Circular 20 of 2024: Updated operational statistics for reporting

This Circular aims to engage stakeholders on the updated operational statistics for reporting purposes following changes to the many terms contained in the Statement of Comprehensive Income. Such a development stems from the implementation of the new Accounting Standard: International Financial Reporting Standard (IFRS)17 Insurance contracts. This engagement is driven by the need to ensure consistent disclosure across medical schemes to enhance comparability in the industry.

Appendix I to the South African Institute of Chartered Accountants (SAICA) Medical Schemes Accounting Guide (Accounting Guide) lists specific minimum operational statistics that needs to be disclosed in the Board of Trustees Report. The following statistics are affected by the change in classification in terms of IFRS 17:

• Risk contributions per average beneficiary per month for the medical scheme as a whole and for each benefit option;
• Relevant healthcare expenditure per average beneficiary per month for the medical scheme as a whole and for each benefit option;
• Non-healthcare expenditure per average beneficiary per month for the medical scheme as a whole and for each benefit option;
• Relevant healthcare expenditure as a percentage of risk contributions per benefit option (claims ratio); and
• Non-healthcare expenditure as a percentage of risk contribution income per benefit option.

The Council for Medical Schemes (CMS) issued Circular 12 of 2024, which required medical schemes to provide information in the notes to their financial statements on the net healthcare result and net surplus / (deficit) (per scheme and per benefit option) by excluding the ‘Amounts attributable to future members’ line item from the Insurance Service Expense.

Download the Circular here