Medihelp announces solid financial results for 2011/2012

23 May 2012 Medihelp

Medihelp, one of South Africa’s largest open medical schemes, performed exceptionally well in 2011 and ended the financial year with a net surplus of R163.9 million and a solvency ratio of 29.2%.

Non-healthcare expenses

According to Anton Rijnen, Principal Officer and CEO of Medihelp, the Scheme’s positive financial results can be attributed to effective risk management and the appropriate utilisation of benefits by members with a younger risk profile. As a result Medihelp’s solvency ratio was 1.8% better than the 27.4% of 2010. In terms of non-healthcare expenses as a percentage of net contributions, Medihelp remains below the industry average at 10.8%. For members this means that Medihelp’s primary focus remains on their healthcare needs affording them real value for their membership contributions.

Interim results for 2012

National Treasury’s decision to migrate 16 646 government pensioner members to Gems on 1 April 2012 resulted in Medihelp’s total number of lives covered stabilising at 217000. “Medihelp retains its position as third largest open scheme in the country, and the migration left Medihelp a younger, healthier scheme. Its average age dropped from 40 years to around 36 years thus bringing it in line with the industry average of 33 years. In effect the migration reduced Medihelp’s average age by 9 years over the past four years. Currently the Scheme’s membership comprises almost 80% private members which is in stark contrast with the 44% in 2008,” says Rijnen.

Furthermore, Medihelp was again awarded an AA- (AA minus) rating from the Global Credit Rating Company for its claims-paying ability – one of the highest ratings in the industry. “As one of the largest players in the industry Medihelp processed more than 3.6 million claims during 2011 of which almost 90% were received electronically. Claims are processed on average in five days from reception and payments to members and service providers are made three times a month,” he says.

Looking forward

“Our primary aim remains to maintain the balance between cover, quality of care and cost,” says Rijnen. “In the remaining months of 2012 we will continue to explore all avenues that will contribute to the continued sustainability of Medihelp and value experienced by our members. These will include partnerships to contain costs, networks and enhancing processes to deliver a customer experience that complements Medihelp’s service reputation,” he says.

Besides Medihelp’s good financial results, the Scheme retained its first place in terms of service delivery compared to that of its closest competitors. “During the last five years Medihelp became known as the medical scheme that renders the best client service in South Africa. In 2011 Medihelp again commissioned Consulta Research to measure its members’ satisfaction. The Scheme was measured against six competitors in the service quality, relationship quality and product quality categories. Medihelp was rated in first place in all three categories as well as in first place for overall satisfaction,” says Rijnen. The research feedback is to be incorporated in Medihelp’s Customer Experience Management process which aims to enhance the Scheme’s ability to deliver an even more personalised experience to its stakeholder groups.

Quick Polls


No developing economy has ever built a single-payer complementary NHI equivalent covering the entire population. NHI promises comprehensive care but it is also 100% free at the point-of-service. Is this practical?


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