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When we look at young people through the eyes of "marketers of medical aid", we see them walking around believing that they will never get into a situation that requires cover. Perhaps it would take a serious event like a car accident or being diagnosed with an illness that would get them to think about it.
Maybe that's why medical aid is easier to sell to older people, they've been there and they know. But as a medical aid that positions itself as young and progressive, we need to keep selling our products to the younger market. Our next campaign does just that. We use the analogy of being naked to show how vulnerable and exposed people are, going through life without even the most basic of cover. It is treated stylishly, in a modern, urban setting with beautiful camera shots and a few pieces of 'eye-candy'. It demonstrates the vulnerability of people without medical aid while also making a point to people who may have a hospital plan or cover, but when it comes to the crunch, find themselves left with shortfalls on their hospital bill.
The advert is aimed at both the covered and uncovered market. To those with other medical aids we are saying: we are better than the rest, find out why. And to the uncovered, we are saying: don't leave yourself unprotected and no matter how young and healthy you are, life happens, and then you need to have the right brand on your side. A brand that focuses on providing real medical aid, that's there when members need it most.
To make our message even stronger we have also chosen an appropriate environment. Fedhealth will be sponsoring the new series of Private Practice 2 that will start on MNET on Monday, 6 July 2009. This series of 22 episodes will run until 30 November and will be on air every Monday from 20:30 - 21:30. Episodes will be repeated on MNET on Sundays between 10:00 and 11:00. Besides the brand building commercial we will also re-inforce our range of unique benefits throughout the series.
So, take this opportunity with both hands and advise your clients about Real Medical Aid - they will be calling you!
Watch the first episode of Private Practice II on MNET, Monday 6 July at 20:30, answer the question below and stand the chance to win a SWATCH worth R3000. Just e-mail your answer to Intermedia@thecheesehasmoved.com. All correct answers will be entered into a draw.
When can you expect Fedhealth to be there? ♦
Currently the Fedhealth Emergency Medical Services (EMS) benefit, which comprises the supply of paramedic, ambulance and life support transport services, is confined to the borders of the Republic, as are all other benefits. Members travelling to neighbouring states are obliged to make use of international travel insurance if they wish to avail themselves of an international travel benefit. These types of benefits are of course insurance products with a number of limitations.
The scheme has now decided to extend its EMS benefit to include certain of South Africa's neighbouring countries. It was agreed to limit this benefit to the southern part of Africa below the 22nd parallel. The 22nd parallel runs just above the Beitbridge border. This line incorporates Windhoek in Namibia, Gabarone in Botswana and up to Inhambane in Mozambique. See map below. Zimbabwe would be largely excluded.
This means that this benefit will now pay for any evacuation below this line as part of the existing scheme benefit. For example, a Fedhealth member holidaying in Ponta Do Oura in southern Mozambique is involved in a serious car accident and requires immediate medical care. The extension of the benefit means that the member only needs to contact Europ Assistance, as he would have when in South Africa, to arrange for immediate evacuation back to South Africa for hospital treatment.
Why would Fedhealth do this?
The objective is to provide more comprehensive cover to existing members. Any international travel insurance which a member may take out will have certain exclusions based on age, pre-existing conditions and various activities.
How will a member access this extended benefit?
The member will contact the normal Europ Assistance number, 0860 333 432 as reflected on their membership cards. ♦
Global Credit Rating, an independent international ratings company, assesses Fedhealth annually around this time of the year. Once again, we have been awarded the second highest rating, that of AA-. Still rated as one of the best, it is reassuring to know that we continue doing everything we can to maintain the high standards we've set for ourselves and to ensure stability to all our stakeholders.
Awarded not only for financial performance, the ratings also look at issues like administration, product range and corporate governance with the focus on claims paying ability. By receiving the second highest possible rating in the industry, Fedhealth is once again giving its members the confidence that they are indeed with a healthy, well-managed scheme that will continue to pay their claims promptly and efficiently. Click here for the full report. ♦
At the 73rd Annual General Meeting held on 24 June in Johannesburg, the chairman, Malcolm Khan, said the scheme successfully navigated a challenging year in 2008, increasing its membership figures by nearly eleven percent with no adverse effects on stability or reserves. A remarkable achievement taking into account the continuing loss of members to GEMS. The scheme is successfully replacing these members with the correct profile members from the private sector. In his review to members for the financial year ending December 31, 2008, he said, the scheme recorded a net surplus of R76,5 million and investment returns of 8,6%. Kahn said that member's reserves stood at R544 million on that date. "Although claims increased by more than 22% to R1,52 billion, judicious investments and careful monitoring of expenditure saw the net position improve significantly."
At the recent AGM, four trustees were up for re-election which resulted in a change in the current BOT structure. The new BOT structure is as follows:
Trustees:
Mr Johann van Vuuren, Chairman
Mr Phil Hemus, Vice-Chairman
Mr Tom Borrill
Mr Koos Cloete
Ms Angela Gahagan
Mrs Marylla Govender
Mr Malcolm Kahn
Mrs Linda Marsh
Mr Nazir Parker
Mr Kevin Prinsloo
Co-opted:
Dr Nathan Finkelstein
Mr Red Metrowich
Mr Hesham Motan ♦
Knowledge is power and with this new feature in Intermedia we would like to make sure that our brokers are empowered with the most up to date information on our products and benefits.
This month, we will begin with a basic overview of all of our benefits; what they are, where they are paid from and the tariffs at which they are refunded. The diagram on the right, the product circle, is one with which you are probably quite familiar. We use the product circle in the Member Guide which we send to new members when they join the scheme.
The product circle illustrates the benefits that make up the scheme and also identifies the risk, or scheme, benefits.
RISK BENEFITS, which comprise the In-Hospital Benefit, the Chronic Disease Benefit, the OHEB and the Safety Net Benefit.
DAY-TO-DAY BENEFITS, which comprise the Out-of-Hospital Expenses Benefit, Savings and the Safety Net Benefit.
What are Risk Benefits?
These are all benefits paid by the scheme, except benefits paid from Savings. These are expenses payable from the general risk pool, which is where the healthy cross-subsidise the unhealthy. Some schemes refer to these benefits as "insured benefits".
What is the In-Hospital Benefit?
The In-Hospital Benefit funds all hospitalisation expenses at cost up to 300% of the National Health Reference Price List (NHRPL) from day one with no overall annual limits. Sub-limits may apply on certain procedures and these limits may differ from option to option. Click here for the In-Hospital table.
NHRPL: This is a reference price list published each year by The Council of Medical Schemes which provides a guideline to tariffs charged by healthcare professonals. Historically, this was known as the Medical Aid Rate or Scale of Benefits. A healthcare professional "contracted in" would generally abide by this guide and charge at the guideline tariff.
What is the Chronic Disease Benefit?
The Chronic Disease Benefit funds medications for listed diseases (which include the 25 Prescribed Minimum Chronic Diseases). The medication will be funded up to the chronic disease benefit limit at the lower of cost or MPL (Medicine Price List), where applicable. Click here for the Chronic Disease Benefit table.
MPL: This is a reference price list that benchmarks each product against generically similar products. It does not restrict member's choice, but limits the amount that the scheme will refund for each product. The MPL reference price is set at a level to ensure that a number of medicines will be available without any co-payment.
What is the Out-of-Hospital Expenses Benefit (OHEB)?
The OHEB is a risk benefit that pays for certain of member's day-to-day expenses. Claims are paid from this benefit up to 100% of NHRPL. If a claim is in excess of NHRPL, the balance will be paid from the savings account up to cost, providing funds are available. Click here for OHEB values on different options.
What is the Safety Net benefit?
The Safety Net Benefit is a risk benefit designed to protect members from unusually high day-to-day expenses. The Safety Net Benefit is reached by the accumulation of claims paid from either OHEB, savings or by the member. Once in Safety Net, claims are paid from this benefit up to 100% of NHRPL, subject to certain limits. Click here for more information on Safety Net Levels.
What is savings?
A portion of member's contribution is allocated to a personal savings account. The funds available in this account may be used for day-to-day medical expenses. The amount not used at year-end is carried forward and is available for day-to-day expenses in the following year.
In the coming issues of Intermedia , we will expand on each of these benefits in greater detail. ♦
