Scheme Stakeholders – who plays which role?
Source: MediBrief March 2016
We regularly receive questions about the relationship between Anglo Medical Scheme, its participating employers and our administrator Discovery Health. We explain the affiliation with these two stakeholders. For more information, please visit the ‘My Scheme’ section.
Anglo Medical Scheme and its participating employers
AMS belongs to its members and is managed by the Board of Trustees, half of whom are elected by the members.
Members are active employees and retirees (and/or registered dependants of its deceased employees or retirees) of participating employers. Participating employers are certain Anglo American Group companies, Mondi, Mpact, E Oppenheimer & Son and NTE. Other companies, like Haggie and Scaw, BOART, etc, were former subsidiaries or associated companies of Anglo American South Africa, which is why their retirees are able to remain on the Scheme.
Participating employers engage with the Scheme on behalf of their employees and pensioners. They do not manage the Scheme, but do have a significant interest in ensuring that the Scheme remains viable and well-run for its employees and pensioners.
Employers also offer their employees and personnel other benefit schemes, such as pension or provident funds, which are also separate and independent legal entities. Assets in each are controlled completely independently of the participating employers by the respective Trustee bodies. Legislation governing pension funds and medical schemes are very protective of members’ interests.
AMS is legally and financially independent from its participating employers and is a not-for-profit organisation. The contributions are collected and pooled for the benefit of all members and used to reimburse all relevant medical services purchased by members. All accumulated funds and assets of the Scheme belong to its members.
As you are well aware, AMS has sufficient reserves to continue as a going concern for at least the next 25-30 years. For more information on the financial health of your Scheme, please look out for the April MediBrief with a summary of the Annual Financial Statements.
Anglo Medical Scheme and its administrator Discovery Health
Discovery Health is a medical scheme administrator and is contracted by AMS, for a fee, to manage the collection of contributions, reimbursement of claims, Call Centre services, etc.
Discovery Health is a for-profit, listed company that has no financial or legal interest in the Scheme or in the participating employers. Discovery Health is required to ensure the rules of the Scheme are implemented and applied as approved by the Board of Trustees and the Council for Medical Schemes.
Discovery Health Medical scheme is also administered by Discovery Health and is a separate, independent scheme for its members with different rules, different Board of Trustees and members.