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Choosing the right solution

01 October 2007 Warren Van Rensburg, Absa Healthcare Consultants

Retirement and investment decisions are almost without exception handled by professionals. As healthcare cover forms an integral part of any client's financial affairs, advisers have a responsibility to ensure clients are adequately and correctly covered.

Selecting a medical scheme without professional guidance and advice is as precarious as servicing your plasma television set yourself. Many consumers and businesses do not give this important monthly expense the attention it deserves, providing an opportunity for accredited professionals to fulfil a vital and valuable role. The costs of comprehensive cover for an average family is often comparable to the monthly repayments on the family's second car or a small bond repayment, and should therefore be thoroughly evaluated to ensure the expense and levels of cover are appropriate.

Key considerations

There are a number of simple questions and key considerations that an adviser could utilise to make the process of selecting an appropriate scheme simpler and ultimately yield a higher level of satisfaction for the client.


Advisers consulting to individuals and families should prepare all evaluations in conjunction with the prospective member and his/her spouse. In most cases this will ensure that the needs of the family are adequately assessed.When consulting to employer groups it is often advisable to evaluate prospective schemes through an employer committee, which is representative of the various employee groupings as this also ensures a greater understanding of the broader employee base and their needs.

Framework

The following questions or considerations provide a helpful framework on which to base a membership or scheme decision. It is important that these are only seen as a guideline, as they are by no means exhaustive.

oWhat are the most important healthcare needs of the client?
oWhich events can the client cover independently?
oHow willing is the client to become involved in the management of the chosen scheme's affairs?
oAre they willing to operate within an environment where choice is restricted?
oWhat level of subsidy do they enjoy?
oHow will the funding of healthcare after retirement work?
oHow large is the potential scheme?
oHow well is it represented nationally?
oIs the scheme well accepted by most service providers?
oWho are the scheme's preferred providers, how good are their reputations and how accessible are they?
oWill the options offered meet the needs of the majority of a client's employees?
oWhat credit rating does the scheme enjoy?
oWhat is the quality of administration?
oWhat is the quality of the care that could be expected?
oWhat has the financial performance been over a 5-year period?
oIs the scheme growing or shrinking in membership?
oDoes it comply with all regulatory provisions?
oAre there any proposed changes to the administration of the scheme or possible mergers with competitors?
oWhat do the scheme's financial reserves look like?
oWhat is the average age for members of the scheme?

The selection of an appropriate scheme need not be a daunting process. All too often, decisions are distorted by many of the ancillary products offered.

A well-informed and knowledgeable adviser can offer consumers and businesses the necessary guidance and advice to ensure they choose the right options.

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