The Government Employees Medical Scheme (GEMS) membership base has grown by 4.65% from 2022 to 2023 (8.5% for the three years 2021 to 2023), sustaining its membership growth in a medical scheme sector where membership has largely been stagnant. GEMS ended the 2023 reporting year with over 844,000 principal members and just over 2.3 million beneficiaries.

Speaking yesterday at the GEMS annual general meeting, the Scheme’s Chairperson, Dr Nomzamo Tutu, said GEMS’ financial performance is a testament to the astute management and discharging of fiduciary responsibilities demonstrated by the GEMS Board assisted by the Executive Management Team led by the Principal Officer, Dr Stanley Moloabi.

“Despite the challenging macroeconomic environment, including the impact of electricity availability on economic growth and unemployment, GEMS has maintained robust performance and financial stability during 2023. Our members, whose health and well-being are our utmost priority, are the ultimate beneficiaries of our efforts.”

“During 2023, the reporting year, GEMS celebrated its 18th anniversary since its registration as a medical scheme. Through all these years, GEMS has achieved unqualified audit opinions by its external auditors. I am proud of the positive impact GEMS has had on its members and the broader healthcare funding sector. GEMS is South Africa’s largest restricted membership medical scheme and the second largest overall, with over 2.3 million beneficiaries accounting for 51% of the restricted medical scheme membership in South Africa.”

Furthermore, Dr Tutu reiterated GEMS’ support for the country’s commitment to universal healthcare coverage through the phased in implementation of the provisions of the recently signed National Health Insurance Act and the attainment of fair and equitable access to healthcare for all South Africans. “GEMS recognises that there will be challenges and complexities involved in implementing such an important and complex system. However, we are committed to working collaboratively with government, labour, healthcare professionals, advocacy groups, and all stakeholders to overcome these challenges.”

Principal Officer Dr Stanley Moloabi said for the 2023 Financial Year and going forward, GEMS is reporting in line with the new International Financial Reporting Standards (IFRS) 17.

Total insurance revenue increased by 7.5% to R51.3 billion (2022: R47.7 billion), underpinned by consistent membership growth, while the investment portfolio delivered impressive returns of R2.4 billion, an average return of 9.47%. This growth and success are due to the determined strategic focus of the GEMS Board assisted by the Executive Management Team. The insurance service expenses increased by 14.7% to R53.4 billion (2022: R48.8 billion), driven mainly by various in-hospital fees.

Other directly attributable expenses, comprised mainly of administration and managed healthcare costs, which increased by around 10% to R2.9 billion (2022: R2.6 billion), while other expenditure, previously referred to as non-healthcare costs, increased by 12.4% to R1.1 billion (2022: R900 million). Dr Moloabi said the increase in these costs reflected the growth in GEMS’ membership and inflation.

Looking ahead, Dr Tutu said GEMS will continue to focus on growing its membership base and maintaining the quality of services it is known for. “We will continue to collaborate with government representatives (as the employer), labour (our members), the regulator, health service providers and our service provider network. We also welcome the recent Cabinet appointments of the seventh administration, particularly the new Public Service and Administration Minister and Deputy Minister who are the employer representatives.”

End.

About GEMS

GEMS is the largest restricted membership medical scheme in South Africa, with just over 859 000 principal members and more than 2.319 million beneficiaries as at end of June 2024. GEMS was created specifically to provide healthcare cover for public service employees. Our purpose is derived from the GEMS mandate received from government in 2004 to ensure that there is adequate provisioning of healthcare coverage to public service employees that is efficient, cost-effective and equitable; and to provide further options for those who wish to purchase more extensive cover. GEMS is an authorised Financial Services Provider (FSP No 52861).

For more information, visit www.gems.gov.za