The number of principal members (excluding the bargaining councils schemes) went up by 3,5% to 2 812 083 and beneficiaries increased 2,6% to 6 835 621.

Gross contribution income increased 5,2% to R54,2bn. Of this amount, R45,8bn was paid out in claims which was an increase of 12,2% on the R40,8bn paid out in the previous year.

Expenditure on hospital services accounted for R16,1bn, or 35,3% of the total paid to providers. Private hospitals expenditure increased by 3,9% to R15,9bn while expenditure on provincial hospitals decreased by 4,9% to R242mn.

Payments to medical specialists increased by 15,2% to R9,4bn, (or 20,5% of claims paid in 2005). General practitioners expenditure increased by 28% to R3,6bn, (or 8% of total benefits paid).

The big decline in expenditure was again seen in the medicines dispensed by pharmacists and providers other than hospitals, which accounted for R7,2bn or 15,7% of the total benefits. This represented an 8,8% decrease in expenditure on medicines compare to 2004.

Dental specialists increased their share of expenditure by 21,9% to R369m. Dentists, on the other hand, saw an increase of 3,75% to R1,72bn. Supplementary and allied health professionals accounted for R4,6bn or 10,1% percent of the total expenditure paid by medical schemes to providers.

Administration expenditure in all medical schemes grew 10,4% to R5,4bn in 2005.

Fees paid for managed care services grew by 17,1% to R4,8bn. 

Broker fees again rose sharply by 21,5% to R855,5m - on a member per month basis the increase was 16,6% to R35,50.

Total impaired receivables (previously known as bad debts) amounted to R202m compared to R213m in 2004, which is a decrease of 5,2%.

Total non-healthcare expenditure (ie. administration fees plus fees paid for managed care and broker fees, etc) rose by approximately 9,6% to R7,8bn in 2005 from R7,1bn.

The overall operating surplus of schemes, taking investment income into account was R2,3bn.

However, the operating position before investments was a deficit off R356,2m. While still a concern, this decrease was probably not unexpected, given that most schemes have build up reserves to 25%.

Nett assets of schemes rose 14,0% to R23,0bn from R20,1bn in 2004. This resulted in the average solvency increasing to 39,1% as at December 2005 from 37,3%. This level was higher than the prescribed solvency level of 25%. The solvency ratio of open schemes was 29,6%, while that of restricted schemes was 63,5%.

The report provides further information on the Council's work during the year. This includes:

the number of administration companies and managed health care organizations accredited by Council were 17 and 55, respectively;

Benefits and contributions rules were assessed for all 131 schemes and approved where appropriate;

Fifteen trustee training workshops and road-shows were conducted, with numerous consumer education efforts also undertaken;

We received 1 833 complains from members and providers about their medical schemes. 81% of these complaints were resolved within 90 days.

The Council's subcommittee on appeals also heard thirty one disputes referred to it - the annual report contains a sample of the important ones.