Time to review your company’s medical aid plan


Employers can assist their staff during these tough economic times by conducting a detailed review of the organisation’s chosen medical aid and healthcare policy, ensuring employees are guided towards plans that may be more suitable to their needs and are most cost effective.

“In terms of the medical aid component of an employee benefits scheme, the process starts with a collation and review of membership usage patterns, covering aspects such as medical savings accounts, above threshold benefits, chronic illness benefits and hospitalisation events experienced over the past 12-month period. Afterwards, an appointed healthcare consultant should be tasked with sourcing the more cost-effective and suitable cover for the employees,” says Jill Larkan, head of healthcare consulting at GTC.

There are various ways to gain the most cost-effective benefit from existing medical aid plans, including:

a) Members can be downgraded to more cost effective plans, reducing levels of in hospital cover;

b) Top-up or gap covers can be added to existing plans, extending in hospital cover levels;

c) Members can downgrade to a network plan option; or

d) Members can be offered combinations of hospital plans and primary care networks, which may also be more cost effective.

The process of reviewing a company’s medical aid plan is time consuming as it requires staff intervention at many stages, such as during the initial investigation to assess satisfaction levels with the existing plans, presentations regarding alternate plans, the completion of application forms and delivery of new medical aid member cards (if required) by year end. With staff interaction a priority during this process, it’s important that the reviewing project begins typically around June or July each year. Where there are proposed changes, staff consultation processes do need to begin as soon as possible to ensure that enough time is given to individuals to make informed decisions timeously.