CMS says GEMS cannot cut 25% reserve requirement
The comment comes amid a growing standoff between organised labour and GEMS after the scheme announced a 9.8% contribution increase for 2026.
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MediCheck claims win as Discovery Health writes off up to R170m in ATB recoveries
Discovery Health has abandoned recovery action against more than 16 500 members, agreeing to absorb up to R170 million in overpaid ATB claims after sustained pressure from MediCheck,
CMS steps in as Discovery Health begins recovering pharmacy overpayments
Discovery Health is engaging affected members individually after a processing error led to some pharmacy claims being paid beyond Above Threshold Benefit limits during 2025.
Transitional delegations under the FSRA pushed to 2028/29
New end-dates extend the temporary allocation of certain supervisory duties to the FSCA and PA while regulatory frameworks are finalised.
‘Medical schemes face structural strain as claims growth outpaces contributions’
The 2024 Industry Report highlights rising utilisation, ageing membership, and persistent under-pricing as the key forces reshaping medical scheme sustainability.
Eleven schemes account for nearly 90% of broker fees
Broker service fees made up 17.65% of medical schemes’ directly attributable insurance service expenditure in 2024.
Sizwe Hosmed making substantial progress, says curator
An accelerated 19% contribution increase is designed to correct historic under-pricing and shore up reserves.
Co-payments unpacked: the real drivers behind member shortfalls
A practical guide to why co-payments arise, how schemes set them, and how advisers can help clients manage the risk.
Bonitas commits to co-operating with CMS investigation
After concluding its section 43 inquiry into Bonitas, the CMS has determined that the allegations merit a further forensic investigation.
From spouses to parents: understanding medical scheme dependants
This edition of Cover to Cover explains medical scheme dependant rules, required documentation, and how advisers can help clients keep their families covered.
Medihelp to appeal contempt judgment in Elaprase case
Medihelp says it will challenge the judgment while the cost of Elaprase awaits a final decision by the CMS Appeal Board.
Family-wide gap cover: a budget lifeline for single-income households
For single parents, a ‘one-family, one-premium’ gap policy turns unpredictable medical shortfalls into a fixed monthly cost, protecting household cashflow.
BHF asks Treasury for clarity on plan to phase out medical tax credits
According to the Board of Healthcare Funders, the Department of Health’s presentation indicates the credits will be eliminated by the beginning of 2029.
NHI Act | Sakeliga opposes Health Minister’s stay-and-consolidate application
The business group says the proposed stay will shield the Act from judicial review while allowing implementation to continue.
ASSA launches national Climate Index to guide risk management
South Africa now has a publicly available Climate Index, developed by actuaries and meteorologists, that tracks extreme weather events.
Waiting periods – how they affect medical scheme benefits
This edition of Cover to Cover explains waiting periods, helping advisers guide clients on when benefits start and strategies to avoid gaps in cover.
CMS: No complaints about brokers’ conduct in 2024/25
The Council for Medical Schemes’ latest annual report shows a decline in registered complaints – continuing a three-year downward trajectory.
