Background

Who we are

GEMS was registered on 1 January 2005 specifically to meet the healthcare needs of Government Employees. We offer five excellent healthcare benefit options: Sapphire, Beryl, Ruby, Emerald and Onyx. Our goal is to help public service employees and their families to get the best possible healthcare at the most affordable rate.

Before GEMS...

• Many employees could not afford medical cover
• Belonging to a medical scheme has continuously become more expensive
• Employees did not receive the best value for their money
• There was little integration with the public health system
• Employees had no healthcare benefits created with their unique needs in mind
• The government, who contributes greatly to its employees' scheme payments, had no opportunity to participate in the management of a medical scheme on which public service employees are part of.

The introduction of GEMS

The beginning of GEMS was a historic moment when in 2002, Cabinet approved a framework policy on a restricted (closed) medical scheme for further development by an interdepartmental working group (departments of Public Service and Administration, National Treasury, Health, Education, Correctional Services and SAPS). The approved framework policy centered on the principles of equity, efficiency and differentiation:

• Equity where employees have equal access to the most extensive set of equal basic benefits under equitable remuneration structures, subject to affordability.
• Efficiency regarding the costs and delivery of benefits.
• Differentiation, where employees choosing more extensive cover have equal access to higher benefits subject to their needs.

Government's commitment to an equitable and affordable medical scheme

Cabinet gave the development and implementation of GEMS intense consideration, relying on substantial research and data analyses. The implementation of GEMS is a positive step that positions government as an employer of choice that truly cares for the health and wellbeing of its employees.

On 3 November 2004 after careful consideration of the findings of a detailed feasibility study conducted in the same year, Cabinet approved that the Department of Public Service continue work on the:

• Registration of a restricted membership medical scheme for public service employees;
• The establishment of the scheme's governance and management structure;
• The development of a member enrolment strategy in consultation with National Treasury; and
• Enhancing an understanding of the possible risks and costs involved.

Bringing health within the reach of public service employees

The implementation of GEMS fulfils government's policy objectives regarding the restructuring of available medical cover. GEMS achieves the promotion of equitable access to comprehensive and affordable healthcare benefits by all public service employees and provides lower income earners with greater access to this benefit. The implementation of GEMS also sets an example to other employers by demonstrating that innovative medical benefits can be made available to all employees.

Implementing GEMS also provides government with greater control over the money it currently contributes to the private healthcare sector and also over the selection and quality of healthcare benefits to which its employees contribute. Government is now able to directly influence the governance of GEMS because it is represented on the GEMS board of trustees. It is also represented during the annual revision of benefits and contributions.

Government is empowered through GEMS to provide more employees with an opportunity to improve their health and wellbeing - in turn impacting positively on improved productivity levels in the public service.

GEMS compliments the current public health infrastructure

GEMS also achieves unique synergies with the work currently being performed by the Department of Health. Nearly two million beneficiaries have already been enrolled on GEMS, through the promotion of greater access to the employer subsidy. The introduction of these additional beneficiaries into the medical scheme environment has resulted in a reduced public sector patient load and a reduction in the demand on the public sector's resources. By enrolling members on our Sapphire option, additional revenue streams for public healthcare facilities and the public private partnerships will be created.

The implementation of GEMS also supports the work performed by the Department of Health on National Health Insurance and the establishment of the Risk Equalisation Fund. 

Government believes that it is important that equitable access to comprehensive healthcare benefits by our employees is promoted, as this will result in:

• More medical scheme beneficiaries and increased revenue that will be generated in the private healthcare sector; and
• A reduction in the pressure on many of our public sector facilities that so many of our citizens are dependent on for the provision of essential healthcare services.

GEMS is committed to delivering access to equitable, comprehensive and sustainable benefits to all public service employees.