On Tuesday, the 10th of September 2019, Sizwe Medical Fund (‘Sizwe’) launched their benefit and contribution changes for 2020. A weighted average contribution increase of 10.6% was announced.

Higher than the expected medical inflation, was one of the reasons highlighted for the increase. Sizwe’s reserves have declined from 54.9% to 39% over the past two years due to nominal membership growth, higher claims ratio and the scheme using its reserves to subsidise contribution increases. While the reserves have declined over the past two years, they are still well above the statutory requirement of 25%.

We have analysed the benefit changes that were introduced by the scheme and we have compiled the below key highlights for your ease of reference. Please look out for the upcoming member information sessions where we will unpack the detail and the impact of these changes per plan option. Our consultants will also be available to assist you with appropriate plan selection.

2020 WEIGHTED AVERAGE CONTRIBUTION INCREASE 10.6%

KEY HIGHLIGHTS

  • All plans have been renamed
  • Enhancement of Efficiency Discounted Options (‘EDO’s’) on Gold Ascend and Platinum Enhanced Plans
  • Introduction of new Member Application Form
  • Collapsing of income bands on Copper Core and Platinum Enhanced Plans
  • Removal of an income bracket on Gold Ascend
  • Benefits increased by 5.25% across all the plans
  • Introduction of newborn hearing test
  • Introduction of stool test for colon cancer for member over 50 years
  • Enhancement of ZEST rewards:
  • Roadside Assist
  • Trauma Assist
  • Travel Breaks
  • Home Comprehensive

RENAMING OF MEDICAL SCHEME OPTIONS

The scheme has undertaken to rename their plans after the unique natural minerals found in South Africa. The new plan options are:

INTRODUCTION OF EFFICIENCY DISCOUNTED OPTIONS
  • Available on the Gold Ascend Plan and Platinum Enhanced Plan – EDO options offer members same benefits at lower cost by making use of network hospitals

COLLAPSE OF INCOME BANDS

  • Copper Core Plan, Platinum Enhanced Plan and Gold Ascend Plan – Copper Core Plan has collapsed the income bands from four to three, having a significant premium increase to the lowest income band of just over 17%. Platinum Enhanced Plan has collapsed its income bands from three to two also resulting in increases in excess of 10%.   Gold Ascend Plan has removed income brackets, with notable increases of just over 20% on the previous lower income band

BENEFIT ENHANCEMENTS

  • Annual benefit increases – The scheme communicated an annual benefit increase linked to CPI of 5.25% across all options
  • Newborn hearing test – The scheme has introduced a newborn screening test on selected options
  • Colon Cancer Enhancements – This benefit will include stool analysis for members over the age of 50 years old who have been diagnosed with colon cancer

ZEST ENHANCEMENTS

  • Home Comprehensive – Household appliance and Home Motor repairs up to R 2 000 per year for members on a Couple and Family Plan
  • Roadside Assist – National Roadside assistance and tow truck services is available 24/7/365 including mechanical and electrical breakdown services on Couple and Family Plans
  • Health – Zest members qualify for discounted membership fees at Planet Fitness and affiliated gyms with over 250 branches nationwide
  • Travel Breaks – You will qualify for x1 family vacation from only R129 per weekend per family per year

ZEST CONTRIBUTIONS