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L A CON V ERSATIONS 2021
2021
LA
CON V ERSATIONS
CONTENTS
L A C ON V ERS AT IONS 2021
LA HEALTH’S LA HEALTH’S COMPREHENSIVE
PERFORMANCE COVID-19 LEVELS OF
RESPONSE COVER FOR
OUR MEMBERS
2021 2021
BENEFIT CONTRIBUTION
UPDATES INCREASES
L A C ON V ERS AT IONS 2021 EXCEPTIONAL PERFORMANCE L A H E A LT H
E N S U R E S F U T U R E SUSTA I N A BILI T Y
MEDICAL
SCHEME
PERFORMANCE
As the established medical scheme of choice in Local Government, LA Health continues to attract new members. The Scheme provides cover to over 220 000 members
and their families, with LA Health’s five Benefit Options suiting all levels of medical and financial needs. The performance of a medical scheme should consider the quality
of the healthcare services that its members experience, while its sustainability is measured by the growth and financial performance of the medical scheme.
LA Health constantly focuses on improving the healthcare experience of our members while continuing to grow and deliver strong financial results.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
LA Health continues to LA Health has steadily
STRONG MEMBERSHIP ATTRACTING YOUNG
experience exceptionally attracted younger
GROWTH strong growth, adding AND HEALTHY LIVES healthier members
Net new principal members (2020) almost 8 000 principal LA Health demographics (2019) over the past decade,
members for the 12 resulting in a significant
>7 700 >750 months up to March
2020.
29.4 5.2% decrease in the average
age of beneficiaries on
LA Health Other schemes in Average age Pensioner ratio the Scheme and a lower COMPREHENSIVE
local government LEVELS OF
average age than it’s
COVER FOR
competitors.
OUR MEMBERS
A consistent positive
SCHEME OF CHOICE IN EXCEPTIONAL
net healthcare result,
LOCAL GOVERNMENT 8%
FINANCIAL STRENGTH healthy reserves and a
well maintained solvency 2021
+R118M R1.8 bn
10%
LA Health is the largest scheme in
ratio ensure that BENEFIT
local government with a market share 31 MARCH LA Health
U P D AT E S
2020 LA Health can withstand
of 41% in 2020. 16% Net healthcare Reserves
result (2019) (2019) planned or unplanned
costs, such as the
26% impact of the COVID-19
42.7% Solvency (2019) pandemic.
3
2021
CONTRIBUTION
INCREASES
L A C ON V ERS AT IONS 2021 HE A LT H Y, L A H E A LT H
S U S TA IN A BL E G ROW T H
MEDICAL
SCHEME
PERFORMANCE
LA Health continues to experience exceptionally strong growth, adding almost 8 000 members for the 12 months up to March 2020.
The Scheme has grown by over 65 000 principal members in the last ten years reinforcing its position as the largest scheme in local government.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
NET GROWTH IN PRINCIPAL MEMBERS
(2010 – 2020) NET GROWTH
IN PRINCIPAL
MEMBERS OVER
7852
THE LAST 10 YEARS COMPREHENSIVE
7628
7583
7799 LEVELS OF
COVER FOR
OUR MEMBERS
+ 65 247
5445
4686 5424 5113
4737 4963
4017
2567
2405
LA Health members
2111
1970
1206 1717
750
+ 3 756
0
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
2021
-290 BENEFIT
Other schemes U P D AT E S
-2648
-2918 in local government
-3114
Other schemes in local government LA Health
4
2021
CONTRIBUTION
INCREASES
L A C ON V ERS AT IONS 2021 HE A LT H Y, L A H E A LT H
S U S TA IN A BL E G ROW T H
MEDICAL
SCHEME
PERFORMANCE
The size of LA Health is best illustrated through the Scheme’s flagship Benefit Option. On a standalone basis there are more principal members
on LA Active than the total local government membership on any of the competitor schemes.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
GROWTH IN BENEFICIARIES TOTAL PRINCIPAL MEMBERS
(2010 – 2020) (31 MARCH 2020)
406% 221 361
202 859
186 879
164 880
COMPREHENSIVE
150 036 LEVELS OF
138 315 COVER FOR
125 638 57 200 OUR MEMBERS
115 531
55 113
100 530
86 181
67 516
34 640
52 862
45 022
43 755 21 564
16 831
17 945
6 605
4 238
1 460
2021
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 YTD
Competitor A
Competitor B
Competitor C
Competitor D
LA Core
LA Focus
LA KeyPlus
LA Active
LA Comprehensive
BENEFIT
U P D AT E S
*Principal members of medical schemes operating in local government
5
2021
CONTRIBUTION
INCREASES
L A C ON V ERS AT IONS 2021 L A HE ALTH REMAINS THE SCHEME OF CHOICE FOR L A H E A LT H
LO CA L GOV E R NME N T E M PLOY E ES
MEDICAL
SCHEME
PERFORMANCE
LA Health has maintained its status as market leader in Local Government through years of consistent membership growth and financial sustainability,
and provides cover to 25 500 more principal members than the next largest competitor. LA Health has consistently increased market share each year,
growing from 18% in 2010 to 41% as at March 2020.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
MARKET SHARE LOCAL GOVERNMENT MARKET SHARE
(2010 – 2020) (2020)
COMPREHENSIVE
100% 8% LEVELS OF
14%
8% COVER FOR
10%
19% OUR MEMBERS
80%
16%
10%
20%
60%
31 MARCH LA Health
26%
2020
40% 29%
16%
20%
41%
18%
2021
BENEFIT
0
26% U P D AT E S
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
LA Health Competitor A Competitor B Competitor C Competitor D
6
2021
CONTRIBUTION
INCREASES
L A C ON V ERS AT IONS 2021 ATTRACTING L A H E A LT H
YO U NG A ND H E A LT H Y LI V ES
MEDICAL
SCHEME
PERFORMANCE
LA Health has steadily attracted young and healthy members over the past decade, resulting in a significant decrease in the average age of
beneficiaries on the Scheme. In 2019, the average age of new beneficiaries joining the Scheme was 22.6 years which is significantly lower than
the Scheme’s existing age profile. Consistent membership growth of young and healthy lives has enabled LA Health to maintain a lower average
age and pensioner ratio than that of its competitors.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
LA HEALTH’S AVERAGE AGE AND
PENSIONER RATIO (2010 – 2019) SCHEME DEMOGRAPHICS
(2018)
YOUNGER AVERAGE AGE COMPREHENSIVE
LEVELS OF
34.4
COVER FOR
32.5 32.4
31.5
31.0
28.6 34.6 OUR MEMBERS
30.3
29.2 29.8 29.4 LA Health Other schemes in
28.6
local government
LOWER PENSIONER RATIO
5.2%
5.2% 10.4% 2021
BENEFIT
LA Health Other schemes in U P D AT E S
local government
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Average age Pensioner ratio
7
2021
CONTRIBUTION
INCREASES
L A C ON V ERS AT IONS 2021 EXCEPTIONAL L A H E A LT H
FINANCIAL STRENGTH
MEDICAL
SCHEME
PERFORMANCE
LA Health has consistently maintained a positive net healthcare result, expertly balancing the need for affordable contribution increases
and comprehensive, quality private healthcare benefits. Over the past nine years, LA Health has achieved a cumulative net healthcare result
of +R934m. With competing schemes experiencing a combined net healthcare result of R243m. In 2019, LA Health achieved a positive net
healthcare result of R118m.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
NET HEALTHCARE RESULTS (RAND MILLION)
(2010 – 2019) NET HEALTHCARE
RESULT (2010 – 2018)
+R934m
COMPREHENSIVE
LEVELS OF
R554
COVER FOR
LA Health OUR MEMBERS
R199 R184 R171 R167
R131 R141 R118
R65 R55 R112 R108 R113 R94
R37 R30
-R58 -R51 -R16
-R478
-R248 -R233
-R394
-R270
+R243m
Other Schemes in
-R713
local government
-R1 073 -R1 058
-R979 2021
BENEFIT
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 U P D AT E S
LA Health Other schemes | Local government Open schemes ex DHMS
Notes: Not all medical scheme’s 2019 Audited Financial Statements were available by the time this publication was released.
LA Health’s 2019 net healthcare result has been included to provide advisors with the Scheme's most current financial information.
8
2021
CONTRIBUTION
INCREASES
L A C ON V ERS AT IONS 2021 EXCEPTIONAL L A H E A LT H
FINANCIAL STRENGTH
MEDICAL
SCHEME
PERFORMANCE
Strong membership growth and sound financial planning have underpinned LA Health’s financial performance. Healthy reserves and a well maintained
solvency ratio ensures that LA Health can withstand planned or unplanned costs, such as the impact of the COVID-19 pandemic. Consistent positive net
healthcare results have resulted in increasing reserves and solvency levels significantly above the statutory solvency requirement of 25%.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
RESERVES SOLVENCY RATIO
(2010 – 2019) (2010 – 2019)
42.7%
R1.8 bn
COMPREHENSIVE
LEVELS OF
COVER FOR
OUR MEMBERS
25%
2021
BENEFIT
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 U P D AT E S
LA Health solvency Statutory solvency
9
2021
CONTRIBUTION
INCREASES
L A C ON V ERS AT IONS 2021 L A HE ALTH’S L A H E A LT H
IMPACT OF COVID-19 ON L A HE ALTH
MEDICAL
SCHEME
PERFORMANCE
IMPACT OF COVID-19 As at 1 October 2020
L A H E A LT H ’ S
Tests conducted Confirmed cases Hospital admissions Deaths C O V I D -19
27 095 7 066 1 409 156 RESPONSE
COVID-19 CONFIRMED CASES CONFIRMED CASES BY AGE AND CHRONICITY COVID-19 CASES PER PROVINCE
36% of confirmed cases are chronic members
8000 80+ 4
73 2 105
117
COMPREHENSIVE
7000
7 066 85 LEVELS OF
70-80 14
6000 COVER FOR
60-70 171
5000 79 318
248 OUR MEMBERS
50-60 549
4000 474
40-50 808
3000 1 132 374
1 372
2000 30-40 499
1 869 192
1000 20-30 55
657
0 22
10-20 340
0
0
0
0
0
20
20
0
0
0
0
0
0
0
0
884
-2
r- 2
-2
-2
-2
-2
l -2
-2
-2
-2
-2
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t- 2
n-
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8
ar
pr
ay
ay
un
ul
ug
ug
ep
ep
Ju
0-10
Ap
Oc
Ju
Ju
-J
-M
-A
M
-M
-J
-A
-A
S
-S
227
-
6-
5-
1-
-
27
13
7-
4-
20
15
29
23
21
24
10
18
1 456
0 500 1 000 1 500 2 000
Chronic Non-chronic 2021
BENEFIT
U P D AT E S
ADMISSION TRENDS
NUMBER AVERAGE COST NUMBER AVERAGE COST NUMBER AVERAGE COST
TOTAL HOSPITAL PER EVENT ICU PER EVENT VENTILATOR PER EVENT
ADMISSIONS ADMISSIONS ADMISSIONS
1 409 R89 075 243 R245 044 149 R355 898
10
2021
CONTRIBUTION
INCREASESL A C ON V ERS AT IONS 2021 L A HE ALTH’S L A H E A LT H
R E S P O N S E T O C OV ID-19
MEDICAL
SCHEME
PERFORMANCE
LA Health has developed a comprehensive response to the COVID-19 pandemic drawing on its resources and capacity to assist members
during the outbreak.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
Enhanced benefits for screening and testing
LA Health has developed the World Health Organisation (WHO) Global Outbreak Benefit aimed at responding to
global health emergencies such as COVID-19. This benefit provides funding in full, from the scheme’s risk pools,
for out-of-hospital management and appropriate supportive treatment for COVID-19 including:
• Unlimited screening consultations with a nurse or GP COMPREHENSIVE
LEVELS OF
• Access to 2 PCR tests per person per year regardless of the outcome, subject to referral by healthcare provider
COVER FOR
• Access to a defined basket of care for pathology, x-rays and scans OUR MEMBERS
• Unlimited consultations with a GP or nurse
• Unlimited supportive treatment
• Access to acute medicine according to a defined list.
Access to the COVID-19 information hub including a risk assessment tool and virtual 2021
consultations BENEFIT
U P D AT E S
A large-scale awareness campaign was launched to provide members with the latest information and guidance on
how to prevent and contain potential infection. The COVID-19 information hub is located on the LA Health website
and provides the latest news, and updates as well as access to the COVID-19 risk assessment tool and virtual
consultations.
11
2021
CONTRIBUTION
INCREASESL A C ON V ERS AT IONS 2021 L A HE A LTH REM A INS FIN A NCIA LLY RE SILIENT TO WITHSTA ND THE L A H E A LT H
IM PAC T O F C OV ID-19
MEDICAL
SCHEME
PERFORMANCE
Using the COVID-19 experience of members on medical schemes administered by Discovery Health as well as the projections of the COVID-19
infections and fatalities across South Africa, one can project the potential costs which may be incurred by medical schemes for the rest of 2020 and
the first six months of 2021.
Three potential scenarios have been modelled, with screening, testing and hospitalisation costs estimated to be between R738 million and R1.2 billion across all local government L A H E A LT H ’ S
medical schemes over the next 18 months. C O V I D -19
RESPONSE
Using the proportion of local government employees on LA Health and its competitor schemes, the reserves attributable specifically to these members have been
approximated. Reserves were then adjusted downwards using the medium scenario of COVID-19 screening, testing and hospitalisation costs to demonstrate the potential
impact of COVID-19 on reserve levels.
LA HEALTH IS SUFFICENTLY
LOCAL GOVERNMENT MEDICAL SCHEMES COULD INCUR CAPITALISED TO COVER COVID-19
SIGNIFICANT COVID-19 RELATED COSTS RELATED COSTS COMPREHENSIVE
LEVELS OF
2 000 COVER FOR
PROJECTED COVID-19 SCREENING PROJECTED COVID-19 OUR MEMBERS
RESERVES NET OF PROJECTED
COVID-19 COSTS (R MILLION)
AND TESTING COSTS FOR HOSPITAL-RELATED COSTS FOR
1 600 Financial position
BENEFICIARIES (R MILLIONS) BENEFICIARIES (R MILLIONS) before COVID-19
costs
1 500 1 200 1 200
Financial position
1227,4 973,2 LA
1 000 910,4 net of COVID-19
HEALTH
costs
1 000 800
800
600 516,0
400 2021
500
221,4 443,4
400 BENEFIT
200
U P D AT E S
0
0
-
0 100 200 300
Low scenario Medium scenario High scenario Low scenario Medium scenario High scenario
LOCAL GOVERNMENT BENEFICIARIES (‘000)
Keyhealth
LA Health Other Local Government medical schemes
Notes: Scheme level impact based on most recent CMS annual report (2018/19) and excludes any surplus that may be generated in 2020 or 2021 due to decreased healthcare utilisation.
12
2021
CONTRIBUTION
INCREASESL A C ON V ERS AT IONS 2021 COMPREHENSIVE LEVELS OF L A H E A LT H
C OV E R F O R O U R M E M BE RS
MEDICAL
SCHEME
PERFORMANCE
With LA Health’s five Benefit Options suiting all levels of medical and financial needs, 2021 will see the Scheme continuing to provide members
with comprehensive, value for money healthcare benefits and the best quality healthcare, while promoting a healthy lifestyle.
L A H E A LT H ’ S
C O V I D -19
TOTAL LA HEALTH CLAIMS RESPONSE
Hospital claims PAID OVER LAST 12 MONTHS Screening and Prevention
R1.9 BN paid for hospital claims R3.7 BILLION 6 168
beneficiaries performing
51% of total claims paid Screening Tests
43 821 hospital admissions
COMPREHENSIVE
LEVELS OF
COVER FOR
ve
Chronic-illness related claims nsi Day-to-day claims OUR MEMBERS
e he Co
pr r
R199 M
paid for claims relating to chronic R1.3 BN paid for day-to-day claims
m
e
Co
conditions 574 932 GP visits
5% of total claims paid
42 191 beneficiaries with chronic conditions
ve
Keyp
Acti
2021
lus
BENEFIT
Oncology claims Maternity claims U P D AT E S
R166 M paid for oncology treatment Focus R132 M paid for births
4% of total claims paid 3 229 number of deliveries
R9 343 average cost per beneficiary per month R41 010 average cost per delivery
13
2021
CONTRIBUTION
INCREASESL A C ON V ERS AT IONS 2021 HIGH LEVELS OF L A H E A LT H
H O S PI TA L C OV E R
MEDICAL
SCHEME
PERFORMANCE
LA Health continues to care for members with complex and emergency healthcare needs
L A H E A LT H ’ S
C O V I D -19
R3.3 m Age 76 | LA Active | 159 days | Infection RESPONSE
R3.2 m Age 63 | LA Active | 71 days | Major cardiovascular procedure
R2.6 m Age 47 | LA Active | 63 days | Long term use of a ventilator (respiratory related)
R2.4 m Age 0 | LA Active | 110 days | Neonate
COMPREHENSIVE
LEVELS OF
R2.1 m Age 48 | LA Active | 39 days | Spleen procedures COVER FOR
OUR MEMBERS
R2.0 m Age 0 | LA Active | 146 days | Neonate
R2.0 m Age 62 | LA Active | 97 days | Heart valve procedure
R1.9 m Age 48 | LA Focus | 79 days | Long term use of a ventilator (gastrointestinal related)
2021
R1.9 m Age 0 | LA Active | 183 days | Neonate BENEFIT
U P D AT E S
R1.9 m Age 0 | LA KeyPlus | 141 days | Neonate
The largest hospital claim would require 102 years of contributions by the beneficiary to cover that single claim.
14
22 00 22 11
C O NBTERNI EBFUITTI O N
I NUCPRDEAT A SE ES SL A C ON V ERS AT IONS 2021 HIGH LEVELS OF L A H E A LT H
H O S PI TA L C OV E R
MEDICAL
SCHEME
PERFORMANCE
Members continue to benefit from consistently high levels of cover. On average, LA Health covered 96% of hospital claims in 2019, meaning
that members only had to pay R4 for every R100 spent in hospital.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
LA COMPREHENSIVE LA CORE LA ACTIVE
OVERALL IN-HOSPITAL 4% 4% 3%
CLAIMS PAYMENT
COVER RATIO
96% 96% 97% COMPREHENSIVE
LEVELS OF
COVER FOR
OUR MEMBERS
96%
LA FOCUS LA KEYPLUS
3% 6%
2021
97% 94% BENEFIT
U P D AT E S
Claims paid Claims unpaid
Claims unpaid Claims payout ratio
15
22 00 22 11
C O NBTERNI EBFUITTI O N
I NUCPRDEAT A SE ES SL A C ON V ERS AT IONS 2021 2021 L A H E A LT H
BE N E F I T U PDAT ES
MEDICAL
SCHEME
PERFORMANCE
L A H E A LT H ’ S
C O V I D -19
RESPONSE
Full cover at the Scheme’s Introduction of an General increase updates
DSP Network for elective Over-the-Counter limit • Most benefit limits will increase
in-hospital PMBs • In 2021, LA Health is introducing by 4.3%.
• Members will automatically be a limit on non-prescribed OTC • The Medical Savings Accounts
covered in full for elective PMB (Over-The-Counter) medicine COMPREHENSIVE
have been increased in line with the
for LA Comprehensive, LA Core, LEVELS OF
treatment and care in a nationwide respective risk contribution increases. COVER FOR
network of hospitals. LA Active and LA Focus.
• The Above Threshold Benefit on OUR MEMBERS
• Members will need to be referred by • All Over-the-Counter medicine LA Comprehensive increases
a Network Specialist or G.P that has not been prescribed by by 4.3%.
a healthcare professional will be
• If the referral process is followed and • The Extended Day-to-day Benefit
subject to an annual benefit limit
treatment is provided at the DSP on LA Core and LA Active was
of R1 200 per person.
Hospital, all accounts related to the increased by 4.3%.
authorised case will be paid in full.
• The income bands on LA KeyPlus
• The Scheme’s Designated Service were adjusted by 5.2% to avoid 2021
Provider for all elective, in-hospital BENEFIT
bracket creep.
U P D AT E S
Prescribed Minimum Benefit treatment
and care is the KeyCare Network of
more than 100 hospitals nationwide.
16
22 00 22 11
C O NBTERNI EBFUITTI O N
I NUCPRDEAT A SE ES SL A C ON V ERS AT IONS 2021 L A HE ALTH MEDICAL SCHEME L A H E A LT H
VA L U E PROP OSI T IO N
MEDICAL
SCHEME
PERFORMANCE
SCHEME OF CHOICE IN LOCAL FINANCIAL STRENGTH AND RICHEST BENEFITS AND
GOVERNMENT LONG TERM SUSTAINABILITY EXTENSIVE NETWORKS
LA Health has the largest membership base in Outstanding performance provides Members continue to benefit from consistently
a platform for future sustainability high levels of cover L A H E A LT H ’ S
local government, representing over 220 000 lives
C O V I D -19
Average overall in-hospital claims payment cover ratio RESPONSE
42.7% R1 806 238 136
8% Solvency
10%
31 MARCH LA Health
2020 96%
16%
26% COMPREHENSIVE
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
LEVELS OF
COVER FOR
FULL SPECTRUM OF BENEFIT COMPETITIVE ACROSS ALL BEST IN CLASS CLAIMS RISK OUR MEMBERS
OPTIONS SEGMENTS MANAGEMENT
LA Health offers members five Benefit Options LA Health offers comparative affordability LA Health employs a strategically integrated
to suit all levels of medical and financial needs across all Benefit Options approach to claims risk management
ive
ens
eh Co Lowest price Highest price
pr r Inter ventions and outcomes management
m
2021
e
Co
Extensive day-to-day
LA Core Average LA Comprehensive
Profiling BENEFIT
U P D AT E S
Limited day-to-day Analytics tools and assets
ve
Keyp
Acti
LA Focus LA Active Average
Technology
lus
Low income
LA KeyPlus Average
Focus Behavioural data
17
22 00 22 11
C O NBTERNI EBFUITTI O N
I NUCPRDEAT A SE ES SL A C ON V ERS AT IONS 2021 L A HE ALTH MEDICAL SCHEME L A H E A LT H
VA L U E PROP OSI T IO N
MEDICAL
SCHEME
PERFORMANCE
L A H E A LT H ’ S
C O V I D -19
RESPONSE
ENHANCED MEMBER COMPREHENSIVE ACCESS TO A WORLD-CLASS
EXPERIENCE THROUGH MATERNITY BENEFITS WELLNESS PROGRAMME
DIGITAL TOOLS FOR YOUNG FAMILIES LA Health members have access to the world’s
Access to comprehensive set of risk- leading behaviour change programme.
Intuitive website navigation with
enhanced real-time digital self-service funded benefits during pregnancy
powered by our chat bot, Ask LA Health. and after the birth of the baby across COMPREHENSIVE
all benefit options. LEVELS OF
COVER FOR
GET Complete relevant Get Eat OUR MEMBERS
HEALTHY health checks active healthily
GET >2.1m >1.3m R286m
Smoothies Flights Healthyfood
REWARDED and coffees cash backs
2021
BENEFIT
U P D AT E S
Ask LA Health, the Chat BOT, available
on the Scheme’s website makes it
possible for members to get real time IMPROVING 28% 40% Lower 75%
answers about their membership HEALTH Reduced tendency of lifestyle- lower
and claims related questions. OUTCOMES hospital PLPM related diseases mortality
18
22 00 22 11
C O NBTERNI EBFUITTI O N
I NUCPRDEAT A SE ES SL A C ON V ERS AT IONS 2021 FINANCIAL ADVISER L A H E A LT H
DIGI TA L S A LES SU PP O RT
MEDICAL
SCHEME
PERFORMANCE
DISPLAY ADVERTISING LEADS GENERATION PAGE
L A H E A LT H ’ S
LA Health, the Scheme of choice for Generating leads digitally to support C O V I D -19
local government employees. you during the window period. RESPONSE
LA Health, the
Scheme of choice
for local government
employees.
Join the LA Health
social media
movement.
COMPREHENSIVE
LEVELS OF
COVER FOR
OUR MEMBERS
LA-Health LA Health
2021
BENEFIT
JOIN THE LA HEALTH SOCIAL MEDIA MOVEMENT. U P D AT E S
5 550 FB followers 491 415 Total impressions
19
22 00 22 11
C O NBTERNI EBFUITTI O N
I NUCPRDEAT A SE ES SL A C ON V ERS AT IONS 2021 DRIVERS OF L A H E A LT H
M EDICA L IN F L AT IO N
MEDICAL
SCHEME
PERFORMANCE
Contributions increase year-on-year to allow for the expected increase in member claims costs the following year. The expected increase is based
on medical inflation. Claims costs increase each year for a number of reasons, including:
• An increase in the cost of existing healthcare services, i.e. tariff increases
• An increase in the amount of healthcare services used by members, i.e. demand-side inflation L A H E A LT H ’ S
• An increase in the supply of hospital beds and advances in medical technology, i.e. supply-side inflation C O V I D -19
RESPONSE
Tariff Inflation Demand-side inflation
Tariff inflation refers to the increases in the prices of healthcare The ‘demand’ for healthcare services correlates with the health of
services, such as the cost of a doctor’s visit, hospital admission, members. If health deteriorates, demand for healthcare services COMPREHENSIVE
increases. The health of the Scheme’s membership is a function of the LEVELS OF
medical device and the price of medicine. These prices increase
COVER FOR
in line with the Consumer Price Index (CPI), with the exception of average age of members and the prevalence of medical conditions.
OUR MEMBERS
medicine, where price increases are regulated and not necessarily On LA Health, the average age of members decreases due to
in line with CPI.
• Existing members ageing by no more than 1 year; and
The Scheme has made provision for an average CPI-related tariff
increase of 4.3% in 2021. • A greater proportion of younger members joining the Scheme.
The prevalence of medical conditions increase due to
• Existing members being diagnosed with medical conditions; and
2021
• A greater proportion of members with existing medical conditions
BENEFIT
Supply-side Inflation joining the Scheme. U P D AT E S
An increase in the supply of healthcare services over time contributes to Projected demand-side inflation for 2021 ranges between 1.3% and
medical inflation. An example of supply-side inflation is advances in treatment 2.9% due to Option-specific variations.
and new technologies. The Scheme assumed 1% increase for 2021.
20
2021
CONTRIBUTION
INCREASESL A C ON V ERS AT IONS 2021 COMPETITIVE L A H E A LT H
C O N T RIBU T IO N I N CRE A SES
MEDICAL
SCHEME
PERFORMANCE
Affordability and access to quality healthcare remain key considerations when members select a medical scheme. The significant growth shown
by the Scheme is underpinned by its commitment to affordable contribution increases, prudent financial planning and the provision of comprehensive,
quality healthcare. In 2021, 96% of LA Health members will experience contribution increases that are lower than the average 4.6% increase.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
2021 CONTRIBUTION INCREASES PROPORTION OF MEMBERS
4,6%
weighted
COMPREHENSIVE
average LA Focus LEVELS OF
6.0%
5.5% 5.5%
COVER FOR
5.0% 4.5% 4.5% 4.5% OUR MEMBERS
20,5%
4.0% 4,6% LA Active
weighted 68.6%
3.0% average
LA KeyPlus 7,1%
2.0%
1.0& LA Core
2,8%
2021
0.0%
2,8% BENEFIT
LAComprehensive LA Core LA Active LA Focus LA KeyPlus
LA Comprehensive U P D AT E S
2021 Contribution Tables
21
2021
CONTRIBUTION
INCREASESL A C ON V ERS AT IONS 2021 COMPARABLE L A H E A LT H
A F F O RDA BIL I T Y O F L A HE A LT H
MEDICAL
SCHEME
PERFORMANCE
To assess LA Health’s comparative affordability, we compared the average contributions for a family of three (principal member, adult and child) across
all Benefit Options of the five accredited schemes in Local Government. This approach allows for comparisons on a like-for-like basis. Based on levels
of coverage, the LA Health contributions are lower than average contributions in each segment.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
AVERAGE CONTRIBUTION COMPARISON
Lowest price Highest price
COMPREHENSIVE
Extensive day-to-day LEVELS OF
COVER FOR
OUR MEMBERS
LA Core Average LA Comprehensive
Limited day-to-day
LA Focus LA Active Average
2021
BENEFIT
U P D AT E S
Low income
LA KeyPlus Average
22
2021
CONTRIBUTION
INCREASESL A C ON V ERS AT IONS 2021 L A HE ALTH FL AGSHIP OPTIONS OFFER THE GRE ATEST L A H E A LT H
VA L U E TO BE N E F ICI A RIES
MEDICAL
SCHEME
PERFORMANCE
LA Active and LA Focus are the Benefit Options of choice for over 190 000 beneficiaries, offering the flexibility of a medical savings account,
rich maternity benefits and full in-hospital cover.
L A H E A LT H ’ S
C O V I D -19
RESPONSE
L A ACTIVE L A FOCUS
This Option has a lower MSA allocation This traditional Option lacks the flexibility of a MSA and members are exposed
and members are exposed to co-payments to co-payments for a wide array of in-hospital procedures
for a wide array of in-hospital procedures
6 000
This Option has a lower MSA allocation and members
are exposed to co-payments for a wide array of
in-hospital procedures COMPREHENSIVE
5 000
LEVELS OF
COVER FOR
4 000 OUR MEMBERS
This Option has a significantly lower MSA allocation
3 000
2 000
1 000
0 2021
BENEFIT
Competitor A
Competitor B
Competitor B
Competitor B
Competitor C
Competitor A
Competitor B
Competitor A
Competitor B
Competitor D
Competitor A
Competitor B
Competitor C
Competitor B
Competitor B
LA Active LA Focus
20% MSA 25% MSA U P D AT E S
plus
Extended
Day-to-Day
Benefit
Risk MSA
23
2021
CONTRIBUTION
INCREASESLA-Health LA Health
Client Services 0860 103 933 Fax 011 539 7276 www.lahealth.co.za service@discovery.co.za Report fraud anonymously 0800 004 500
LA Health Medical Scheme, registration number 1145, is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07. Discovery Health (Pty) Ltd is an authorised financial services provider.
RCK_74590DLA_05/10/2020_V11
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