Employers turn to private primary healthcare plans in lieu of elusive NHI

Some employers are not waiting for the elusive National Health Insurance scheme to improve the health of their workers, absenteeism levels and productivity.

In 2017, regulations under the Insurance Act differentiated health insurance from medical schemes. Providers of primary health-care plans are expected to apply for exemptions from the Medical Schemes Act, while a low-cost medical scheme option, enjoying a general exemption from the act and catering for these plans, is devised.

Two years ago the Council for Medical Schemes granted only 23 of 40 providers exemptions for primary health-care plans. New insurers cannot enter the market because the exemptions were only available to those operating when the regulations were issued. Like compulsory insurance plans, occupational health care is made available to all employees, but Neethling said there are strict rules about what benefits can be offered and Sanlam has taken legal advice on what can be offered.

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