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Medical scheme brokers generally agree that a medical scheme's key indicators (its solvency ratio, average beneficiary age, pensioner ratio and expense ratios) provide a reliable indication of a medical scheme's long-term viability, financial stability and value for money.

Bonitas Key Indicators

The table below sets out the key indicators for Bonitas compared to the open scheme average based on the latest annual report of 2011 from the Council for Medical Schemes:

Solvency ratio

The law requires that medical schemes maintain a solvency ratio of at least 25% to ensure the scheme has the ability to meet its financial commitments. A medical scheme's solvency ratio is therefore the most reliable indication of its financial soundness and ability to pay claims.

Fact: Bonitas' solvency ratio for 2011 is 37.3% - one of the highest in the industry and higher than the required minimum of 25%.

Average beneficiary age and pensioner ratio

As people age, their medical costs rise and this tends to increase contributions. It therefore makes sense to choose a medical scheme with a relatively young beneficiary age and low pensioner ratio to ensure you get value for money.

Fact: The average beneficiary age of 31.5 years and pensioner ratio of 4.78% for Bonitas are much lower than those of the vast majority of open schemes in the industry.

Non Healthcare expense ratios

Expense ratios are an important indicator of whether a scheme offers value for money or not. Inevitably medical schemes have expenses (such as administration fees and broker commission) and the higher these "non healthcare" costs, the less there is available to pay claims. Schemes with higher than average expense ratios are generally not offering good value for money.

Fact: Bonitas' non healthcare expenses of R126 is lower than the open scheme average of R153. Bonitas non healthcare expenses of 11.8% of gross contribution income is lower than the open scheme average of 13.7%

Size of the medical scheme

In the medical scheme industry, there is safety in numbers. The larger the scheme's membership base, the better its ability to spread the risk of high claims.

Fact: With over 275 000 principal members and 603 000 beneficiaries covered, Bonitas is the second largest open medical scheme in South Africa.

Value for money

Bonitas exists for the benefit of its members. We believe that one of the most important considerations when designing and costing benefit options is value-for-money, particularly during these difficult financial times. This is not only demonstrated by the indicators shown above but also by the introduction of innovations such as the Bonitas GP Network and Specialist Network which:

• eliminates the need for co-payments on GP and Specialists visits
• ensures that members receive quality, cost-effective healthcare.

Above all, Bonitas is serious about providing an excellent product at an affordable price.

Major Medical Benefits

Major medical benefits cover medical expenses in hospital and major medical events. Hospital accounts are covered in full as per the negotiated rates between Bonitas and the major hospital groups. Hospital admission is subject to pre-authorisation by Hospital Benefit Management, except in the case of emergencies.

Chronic Benefits

Chronic Benefits covers medicine for conditions that require medication on an ongoing basis. Subject to pre-authorisation by Chronic Medicine Management.

Out of Hospital Benefits

Out of hospital benefits cover day to day medical expenses incurred out of hospital.

Supplementary Benefits

Additional benefits, medical expenses incurred in or out of hospital. All of the following benefits are paid from risk, subject to benefit limits.