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Tag Archives | Demarcation

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CMS Circular 18 of 2019: Status update on Demarcation Regulations and a Low-Cost Benefit Package

The current exemption of indemnity products that are doing the business of a medical scheme expires on 31 March 2019. Entities that were granted exemption on their indemnity products in 2017, should submit renewal applications, which will be evaluated on merit, to extend the exemption period to 31 March 2021. The Council for Medical Schemes (CMS) mentioned that details […]

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demarcation

Demarcation of health insurance products

The demarcation debate started when the Council for Medical Schemes stated that the so called “hospital plan” insurance products contravened the Medical Schemes Act. What is a medical scheme? Medical schemes are non-profit organisations governed by the Medical Schemes Act. Schemes have to match premiums and benefits paid to providers or members, over the period […]

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Draft Demarcation Regulations tabled in Parliament

On Friday, 28 October 2016, draft Demarcation Regulations were published on which types of contracts are regulated under the LTIA and STIA as health policies and accident and health policies, and accordingly excluded from the Medical Schemes Act, No. 131 of 1998 (MSA), despite such contracts meeting the definition of the business of a medical scheme. […]

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New Battle Lines Drawn in Demarcation Debate

The invitation to respond to the proposed demarcation regulations on healthcare products elicited 461 responses, according to Business Day. The proposals may be unconstitutional, and is likely to be challenged in court. If the existing proposals are passed, short-term insurers will be banned from selling policies for primary healthcare that pay for visits to a […]

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Draft Demarcation Regulations

Proposed amendments to the definition of a “business of a medical scheme” The publication of the Second Draft Demarcation Regulations follows the enactment of the Financial Services Laws General Amendment Act, No. 45 of 2013 which became effective on 28 February 2014. An amendment to the definition of a “business of a medical scheme” was deferred to come […]

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Demarcation Proposals Under Fire

The proposals by National Treasury to find a solution to what it regards as a threat to medical schemes did not find favour with all in the industry. An article in the Financial Mail quoted a number of reactions from industry experts who felt that the retraction of the proposed ban on gap cover and […]

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