Concession business for January 2025 take-on

 

Here is detailed information regarding the concession business for January 2025.

The Medical Schemes Act provides a unique opportunity for employer groups to transition between medical schemes each year on the 1st of January without incurring any waiting periods. This process is commonly known as Concession Business, and it serves to facilitate smoother transitions for employees and their families in terms of healthcare coverage.

When considering applications for the 2025 Concession Business, several important criteria must be adhered to. Firstly, it is essential that the employer group's date of commencement aligns with 1 January 2025. Additionally, there must be a legitimate employer-employee relationship in place, which underscores the importance of a structured workplace environment. Furthermore, it is required that employer groups consist of at least two employees to qualify for this concession. It is also important to note that self-employed individuals are not eligible for the underwriting concession under this act. Billing and collection of contributions will be conducted in advance through debit orders exclusively, ensuring that payment processes are streamlined and efficient. Moreover, it is mandatory for all staff members who are currently enrolled in an existing medical scheme to transfer their membership to the Momentum Medical Scheme. For employees who are not beneficiaries of any existing medical scheme, full underwriting will be applicable. Additionally, late joiner penalties may be enforced where relevant, and any existing waiting periods or exclusions will carry over into the new coverage.

RequirementsIn order to proceed with the application process, certain requirements must be submitted through your designated Business/Practice Consultant or a Momentum Medical Scheme Specialist by the deadline of 30 September 2024. These requirements include: a formal letter of intent indicating the desire to join the Momentum Medical Scheme effective from 1 January 2025; a fully completed company application form; and the payroll records for the previous three months. If the employer is unable to provide proof of payroll, alternative documentation may be submitted, such as records submitted to SARS, proof of UIF payments for each employee, or a letter from an auditor confirming the list of employees. Additionally, the demographics of the group must be submitted electronically in an MS Excel spreadsheet, which should include comprehensive details such as the full names, dates of birth, and genders of the principal members, as well as information about spouses, adult dependants, and child dependants. It is also necessary to indicate any chronic conditions and provide income details for each employee.

If all specified criteria are satisfied and the required documentation is submitted within the stipulated timeframe, the terms of acceptance will be communicated by 31 October 2024.

Once the terms of acceptance are received, they must be duly signed by the employer. This signed document, along with additional required documentation, must be submitted by 29 November 2024. The additional documentation includes fully completed individual member application forms and a certificate of existing medical scheme membership for each employee.

For groups that meet the standard group underwriting criteria, submissions should be made through the usual New Business channels. Should you require further information regarding Concession Business, please do not hesitate to reach out to your Business/Practice Consultant or a Momentum Medical Scheme Specialist for assistance.