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Circular 49 of 2021: Qualification requirements for healthcare broker applicants

The Council for Medical Schemes (CMS) wishes to advise broker applicants on the minimum qualification, and verification process in order to be accredited as a healthcare broker in terms of the Medical Schemes Act (131 of 1998) (MSA).

  1. Background

The CMS has a regulatory mandate to ensure that any person applying to be accredited as a healthcare broker, meets the accreditation requirements as set out in the MSA, under section 65 and Regulation 28.

  • Section 65 (1) of the MSA provides that “No person may act or offer to act as a broker unless Council has granted accreditation to such a person on payment of such fees as maybe prescribed”
  • Section 65 (4) provides that “An application for accreditation shall be made to the Council in the manner and be accompanied by such information as may be prescribed, and any other information as the Council may require”

Regulation 28B (1) provides that “Any person desiring to be accredited as a broker must apply in writing to the Council, and the application must be accompanied by –

  1. documentary proof of a recognised educational qualification and appropriate experience; 
  2. documentary evidence of having passed or current enrolment in a relevant course of study recognised by the Council;
  3. in the case of a juristic person, documentary proof and a sworn affidavit that any person employed by the person, or acting under the auspices of the person, who provides or will provide advice on medical schemes to clients, is accredited with Council as a broker or an apprentice broker; and
  4. such additional information as the Council may deem necessary.
  • A recognised educational qualification and appropriate experience, for the purposes of this regulation, means
    • Grade 12 education or equivalent educational qualification; and
    • a minimum of two years demonstrated experience as broker or apprentice broker in health care business.
  • Individuals not meeting the qualifications for a broker may apply to the Council for accreditation as apprentice brokers and such applications must be accompanied by documentary proof of – 
    • Grade 12 education or equivalent educational qualification;
    • agreement by a fully accredited broker to supervise the applicant;
    • current accreditation of the supervising broker;  
    • having passed or current enrolment in a relevant course of study recognised by the Council; and
    • such additional information as the Council may deem necessary.  
  • In the case of a natural person, an application for accreditation as a broker or an apprentice broker must also be accompanied by information to satisfy the Council that the applicant complies with – 
    • any requirements for fit and proper brokers which may be determined by the Council, by notice in the Gazette; and
    • any relevant requirements for fit and proper financial services providers or categories of providers which may be determined by the Registrar of Financial Service Providers in terms of section 8 (1) of the Financial Advisory and Intermediary Services Act, 2002.
  • In considering an application for accreditation in terms of this regulation, the Council may take into consideration any other information regarding the applicant, derived from whatever source, if such information is disclosed to the applicant and she or he is given a reasonable opportunity to respond thereto.  
  • The Council must, after consideration of an application –
  • if satisfied that an applicant complies with the requirements of this Act, grant the application subject to any conditions that he or she may deem necessary; or 
  • if not so satisfied, refuse the application and provide reasons to the applicant for such refusal. 
  • If accreditation is granted by the Council to a broker or an apprentice broker, it shall be granted for twenty-four months, and shall be accompanied by a certificate from the Registrar clearly specifying the expiry date of the accreditation and any conditions imposed by the Council in terms of sub regulation (6)(a). 
  • The Council may at any time after the issue of a certificate of accreditation, on application by the broker or apprentice broker or on own initiative add, withdraw or amend any condition or restriction in respect of the accreditation, after having given the relevant broker or apprentice broker a reasonable opportunity to make submissions on the proposed addition, withdrawal or amendment and having considered those submissions, if the Council is satisfied that any such addition, withdrawal or amendment is justified and will not unfairly prejudice the interests of the clients of the broker or apprentice broker, and must in every such case issue an appropriately amended certificate to the broker or apprentice broker, as the case may be. 
  • A broker or apprentice broker wishing to renew his or her accreditation shall apply to the Council for such renewal in such format as the Council may from time to time determine, provided that – 
  • such application for renewal shall be made by the broker or apprentice broker at least three months prior to the date of expiry of the accreditation; 
  • the broker or apprentice broker shall furnish the Council with any information that the Council may require. 
  • The provisions of sub regulations (6) to (8) shall apply mutatis mutandis to an application for renewal of accreditation in terms of sub regulation (9). 

 

  1. The qualification requirements 
  • The provision of Regulation 28B(2)(a) requires that prospective brokers must have a Grade 12 education or equivalent educational qualification for CMS to consider their applications.
  • The CMS will accept an educational qualification that is registered on the South African Qualification Framework on NQF level 4 or higher, as equivalent to Grade 12 education.
  • The prescribed qualification must be submitted to the CMS together with all relevant supporting documents as determined by CMS from time to time;

 

  1. The qualification verification process
  • In 2014, the CMS introduced a process of verifying the qualifications submitted by broker applicants for authentication purposes with Managed Integrity Evaluation (MIE). Since then, CMS had successfully verified about 10 810 qualifications received from new and renewal broker applicants.  The CMS has taken a decision, as part of their mandate to ensure that broker applicants comply with the qualification requirements for accreditation, that broker applicants must verify and pay for the verification of their qualifications with the verification agents prior to applying for accreditation. This new process will be implemented by CMS with effect from 1 December 2021.
  • The broker applicants must submit the verification report received from the Verification Agents and the relevant supporting documents, together with the application form. Failure by the applicants to submit the verification report together with the relevant supporting documents, will delay the processing of the application forms and have an impact on the outcome of the applications.  The qualification verification is a once off process.  If the qualification was previously verified by the CMS, the broker applicant will not be required to verify the qualification again.
  • This process will apply to new applicants and applicants applying for renewal of accreditation whose qualifications were not previously verified by CMS. Applicants can contact the CMS Contact Centre on 0861 123 267 to confirm whether their qualifications were previously verified or not.
  • Broker applicants who wish to verify their qualifications with MIE may do so by visiting the MIE website, mie.co.za and register on the MIE Electronic Personal Credential Verification – or ePCV – website. The user manual has all the necessary information regarding the verification process with MIE.
  • When capturing your registration details, please capture two email addresses on the required fields. Your personal email address and the CMS email address, which is verifyreports@medicalschemes.co.za. All documentation and verification results will be sent to both email addresses.
  • The CMS will receive proof of your MIE verification report, saving applicants time from uploading the report when applying for accreditation with the CMS. It will also speed up the process for accreditation since CMS will not be required to validate the reports received directly from MIE.
  • The verification reports received from other Verification Agents will be subject to a validation process by CMS, which will impact on the turnaround time of the application process.
  1. Contact 

Download the Circular here.

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