Staff Writer
The Namibia Financial Services Supervisory Authority (Namfisa) has embarked on proactive measures aimed at securing the long-term sustainability of the medical aid fund industry.
In response to the escalating challenges posed by rising medical aid contribution rates, Namfisa says it is dedicated to members’ well-being and industry sustainability, and has implemented a temporary cap on some funds’ annual contribution increases, limiting it to a single-digit percentage (maximum increase of 9.99%).
The industry has been given until 20 March 2024, to submit additional contribution increase applications
along with realistic medium-term strategies to address the sustainability of the funds.
Namfisa says the decision comes on the heels of the Registrar’s observation of significant variances
between actual and forecasted solvency numbers over the past three to four years, often absorbed by members through contribution rate and benefit limit adjustments.
“Amidst the backdrop of rising healthcare costs, we invite medical aid funds to explore innovative solutions for alleviating financial burdens on individuals and families, urging collaboration with medical service providers and administrators to establish a new pricing equilibrium that prioritizes affordability and sustainability. This initiative aligns with NAMFISA’s mission to regulate and supervise financial institutions in the public interest, Namfisa CEO Kenneth Matomola stated.
Recognising the urgency to curb escalating contribution rates, Namfisa called on medical aid funds to engage in renegotiations with both medical and non-medical service providers.
Namfisa has emphasized the need for transparency and accountability, encouraging the adoption of the International Classification of Diseases, Tenth Revision (ICD-10) coding structure by 2025. This standardized coding system will improve transparency, accuracy in pricing, enable granular trend analysis, enhance fraud detection, and support initiatives to reduce over-servicing.
Namfisa regulates and supervises the N$ 1.9 billion total assets medical aid insurance industry (30 September 2023) consisting of 8 Funds (five open funds; 3 closed funds) with a membership size of 214 176 (99,669 principal members; 114,507 – dependents). Pensioners, 13,524 (included in total membership size).
