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FAQs


Membership & Dependants ›

Who can join GEMS?
 
Employees or former employees of national departments, provincial administrations, provincial departments and organisational components contemplated in section 7(2) of the Public Service Act, 1994 may join GEMS. As the principal member you may apply to register your dependants on the Scheme. Employees of the South African National Defense Force, the National Intelligence Agency and the South African Secret Services are disqualified from joining GEMS, including any department where the conditions of service do not allow their enrolment on GEMS.

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

  • For a customary marriage, we need an affidavit from the main member confirming the obligation towards the husband or wife.
  • We need a copy of the marriage certificate if married and the surname of the husband or wife is different from the main member's surname.

Ex-husband or ex-wife

  • We need a copy of the court order to provide medical support as required by the divorce settlement.

Partner

  • We need an affidavit (completed by the main member, partner and a witness) confirming that the dependant is the main member's life partner.

Children (biological, adopted, step or foster) under the age of 21

  • If the child's surname is different to that of the main member, the main member must complete an affidavit stating the reason for the difference and confirming the obligation towards the child.

Children (biological, adopted, step or foster) over the age of 21

  • If the child is a student and not yet 28 years old, we need:
    • Proof of registration at a recognised tertiary institution
    • Affidavit from the main member confirming financial dependency.
  • If the child is totally dependent due to mental or physical disability, we need:
    • Proof of disability from a medical practitioner (medical assessment report to be completed by a medical practitioner)
    • An affidavit from the main member confirming financial dependency and that the child is not in a state institution.
  • If the child is neither a student nor disabled, we need:
    • An affidavit from the main member confirming financial dependency. (Please note that in this instance, you will pay adult contribution rates for this dependant.)

Parents, parents-in-law, grandparents and grandparents-in-law

  • We need an affidavit from the main member confirming financial dependency of the dependants.
    Parents-in-law and grandparents-in-law may only be registered if the husband, wife or partner is also registered as a dependant.

Grandchildren and great-grandchildren

  • They may be registered as dependants if the main member or the husband or wife submits documentary proof that a child support grant is received OR if the main member or husband or wife gives us a sworn affidavit that he or she takes primary responsibility for meeting the daily needs of the child.
  • We need an affidavit to be completed by the main member and biological parent, where applicable confirming financial dependency of the grandchild on the main member.
  • If the parent of the child is also registered as a dependant, an affidavit is only needed from the main member for the grandchild or great grandchild.

Siblings (brothers or sisters), half-siblings, step-siblings and siblings in-law

  • We need an affidavit (to be completed by the main member) confirming financial dependency of the sibling on the main member.

Nephews and nieces (including in-laws)

  • We need an affidavit confirming financial dependency of nephews and nieces on the main member. The affidavit must be completed by the member and the sibling, where applicable.
    If the parent of the child is also registered as a dependant, an affidavit is only needed from the main member for the niece or nephew.

Special dependants (where the member is liable for family care and support)

  • We need an affidavit from the main member confirming financial dependency of the special dependant.
  • Proof of financial dependency will be subject to review and Scheme approval.

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:

  • An affidavit certifying financial dependency
  • A letter that proves that the dependant is registered at a recognised tertiary institution
  • All affidavits and documents have to be certified by a commissioner of oaths.

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 structureJanuary 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 

How can HR practitioners assist members with option changes?
 
Five easy steps to change options
  • Carefully consider their medical aid needs
  • Select an option they know they can afford
  • Complete the option change form if they would like to change to another option
  • Check to see if all their personal details are still correct and amend if necessary
  • Fax the form back to us at 0861 00 4367 by the deadline.

How do we assist members to pay their medical aid arrears?

  • No backdated amendments more than 3 months can be performed directly via Persal
  • Example: GEMS receives information for August 2009 where an employee had a salary increase backdated to 1 January 2009
  • GEMS can now only request the increased contribution as far back as 1 June 2009. The months of January until May fall outside the 3 month rule 

What is a late notification of terminated service?
 
GEMS members should be resigned from the Scheme on their last day of service in the following instances:

When they resign from the public service or have passed away, or
when their contracts of employment expire and when they are discharged for misconduct

PERSAL controllers/users must therefore update the PERSAL system timeously in order to terminate GEMS medical deductions where a change in employment will render the employee ineligible for membership of GEMS.

When termination of employment or death is done backdated on PERSAL (periods of between 6 to 12 months is common), it leads to a reclaim from the Department of all contributions already paid to GEMS for the number of months affected
This practice results in debt being created as claims paid during the affected period will be reversed

The member will be held liable for all claims paid after the termination of employment as the member was effectively ineligible for GEMS membership (closed medical scheme)

According to the Scheme rules: "a member who resigns from the service of the employer shall, on the date of such termination of employment, cease to be a member, and all rights to benefits shall thereupon cease."

What is the correct reference that we should use when submitting medical deductions for employees?

  • HR officials must ensure that the correct reference number (member number) is used on the member's salary
  • The reference needs to be 7 digits long and only numeric in order to match the payment received from the Department to the correct member on the system GEMS uses to administer the medical aid
  • When the incorrect reference is used it may result in payments allocated incorrectly or not allocated and rectified at a later stage. This in turn can lead to the member receiving a debt letter incorrectly
  • It can also have an effect on changes in contributions (52 transactions) as transactions will be rejected by PERSAL because the references do not match.

How do we manage medical deductions for staff with cost-to-company packages?
 
When contract employees who are on 37% in lieu of benefits join GEMS they will not get the employer subsidy
The system will by default put the indicator at "No"

Should this person be employed in a permanent capacity, the employer contribution indicator needs to be changed to "Yes"
The member will not receive a subsidy should the indicator remain at "No"

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