12 Mar The right broker for your family

Should employer groups and larger corporates enforce a specific medical scheme on their staff? This HR headache remains a hurdle for employers, but partnering with the right broker or intermediary can provide a solution, which will keep both the employer and staff happy.

The issue?
“The best solution for both employer and employee could be having access to a broker/intermediary that is able to provide comparative quotations and individual medical scheme support.” The issue?
The National Consumer Forum (NCF) recently raised their concern in the media about employees being forced to become members of their employer’s preferred medical scheme. Financial planner magazine RiskSA reports that companies that do not have a closed scheme or pay a medical scheme subsidy, cannot force their staff to belong to a specific scheme. It does however happen often, especially when the medical scheme contribution is part of the company’s payroll administration.

Although working with just one scheme is less complicated, employees should have the right to choose their own medical scheme – and the NCF confirmed that they will be giving this issue “some serious attention”.

“The best solution for both employer and employee could be having access to a broker/intermediary that is able to provide comparative quotations and individual medical scheme support.”

All about the broker
“The best solution for both employer and employee could be having access to a broker/intermediary that is able to provide comparative quotations and individual medical scheme support.” All about the broker 
“It’s often the company’s broker that advises them to choose the ‘easier solution’ to have employees belong to one specific medical scheme,” says Karin Haggard of Optivest Health Solutions. “Very few medical scheme brokers/intermediaries have the infrastructure and quoting tools to provide individual employees with a comparative medical scheme quotation and individualised advice.”

This could also be the same reason why employer groups are very rarely advised by their medical scheme brokers to change to an alternative, possibly better suited medical scheme solution.
According to Circular 21 of 2002 of the Medical Scheme Act, if the employee is not required in terms of his/her employment conditions to have medical scheme membership, he/she cannot be forced to be on the preferred, or in fact any, medical scheme.

“For companies that acknowledge the value of medical scheme membership, this can be problematic and could cause other human resources challenges,” Karin adds.
The best solution for both employer and employee could be having access to a broker/intermediary that is able to provide comparative quotations and individual medical scheme support.

Taking employee benefits to the next level

“Although not compulsory, the advantages for employees to be part of an employer group should also be explored and considered,” says Karin. “Joining a medical scheme as part of a group can ensure underwriting concessions. This gives individual employees with existing medical conditions the ability to join the preferred medical scheme without being exposed to waiting periods or condition specific exclusions.”

“The advantages for employees belonging to an employer group should also be explored and considered.” The medical scheme act makes provision for employer groups to change from one medical scheme to another without being exposed to underwriting as long as the employer group gives reasonable notice to the relevant medical scheme and the transfer takes place at the beginning of the financial year.

“The advantages for employees belonging to an employer group should also be explored and considered.”

“The advantages for employees belonging to an employer group should also be explored and considered.” All the pros and cons of offering employer group medical scheme benefits to your staff boil down to your broker/intermediaries ability to offer both the company and its staff the best health cover solution that will serve them best.

To speak to Karin about the employer group and individual medical scheme support and advice services that Optivest Health Solutions offer, mail her at karin@optivest.co.za.