Employers you can change Medical Aid Schemes – without any waiting periods!!!

Every year an employer has the option of moving his company medical aid scheme to another medical aid scheme, without incurring waiting periods on the members.

Preparations for a move of schemes should be looked at in August, by speaking to your broker. DO NOT leave this too late.

Why would you want to change schemes?

Perhaps poor claims payment experience.
Perhaps poor billing issues.
Perhaps you want one provider for all your company benefits.
Perhaps some products have benefits that your staff want to use.

There are many reasons, suffice it to say that you can do so as at the 1st of January every year…. and that the preparation time should begin now. This is so your company experiences a trouble free and positive transition.

How does this work? 

Section 29A (6) (b) of the Medical Schemes Act says that medical schemes cannot impose waiting periods if the application is for an employer group transferring medical scheme membership of all covered employees if:

• The transfer occurs on 1 January each year
• Reasonable notice is given to the new medical scheme
• The move must take place inside 90 days from the date of termination of the previous scheme

Late joiner penalties can still apply to where applicable.

A scheme would also reserve the right to apply waiting periods and late-joiner penalties for the addition of:

• A spouse, child or adult dependant
• New entrants if the scheme is a non-compulsory scheme
• Existing employees not joining the scheme at the time of take on

What is needed?   (this is if you intend to move your scheme to Discovery Health)

The first thing that is needed is the following…so let me know if you want to move schemes!

. Letter of intent – by 30 September (stating that the company intends to move schemes).

o The date of commencement with Discovery Health is 1 January.
o Termination/ resignation from the employees’ current medical aid (from 31 December). The move to Discovery must be within 90 days from date of termination.
o All employees currently on a medical scheme must transfer to the Discovery Health Medical Scheme.


More on this below:


Companies you need to Act now if you want to change your scheme without Waiting periods!

Kenny Williamson


Employers you can change Medical Aid Schemes – without any waiting periods!!! was last modified: September 25th, 2018 by Kenny Williamson

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