
GEMS targets future contribution relief after CMS setback
The scheme says R1.7 billion in projected savings could moderate future increases as it prepares for robust talks with organised labour.

The scheme says R1.7 billion in projected savings could moderate future increases as it prepares for robust talks with organised labour.

The CMS argues that a 7.5% increase would have weakened GEMS’s financial sustainability and shifted costs to members in future.

The regulator has rejected the scheme’s proposal to reduce its weighted average contribution adjustment to 7.5%, leaving the existing 9.5% increase in place.

Twenty years of industry data show that medical schemes have become increasingly dependent on scale, investment returns, and strong reserves to remain sustainable.

The comment comes amid a growing standoff between organised labour and GEMS after the scheme announced a 9.8% contribution increase for 2026.

The Board of Healthcare Funders and Discovery Health say the panel’s final report on FWA investigations rests on flawed methodology and the misinterpretation of data.

Launched in 2019, the inquiry sought to investigate allegations of racial profiling by medical schemes. As 2024 draws to a close, the CMS is still battling objections and technical reviews to finalise the report.

In 2022, the industry saw a net income of R2.57 billion – down from R12.18bn in 2021 – and faced an operating deficit of R6.155bn, the largest in 23 years.