Schemes advised not to exceed 5% contribution increase

To protect medical scheme members from further financial distress and the likely risk of losing health insurance coverage due to affordability constraints, the Council for Medical Schemes (CMS) has advised schemes to limit their cost assumptions for tariff increases to 5% plus reasonable utilisation estimates for the 2024 benefit year.

Staff Writer
Aug 4, 2023

“Contribution increases higher than CPI plus a reasonably assumed utilisation factor will be evaluated and approved on the strength of the motivation submitted,” the CMS has explained in a covering note to its most recent circular, Circular 27 of 2023: Guidance on contribution increases and benefits changes for 2024*.  

“Only contribution increases that have been approved by the Registrar may be implemented by medical schemes.

“Moreover,” the council adds, “it is advised against communicating any benefit changes or contribution increases before obtaining the necessary approval from the regulator.”

*Circular 27 can be downloaded at https://www.medicalschemes.co.za/download/3684/2023-circulars-current/27449/circular-27-guidance-on-contribution-and-benefits-changes-for-2024-benefit-year-final_edited

SOURCE: CMS Communications

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