1. 2016 Benefit Changes

2. 2016 Increases Option % Increase R – Value Increase Private Choice
5.6%
R50
Private
6.0%
R80
Private Plus
6.8%
R115
Private Comprehensive
3.6%
R75
Average Increase
5.5%(*)
(*) Based on adult contributions

3. Specific Benefit Changes
Diagnostic scopes
Colonoscopy benefit increased by 7%
to R3 750 per scope
(Private, Private Plus & Private Comprehensive)
External medical / surgical appliances
Benefit increased by 10%. New benefit is 75% of cost up to R per member family p.a.
(All benefit options)
In-and-out-of-hospital MRI / CT scans
Benefit enhanced to now include previously excluded scans relating to the conservative treatment of back / neck conditions
(Private, Private Plus & Private Comprehensive)
Maxillo-facial surgery
New in-hospital benefit added to provide cover if required as a result of major trauma / accident
(Private Choice)

4. Specific Benefit Changes
Basic dental benefits
New benefit for dentures & bridges now included. New benefit is R3 000 per beneficiary p.a. for crowns, dentures & bridges.
In-hospital age limit for extractions & fillings improved to include beneficiaries < 9 years
Fillings capped at 6 fillings per beneficiary p.a.
Plain X-rays capped at 6 X-rays per beneficiary p.a.
Root canal treatment capped at two root canal treatments per beneficiary p.a.
(All options)

5. Specific Benefit Changes
Medical savings account
Increased by 10% to R3 960 per adult p.a. (18% of contribution)
(Private Plus)
Decreased by 9% to R2 520 per adult p.a. (10% of contribution)
(Private Comprehensive)
Medication benefit
Increased by 20% to R3 600 per adult p.a.
(Private Comprehensive)
Consultation benefit
Consultation benefit increased by 13% to R350 per consultation per adult p.a.
Number of consultations reduced from 6 to 4 consultations per adult p.a.
(Private Comprehensive)

6. Unique Benefits
• Average contribution increase of 5.5% lowest in industry (4th consecutive year)
• Private Choice rated as best value for money hospital plan in South Africa (Towers Watson & GTC Healthcare)
• The luxury to choose (no networks)
• Unique basic dentistry benefit – R per beneficiary p.a. on all benefit options
• Child dependent rates exceptionally well positioned
• Out of hospital MRI / CT benefits
• No upfront deposits prior to hospitalisation
• Provides excellent financial cover (200% on 3 of the 4 benefit options)
• Strong financial position
• “You don’t need to pay more to occupy the same bed in hospital”

7. Financial sustainability
One of the
TOP 5
Open Schemes
since
1st Position
2013

8. Annual contribution Increases
Year
Average annual contribution increase
2016
5.50%
2015
5.30%
2014
6.43%
2013
4.95%
2012
7.20%
2011
9.50%

9. 2016 contributions Private Choice Adult R950 First Child Dependent
Additional Children
R250
Private
Adult
R1 420
Child
R350
Additional Children
R275 each
Private Plus
Adult
R1 800
Child
R350
Additional Children
R275 each
Private Comprehensive
Adult
R2 150
Child
R350
Additional Children
R275 each