Overview of financial performance

Tebogo Maziya

GM: Financial Supervision

Outline of presentation

• Contribution and claims

• Claims seasonality

• Non healthcare expenditure

• Scheme results

• Solvency

• Investments

• Administrator market share

Contribution and claims

• Gross contributions R140.2 bn (2013: R129.8 bn)

• Risk contributions R126.9 bn (2013: R117.7 bn)

• Gross claims R124.3 bn (2013: R112.97 bn)

• Risk claims R111.9 bn (2013: R101.8 bn)

Risk and savings accounts contributions and claims pabpm

342.

3 409

.0

476.

0 53

8.5

576

.1

591.

8

613

.4

662.

4 726.

2

80

8.9

88

6.9

96

6.6

1 0

33

.6

1 1

20

.9

1 2

03

.9

305.

5

340.

3

390.

5

426.

3

45

2.6

497.

7

539.

6

573.

3

630.

8 722.

5

774

.6

83

6.3

90

6.3

96

9.3

1 0

62

.2

50.2

54.9

61.9

74.7

81

.5

91.

6

99.8

94.3

100.

9

105

.6

110.

8

116

.2

123

.6

115.

2

126.

0

44.8

48.9

53.3

62.2

68.5

77.5

95.3

88.

1

95.0

101.

2

105.

0

109.

1

115.

1

106.

6

116.

9

0

200

400

600

800

1 000

1 200

1 400

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Risk contributions Risk claims Savings contributions Savings claims

Risk and savings accounts contributions and claims pabpm: 2014 prices

757.1

856.2 912.8

976.4

1 029.3 1 024.0 1 013.4 1 022.0 1 004.6

1 048.9 1 103.1

1 145.1 1 159.3 1 189.2 1 203.9

111.0

114.9

118.6

135.5

145.7 158.4 164.8 145.5 139.6 136.9

137.9 137.6 138.6

122.3 126.0

675.8 712.5

749.0 772.9

808.6 861.1

891.5 884.5 872.7

936.8 963.4

990.7 1 016.6 1 028.3

1 062.2

99.0 102.4

102.2 112.7

122.4 134.0

157.4 135.9 131.4

131.2 130.6

129.3 129.2 113.1

116.9

0

200

400

600

800

1 000

1 200

1 400

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

pabpm (R)

Risk contributions Savings contributions Risk claims Savings claims

Risk contributions and claims: 2014 prices

757.1

856.2 912.8

976.4 1 029.3 1 024.0 1 013.4 1 022.0 1 004.6

1 048.9 1 103.1

1 145.1 1 159.3 1 189.2 1 203.9

675.8 712.5 749.0 772.9 808.6 861.1 891.5 884.5 872.7

936.8 963.4 990.7 1 016.6 1 028.3 1 062.2

89.3%

83.2%

82.1%

79.2%78.6%

84.1%

88.0%

86.5%86.9%

89.3%

87.3%

86.5%

87.7%

86.5%

88.2%

72.0%

74.0%

76.0%

78.0%

80.0%

82.0%

84.0%

86.0%

88.0%

90.0%

92.0%

0

200

400

600

800

1 000

1 200

1 400

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014Year

Risk contributions Risk claims Risk claims ratio

pabpm(R

Claims seasonality

0

10

20

30

40

50

60

70

80

90

100

110

120

Janu

ary

Feb

ruar

y

Mar

ch

Apr

il

May

June

July

Aug

ust

Sep

tem

ber

Oct

ober

Nov

embe

r

Dec

embe

r

Open - claims ratio Restricted - claims ratio All - claims ratio

claims ratio (%)

Non-healthcare expenditure papbm

0

500

1 000

1 500

2 000

2 500

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Gross NHE

NHE: 2014 prices

0

500

1 000

1 500

2 000

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Administration (Risk+Savings) Managed care: management services Broker fees and distribution costs Nett reinsurance Impaired receivables

Schemes with the highest PO fees

497 068

2 598 577

190 272 116 522

1 837 809

124 626 652 602 81 042 55 743 65 137

50

1 050

2 050

3 050

4 050

5 050

6 050

Sou

th A

fric

an P

olic

e Se

rvic

e M

edic

alSc

hem

e (P

OLM

ED)

Dis

cove

ry H

ealt

h M

edic

al S

chem

e

Bes

tmed

Med

ical

Sch

eme

Lib

erty

Med

ical

Sch

eme

Go

vern

men

t Em

plo

yee

s M

edic

alSc

hem

e (G

EMS)

Sizw

e M

edic

al F

und

Bo

nit

as M

edic

al F

un

d

Tran

smed

Me

dic

al F

un

d

Um

vuzo

Hea

lth

Med

ical

Sch

eme

Pro

fme

d

PO fees 2014 PO fees2013 Average Beneficiaries

Composition of trustee remuneration

-

1 000

2 000

3 000

4 000

5 000

6 000

7 000

8 000

Fees

fo

r m

eeti

ngs

Fees

fo

r h

old

ing

off

ice

Fees

fo

r co

nsu

ltin

g

Allo

wan

ces

Trai

nin

g

Co

nfe

ren

ceFe

es

Tele

ph

on

e e

xpen

ses

Acc

om

od

atio

n a

nd

me

als

Oth

er

Ave

rage

fee

per

tru

ste

e

Government Employees Medical Scheme (GEMS) Bonitas Medical Fund Discovery Health Medical Scheme

Fedhealth Medical Scheme Liberty Medical Scheme LA-Health Medical Scheme

Spectramed Bankmed Profmed

Bestmed Medical Scheme

Net results

-1 019.7

204.9

1 076.3

2 326.0

2 731.3

-406.5

-2 129.7

-1 056.5 -912.7

-2 583.3

-459.5

1 034.3

29.0

1 552.8

-464.5

167.1

1 453.7

2 409.7

4 317.0

5 010.6

2 291.8

1 142.9

2 786.22 553.4

972.1

2 851.5

4 290.7

3 693.3

5 257.6

3 409.9

-3 000

-2 000

-1 000

0

1 000

2 000

3 000

4 000

5 000

6 000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Million (R)

Year

Net healthcare result Net surplus/(deficit)

Solvency

20.2 20.4 22.9

29.3

37.3 39.1

37.9 38.0 36.6

32.9 31.8 32.5 32.6 33.3 33.3

13.3 13.5 15.1

20.9

28.5 29.6 27.7 28.6

29.8 27.4 27.6

28.7 29.1 29.7 30.0

34.2 36.3

41.3

49.6

58.8

63.5 64.7

58.7

49.7

42.5

38.6 38.3 37.4 38.2 37.9

-

10.0

20.0

30.0

40.0

50.0

60.0

70.0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Prescribed solvency level Industry average (all schemes) Industry average (open schemes) Industry average (restricted schemes)

Solvency

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

2006 2007 2008 2009 2010 2011 2012 2013 2014

solvency:all solvency: open solvency: open excl DHMS solvency: restricted solvency: restricted excl GEMS

Beneficiaries and solvency

5

18

2

58

6

18

3

60

212

4 688

1 914

2 000

2 861

1 986 1 995

1 937

0

500

1 000

1 500

2 000

2 500

3 000

3 500

4 000

4 500

5 000

0

10

20

30

40

50

60

70

Open schemes Below prescribedlevel

Open schemes Above prescribedlevel

Restricted schemes Belowprescribed level

Restricted schemes Aboveprescribed level

Beneficiaries (thousands)No. of medical schemes

No. of medical schemes - 2014 No. of medical schemes - 2013 Beneficiaries - 2014 Beneficiaries - 2013

Beneficiaries and solvency

212 169

1 914 481

2 860 768

1 978 668

Beneficiaries in open schemes with solvency < 25% Beneficiaries in restricted schemes with solvency < 25%

2014

2013

Scheme Investments

0

5 000

10 000

15 000

20 000

25 000

30 000

2014 2013 2014 2013

Open Restricted

Millions

Cash and Cash Equivalents Bonds Debentures Equities Properties Insurance Policies Other Total

Administrator market share

Discovery Health (Pty) Ltd27.2%

Metropolitan Health Corporate (Pty) Ltd25.3%

Medscheme Holdings (Pty) Ltd27.2%

Self-administered6.6%

Momentum Medical Scheme Administrators (Pty) Ltd

2.9%

V Med Administrators (Pty) Ltd*1.2%

Other9.6%