PROFMED BENEFITS AND NEW CHANGES FOR 2013

Carin Swanepoel

HISTORY/DEMOGRAPHICS

• Profmed was established in 1959 and registered in 1960

• Serves 64 000 lives

• Restricted medical scheme

• Healthy Professional risk pool

PROFMED SCHEME DEMOGRAPHICS AS AT 2012

• SOLVENCY 40+/-%

• PRINCIPAL MEMBERS 26800

• AVG CONTRIBUTION INCREASE FOR 2013 8.59%

• GLOBAL CREDIT RATING AA-

BENEFIT OPTIONS

PROPINNACLEIn Hospital Benefits

• Unlimited Cover

• 300% of Profmed Tariff

• Surgery & In-hospital procedures

• Consultations in hospital

• Private Ward

PROPINNACLE

Chronic Medication

• Unlimited cover

• 58 chronic conditions

PROPINNACLEOut of Hospital Benefits

• 100% of Profmed Tariff

• GP & Specialist consultations

• Procedures in Doctor’s rooms

PROPINNACLEOut of Hospital Benefits

• Day-to-day benefits

• Pooled benefit

• 100% of Profmed tariff

• M R13 000 - R 13 500• M+1 R19 500 - R 20 000• Max R26 000 - R 26 000 per family

PROSECURE PLUS

In Hospital Benefits

• Unlimited Cover

• 300% of Profmed Tariff – 2013 Profmed Tariff 200%

• Surgery & In-hospital procedures

• Consultations in hospital

PROSECURE/ PROSECURE PLUS

Chronic Medication

• M R12 000• M+1 R20 400• Family R27 000

• 38 chronic conditions - Unlimited

PROACTIVE PLUS

In Hospital Benefits

• Unlimited Cover

• 300% of Profmed Tariff - 2013 Profmed Tariff 200%

• Surgery & In-hospital procedures

• Consultations in hospital

• 26 PMB’s

PROACTIVE In Hospital Benefits

• Unlimited Cover

• 100% of Profmed Tariff

• Surgery & In-hospital procedures

• Consultations in hospital

• 26 PMB’s

Profmed Benefit Philosophy

• There when our members needs us • Unlimited hospital cover on all options • No co-payments or deposits paid in hospital• In-hospital dental cover on both ProActive options • Preventative care benefits on all options • Oral contraceptives on all options• Trauma an post HIV exposure assistance on all

options

New Benefit for 2013

• HPV Vaccine

• International Travel

• Dental Benefit

Contribution Increase for 2013

Average Increase (member weighted) – 8.59%

- ProActive 7.94%- ProActive Plus 8.10%- ProSecure 9.42%- ProSecure Plus 9.28%- ProPinnacle 9.26%

CONTRIBUTIONS R0-R3000 MONTHLY INCOME

ProPinnacle ProSecure Plus ProSecure ProActive Plus ProActive

Adult NOTAVAILABLE

NOTAVAILABLE

NOTAVAILABLE

NOTAVAILABLE

R416R452

Adult Dependant

NOTAVAILABLE

NOTAVAILABLE

NOTAVAILABLE

NOTAVAILABLE

R416R452

Child NOT AVAILABLE

NOTAVAILABLE

NOTAVAILABLE

NOTAVAILABLE

R268R290

CONTRIBUTIONS R3001-R6 000 MONTHLY INCOME

ProPinnacle ProSecure Plus ProSecure ProActive Plus

ProActive

Adult NOTAVAILABLE

NOTAVAILABLE

R1 286R1 412

NOTAVAILABLE

R688R746

Adult Dependant

NOTAVAILABLE

NOTAVAILABLE

R1 286R1 412

NOTAVAILABLE

R688R746

Child NOT AVAILABLE

NOTAVAILABLE

R584R640

NOTAVAILABLE

R308R334

CONTRIBUTIONS R6 000 + MONTHLY INCOME

ProPinnacle ProSecure Plus ProSecure ProActive Plus

ProActive

Adult R3698R4040

R2202R2412

R1790R1964

R1040R1128

R924R1002

Adult Dependant

R3430R3748

R2038R2232

R1656R1818

R966R1048

R854R926

Child R924R1010

R880R940

R716R766

R416R440

R370R390

PREVENTATIVE CARE

• Early detection of high risk• Testing for particular diseases• Facilitates early treatment – maximise outcome• Influenza vaccine• Oral contraceptives • Human papillomavirus (HPV) vaccine

PROFMED WELLNESS

• Profmed partnered with Multiply to provide members with a lifestyle program to maximise health care

• Some of the benefits include:• Online wellness profile to assess your health status • Lower fees for fitness assessments• Discounted gym fees• Discount on selected nutritional supplements• Up to 50% reduction on flights.• Other rich discounts on lifestyle products

THANK YOUTHANK YOU