Your age can greatly affect and alter the price of medical aid contributions. It is not a concern if you are younger than 35 years of age. But after 35 you may be liable for a late joiner penalty, depending on how long you had/didn’t have credible cover. It is a permanent monthly penalty that is based on a percentage of your monthly risk contribution. You will have to continue paying this additional fee along with your regular premium for as long as you remain on the medical aid. However, when joining the medical aid via an employer group, members are sometimes exempted or “forgiven” from paying penalty fees for joining late.

Joining the medical scheme via an employer group allows the members to join the scheme with no waiting periods, e.g. three months’ general waiting period and 12 months for specific pre-existing conditions. This will be determined by the number of employees joining the scheme, with data submitted to the scheme looking at the average age, pension ratio and demographics of the members, and if the group scheme will be compulsory or voluntary.

This is known as free underwriting or status C. When you join privately as an individual, the scheme may impose a waiting period depending on your medical assessment, which means you may not use your benefits for 3 to 12 months, even though you are paying for the benefits.

When new employees join the medical aid after the inception of the group scheme, they have three months to join the medical aid from the permanent employment date. No waiting periods or late joiner penalty fees will be imposed. How can the company determine a funding structure which accommodates employees while promoting fairness?

The company can add medical aid fringe benefits by subsidising the monthly premiums in three different methods:

1. An employer may choose to contribute 50% of monthly premiums, regardless of the benefit option.
2. An employer may contribute 50% of the monthly premiums up to a benchmark option – for example, Plan A @ R 3, 814.00 X 50% = R1, 907.00, which the employee will be liable for the difference depending on which option has been selected.
3. An employer may contribute a capped amount and regardless of the option selected by the employee, the member will be liable for the balance of the contribution.