HIV/AIDS IN THE WORKPLACE
On World AIDS Day 2009, the President announced that a new approach in the fight against HIV/AIDS would be implemented. The aim of this approach is twofold. The first objective is to cut the rate of HIV infection by 50% by 2011 and the second, to ensure that 80% of people requiring treatment are able to gain access to it.
This represents a huge and very welcome change in the message and efforts of Government to stem the tide of HIV/AIDS in South Africa. The first method implemented to meet these objectives was the launch of a National HIV Counselling and Testing campaign on 25 April this year.
You may be wondering how this will benefit you or your staff as Fedhealth members, or if it will have any impact on you at all. Perhaps the first thing to understand is why each of us needs to know our status. Testing is no longer simply a way of finding out if you're HIV positive or negative, but can provide you with an opportunity to take stock of one's lifestyle and behaviour. Education on "Knowing Your Status" and on the advantages of early treatment can also better the lifestyles of affected staff and allow for greater equality in the workplace.
Fedhealth has in place the benefit, managed by Aid for AIDS (AfA), which is available to all HIV positive members and their beneficiaries. Registering with AfA is a simple process and provides the correct ongoing monitoring of the disease like regular pathology etc. After registering for the programme, the monitoring will be then be paid from members' Risk benefit and not deducted from Day-To-Day benefits.
Like any other chronic condition, early diagnosis, appropriate treatment and possibly some adjustments in lifestyle can improve and maintain the quality of life of an HIV positive person. Besides medication to treat HIV, which includes drugs to prevent mother-to-child transmission, AfA authorises medication to prevent other infections to which the virus makes an HIV positive person susceptible; provides regular monitoring of the disease's progression and response to therapy; ongoing patient support through a nurse-line and clinical guidelines and telephonic support for doctors.
Should someone test positive, they will be given advice on how to take care of their health so as to slow down the progression of the disease as well as what precautions to take in order to reduce the risk of infecting others. For those who test negative, there is also a huge benefit. Knowledge of their status will alleviate any anxiety they may have had over the matter and will increase their awareness of how vulnerable each of us are to infection with HIV should we choose certain sexual behaviour.
The two most important messages to communicate to Fedhealth members in order for a better understanding are the following:
| • | The HIV benefit managed by Aid for AIDS is available to all who need it, with no extra financial contribution from the member, within the normal rules of the Scheme. All you have to do is register on the programme |
| • | Early registration on the AfA programme is critical for the best possible management of HIV. By registering before medication is even needed, you will gain access to invaluable support and guidance thus preparing you mentally and emotionally for the journey ahead. You will also be well placed to be introduced to treatment at the right time, which is critical for improving the effectiveness of the medicine. |
If you have any questions about HIV testing and treatment, how to register on the programme, or you'd like confidential advice on the illness, contact Aid for AIDS on 0860 100 646.
| Important information for employers | ||
| • | Any membership changes processed after the 10th of the month will only reflect on the following month's Pro-Forma billing | |
| • | Members tax certificates were e-mailed to members with e-mail addresses on 29th April and have been posted with the April statements | |
| Have you notified the scheme of your new contact details? | ||
| • | Any changes to the name or address of the group needs to be forwarded to us | |
| • | When an employee leaves the scheme, it is important for us to know the reason why, for example: | |
| - | Joining a spouse's medical aid | |
| - | Resignation from the company | |
| - | Staying with the company, but joining another scheme | |
| - | Death of employee | |
| • | To avoid discrepancies on the monthly billing, we encourage you to ensure your employees notify you of any changes that have a financial implication on their membership, instead of approaching the scheme directly. Examples of this would be: |
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| - | Annual option changes | |
| - | Registration of a new baby | |
| - | Adding or deleting of other dependants. | |
THIRD PARTY CLAIMS AND A MEMBER'S BENEFITS
When a third party is involved in a medical claim, for example injuries sustained in a motor vehicle accident, Fedhealth is actually not responsible for the payment of medical costs arising from this accident, should the third party be liable to compensate the member. However, the Scheme does assist members by paying their accident-related hospital and medical costs in terms of the benefits allowed by their option, provided that the member and their attorney complete and sign an accident report form and undertaking.
If a member believes that someone else other than themselves is to blame for their injuries then the member may have a third party claim. Members need take the following actions:
| • | The member or their next of kin needs to call the scheme's MVA Third Party Recovery Department on (011) 669 3166/7/9 so that the accident report form can be completed and their third party claim established. It is important that members return these documents as soon as possible, as payment of the accident-related accounts can only be made once the MVA department has received the completed documents |
| • | If the scheme advises a member that there is a valid third party claim the member will need to contact an attorney to arrange an appointment. The scheme will recommend an attorney and the first consultation with the scheme's recommended attorney is considered free of charge; the member is in no way committed to make use of this attorney to proceed with the claim. Members can use their own attorney, but at their own cost |
| • | The attorney will proceed with lodging a claim with the Road Accident Fund (RAF) on the member's behalf |
| • | In-hospital accounts will not be paid until an indemnity is received from the attorney stating that any monies paid out on the member's behalf will be refunded to Fedhealth on the successful finalisation of the claim with the RAF |
| • | Members are to please ensure that they submit all claims within the usual four months after the treatment date. The claims will be paid according to normal scheme rules |
| • | Once a member's claim with the RAF has been finalised, the scheme will be reimbursed by the attorney for all expenses paid by the scheme. |
If a Fedhealth member is involved in, or is subject to, a work-related accident or is diagnosed with a work-related disease, the member or their dependants will be entitled to compensation under the COID (Compensation for Occupational Injuries and Diseases) Act. An accident is defined by the COID Act as a personal injury, an illness or the death of the member during the course of his or her employment. An occupational disease is a disease that has arisen out of and in the course of employment.
The Commissioner is liable for the payment of the reasonable medical costs incurred by the member as a result of an occupational injury/ disease for a maximum period of 24 months from the date of injury or diagnosis of disease. Fedhealth is not responsible for the payment of these claims. The member has to inform his/ her employer of the accident or the disease if he or she is physically able to do so. As an employer you are then obliged to inform the Commissioner of the employee's situation within 7 days in the case of an accident or 14 days in the case of an occupational disease. These prescriptions apply from the time that you as the employer are made aware of the condition of the member. The Commissioner will then engage in an enquiry of the lodged claim and if found valid, will pay the medical expenses. If the claim is found to be invalid, the scheme will pay the member's claims according to scheme rules.
2010 OPTIONS
After the implementation of the new 2010 contributions at the end of January 2010 the scheme received numerous enquiries from members complaining of not being informed of the 2010 increases. Members also requested to downgrade to lower options.
Communication: Fedhealth communicates its benefits and rates for the following year through a special edition of HouseCall! in October every year. The rates and benefits for 2010 were contained in HouseCall! Issue no. 9 of 2009, which was forwarded electronically as well as posted with the end of September member statements. An electronic issue of Pulse was also sent out in October 2009 to paypoints.
Click here for the PULSE newsletter index and the October 2009 Issue 1 of PULSE
Renewal process: As part of the above communication, members were advised to contact the scheme to request an Option Selection Form if they wanted to change their option. The form was also available on the scheme's website. Members who wanted to change (downgrade or upgrade) their option had to complete the Option Selection Form and forward it to the scheme before the end of November 2009.
Option downgrades: Members can only downgrade their option once a year within the rules of the renewal process as described above and the downgrade will be effective as from 1 January the following year.
Option upgrades: All medical schemes only allow option downgrades and upgrades once a year during their respective renewal processes. At Fedhealth however, one of our unique benefits is the fact that members can upgrade anytime of the year when they or any of their dependants are diagnosed with a life-threatening condition that requires a higher level of benefits than the option that they are currently on. The request for an option upgrade must be done within one month of the diagnosis. Members can call the customer call centre on 0860 002 153 for assistance in this regard. This is just another way for the Scheme to reassure its members that Fedhealth is there for them in times of need.
Please remind staff that any changes made to their membership must be approved by HR before being sent to the scheme to implement.
CHILD RATES FOR FINANCIALLY DEPENDENT CHILDREN UNTIL AGE 27
Members To Make Sure They Benefit
When it comes to offering unique benefits, Fedhealth is one of the top schemes in the market. We understand the financial burden on a family when children continue their tertiary studies, but at the same time realise the importance of a parent ensuring that his child remains covered. Most medical schemes only cover financially dependent children at the child rate until they turn 21. Thereafter, even if the child is still studying they are charged the adult rate. Fedhealth however, offers cover for financially dependent children up to the age of 27 at child rates. This means the annual saving on the monthly contribution on the various options will make a healthy contribution to the child's education fund.
From the year that children turn 21, members will automatically receive a letter every year requesting them to confirm that the child is still financially dependent. Financially dependent means that the child is still a full time student or that the child is not earning in excess of the monthly state pension until age 27.
The cut-off date for the 2010 renewal of the child's financially dependent status was 30 April 2010. If a member has not yet received communication in this regard, the member must please contact the customer call centre on 0860 002 153 to complete a reply form and have it returned to the scheme as soon as possible!
SMOKING AND THE WORKPLACE
Thursday, 31 May is globally known as World No-Tobacco Day and is used as an opportunity to alert the public to the dangers of smoking.
According to the South African Heart Foundation, tobacco causes 10000 deaths each year, which equates to approximately one tobacco related death every hour. Smoking has been named as the single largest preventable factor in premature death, disability and disease.
Each time you light up a cigarette, you are taking away eleven minutes of your life and when you inhale you are inhaling over 4 000 chemicals and poisons.
The dangers of passive smoking
Second-hand smoke contains all the same carcinogenic and toxic chemicals that the smoker inhales, but at even greater levels. The toxins in second-hand smoke aren't filtered as they are when inhaled directly from the cigarette. Also, because side-stream smoke is formed at lower temperatures, it gives off even larger amounts of some harmful substances. It is estimated that a non-smoker in a smoke-filled room for eight hours will inhale the equivalent amount of carcinogens to smoking 36 cigarettes.
The immediate negative effects of second-hand smoke may include eye irritation, headache, nasal discomfort and sneezing, cough, sore throat, nausea, dizziness, and increased heart rate and blood pressure.
Passive smokers are also at increased risk for nearly all the medical conditions associated with smoking. Lung cancer, heart disease, asthma and other respiratory problems, infertility and impotence have been particularly strongly linked to passive smoking.
Exposure to second-hand smoke and smoking while pregnant are both linked to miscarriage, low birth weight and stillbirths. It is now illegal to smoke inside public places or workplaces.
Things to remember:
| • | Other peoples' smoke can harm your health |
| • | You have a right to clean air and somebody smoking where it affects you, is against the law |
| • | You can put in an official complaint if your requests are not met |
| • | In all public places, including restaurants, government buildings and places of work smoking is not permitted. |
