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Who carries the burden: The broker, the fund member or the medical scheme?

03 July 2008 | Healthcare | Medical Schemes | Gareth Stokes

FAnews Online was recently paging through the Council for Medical Schemes June 2008 issue of CMS News. The publication serves to make various stakeholders in the private medical sector aware of some of the work the CMS is doing to make things easier. In his introduction the Registrar of Medical Schemes, Patrick Masobe, said that: “An important function of the Council is to keep the medical schemes industry healthy. We also seek to protect the interests of the beneficiaries, making sure they are treated fairly at all times.” When all is said and done, keeping the medical schemes healthy might be one of the best ways to serve the interests of beneficiaries!

The Fair Treatment of Beneficiaries is the core strategic objective of the CMS for the 2008/2009 year. They’ve set three secondary objectives to help in achieving this. These are: Containing Costs, Improving Governance and Protecting Risk-Pools. Another major function that the CMS must fulfill is the compliance with and enforcement of provisions in the Medical Schemes Act (MSA). That’s why, a couple of days ago, they were forced to intervene at Medshield, instructing the schemes trustees to terminate an administration arrangement with Old Mutual Healthcare.

In their press release the CMS states: “The MSA requires medical schemes to appoint an administrator following a fair process of evaluating a range of potential administrators to select the one that suits the needs of the scheme, taking into consideration costs, capacity, experience in administration, financial soundness, and that the appointment is free of conflicts of interest.” And they alleged that Trustees of Medshield failed to meet these requirements. But we digress. Let’s bet back to CMS News, July 2008.

The complex relationship between brokers, members and medical schemes

One of the articles that immediately caught our attention was titled “Medical schemes, clients & brokers” by Danie Kolver, Head of Accreditation. He set out to define the relationship between these entities and summarise the role each of these should play in the medical schemes environment. “The challenge for intermediaries is to consider the best interest of their clients at all times, to always provide the best advice taking into account their clients’ individual needs, and to act with honesty and integrity,” said Kolver. Before going about business as a medical broker individuals must be licensed with the FSB and comply with the fit and proper requirements as legislated in the FAIS Act.

Let’s take a look at what Kolver concluded. He says that a broker must:

  • Know the rules of the scheme you promote to the client.
  • Not commit the medical scheme by misleading undertakings to potential clients on matters such as guaranteed waiver of waiting periods or granting of special dispensations.
  • Analyse the annual financial statements and Annual Report of the scheme with due regard for regulatory requirements and measures introduced by the scheme with the consent of the Registrar.
  • And not advise clients not to disclose certain conditions which may result in the client’s membership being terminated retrospectively for failure to disclose such conditions.

And people ask why brokers offer them a limited choice of open medical schemes! Points 1, 2 and 4 on the above list seem fairly reasonable. But to expect a broker to ‘analyse’ the financial statements and Annual Reports of each scheme he represents might be a bit of a stretch.

Members and medical schemes enjoy an ‘easier’ ride

According to Kolver the members and medical schemes have a much simpler task to keep the relationship going smoothly. All the member has to do is “Disclose all relevant information required to you by the medical scheme...” But even in this simple task, the “broker must help you with this, particularly with regard to healthcare treatment previously obtained.” It makes sense that the broker asks these questions when a new member signs on; but full and proper disclosure should remain the member’s responsibility. The way this ‘duty’ is worded a member might believe that if the broker doesn’t ask about a particular condition he doesn’t have to mention it...

As for medical schemes – they can bring their end by simply remaining financially sound.

Editor’s thoughts:
With administrative and regulatory compliance tying up more and more of brokers’ time is it reasonable to expect them to peruse the financial statements and Annual Reports of the medical schemes they sell? If you’re a medical broker we’d like to hear your views about what should be expected from the broker. Add your comments below, or send them to [email protected]

Comments

Added by Lucille Horn, 04 Jul 2008
Belaglik verby!!!
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Added by JC, 04 Jul 2008
I do believe that brokers should review the financials of a medical scheme, as they have a tale to tell - and quiet often its not a pretty one either! Unfortunately accessing such is almost impossible - schemes are not willing to share this information with brokers, neither for that matter is the Council of Medical Schemes as they have the information but won't disclose it to third parties, and do not publish it either. This leaves the broker quiet literally in the dark with regard to the financial status of a scheme, and whilst for a majority of schemes that will work to their favour, it does not assist the broker in being able to offer best advice. There are institutions such as Global Credit that rate medical schemes and offer wonder insightful information into a scheme's historic financial performance, and is something all brokers should subscribe to. But again, the information is not always current. Council needs to make the financial information of schemes available to brokers on request so that brokers can do an indepth analysis of a scheme before they sign up members.
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Added by TM, 04 Jul 2008
Reading AFS is one thing, but actually expecting the broker to do something about is, is another. The AFS is a statement of days gone by, at best. Did the FSB stop damage at Fidentia because of what they saw in the AFS? Or what thy could not see because it wasn't submitted? By then it was too late. So what should we do, even if we can read between the lines? Rip our clients out? And what about people with medical conditions - incur another general waiting period which will be on our heads if the client needs medical care? I wish people who have little or no understanding about the practicalities of day to day financial services rendered by brokers would stop opening their big months about what brokers should or should not do - Mr. Kolver included.
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Added by DO, 04 Jul 2008
We are doing it currently. However,I would think that in an ideal world Mr Masobe and his team should actually be responsible for that. Unless he wants to contract it out to the brokers at a cost!! Sometimes I think we are crazy! We do all these things for a mere R40 per member per month. Is that good business sense??
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Added by AH, 04 Jul 2008
I found the paragraph about medical schemes' administrators very interesting. That medical schemes in appointing an administrator should follow a fair process, take into consideration costs, capacity etc, and that the appointment should be free of conflicts of interests. Does this apply to the Discovery medical aid? Do you think they have ever considered any administrator other than Adrian Gore's company? Mr Gore could never allow it to happen. Discovery medical aid is his only client. He regards the medical aid as his medical aid. I've raised this point many times over the last 15 years and have been assured that there is no conflict of interest whatsoever.
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Added by Johan van Zyl, 04 Jul 2008
Doesn't deserve comment. Problem is these people have the power
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