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7.1.1.1 Define the following concepts in your own words:
i) Medical Scheme
ii) Medical Insurance
iii) Member
iv) Prescribed minimum benefits (PMB’s)
v) Ex gratia payments
vi) Date of inception
vii) Termination
viii) Pre-existing condition
ix) Late joining penalty
This response will be reviewed and graded after submission.
7.1.2.1 Explain the duties of trustees in a medical scheme
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7.1.3.1 Explain the role of the Administrator in a medical scheme.
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This response will be reviewed and graded after submission.
7.1.5.1 In the table below, indicate two differences between a medical scheme and a medical insurance product, with regards to payments of claims. (4)
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7.1.6.1 List and discuss 2 pieces of legislation that governs medical schemes and medical insurance products. (2)
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7.1.7.1 List 3 ‘new generation’ medical scheme products. (3)
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7.1.8.1 Compare in the table below the products listed in Activity 7 and give a brief description of each product’s guaranteed benefits as well as discretionary benefits.
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7.1.9.1 Why, would you say, has the industry moved away from traditional medical products to ‘new generation’ medical products? (2)
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7.1.10.1 Explain in your own words what the ‘Pro-ration’ of benefits is. Make use of examples in your discussion.
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7.1.11.1 Calculate the late joining penalty for the following applicants to a medical scheme with a premium of R800 for the Principal member and R600 first dependant: (4 x 1 = 4)
A. 65-year-old single client applies for membership. He has been on a medical scheme for several years.
B. 36-year-old married client and her husband (also 36 years old) apply for membership. She hasn’t been on a medical scheme for several years. From the age of 28 to 30 she was on a registered scheme. Her husband has never been on a medical scheme.
C. 68-year-old widow applies for membership. She has been on a medical scheme for all her life but feels that she wants more benefits now that she is old. Her current medical scheme does not provide the benefits (with the coverage amounts) that she is looking for.
D. 29-year-old single client applies for membership. He has never been on a medical scheme.
i) Make use of the contribution table and penalty fee table in your Learner Guide when you answer this question.
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7.1.12.1 List 6 benefits that could be excluded by a medical scheme. (6)
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The REready! Pack is designed to be used to prep for RE1 or RE5 or both.
The content for RE1 and RE5 overlaps as both exams test your practical knowledge of the FAIS Act and FICA.
The class is not a facilitator that is going to read the law out of a book for you.
Anna Bouhail contextualizes the content and creates an understanding of basic concepts related to law, the industry, and competency exams.
The class is structured to also instill compliance skills allowing the learner to answer practical questions.