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Genesis Medical Scheme 2015 Benchmarking

Towers Watson is a leading international professional services company that helps organisations improve performance through effective people, risk and financial management. With 15,000 associates around the world, they offer consulting, technology and solutions in the areas of benefits, talent management, rewards, as well as risk and capital management.


They recently conducted a benchmarking exercise on 181 open medical scheme benefit options in South Africa.  All these benefit options are current (2015) benefit options and were categorised into 4 segments, namely:

Category

Explanation

“Affordable”

Options mainly targeting low-income members

“New Generation”

Options that are mainly hospital plans or savings options

“Comprehensive”

Options that provide day to day cover for a member with medium to   high healthcare needs

“Executive”

Options that are typically the most expensive options offered by open   schemes

The benchmarking exercise used the demographic and claims profile of an average member to determine the cost and benefits of the 181 benefit options.

Each of the four Genesis benefit options were mapped against equivalent benefit options, taking into account contributions levied (cost) (*) vs benefits provided (**).  Results were as follows:

  • The Private Choice, Private and Private Plus benefit options were compared against 76 other equivalent open scheme benefit options in the “New Generation” segment.
  • The Private Comprehensive benefit option was compared against 48 other equivalent open scheme benefit options in the “Comprehensive” segment.

Genesis does not compete in the “Affordable” or “Executive” open segments. (*)     Calculated on 2015 contributions paid by the average member. (**)  Calculated using the average member’s claims in 2014;  adjusted with 2015 inflation.

“New Generation” segment results:

Genesis benefit option

Result

Private Choice
  • Offers the best value for money in this market   segment
  • Offers 63% more value for money than the 78 other equivalent options in   this market segment
Private
  • Offers 15% more value for   money than the other equivalent options in this market segment
Private Plus
  • Offers 7% more value for   money than the other equivalent options in this market segment

“Comprehensive” segment results:

Genesis benefit option

Result

Private Comprehensive
  • 40% more affordable than the   48 other equivalent options in this market segment
  • 3% better (more generous)   benefits than the 48 other equivalent options in this market segment
  • Overall offers 43% more value for money than the 48   other equivalent options in this market segment

Above benchmarking results demonstrate that all four benefit options of Genesis Medical Scheme offer exceptional value for money in its respective segments.  In particular, our Private Choice and Private Comprehensive benefit options are absolute market leaders in its respective segments. These benchmarking results for 2015 once again demonstrate that the benefits of self-administration, prudent risk management and having sufficient reserves, are critical components in containing both healthcare costs, benefits structure and overall value for money.

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