Is it compulsory for new permanent appointments to join GEMS or can they join any medical scheme of choice and be subsidised?
New appointees with an appointment date of 1 July 2006 or later will only be subsidised on GEMS. They will not qualify for an employer subsidy if they join an open medical scheme.
Can contract workers join GEMS?
Contract employees whose term of appointment is at least 6 months may join GEMS. Note that some contract employees are remunerated by means of all-inclusive remuneration packages, i.e. basic salary and a cash amount calculated as 37% of basic salary. PERSAL will not generate an employer subsidy when such a contract worker joins GEMS since the subsidy is already built into the remuneration package.
Who can join GEMS as dependants?
Husband or wife
Ex-husband or ex-wife
Children (biological, adopted, step or foster) under the age of 21
Children (biological, adopted, step or foster) over the age of 21
Parents, parents-in-law, grandparents and grandparents-in-law
Grandchildren and great-grandchildren
Siblings (brothers or sisters), half-siblings, step-siblings and siblings in-law
Nephews and nieces (including in-laws)
Special dependants (where the member is liable for family care and support)
Why does GEMS check the eligibility of student dependants?
The annual dependant eligibility review process is an initiative aimed at protecting the interests of Scheme members. This process ensures that only eligible beneficiaries are registered and enjoy benefits according to the Scheme's rules.
In order to ensure that student dependants (who are 21 years and older but younger than 28) can stay registered on GEMS as child dependants and not pay adult contribution rates, members have to provide GEMS with the following documentation:
Questions about the employer subsidy ›
How the subsidy works
New approved medical scheme subsidy
One of our objectives as GEMS is to ensure that member contributions remain affordable and the medical scheme subsidy provided by your employer plays an important role in ensuring the continued affordability of your medical benefits. We are therefore proud to announce that government has increased this subsidy backdated to January 2015. According to the Public Service Co-ordinating Bargaining Council (PSCBC) Resolution 2 of 2015, the subsidy has been approved and increased by 28.5% for active employees. The subsidy will also increase by Medical Price Index in January every year. Please consult your employer regarding the subsidy increase implementation date as well as information on how this applies to you as an individual.
Employees on salary level 1 to 5 participating on Sapphire will continue to be subsidised at 100% up to the maximum amounts as indicated below.
In-service employees on GEMS will receive a subsidy of 75% of their total contribution up to the maximum as indicated below.
The new subsidy policy for pensioners is as follows:
Pensioner members who were on salary level 1 to 5 and on the Sapphire option while they were active employees, and retire on the same option, will now continue to receive a 100% subsidy for the member and up to one dependant (up to a maximum of R1 850).
Pensioner members on GEMS will receive 75% of their monthly contribution as a subsidy up to the following maximum. If you have any questions about your subsidy, you should discuss them with the Government Pensions Administration Agency (GPAA).
|Family structure||January 2016||January 2017|
|Main member||R1 008||R1 097|
|Main member + 1||R2 017||R2 195|
|Main member + 2||R2 633||R2 865|
|Main member + 3||R3 249||R3 535|
|Main member + 4||R3 865||R4 205|
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