CIRCULAR 69 OF APPROVAL OF BENEFIT OPTIONS FOR OPEN SCHEMES (2011)
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1 ` CIRCULAR 69 OF APPROVAL OF BENEFIT OPTIONS FOR OPEN SCHEMES (2011) Scheme Name Benefit Option Name Decision Made Bases for the decision BLUE PRINT BONUS PLUS BEAT 2 (WAS MILLENNIUM BASIC) MILLENNIUM COMPREHENSIVE BEAT 3 (WAS MILLENNIUM STANDARD) BESTMED MEDICAL SCHEME TOPCARE BEAT 1 (WAS VITAL CARE) PLATINUM GOLD GOLD SELECT BONITAS MEDICAL FUND BONCAP BONCOMPREHENSIVE BONSAVE PRIMARY STANDARD BONESSENTIAL CAPE MEDICAL PLAN HEALTHPACT PREMIUM HEALTHPACT SILVER HEALTHPACT SELECT
2 Scheme Name Benefit Option Name Decision Made Bases for the decision COMMUNITY MEDICAL AID SCHEME (COMMED) FUNDAMENTAL (WAS CORE) DELUXE STANDARD COMPCARE WELLNESS MEDICAL SCHEME DYNAMIX PINNACLE MUMED SYMMETRY AXIS NETWORX DISCOVERY HEALTH MEDICAL SCHEME CLASSIC COMPREHENSIVE CLASSIC DELTA COMPREHENSIVE CLASSIC CORE CLASSIC DELTA CORE CLASSIC PRIORITY CLASSIC SAVER CLASSIC DELTA SAVER COASTAL CORE COASTAL SAVER ESSENTIAL COMPREHENSIVE ESSENTIAL DELTA COMPREHENSIVE ESSENTIAL CORE ESSENTIAL DELTA CORE ESSENTIAL PRIORITY ESSENTIAL SAVER ESSENTIAL DELTA SAVER EXECUTIVE FOUNDATION CORE KEYCARE CORE KEYCARE PLUS FEDHEALTH MEDICAL SCHEME MAXIMA BASIS MAXIMA CORE MAXIMA PLUS
3 Scheme Name Benefit Option Name Decision Made Bases for the decision MAXIMA STANDARD ULTIMA 300 WITH OHEB MAXIMA EXEC (renamed from ULTIMA 200 WITH OHEB as at 01/01/2011) ULTIMA 200 ULTIMAX BLUE DOOR ENTRYZONE (NEW 1/09/2010) BASIC COVER PLAN LIQUIDATED WEF 12/10/2010 MEMBERS TRANSFERRED TO MEDSHIELD 13/10/2010 GEN-HEALTH MEDICAL SCHEME COVER PLUS PLAN LIQUIDATED WEF 12/10/2010 MEMBERS TRANSFERRED TO MEDSHIELD 13/10/2010 PRIMARY COVER LIQUIDATED WEF 12/10/2010 MEMBERS TRANSFERRED TO MEDSHIELD 13/10/2010 GENESIS MEDICAL SCHEME PRIVATE PRIVATE PLUS PRIVATE COMPREHENSIVE PRIVATE CHOICE(NEW 01/01/2011) GETMED MEDICAL SCHEME B300 G200 G500 HOSMED MEDICAL AID SCHEME PLUS STEP VALUE INGWE HEALTH PLAN CAPITATION DISCONTINUED SCHEME AMALGAMATED WITH MOMENTUM (1/10/10) PIONEER DISCONTINUED SCHEME AMALGAMATED WITH MOMENTUM (1/10/10) PLUS DISCONTINUED SCHEME AMALGAMATED WITH MOMENTUM (1/10/10) MEDICARE DISCONTINUED SCHEME AMALGAMATED WITH MOMENTUM (1/10/10) KEYHEALTH PLATINUM GOLD SILVER BRONZE BRONZE PLUS
4 Scheme Name Benefit Option Name Decision Made Bases for the decision LIBERTY HEALTH MEDICAL SCHEME GOLD FOCUS GOLD SAVER (WAS GOLD PLUS) PLATINUM COMPLETE PLATINUM FOCUS PLATINUM SAVER (WAS PLATINUM PLUS) SILVER FOCUS DISCONTINUED (31/12/10) SILVER CORPORATE NETWORK DISCONTINUED OPTION MERGED WITH BONA PLUS (31/12/10) BONA PLUS TITAN MAKOTI MEDICAL SCHEME ( WAS GOOD HOPE MEDICAL AID SOCIETY) MAKOTI COMPREHENSIVE MAKOTI PRIMARY MEDIHELP DIMENSION ELITE DIMENSION PRIME 1 DIMENSION PRIME 2 DIMENSION PRIME 3 MEDIHELP PLUS NECESSE UNIFY MEDIMED MEDICAL SCHEME ALPHA MANAGED CARE MEDISAVE - MAX MEDISAVE - STANDARD MEDSHIELD MEDICAL SCHEME MEDIBONUS MEDIPLUS MEDIVALUE 80% OPTION(OXYGEN) CORE PLUS (OXYGEN) ESSENTIAL (OXYGEN) ESSENTIAL CARECROSS(OXYGEN) PREMIUM PLUS(OXYGEN) STANDARD (OXYGEN)
5 Scheme Name Benefit Option Name Decision Made Bases for the decision MOMENTUM HEALTH MEDICAL SCHEME SUMMIT ACCESS CUSTOM ANY GP/ PHARMACY & ANY STATE & ANY STATE & ASSOCIATED ANY GP/PHARMACY & ASSOCIATED ASSOCIATED GP/PHARMACY & ASSOCIATED ASSOCIATED GP/PHARMACY & ANY INCENTIVE ANY GP/ PHARMACY & ANY STATE & ANY STATE & ASSOCIATED ANY GP/PHARMACY & ASSOCIATED ASSOCIATED GP/PHARMACY & ASSOCIATED ASSOCIATED GP/PHARMACY & ANY EXTENDER ANY GP/ PHARMACY & ANY STATE & ANY STATE & ASSOCIATED ANY GP/PHARMACY & ASSOCIATED ASSOCIATED GP/PHARMACY & ASSOCIATED ASSOCIATED GP/PHARMACY & ANY INGWE (WAS BASE) PRIMECURE & NETWORK PRIMECURE & STATE CARECROSS & NETWORK
6 Scheme Name Benefit Option Name Decision Made Bases for the decision CARECROSS & STATE BASE FARANANI & NETWORK DISCONTINUED-31/12/2010 BASE FARANANI & STATE DISCONTINUED-31/12/2010 NATIONAL INDEPENDENT MEDICAL AID SOCIETY (NIMAS) SUPREME MILLENIUM CLASSIC CORE (NEW 1/1/2011) OXYGEN MEDICAL SCHEME 80% PLAN CORE PLUS ESSENTIAL ESSENTIAL CARECROSS STANDARD PREMIUM PLUS AMALGAMATED WITH MEDSHIELD (1/10/10) AMALGAMATED WITH MEDSHIELD (1/10/10) AMALGAMATED WITH MEDSHIELD (1/10/10) AMALGAMATED WITH MEDSHIELD (1/10/10) AMALGAMATED WITH MEDSHIELD (1/10/10) AMALGAMATED WITH MEDSHIELD (1/10/10) PHAROS MEDICAL PLAN FOOTPRINT COMPREHENSIVE FOOTPRINT PRIMARY METHCARE PALADIN COMPREHENSIVE RAINBOW COMPREHENSIVE RAINBOW PLUS RAINBOW PRIMARY PRO SANO MEDICAL SCHEME PROCEDURE PROCLASSIC PROVIDER PROVISION PRO-ELITE PROTEA MEDICAL AID SOCIETY PLAN
7 Scheme Name Benefit Option Name Decision Made Bases for the decision ESSENTIAL-PLAN RESOLUTION HEALTH MEDICAL SCHEME FOUNDATION (WAS FUNDAMENTAL) PRESTIGE PROGRESSIVE FLEX (WAS PROGRESSIVE) PROGRESSIVE SELECT (NEW 1/1/2011) SELFMED MEDICAL SCHEME MEDXXI MED ELITE SELFMED 80 % SELFSURE SIZWE MEDICAL FUND SIZWE AFFORDABLE SIZWE AFFORDABLE NETWORK DISCONTINUED 31/12/2010 SIZWE FULL BENEFIT SIZWE PRIMARY SPECTRAMED SPECTRA CYAN (WAS ALLIANCE) SPECTRA AZURE (WAS ELITE) SPECTRA AQUA (WAS ) SPECTRA COBALT (WAS PLUS) SPECTRA CAPRI (WAS ELITE) SUREMED HEALTH CHALLENGER NAVIGATOR SHUTTLE EXPLORER THEBEMED ENERGY FRONTIER UNIVERSAL CHALLENGER (SUREMED) NAVIGATOR (SUREMED)
8 Scheme Name Benefit Option Name Decision Made Bases for the decision TOPMED MEDICAL SCHEME TOPMED TRADITIONAL TOPMED PLAN TOPMED INCENTIVE COMPREHENSIVE TOPMED INCENTIVE SAVINGS TOPMED NETWORK APPROVAL OF BENEFIT OPTION FOR RESTRICTED SCHEMES (2011) Scheme Name Benefit option name Decision made Bases for the decision BASIC AECI MEDICAL AID SOCIETY COMPREHENSIVE AFRISAM (SA) MEDICAL SCHEME SCHEME AMALGAMATED WITH DISCOVERY HEALTH ON AFRISAM DELUXE DISCONTINUED (1/6/10) SCHEME AMALGAMATED WITH DISCOVERY HEALTH ON AFRISAM STANDARD DISCONTINUED (1/6/10) SCHEME AMALGAMATED WITH DISCOVERY HEALTH ON AFRISAM BUDGET PLAN DISCONTINUED (1/6/10) AFROX MEDICAL AID SOCIETY BASE PLAN DIAMOND PLAN DISCONTINUED 31/12/2010 ALLIANCE MIDMED MEDICAL SCHEME ALLIANCE MIDMED POLICY 120 ALTRON MEDICAL AID SCHEME BASIC ENHANCED ANGLO MEDICAL SCHEME MANAGED CARE PLAN
9 Scheme Name Benefit option name Decision made Bases for the decision STANDARD CARE PLAN VALUE CARE PLAN ANGLOVAAL GROUP MEDICAL SCHEME ANGLOVAAL GROUP MEDICAL SCHEME BANKMED BASIC BANKMED COMPREHENSIVE BANKMED BANKMED CORE SAVER BANKMED PLUS BANKMED TRADITIONAL BARLOWORLD MEDICAL SCHEME BARLOWORLD MEDICAL SCHEME BMW EMPLOYEES MEDICAL AID SOCIETY BMW OPTION 119 BP MEDICAL AID SOCIETY BP MEDICAL SOCIETY (BENEFIT BUILDING &CONSTRUCTION INDUSTRY MEDICAL SCHEME BASIC OPTION BUILT ENVIRONMENT PROFESSIONAL ASSOCIATIONS MEDICAL SCHEME (BEPMED) PRO-BASIC DISCONTINUED SCHEME AMALGAMATED WITH TOPMED (1/1/2011) PRO-CORE DISCONTINUED SCHEME AMALGAMATED WITH TOPMED (1/1/2011) PRO-ELITE DISCONTINUED SCHEME AMALGAMATED WITH TOPMED (1/1/2011) CA-ALLIANCE CA-DOUBLE PLUS CHARTERED ACCOUNTANTS (SA) MEDICAL AID FUND (CAMAF) CA-FIRST CHOICE CA-VITAL NETWORK CHOICE CLICKS GROUP MEDICAL SCHEME CLICKS GROUP MEDICAL SCHEME DISCONTINUED SCHEME AMALGAMATED WITH MOREMED 1/1/2011 (NAME CHANGED TO HORIZON MEDICAL SCHEME ON AMALGAMAITON) DE BEERS BENEFIT SOCIETY DE BEERS BENEFIT SOCIETY EDCON MEDICAL AID SCHEME ESSENTIAL COMPREHENSIVE
10 Scheme Name Benefit option name Decision made Bases for the decision KEYCARE (WAS ESSENTIAL LIMITED) DISCONTINUED (31/12/10) ESSENTIAL SAVER ENGEN MEDICAL BENEFIT FUND ENGEN MEDICAL BENEFIT FUND (BENEFIT EYETHUMED MEDICAL SCHEME EYETHU MEDICAL SCHEME (BENEFIT FISHING INDUSTRY MEDICAL SCHEME (FISH-MED) PRIMARY STANDARD FOOD WORKERS MEDICAL BENEFIT FUND FOSCHINI GROUP MEDICAL AID SCHEME FOOD WORKERS MEDICAL BENEFIT FUND PLAN A PLAN B NO CHANGES FOR 2011 GOLDEN ARROWS EMPLOYEES MEDICAL BENEFIT FUND ADVANCE PRIMARY STANDARD GOLD FIELDS MEDICAL SCHEME HERITAGE PLAN PRIDE PLAN GOVERNMENT EMPLOYEE MEDICAL SCHEME (GEMS) GRINTEK ELECTRONICS MEDICAL AID SCHEME HORIZON MEDICAL SCHEME (NAME CHANGE AS A RESULT OF AN AMALGAMATION BETWEEN MOREMED AND CLICKS MEDICAL SCHEMES 1/1/2011) BERYL EMERALD ONYX RUBY SAPPHIRE GRINTEK ELECTRONIC MEDICAL AID SCHEME MAJOR MEDICAL MAJOR MEDICAL PLUS CARECROSS IBM (SA) MEDICAL SCHEME ESSENTIAL COMPREHENSIVE
11 Scheme Name Benefit option name Decision made Bases for the decision IMPALA MEDICAL PLAN IMPALA MEDICAL PLAN IMPERIAL GROUP MEDICAL SCHEME IMPERIAL GROUP MEDICAL SCHEME LA ACTIVE LA COMPREHENSIVE LA-HEALTH LA CORE LA FOCUS LA KEYPLUS LIBCARE MEDICAL SCHEME LIBCARE LONMIN MEDICAL SCHEME LONMIN MEDICAL SCHEME BENEFIT PLAN PLAN A MALCOR MEDICAL SCHEME PLAN B PLAN C MASSMART HEALTH PLAN MASSMART HEALTH PLAN (BENEFIT MBMED MEDICAL AID FUND PLAN A OPTION A MEDIPOS MEDICAL SCHEME OPTION B OPTION C METROCARE METROCARE PLAN 211 CLASSIC METROPOLITAN MEDICAL SCHEME PREMIER MINEMED MEDICAL SCHEME AFFORDABLE OPTION OPTIMUM ESSENTIAL PRIMARY PLUS DISCONTINUED 31/12/2010 OPTION MERGE WITH ESSENTIAL OPTION 1/1/2011
12 Scheme Name Benefit option name Decision made Bases for the decision MOTO HEALTHCARE CLASSIC OPTMUM ESSENTIAL CUSTOM HOSPICARE NAMPAK (SA) MEDICAL SCHEME EXTENDED OPTION STANDARD OPTION NASPERS MEDICAL FUND M-MED OPTION N OPTION BASIC N OPTION PLUS (BENEFIT (BENEFIT NEDGROUP MEDICAL AID SCHEME TRADITIONAL PLUS (WAS NETWORK) PLATINUM SAVINGS TRADITIONAL NETCARE MEDICAL SCHEME NETCARE SAVINGS OPTION OLD MUTUAL STAFF MEDICAL AID FUND PLAN MID-YEAR CONTRIBUTION AND BENEFIT CHANGES NETWORK PLAN MID-YEAR CONTRIBUTION AND BENEFIT CHANGES SAVINGS PLAN MID-YEAR CONTRIBUTION AND BENEFIT CHANGES TRADITIONAL PLAN MID-YEAR CONTRIBUTION AND BENEFIT CHANGES TRADITIONAL PLUS PLAN MID-YEAR CONTRIBUTION AND BENEFIT CHANGES PARMED MEDICAL AID SCHEME PLAN PG BISON MEDICAL AID SOCIETY PG BISON (BENEFIT PG GROUP MEDICAL SCHEME PG GROUP MEDICAL SCHEME PICK & PAY MEDICAL SCHEME PICK N PAY MEDICAL SCHEME
13 Scheme Name Benefit option name Decision made Bases for the decision PLATINUM HEALTH BASIC OPTION ENHANCED OPTION PROFMED PRO ACTIVE PRO ACTIVE PLUS PRO PINNACLE PRO SECURE PRO SECURE PLUS PRO BASIC (SUBMITTED-NEW 1/1/2011) NOT QUANTUM MEDICAL AID SOCIETY ESSENTIAL COMPREHENSIVE ESSENTIAL SAVER KEYCARE PLUS RAND WATER MEDICAL SCHEME REMEDI MEDICAL AID SCHEME OPTION A OPTION B CLASSIC COMPREHENSIVE STANDARD RETAIL MEDICAL SCHEME ESSENTIAL COMPREHENSIVE OPTION ESSENTIAL OPTION ESSENTIAL PLUS OPTION RHODES UNIVERSITY MEDICAL SCHEME S A BREWERIES MEDICAL AID SOCIETY RUMED CASTELLION OPTION SAB OPTION APRROVED SABC MEDICAL AID SCHEME SABC PLAN 009 SOUTH AFRICAN MUNICIPAL WORKERS UNION NATIONAL MEDICAL SCHEME (SAMWUMED) OPTION A OPTION B SAPPI MEDICAL AID SCHEME SAPPI MEDICAL AID SCHEME
14 Scheme Name Benefit option name Decision made Bases for the decision SASOLMED SASOLMED (BENEFIT SEDMED SEDMED SIEMENS MEDICAL SCHEME SIEMENS MEDICAL SCHEME SOUTH AFRICAN POLICE SERVICE MEDICAL SCHEME (POLMED) HIGHER PLAN LOWER PLAN TIGER BRANDS MEDICAL SCHEME OPTION 1 TRANSMED MEDICAL FUND GUARDIAN PRIVATE COVER PLUS SAVINGS STATE PLUS NETWORK STATE PLUS OWN CHOICE PRIVATE NETWORK CORE PRIVATE NETWORK SAVER DISCONTINUED(01/02/2010) DISCONTINUED(31/12/2010) TSOGO SUN GROUP MEDICAL SCHEME CLASSIC COMPREHENSIVE CLASSIC SAVER UMED MEDICAL SCHEME SCHEME AMALGAMATED WITH DISCOVERY HEALTH CLASSIC DISCONTINUED (1/7/10) SCHEME AMALGAMATED WITH DISCOVERY HEALTH VALUE DISCONTINUED (1/7/10) UMVUZO HEALTH MEDICAL SCHEME STANDARD SUPREME ULTRA AFFORDABLE UNIVERSITY OF KWA-ZULU NATAL MEDICAL SCHEME UNIVERSITY OF THE WITWATERSRAND STAFF MEDICAL AID SCHEME SAVINGS PLUS PLAN UNIVERSITY OF WITWATERSRAND STAFF MEDICAL AID WITBANK COALFIELDS MEDICAL AID COMPREHENSIVE OPTION
15 Scheme Name Benefit option name Decision made Bases for the decision SCHEME YEBOMED CORE OPTION WOOLTRU HEALTHCARE FUND EXTENDED OPTION PLUS OPTION XSTRATA MEDICAL AID SCHEME XSTRATA (BENEFIT
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