Lee Callakoppen, Principal Officer of Bonitas Medical Fund, talks about the year ahead for Bonitas Medical Scheme and its members.
Our value creation model has stood us in good stead with over R1.4 billion in reserves returned to members through benefit enhancements and low and deferred increases in 2022 and 2023. Our solvency ratio has reached an all-time high of 41.5%, well above the 25% minimum, which indicates a strong financial position and ability to pay member claims. This healthy solvency ratio is in place to cover an unexpectedly high number of claims. Our objective is to sustain solvency levels above 30% and to utilise the additional funds to add more value for our members, although these funds cannot be used for day-to-day claims.
Over the past few years, we kept our contribution increases well below the industry average, maintaining a healthy financial position while ensuring benefits are not eroded. For this reason, contribution increases range from 8.7%* to 14.9%* per plan (the latter impacting 1% of members) with a weighted increase of 10.2%* from January 1, 2025.
Calculating the changes
The percentage increases are meticulously calculated by our actuaries, balancing the financial sustainability of the Scheme, while adhering to regulatory guidelines and requirements outlined by the Council for Medical (CMS). And, while Bonitas has seen a positive performance, we’ve had to take measures to prevent instability in our environment.
Membership profile
Our members are from across a diverse range of backgrounds and profiles. Cross-subsidisation is important as it balances the share of contributions and utilisation between young and old, sick and healthy. It also means the pool of money available for claims and day-to-day benefits is accessible to all members, equally. Attracting younger, healthier members (average age of 35.9) also ensures sustainability. Our corporate profile, across 65 industries, makes up 70% of our total membership
A quintet of awards
Recently Bonitas was announced as the winner of the ‘Medical Scheme Category’ in the Ask Afrika Orange Index® Awards for 2024/2025. It is the fourth category win over the past seven years. Principles such as trust, sustainability, reputation and care feature strongly.
It is also the fifth accolade for the Scheme this year, others include: two BHF Titanium Awards for’ Best Integrated Report’ and ‘Best Operational Performance’, Top 500’s ‘Leader for Medical Scheme’ and gold in the Daily Sun Readers’ Choice Awards.
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The life stage model
Our new model is designed to revitalise our approach based on industry, life stage and various psychographic and behavioural science elements. This is supported by a diverse product range, tailored wellness and screening benefits, access to healthcare services and optimised member communication.
Health risk assessments and preventative care screenings are pivotal to managed healthcare initiatives. With early detection and speedy intervention critical to enhancing our member’s quality of life.
What’s new?
Integrated chronic care family practitioner network
There is a direct correlation between chronic diseases and mental health. For 2025, we have added a mental health component into our GP network, to facilitate early disease detection, diagnosis and multi-disciplinary care coordination.
Hearing Loss Management
This includes free online hearing screenings for all South Africans. Members on selected plans will receive hearing aids, audiology services and hearing aid acoustic services.
Weight Management Programme
Obesity or being overweight, substantially increases the risk of morbidity from at least fifteen conditions. The programme, led by a biokineticist, provides a holistic approach to weight loss with access to a dietician and psychologist for support on exercise, nutrition and mental health.
Female Health Programme
A new Female Health Programme and enhanced Mother and Child Care Benefit, including the Maternity Programme, was launched earlier this year in collaboration with CareWorks. It emphasises preventative care and early detection of female-specific health issues, based on life stages.
The Maternity Programme includes: Early identification and weekly engagement for high-risk pregnancies, antenatal vitamins, post-childbirth care and associated mother mental health follow-up calls, milestone reminders for children under three, immunisation reminders and online screenings for infant and toddler health. Vision screening by an ophthalmologist for premature neonates, is offered on all options, except BonCap
Bonitas Geriatric Care
A range of personal screening, prevention and wellness benefits – including chronic care management and support and fall-risk assessments, covered by Risk, allows seniors to live independently.
Diabetic retinopathy screenings
Our members can access cutting-edge, AI-driven screenings for diabetic retinopathy other conditions of the eye.
Benefit Booster
We are offering even more value for money on the Benefit Booster which gives access to up to R5 000 as an additional benefit to use for out-of-hospital expenses, at no extra cost.
Despite the challenges in the healthcare industry, we continue to run a tight ship, while meeting the diverse needs of our members with innovative benefits, a life stage model and a commitment to quality care.
*The increases and new benefits have been submitted to the CMS and are subject to their approval.