GEMS keeps 2009 contribution increases low

The Government Employees Medical Scheme (GEMS) today announced that members will only have to pay 11.18% more per month in 2009 for their healthcare cover, despite the fact that their benefits have been substantially enhanced by benefit limit increases which include new and innovative benefits.

"GEMS continues to offer members true value for money whilst creatively finding ways to improve their general health. This is accomplished in the face of building reserves, continued member growth and the strategic enhancement of the benefits available to members" said Dr Eugene Watson, Principal Officer of GEMS. "We are cognisant of the current economic climate where everyone is compelled to stretch their rands as far as possible."

GEMS members on the Sapphire and Beryl options can look forward to a 10% increase on the 2008 benefit limits, while on the Ruby, Emerald and Onyx options all benefit limits have been increased by 5%.

While several different benefit enhancements were made on each benefit option, the highlights include private maternity benefits and optical enhancements on Sapphire, increased specialist dentistry benefits on Beryl, Ruby, Emerald and Onyx, enhanced prostheses and appliances benefits on Ruby, Emerald and Onyx, a breast reduction benefit on Emerald and Onyx, an additional block benefit on Emerald, and a healthcare risk assessment benefit on Ruby.

In addition to these and other benefit enhancements, GEMS will also be introducing a maternity programme for all members across all options in 2009.

Dr Watson explained the reasoning behind this: "The Scheme has a relatively young membership profile and many members enroll on a Scheme for the first time, because they need maternity care. Maternity related conditions remained the highest number of admissions during both 2007 and 2008."

The announcement regarding the benefit enhancements and member contribution increases was made during a media presentation in Pretoria, with the newly appointed Minister of Public Service and Administration, Richard Baloyi, in attendance.

In his address to the media, the Minister said that GEMS is a Public Service initiative that works well. "GEMS' success as a medical scheme serves as an example of how Government, as employer, is improving the health and wellbeing of its employees," he said.

The Minister also announced that GEMS now has 300 000 principal members and provides healthcare cover to over 800 000 people. "What is more, 54% of GEMS' members previously did not access the employer subsidy for medical schemes. This means that in excess of 430 000 people who did not previously have healthcare cover now do."

Prof. Richard Levin, Chairperson of GEMS, announced that the re-issued tenders for three of the Scheme's operational services had been awarded following a transparent and fair procurement process. Metropolitan Health Group (MHG) retained the tender for scheme administration services while Qualsa retained the tender for medicine clearing house services. The tender for emergency medical evacuation services was awarded to Netcare 911.

Levin went on to say that "the business of GEMS is working well and the Scheme continues to grow, post surpluses and maintain an effective control environment."