New Benefits
2023
Financial Strength
The past two years have been particularly hard for our country and its people, with the building and construction industries being amongst the hardest hit by the economic hardships and job losses, that followed in the wake of the Pandemic.
Towards the end of every year, BCIMA reviews the financial well-being of the scheme in consultation with a healthcare actuary.
Following this, informed decisions can be made about benefit enhancements
and contribution rate increases for the forthcoming year. Ensuring that the interests of the fund and its members are safeguarded so that it will remain financially strong enough to provide for members well into the future is a delicate balancing act.
This is made even more complex when cognizance is taken of the financial position of members and how best to meet their healthcare needs affordably.
Message from the Fund
The contribution increase for 2023 is only:
6.5%.
Despite the low contribution increase, the Fund will increase benefits with an average of
4.2%
resulting in real tangible benefits to the member.
Employers are urged to complete and submit the monthly wage schedule, as contributions are paid in accordance with the actual earnings of the individual member.
Employee Annual contributions are structured over 48 weeks/12 months. These contributions allow for cover throughout the year and cover
for the 4 week holiday period.
Contribution Structure
The Scheme is Healthy
BCIMA is a well-managed scheme that has continued to grow despite the economic slowdown. The scheme has a healthy solvency ratio of 113%, higher than the Council for Medical Schemes required minimum of 25%. The Scheme's stability as well as a healthy solvency ratio has ensured that the Scheme can offer lower contribution
increases while enhancing benefits.
2023 Plus Option
A good history
BCIMA was established in 1964 and has a strong foundation in providing members of the Building, Construction and Civil Engineering industries with medical cover.
The Fund has a long-standing relationship with the building, construction and civil engineering industries, which allowed it to develop an in-depth understanding of the needs of employers and their employees within this specific market. This deep-rooted legacy has allowed the BCIMA team to design the most appropriate and suitable contributions and benefits for these sectors, as we truly understand the needs of our members.
Plus Option Benefits
Our impressive member benefits and benefit features include:
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Cover for all PMB conditions
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No network restrictions on healthcare providers (doctors, dentists etc)
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Members have access to:
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Private hospitals (subject to authorisation)
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Health services at private healthcare providers
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Unlimited HIV Benefits (subject to registration with LifeSense)
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COVID-related admissions and treatment
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Preventative Care Benefits - Unlimited
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NETCARE911 for emergency services - to ensure prompt and clinically appropriate emergency transport
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Health-on-Line Benefit - Call 082 911 - 24 hour Emergency/Non-emergency Telephonic Medical Advice and information
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Specialist Referrals
BCIMA requires that members consult with a GP before going to a Specialist, for the Specialist consultation to be paid. This requirement is only for out of hospital claims.
The relationship between a GP and a patient is especially important. The GP is the healthcare provider who looks at the member in totality, and is aware of the mental and physical health status of the member, the GP is thus the healthcare provider that will know if the patient needs a specialist, and from which field of specialty.
Members do not need a GP referral to a Specialist in the following instances:
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Gynaecologist, Paediatrician, Oncologist and Anaesthetist (in-and out of hospital)
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The follow-up consultation after a hospital stay and/or operation.
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All in-hospital consultations, subject that a hospital authorization was obtained.
BCIMA Funds Emergency Transport Service through Netcare 911.
The member will not be liable for any short payments if authorised with Netcare 911, as we have an agreed tariff rate with them.
When you have a medical emergency please call 082 911.
Assistance and advice is just a phone call away through Netcare 911’s Health-on-Line, a 24-hour Emergency
Operations Centre which provides emergency as well as non-emergency telephonic medical advice to members and can dispatch an ambulance if it is clinically indicated.
Emergency Ambulance Services
LifeSense
The HIV/aids disease management programme: Members are reminded to contact LifeSense for HIV related issues.
You can call 0860 506 080 – 24hrs a day; your query will be logged and a case manager will be in touch with you as soon as possible.
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Personal Information Update
Included below is the Personal Information Update Form, please complete and return to us as soon as possible. Please use this opportunity to update any information with BCIMA that might be outdated, this will ensure that you receive important information regarding your fund.
Please also indicate your race and provide your Tax Reference number – this is a requirement from Government.
Fraud
Please keep in mind – it is fraud to give your card to your friends or co-workers to obtain benefits such as glasses or medicine!
Please remember – do not take money or any other non-medical incentives from any provider! This is fraud. Providers are only allowed to provide you with medical treatment.
We all have a responsibility to fight fraud and corruption, if we are aware of fraud, we have a responsibility to report this!
Please contact the anonymous-secure-confidential Vuvuzela hotline on Toll Free number: 080 111 447. The case will be investigated and the appropriate action taken.
SMS – call back system
Remember to use the sms call back system to assist you.
Simply sms the word “CALL” followed by your membership number (e.g. CALL 1234567) to 47975 and one of our agents will call you.
The sms line is open from 7h00 to 19h00 during weekdays and from 8h00 to 13h00 on Saturdays.
As we are nearing the end of 2020 and looking forward to 2021 with great hope and expectation that next year will be better for the building and construction industry, as well as the Fund and the country, please know that BCIMA will be there to support its members and we remain committed to offering the best quality and affordable healthcare.
We are committed to offering the best quality and affordable healthcare.
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