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Izak J v H Fourie 17 January 2007

Implications of Medical Schemes Amendment Bill for Restricted Membership Medical Schemes and Associated Employers. Izak J v H Fourie 17 January 2007. AGENDA. REF Benefit Design Contributions LIMS Corporate Governance. “TYPICAL” RESTRICTED MEMBERSHIP MEDICAL SCHEME.

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Izak J v H Fourie 17 January 2007

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  1. Implications of Medical Schemes Amendment Bill for Restricted Membership Medical Schemes and Associated Employers Izak J v H Fourie17 January 2007

  2. AGENDA REF Benefit Design Contributions LIMS Corporate Governance

  3. “TYPICAL” RESTRICTED MEMBERSHIPMEDICAL SCHEME Compulsory membership higher category employees Voluntary membership lower categories (low uptake) Aging demographic profile High solvency ratio Union pressure ++ Post-employment subsidies and liabilities Own facilities (on-site OH centre  hospital)

  4. REF Net recipient  Gross-subsidy liability and need for  reserves  Post-employment liability Accounting implications Mergers and acquisitions Role of actuarial modelling

  5. Cross-subsidyLiability RANDS ContributionLiability 60 85 Claims AGE Contributions

  6. BENEFIT DESIGN Low cost option ? Wait for LIMS Open schemes “menu” (union sweetheart schemes) Dilution of reserves

  7. CONTRIBUTIONS Promote use of own facilities In and out-of-area networks Public facilities as provider

  8. CORPORATE GOVERNANCE Elections 50% member-elected 50% employer/union nominated Employer subsidy policy

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