For risk benefits, the scheme pools together employees’ contributions and uses the money to fund a set of benefits, including the Major Medical Benefit, Chronic Disease Benefit, Out-of-Hospital Expenses Benefit and Threshold Benefit.
The scheme has rules for when each of the risk benefits is allowed to pay out. These scheme rules give limits for what the benefit can pay out for particular conditions, treatments and medicines. As the scheme applies its rules consistently, we can be confident that:
- We treat all your employees – as members – fairly, and do not discriminate against any employees
- The medical scheme is sustainable and will not run out of money.