2021 Benefit and Contribution Launch
06 October 2020
MORE THAN A MEMBER. MORE WITH BANKMED.
MORE COVER
Agenda
01 Bankmed Value Proposition
02 Industry Matters
03 Bankmed Financials
04 2021 Contribution Increases
05 Plan Structure
06 2021 Benefit Enhancements
07 2019 Health Quality Assessment Results
08 Communications Overview
09 Client Management
10 Q and A
3
Value Proposition
Partnership in Health and Wellness
Exclusivity and Responsiveness(Closed Scheme)
38% Better Value in 2020 (NMG)
Better Quality (HQA)
Financial Stability(GCR)
Technology and Innovationas Enablers
Commitment to Best-of-Class Member Experience
Our financial stability allows us to
maintain value for our members
Our partnership spans over
more than 100 years- and we are
still going strong
VS
2018 Annual Financial Statements
2019: 40.5%
2018 Council for Medical Schemes Annual Report;The average for restricted schemes in 2018 was 41.9%
Industry average
38.7% 34.5%
Solvency ratio
Non-healthcare costs 2018
VS
2019: 4.8%
Industry average
4.9% 8.2%Non-healthcare
expenses are the costs associated with running
the Scheme e.g. administration and general
administration expenses
Your money is
spent on you
Industry Matters
General Industry Update
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Bankmed continues to stay close to industry developments
Member of the Health Funders Association (HFA)
Participating proactively to influence howthe healthcare landscape changes
COVID-19 dominating industry deliberations
Bankmed has been diligent in its own response to COVID-19
Bankmed’s Response to COVID-19
Details of Bankmed’s response is available on the Scheme’s websiteThe Scheme’s response includes the following:
Tests paid for from insured benefits
COVID-19 Isolation Hotel benefit
Relaxation of networks, specifically
for COVID-19
In-and-out of hospital cost of treatment paid from insured benefits
Pulse Oximeter and additional consultations for
high risk members
Virtual and Telephonic
consultations
4 342
610251
419
697
87
173
136
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BANKMED CONFIRMED CASES | 6 846 | 29 September 2020COVID-19 cases by Province
*We have extended the definition of confirmed positive members to also include admissions coded with U07.1 but not confirmed through pathology testing yet
COVID-19 clinical tracker
Tests conducted
Positive members
COVID admitted members
Recoveries Deaths
SA
Bankmed 90443 036 6 846 1106 548
4 152 480 671 669 604 478 16 586-
13.2%Proportion admitted
95.6% Recovery rate(DH: 94.3%)
90.0% National recovery rate
1.6% Case fatality rate
(DH: 2.2%)
2.5% Nationalcase fatality rate
Bankmed COVID-19 experience
As at 29 September
1 014admissions
78Ventilator
admissions in ICU
Source: Internal analysis
Distribution by age and chronicity Admissions for COVID-19 positive members
150 ICU
admissions
Admission costs
Completed Admissions Total cost Average
CostAverage Length
of stayDeath rate
Other Wards 651 R 28 236 682 R 43 374 6.6 4.8%
High Care 158 R 17 737 330 R 112 262 9.7 5.9%
ICU 71 R 21 199 023 R 298 578 16.6 34.8%
Ventilation 79 R 33 867 578 R 428 704 18.8 68.8%
Total 959 R 101 040 613 R 105 360 8.9 12.5%
904Members admitted
210 278
1086
2115
693227
528
526
3992340
1000
2000
3000
0-10 10-20 20-30 30-40 40-50 50-60 60-70 70-80 80+Age Band
Distribution of positive members by age and chronicity
Y N
97% 97% 98% 98% 96% 93% 85% 76% 77%
3%6%
10% 8%
8% 14% 15%
0%
20%
40%
60%
80%
100%
120%
0-10 10-20 20-30 30-40 40-50 50-60 60-70 70-80 80+
Distribution of positive members by current status
Deceased Active Recovered
Utilisation of Virtual and Telephonic Consultations
Consultation Type January to June 2020
July 2020 August 2020 September 2020
Virtual Consultations 135 96 45 22
Telephonic Consultations 4 069 2 755 1 271 673
Utilisation of Isolation Hotel Benefit
June 2020 July 2020 August 2020 September 2020
Number ofMembers
13 15 5 0
Number of Days 105 116 24 0
Pulse Oximeter Uptake
August 2020
September2020
Number of Approved Pulse Oximeters
424 59
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Bankmed is an active participant in these discussions
Final report on the Health Market Inquiry (HMI) released in September 2019: But focus shifted to COVID-19
COVID-19 also generated many views about the National Health Insurance (NHI): • Will implementation be accelerated?• Has COVID-19 made it impossible to prioritise NHI?
Bankmed’s view: COVID-19 has imposed many lessons that are useful for solutions that we really need in the future, and we intend to stay engaged and contribute to the desired solution, in the best interest of our members
Other Industry Developments
Variety of other industry conversations underway, relating to legislation and regulations in the healthcare industry
Bankmed Financials
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3
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Bankmed’s Invested Reserves
The Two Key Financial Ratios
The Financial Mechanics of Bankmed
Reserve Management
Summary
Financials
Members Savings Accounts2
6
1
2
3
4
5
YTD July: R3.65bn reserves invested
Two additional multi-asset managers introduced in March 2019, in order to further diversify investment manager skill
Four multi-asset managers: INVESTEC, PRUDENTIAL, ALLAN GRAY and ABAX, andone Money Market manager: TAQUANTA
Overall benchmark, related to medical inflation, amounts to CPI + 3.5% over a rolling 3-year period
Due to ongoing economic conditions, the benchmarkhas not been attained over the last 5 years
Bankmed’s Investments
17
6Bankmed’s Investment Committee closely monitors the performance of the individual investment managers, and the overall investment strategy of the Scheme
Applies to the Core Saver, Comprehensive and Plus Plans only
Consists of contributions paid by members which are allocated to a members savings account and held there to settle certain healthcare costs that aren’t paid from Insured Benefits
Although the member pays monthly contributions in this the regard, Bankmed offers the total annual benefit for utilisation as at 1 January
Bankmed’s practice in this regard creates a risk of creating member debt to the Scheme, in the form of savings claw-backs
The interest is calculated on a monthly basis , but credited to the members savings accounts once annually
Members Savings Accounts
Bankmed allocates 50% of the interest rate earned on the Scheme’s money market portfolio to the members, although there is no obligation to pay members any interest
50%
The Financial Mechanics of Bankmed
GROSS CONTRIBUTIONS RECEIVED (including savings)
NET CONTRIBUTIONS INCOME
RELEVANT HEALTHCARE CLAIMS EXPENDITURE
INSURED HEALTHCARE CLAIMS (Non Savings)
RISK TRANSFER ARRANGMENT PREMIUMS
MANAGED CARE EXPENDITURE
Hospital CostsDoctors
Medication etc.
Premiums to provider who then commits to cover certain healthcare
expenditure for the year
Fees paid to service providers who conduct managed care initiatives in
order to contain healthcare costs
LESS: SAVINGS CONTRIBUTIONSWhat comes into the Scheme?
What is paid from the Scheme on
Medical Costs?
GROSS HEALTHCARE RESULT
INVESTMENT INCOME
OPERATING DEFICIT
NET RESULT
NON-HEALTHCARE EXPENDITURE
• Administration Fees• Scheme Management Costs
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The Financial Mechanics of Bankmed (cont.)
What is paid by the Scheme on Administration
Costs (Delivery Costs)?
Reservesat work
Value to members
Accumulated Reserves / Annual Contributions
• Key indicator of financial health, with statutory minimum of 25%
• Balance between sufficient reserves and using excess reserves to the benefit of members
The Two Key Financial Ratios
Operating Deficit / Annual Contributions
• Incur operating losses to the benefit of members which investment income must cover
Reserve Ratio
Operating Ratio
Reserve Management Strategy
To maintain the required level of
reserves to ensure long term financial
sustainability of the Scheme
Bankmed’s required reserve ratio is
between 35%-40%
The upper end of required reserve
ratio was maintained in 2019, at 40.5%
(38.7%: 2018)
The actuarially forecasted reserve ratio as at the end of 2020 is 46.6%,
due to the unusually low claims
experience resulting from the COVID-19
lock-down measures.
The budgets for the years thereafter will
be aimed at stabilising the
reserve ratio at approximately 38%
RatioYear Reserve Ratio
2016 40.1 %
2017 38.8 %
2018 38.7 %
2019 39.2 %
2020 (forecast) 46.6 %
2021 (budgeted) 38.2%
Reserve Management Strategy (cont.)
Summary
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To keep contribution increases low while maintaining rich benefits, the Scheme needs to run sustainable operating deficits
To run sustainable deficits the Scheme’s reserve levels need to be adequate in order to produce the required investment returns
The required investment returns must be sufficient to cover the planned operating deficits and grow reserves adequately to keep the Reserve Ratio stable
During times when investments areperforming poorly, a Scheme has to generate savings elsewhere by utilising effective managed care initiatives and other cost cutting techniques.
Summary (cont.)
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Regardless of low investment returns, Bankmed has performed well enough over the past few years, to maintain stable contribution increases
This has been achieved by savings generated on claims expenditure via effective managed care initiatives and favourable provider tariff negotiations
Overall, Bankmed is well managed and financially sound, which is confirmed by its AA+ credit rating
2021 Contribution Increases
Average Contribution Increases 2021 Other Medical Schemes
Fedhealth
8.8%
DHMS
0% (6/12)
Bonitas
4.6%
Momentum Health Medical Scheme
3.9%
CAMAF
3.5%
BestMed
4.0%
KeyHealth
5.0%
0% increase for the first 6 months of the year after which a 5,9% increase will be implemented
MedShield
5.9%
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Annual Increase Comparisons
8,98,6
10,6
8 7,8
10,2
11
11,9
10,7
7,97,98,3
8,7
7,78,1
9,2
8,2
8,9
10,7
7,9
9,5
8,2
9,9
7,3 7,3
0
3,9
4,6
3,5 3,6
0
2
4
6
8
10
12
14
DHMS Momentum Bonitas CAMAF Bankmed
2016 2017 2018 2019 2020 2021
*
* 0% increase for the first 6 months of the year after which a 5,9% increase will be implemented
Annual limits of many medical categories were increased generally by 4.5%
Plan 2015 Increase
2016 Increase
2017 Increase
2018 Increase
2019 Increase
2020 Increase
2021 Increase
Essential 3% 5% 6.5% 6% 5.5% 5% 2.5%
Basic 6% 5% 6.5% 6.5% 6.5% 6% 2.5%
Core Saver 6% 6% 7.5% 7.5% 7.4% 7% 3.5%
Traditional 7.5% 7.8% 8% 8.25% 7.4% 7% 3.5%
Comprehensive 8.5% 8.5% 8% 8.5% 8.5% 7.8% 3.9%
Plus 9% 9.5% 9% 8.75% 9% 8% 3.9%
Average 7.9% 7.8% 7.9% 8.1% 7.9% 7.3% 3.6%
2021 Bankmed Contribution Increases
Plan structure
A Plan to suit everyone
Comprehensive range of benefits paid from both insuredand savings out-of-hospital
Wide range of benefits with annual sub-limits for day-to-day expenses. Network Plan
Hospital plan with a savings component for day-to-day expenses
Wide range of primary care benefits (including non PMBs) available via GP Entry Plan Network
Lean, low cost Plan. Benefits limited to PMBs only available via GP Entry Plan Network
Top of range Plan with savings and an ATB(safety net) for when savings are exhausted
Essential
Core Saver
Plus
Comprehensive
Co
ntr
ibu
tio
ns
Benefit range and specific networks
Wellness and Preventive Care
Managed Care ProgrammesWellness-Based Incentive Programme
Bankmed Balance available to all members
Traditional
Basic
Essential and Basic Plan Overview
Plan Benefits Essential Plan Basic Plan
Positioned forEntry level Plan, suited for low healthcare needs.
PMB cover onlyLow contribution Plan with IH and OH benefits
and chronic disease benefits
Wellness and Preventative Care Benefits Rich spectrum, expect for contraception Rich spectrum
Restricted GP Network Yes Yes
Specialist Network Yes Yes
GP Specialist Referral Yes Yes
Hospital NetworkYes Yes
Pathology, Radiology and Medication Restricted formularies
Managed Care Programmes HIV Programme and Oncology Programme: PMB level of cover only
Optometry Benefit No Isoleso Optometry Network
Basic Dentistry No Yes
33
Core Saver, Traditional, Comprehensive and Plus Plan Overview
Plan Benefits Core Saver Plan Traditional Plan Comprehensive Plan Plus Plan
Positioned for
Young, healthy members with relatively low healthcare needs.
Limited MSA for day-to-day expenses
Plan provides comprehensive medical cover to meet moderate
to high healthcare needs. Network Plan.
Plan suitable for moderate to high healthcare needs for members who want a savings component
Designed for moderate to high healthcare needs for
members who want a savings component and ATB
Wellness and Preventative Care Benefits
Rich spectrum Rich spectrum Rich spectrum Rich spectrum
Medical Savings Account Yes No Yes MSA + ATB
GP Network Yes Yes Yes Yes
Specialist Network Yes Yes Yes Yes
GP Specialist Referral Yes Yes No No
Hospital NetworkNo Yes No No
Managed Care Programmes PMB level of cover Cover for both PMBs and Non-PMBs subject to pre-authorisation
Optometry Benefit Subject to MSA Insured Insured / MSA MSA / ATB
Basic Dentistry Subject to MSA Insured Insured MSA / ATB
Dental Admissions Emergency/PMB cover only R1 950 deductible
2021 Benefit Enhancements
The principles behind the annual review include the following:
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To enhance benefits/innovation - these do come at a cost but are necessary to remain competitive and be the medical scheme of choice for the banking industry
To optimise Risk Management in order to keep contribution increases as low as possible
To consider a tiered differentiation in benefits between Plans especially for the “discretionary benefits” where members perceive value and would therefore consider higher premiums justifiable
To lower out of pocket payments
To improve member experience
2021 Enhancements informed by
Minimal enhancements in favour of lower
contribution increases due to the state of the
economy
COVID-19: Lockdown/Job
insecurity/Isolation
Mental Health issues on an
incline
Member-centric philosophy of
Bankmed
Employer Group requests
• Mental health disorders are emerging as the number one cost driver in the healthcare sector
• The impact of mental illness is not only felt in the healthcare sector. It is also the largest contributor to global disability and accounts for 10 billion days of work lost on an annual basis
• The most common condition within the mental illness cluster is depression, typically accounting for greater than 50% of all members registered with a mental illness and more than 50% of total spend on mental health disorders
Mental Health Disorders
• “As many as one in six South Africans suffer from anxiety, depression or substance-use problems (and this does not include more serious conditions such as bipolar mood disorder or schizophrenia), according to statistics released by the South African Depression andAnxiety Group (SADAG)”
• Previously the focus was on four chronic diseases (cardiovascular, diabetes, respiratory and cancer) that contributes to 60% of deaths. The focus currently is on five chronic diseases that contributes to 75% of deaths, the fifth one being Mental Health
• The very concerning incline in Mental Health conditions is certainly• Impacting productivity of the employee base due to absenteeism and presenteeism• Impacting the claiming patterns• Impacting scheme sustainability
Mental Health Disorders
The Social Impact of Mental Illness on South African patients
• 17% cannot take care of dependents
• 26% are separated or divorced
• 47% lose friends (a key part of their support network)
• 49% experience negative family relationships
• Only 27% of South Africans reporting severe mental illness ever receive treatment. This means that nearly three-quarters of these sufferers are not accessing any form of mental health care at all
• South Africa has one of the highest rates of gender-based violence (GBV)
• 23 South Africans commit suicide every day
The Social Impact of Mental Illness
Depression has a serious impact on the South African economy. Depression costs SA more than R218bn in lost productivity:
• R28bn is attributable to absenteeism (unscheduled absence from work)
• R190bn is attributable to presenteeism attending work while unwell)
The lifetime prevalence of Depression in SA is 9.7% or 4.5 million. About 20% of South Africans will experience a depressive
disorder at least once in a lifetime. Depression is a treatable condition and between 80% and 90% of people have a good
response to treatment.
Mental Health Disease Management Programme
Comprehensive programme that includes both out-of-hospital andin-hospital support. The following are some components of the programme:
• Members on all six plans have access to the mental health programme, however plan benefits will apply with respect to condition cover
• The programme looks at strategies across the spectrum from the healthy to those members requiring comprehensive inpatient care
• The healthy and at risk segments are promoted through regular screening at wellness days and online
• Access to a mental wellbeing module on the website which includes information that promotes mental well-being e.g. advice on mindfulness, meditation exercises
• Access to counselling should someone at risk wishes to speak to a counsellor
• A primary care programme which is GP level of care. This is a crucial component and the mainstay of treatment
Mental Health Disease Management Programme
• The Premier Plus GP Network will play a pivotal role in this programme. This network is already managing Diabetes, Cardiovascular Disease and HIV for Bankmed. Mental Health will be an extension to the Premier Plus Programme
• The GP will enrol member onto programme e.g. Major Depressionmonitor compliance to medication, ensure follow up visits, script renewal etc.
• Coaching and educational material will be provided
• The programme includes a hospital DSP/Network which Bankmed isalready participating in, case management and discharge planning by a care coordinator
• Enrolment on a relapse prevention programme to provide the necessary support on discharge to prevent unnecessary readmissions
• The implementation will be phased in. The employers EAP is included as part of this model
Frail Care
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Frail care is an existing benefit
Members on the top 3 plans haveaccess to this benefit
The benefit is, however, complex.
2020 benefit: 50% of cost limited to R470 per day
5 2021 benefit: Flat daily rate
Health QualityAssessment (HQA)
Health Quality Assessment
• Benchmarking exercise in the funding industry
• Highlights key quality issues in the SA medical scheme industry
• Drives improvement in the delivery of evidence-based medicine
• 18 schemes participated in 2019 HQA from 9 different Administrators
• Comprised of 115 benefit options
• Represented 7,29 million beneficiaries (81,63% of the medical scheme population)
• 206 Indicators in four categories are evaluated, namely:
1. Prevention and Screening
2. Hospitalisation
3. Maternity and New-born
4. Chronic Disease Management
Definition of Quality
Agency forHealthcare Research and Quality (AHRQ) defines quality as
“the degree to which healthcare services for individuals and populations increase the
likelihood of desired health outcomes and are consistent with current professional
knowledge”.
Bankmed compared to Industry | 2019Primary Care (Including Screening)
Indicator Bankmed Industry Benchmark CMS
PreventionFlu vaccine coverage > = 65years (%) 28.38% 20% 61% 3.85%
Pneumococcal vaccine coverage ≥ 65 years old (%) 9.60% 3.49% 72.7-77% N/A
Screening
Cervical Cytology coverage (previous 3 years) (%) 41.96% 32.67% 59.3-75.2% 15.99%
Mammogram coverage (ages 50-74 years in previous 2 years) (%)
37.90% 24.07% 72% 32.68%
Bone densitometry coverage for all females aged 65 years or older (%)
9.25% 7.25% N/A N/A
Colorectal cancer screening ≥ 50 years in previous year (FOBT, %)
14.91% 10.79% N/A N/A
Percentage of beneficiaries ≥ 2 years old visiting dentists 32.45% 21.61% NA N/A
Bankmed compared to Industry | 2019Chronic Disease Management
Indicator Bankmed Industry
Diabetes
HbA1c coverage for Diabetic patients (%) 65.56% 60.31%
Cholesterol related tests coverage for Diabetic patients (%) 60.33% 55.00%
Monitoring Nephropathy for Diabetic patients (%) 71.56% 67.23%
Podiatrist cover (%) 6.65% 3.52%
Statin coverage (%) 62.08% 56.42%
% of Hypoglycaemia related hospital events 0.56% 4.59%
Lower Limb amputations per 1 000 diabetics 2.23 3.16
Bankmed compared to Industry | 2019Chronic Disease Management
Indicator Bankmed Industry
Ischaemic Heart Disease
Aspirin coverage for IHD beneficiaries (%) 83.04% 69.78%
Cholesterol test coverage for IHD beneficiaries (%) 61.63% 53.25%
Statin Coverage for IHD beneficiaries (%) 82.05% 75.38%
Beta blocker coverage 52.48% 49.96%
Flu coverage of IHD registered beneficiaries 25.09% 18.66%
AsthmaLung function test coverage 15.63% 11.47%
Flu vaccine coverage 16.01% 12.27%
Bankmed compared to Industry | 2019Chronic Disease Management
Indicator Bankmed Industry
Cardiac FailureFlu vaccine coverage (%) 25.17% 18.47%
ACE & ARB inhibitor coverage (%) 56.56% 61.73%
Depression
10 day post discharge follow up (%) 13.2% 39.69%
30 day post discharge follow up (%) 30.54% 47.47%
Multiple admissions for Depression 1.81% 0.78%
COPD
Flu coverage for COPD beneficiaries (%) 34.29% 28.77%
Lung Function test coverage for COPD beneficiaries (%) 37.53% 33.52%
COPD beneficiaries admitted once for respiratory condition (%) 31.40% 27.32%
COPD beneficiaries admitted more than once for respiratory condition (%) 10.82% 9.54%
Bankmed compared to Industry | 2019
Hospitalisation
Indicator Bankmed Industry
Cardiac Procedures
Stents 1.36 1.48
Average length of stay for all cases (days) 5.93 5.45
Readmission for any reason within 30 days 8.04% 10.83%
Bankmed compared to Industry | 2019Maternal and New-born
Indicator Bankmed Industry
Maternal and New-born
Number of Teenage Pregnancy (10-19 years inclusive) cases per 1 000 teenage beneficiaries
2.55 2.52
TSH Coverage in New Borns (≤ 6 weeks old) (%) 90.31% 83.52%
Hepatitis B serology coverage during pregnancy 65.97% 42.70%
HIV Screening during pregnancy 72.31% 46.02%
Haemoglobin (Hb) test coverage during pregnancy 80.38% 77.42%
Caesarean Section rate 73.19% 76.04%
Bankmedcompared to
Industry |2019
2021 Integrated Communications Overview
Educate
Educate and inform members
Delight
Enhance the member journey and experience
across all channels
Add value
Your partner in health, wellness and
lifestyle design
Our message to our client's and members
Key message 1
Educate
We help create a Smart member through educational and informative campaigns:
A ‘Smart’ member:
• Better understands their benefits and Plan options to make more informed Plan choices
• Knows how to optimise their managed and preventative care programmes to stay healthy
• Is digitally savvy and can access Bankmed platforms i.e. App, website and social media platforms etc.
• Engages on multiple communication channels for convenience and ease of use
• Enhances their wellness and healthy habits through regular engagement in wellness initiative’s, PHAs, etc.
• Understands their health status and derives insights about their health to make informed decisions (data-driven insights)
Key message 2
Delight
We delight our members by enhancing the member journey and experience across all channels:
App
Re-Launch October 2020
Print is on hold unless specifically
required at Employer Group
Clients but online copies are always available
SMS
SMS optimised to replace postal
during COVID-19
Segmented communication
via email to specific audiences i.e. members with
co-morbidities etc.
Social
Launched LinkedIn
March 2020
Website
Re-Launch October 2020
Enhancing the member journey and experience
App | Phase 1: new features
New login screen
Phase 2 coming soon….
Brand and screen enhancements
Medicine Tracker
Benefit and Limit tracker
Provides members with key messages.
New design presents the member with a detailed
description of the benefit, the limits associated with
the benefit, how much has been used,
and which claims have accumulated to the benefit.
Keeps track of all the medicine a member needs to take by adding it to their
Pillbox. Reminds the member of when to take
their medicine and when to renew their script.
Set the appearance of your medicine so it’s easily
recognisable. Each medicine reminder can be set up
precisely according to the instructions set.
Enhancing the member journey and experience
Website | new features
Enhancing the member journey and experience across all channels:
Enhancing the member journey and experience
Get the latest information at your fingertips:
• Health and wellness information
• Industry news
• Topical information such as the COVID-19 pandemic
• Opinion pieces from our Healthcare and Clinical experts
• Member stories
• Participation in medical and health forums
• Benefit and Plan information
Key message 3
Add value
We add value to our members and clients through rich,engaging and relevant content:
• Thought Leadership
• News blog on our website
• Collaboration with Employer Group Clients (Campaign toolkits)
• Access to information around the Global Pandemic and what Bankmed is offering members – COVID-19 webpage
Client Management
Client Management
• Custodian Support
• Roadshow Project Planning
• Marketing the Project
• Preferred channels
• Communications Content and Distribution
• Encouraging employees to view digital presentationsand schedule a virtual consultation if further clarity is required
• Project roll-out timelines(Including festive season closure and re-opening dates)
www.bankmed.co.za
0800 BANKMED (0800 226 5633)
http://www.facebook.com/BankmedSA/
http://twitter.com/Bankmed_SA
Mobi App
Contact Us
Thank you
Q&A
MORE THAN A MEMBER. MORE WITH BANKMED.
MORE COVER