Circular 78 of 2017: Medical Scheme benefit options for open & restricted schemes approved with effect from 01 January 2018

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1 CIRCULAR Reference: Benefit option status for open and restricted schemes for 2018 Contact person: Lindiwe Twala Tel: (012) Fax: Date: 19 December 2017 Circular 78 of 2017: Medical Scheme benefit options for open & restricted schemes approved with effect from 01 January The Council for Medical Schemes (CMS) would like to provide and update on the status of medical scheme benefit options in open schemes for the 2018 benefit year. The table below provides details on the approval status of the different benefit options for open medical schemes. NAME OF BESTMED PACE4 PACE3 PACE2 PACE1 BEAT BEAT3 BEAT3 NETWORK BEAT2 BEAT2 NETWORK BEAT1 BEAT1 NETWORK PULSE2 PULSE1

2 BONITAS FUND BONCAP BONCOMPREHENSIVE BONSAVE PRIMARY STANDARD STANDARD EDO BONESSENTIAL BONCLASSIC BONFIT BONCOMPLETE HOSPITAL PLUS HOSPITAL STANDARD CAPE PLAN HEALTHPACT PREMIUM HEALTHPACT SILVER HEALTHPACT SELECT COMMUNITY AID (COMMED) DELUXE STANDARD ROOTS SHINA DISCONTINUED DISCONTINUED DISCONTINUED DISCONTINUED Scheme is currently under liquidation. COMPCARE WELLNESS DYNAMIX DSP NETWORK PINNACLE DSP NETWORK MUMED DSP NETWORK SYMMETRY DSP NETWORK AXIS DSP NETWORK NETWORX DSP NETWORK UNISAVE Page 2

3 DISCOVERY HEALTH FEDHEALTH CLASSIC COMPREHENSIVE CLASSIC DELTA COMPREHENSIVE CLASSIC CORE CLASSIC DELTA CORE CLASSIC PRIORITY CLASSIC SAVER CLASSIC DELTA SAVER COASTAL CORE COASTAL SAVER ESSENTIAL COMPREHENSIVE ESSENTIAL DELTA COMPREHENSIVE ESSENTIAL CORE ESSENTIAL DELTA CORE ESSENTIAL PRIORITY ESSENTIAL SAVER ESSENTIAL DELTA SAVER EXECUTIVE KEYCARE CORE KEYCARE PLUS KEYCARE ACCESS CLASSIC COMPREHENSIVE ZERO MSA CLASSIC SMART ESSENTIAL SMART MAXIMA BASIS MAXIMA BASIS GRID MAXIMA CORE MAXIMA CORE GRID MAXIMA PLUS Page 3

4 MAXIMA STANDARD MAXIMA STANDARD ELECT MAXIMA EXECUTIVE MAXIMA ADVANCED ULTIMAX BLUE DOOR PLUS MAXIMA SAVER MAXIMA SAVER GRID MAXIMA ENTRYZONE MAXIMA ENTRYSAVER DYNAMIC SAVER REJECTED DYNAMIC HOSPITAL DISCONTINUED WEF 01/01/2018 GENESIS HOSMED AID PRIVATE PRIVATE PLUS PRIVATE COMPREHENSIVE PRIVATE CHOICE PLUS ESSENTIAL VALUE ACCESS KEYHEALTH PLATINUM GOLD SILVER EQUILIBRIUM ESSENCE ORIGIN MAKOTI COMPREHENSIVE PRIMARY MEDIHELP DIMENSION ELITE Page 4

5 DIMENSION PRIME 1 DIMENSION PRIME 1 NETWORK DIMENSION PRIME 2 DIMENSION PRIME 2 NETWORK DIMENSION PRIME 3 DIMENSION PRIME 3 NETWORK MEDIHELP PLUS NECESSE UNIFY MEDIMED MEDSHIELD ALPHA MEDISAVE ESSENTIAL MEDISAVE - MAX MEDISAVE - STANDARD MEDIBONUS MEDIPLUS MEDIVALUE MEDICORE PREMIUM PLUS MEDISAVER MEDIPHILA MOMENTUM HEALTH INGWE PRIMARY CARE/STATE HOSPITAL NETWORK PRIMARY CARE/INGWE HOSPITAL NETWORK ACTIVE NETWORK/INGWE ANY OPTION Page 5

6 CUSTOM STATE/ASSOC HOSPITALS STATE/ANY HOSPITAL ASSOC GP & PHARM/ASSOC HOSPITALS ASSOC GP & PHARM/ANY HOSPITAL ANY GP & PHARM/ASSOC HOSPITALS ANY GP & PHARM/ANY HOSPITAL INCENTIVE STATE/ASSOC HOSPITALS STATE/ANY HOSPITAL ASSOC GP & PHARM/ASSOC HOSPITALS ASSOC GP & PHARM/ANY HOSPITAL ANY GP & PHARM/ASSOC HOSPITALS ANY GP & PHARM/ANY HOSPITAL EXTENDER STATE/ASSOC HOSPITALS STATE/ANY HOSPITAL ASSOC GP & PHARM/ASSOC HOSPITALS ASSOC GP & PHARM/ANY HOSPITAL ANY GP & PHARM/ASSOC HOSPITALS ANY GP & PHARM/ANY HOSPITAL IMPACT (WAS ACCESS) PENDING EDO application SUMMIT Page 6

7 RESOLUTION HEALTH HOSPITAL PROGRESSIVE FLEX EDO application PROGRESSIVE FLEX PLUS SUPREME MILLENNIUM MILLENNIUM SELECT FOUNDATION SELFMED SIZWE FUND MEDXXI MED ELITE SELFMED 80% SELFSURE SELFNET SELFNET ESSENTIAL AFFORDABLE CARE OPTION FULL CARE OPTION PRIMARY CARE OPTION HOSPITAL CARE GOMOMO CARE OPTION REJECTED REJECTED REJECTED REJECTED REJECTED SPECTRAMED CYAN AZURE AQUA COBALT CAPRI SUREMED HEALTH CHALLENGER NAVIGATOR SHUTTLE EXPLORER THEBEMED ENERGY CORE MEDIUM OPEN Page 7

8 UNIVERSAL UNIVERSAL EDO FANTASY New Option WEF 01/01/2018 TOPMED TOPMED COMPREHENSIVE TOPMED FAMILY TOPMED EXECUTIVE TOPMED SAVINGS TOPMED ACTIVE SAVER TOPMED ESSENTIAL TOPMED NETWORK TOPMED LIMITED Page 8

9 The table below provides details on the approval status for the different benefit options for the 2018 benefit year, for restricted schemes. NAME OF AECI AID SOCIETY VALUE OPTION COMPREHENSIVE OPTION ALLIANCE-MIDMED ANGLO ALLIANCE-MIDMED MANAGED CARE PLAN STANDARD CARE PLAN VALUE CARE PLAN ANGLOVAAL GROUP ANGLOVAAL GROUP BANKMED BANKMED BASIC PLAN BANKMED COMPREHENSIVE PLAN BANKMED CORE SAVER PLAN BANKMED PLUS PLAN BANKMED TRADITIONAL PLAN BANKMED ESSENTIAL PLAN BARLOWORLD BMW EMPLOYEES AID SOCIETY BP AID SOCIETY BUILDING &CONSTRUCTION INDUSTRY CHARTERED ACCOUNTANTS BARLOWORLD BMW EMPLOYEES AID SOCIETY BP SOCIETY BASIC OPTION ALLIANCE BENEFIT OPTION DOUBLE PLUS BENEFIT OPTION Page 9

10 (SA) AID FUND (CAMAF) FIRST CHOICE BENEFIT OPTION VITAL BENEFIT OPTION NETWORK CHOICE BENEFIT OPTION ESSENTIAL PLUS BENEFIT OPTION DE BEERS BENEFIT SOCIETY ENGEN BENEFIT FUND FISHING INDUSTRY (FISH-MED) FOOD WORKERS BENEFIT FUND GLENCORE GOLDEN ARROWS EMPLOYEES BENEFIT FUND GOVERNMENT EMPLOYEES (GEMS) DE BEERS BENEFIT SOCIETY ENGEN BENEFIT FUND PRIMARY STANDARD FOOD WORKERS BENEFIT FUND GLENCORE ADVANCE PRIMARY STANDARD ONYX EMERALD EMERALD VALUE RUBY BERYL SAPPHIRE GRINTEK ELECTRONICS AID HORIZON GRINTEK ELECTRONIC AID HOSPITAL CORE PLAN HOSPITAL PLUS NETWORK PLAN HOSPITAL PLUS SAVINGS PLAN Page 10

11 IMPALA PLAN IMPERIAL GROUP IMPALA PLAN IMPERIALMED HEALTH PLAN IMPERIALMED BUDGET PLAN LA-HEALTH ACTIVE COMPREHENSIVE CORE FOCUS KEYPLUS LIBCARE LONMIN MALCOR MASSMART HEALTH PLAN MBMED AID FUND MEDIPOS LIBCARE LONMIN PLAN A PLAN B PLAN C PLAN D CHOICE OPTION NETWORK OPTION ESSENTIAL OPTION MBMED OPTION A OPTION B OPTION C METROPOLITAN CLASSIC DISCONTINUED Amalgamated with PREMIER DISCONTINUED Momentum WEF 01/07/2017 MOTO HEALTHCARE OPTIMUM CLASSIC Page 11

12 NASPERS FUND CLASSIC NETWORK HOSPICARE HOSPICARE NETWORK CUSTOM ESSENTIAL M-MED OPTION N OPTION BASIC DISCONTINUED WEF 01/01/2018 N OPTION PLUS DISCONTINUED WEF 01/01/2018 NEDGROUP AID PLATINUM PLAN TRADITIONAL PLAN COMPREHENSIVE PLAN (WAS TRADITIONAL PLUS) SAVINGS PLAN HOSPITAL PLAN Name change WEF 01/01/2018 NETCARE OLD MUTUAL STAFF AID FUND PARMED AID PG GROUP PICK & PAY NETCARE SAVINGS OPTION TRADITIONAL PLUS PLAN TRADITIONAL PLUS SELECT TRADITIONAL PLAN TRADITIONAL SELECT NETWORK PLAN NETWORK SELECT HOSPITAL PLAN SAVINGS PLAN PARMED AID PG GROUP PICK N PAY PRIMARY OPTION PLATCOMPREHENSIVE WEF 01/07/2017 WEF 01/07/2017 WEF 01/07/2017 PENDING Page 12

13 PLATINUM PLATCAP HEALTH PROFMED PROACTIVE PROACTIVE PLUS PROPINNACLE PROSECURE PROSECURE PLUS QUANTUM AID SOCIETY RAND WATER REMEDI AID RETAIL ESSENTIAL COMPREHENSIVE PLAN ESSENTIAL SAVER PLAN KEYCARE PLUS PLAN OPTION A OPTION B PLUS CLASSIC COMPREHENSIVE STANDARD ESSENTIAL OPTION ESSENTIAL PLUS OPTION RHODES UNIVERSITY S A BREWERIES AID SOCIETY SABC AID SOUTH AFRICAN MUNICIPAL WORKERS UNION NATIONAL (SAMWUMED) RUMED ESSENTIAL COMPREHENSIVE SABC OPTION A OPTION B Page 13

14 SASOLMED SASOLMED SEDMED SEDMED SISONKE HEALTH HERITAGE PLAN PRIDE PLAN SOUTH AFRICAN POLICE SERVICE (POLMED) MARINE AQUARIUM TFG PLAN A PLAN B PENDING TIGER BRANDS OPTION 1 MZANSI NETWORK OPTION TRANSMED FUND GUARDIAN STATE PLUS NETWORK STATE PLUS OWN CHOICE PRIVATE NETWORK TSOGO SUN GROUP UMVUZO HEALTH CLASSIC COMPREHENSIVE PLAN CLASSIC SAVER PLAN STANDARD SUPREME ULTRA AFFORDABLE EXTREME ACTIVATOR UNIVERSITY OF KWAZULU-NATAL STANDARD PLAN UNIVERSITY OF THE UNIVERSITY OF WITWATERSRAND STAFF AID DISCONTINUED Amalgamating with Discovery Health Page 14

15 WITWATERSRAND, JOHANNESBURG STAFF AID WITBANK COALFIELDS AID WITSMED NETWORK OPTION (WAS WITSMED LOW COST OPTION) DISCONTINUED Medical Scheme WEF 01/01/2018 COMPREHENSIVE OPTION YEBOMED OPTION MIDMAS OPTION DISCONTINUED WEF 01/01/2018 NTSIKA OPTION DISCONTINUED WEF 01/01/2018 WOOLTRU HEALTHCARE FUND CORE OPTION EXTENDED OPTION PLUS OPTION Page 15