. It says 95% of members are within 10 kilometres of a preferred provider.

Bonitas found that some members who were flagged for a possible health risk put off seeing a doctor because they were concerned about using their existing medical benefits.

From 2027, the GP Confirmation Benefit will give an eligible member who is flagged for a potential health risk access to one risk-funded GP consultation within 14 days of the wellness screening.

The GP can confirm or rule out the risk and direct the member to the appropriate care. If the member does not use the benefit within 14 days, it falls away.

Members who do not follow up will also receive proactive wellness outreach, while Bonitas says its managed-care data and protocols will be integrated to facilitate enrolment into appropriate treatment programmes.

Bonitas says this broader managed-care approach includes Live Lean, the Ocular Health Programme, enhanced rehabilitation support through a new Back, Neck, Shoulder, and Knee Rehabilitation Programme, and expanded mental health services.

The Benefit Booster will be expanded

The Benefit Booster, which has been a feature of the Bonitas offering for several years, will also be expanded.

Bonitas says members accessed more than R250 million in additional value through the benefit in 2025. For 2027, the maximum increases to R12 000 per family, which the scheme describes as a 140% increase.

The benefit will also be available on BonCap for the first time.

Access will be linked to a health-risk assessment and registration on B Value, with members guided towards health journeys based on their individual data.

The B Value programme has more than 25 000 active users, with more than 18 000 vouchers issued since its launch in August 2025. Bonitas says almost 5 000 free accidental death policies have also been issued.

For 2027, B Value will take on a broader role in the member experience. The app will allow members to track areas including exercise, hydration, and sleep, set goals, and view their health-risk assessment information, while new partners including Takealot and Checkers Sixty60 will expand the rewards offering.

The administrator transition

The 1 June transition from Medscheme to Momentum Health Solutions, together with the move of managed care to PHA, resulted in problems with claims, authorisations, chronic medication, and call-centre support during the first weeks. By August, there had been improvement, but healthcare providers were still reporting short-paid or unpaid claims, tariff discrepancies, and delays in resolving some authorisation problems.

“While we have turned the corner,” Callakoppen said, “service levels are starting to normalise.”

He also identified escalations as an area where Bonitas “could have done better” and said the scheme needed to improve the way claims were paid and workflows moved between its service providers.

Momentum Health Solutions’ Kobus Dreyer similarly acknowledged that the initial rollout had been more complex than anticipated, particularly because of the wind-down and data processes involved.

Momentum says its administration complement has now been increased to 900 employees, with additional overflow capacity through more than 200 teams. It has also changed its claims and finance processes and says group and individual applications can now move through capturing, underwriting, and activation in less than 48 working hours.

Bonitas has also added digital channels since June, including a member app, Broker Zone, Member Zone, and WhatsApp line.

From January 2027, it plans to introduce a Corporate Zone. More than 70% of Bonitas’ business comes from groups, and the new platform is being piloted with 12 pay points before a wider rollout. It will allow employers to manage member information, applications, correspondence, and other administrative functions online.

A financially strong scheme

The scheme reported a solvency ratio of 36.9% and reserves of R10.8 billion. Callakoppen said Bonitas would continue using its financial position to provide additional value while maintaining what the scheme considers competitive contribution increases.

Bonitas says it took several factors into account when setting the 2027 increases. These included the economic pressure on households, inflation, and the expected rise in healthcare inflation, as well as the financial position and performance of the scheme. The aim, according to the scheme, was to balance affordability with long-term sustainability, while keeping its growth options competitive enough to attract the younger membership it is targeting.

The exercise was complicated by the disruption caused by the change in administrator and managed-care provider during the year. Bonitas says its usual product development process had to be adapted to accommodate the mid-year appointments, with input from the new service providers across the value chain.

The 2027 review included data analysis, independently commissioned research among members, brokers and pay points, industry benchmarking, predictive modelling, 12 dedicated workstreams, independent actuarial analysis, and a governance review.

Lower increases have been concentrated on the options Bonitas identifies as its growth plans, while some of the more comprehensive and hospital options carry increases above 10%.

Callakoppen said the financial position gives Bonitas room to focus on the member experience, as well as the numbers.

“Our core focus remains on serving our members with personalised, high-quality care, supported to provide them with tangible value in the long term.”