Today's Labour News

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GEMSBusinessLive reports that the Government Employees Medical Scheme (Gems) has turned its finances around by tightening control of hospital admissions and introducing new rules for public servants who hop on and off the scheme as their healthcare needs wax and wane.  

Gems, the biggest restricted medical scheme in SA, had 1.833-million beneficiaries at the end of 2016, providing cover to more than half (56.8%) of all eligible public servants.  It made headlines in August 2016 when it emerged its solvency ratio was plummeting as it grappled with an unexpected surge in costly hospital admissions.  Confronted with a situation in which monthly claims outstripped contributions, from October Gems imposed a three-month waiting period on members and their dependants returning to the scheme after a break and on dependants who joined after the principal member.  It also increased premiums for 2017 by 15% and introduced measures to combat hospital fraud and over-servicing.  These measures have borne fruit and Gems is set to make an operating surplus in 2017.  It is also set to meet the Council for Medical Schemes’ 8.2% solvency target.

  • Read this report by Tamar Kahn in full at BusinessLive
  • Read too, Kranklike Gems sê hy is op pad na herstel, at Netwerk24 (limit on access)

Get other news reports at the SA Labour News home page