CMS updates and what is expected of you

It is always good to take the opportunity to remind everyone of the CMS (Council for Medical schemes) requirements for PHC (Primary Health Care) going forward. As per our previous communications, Unity Health and the key industry stakeholders are engaged in detailed and ongoing workshops with the CMS and other key Industry players to resolve the many items referenced in Circular 56, and the one that requires your direct attention is cited under point 16.1 in Annexure 1 of Circular 56.

As Brokers who carry the responsibility to market these PHC products to your clients your accreditation under this new requirement will allow this much needed product in the healthcare landscape to continue to grow. And if there is anything Unity Health can assist you with, please reach out to your key contact (Broker Development Manager) at Unity Health who will endeavour to assist you where possible.

What is required for Brokers and Brokerages to be accredited with Council of Medical Schemes (CMS)

To offer your clients intermediary services and/or advice on Medical Schemes, you and your brokerage must be accredited with the Council of Medical Schemes (CMS) – and retain accreditation by reapplying every two years.

According to the Financial Advisory and Intermediary Services (FAIS) Act, advisors who want to provide a service in the Health Services Benefits product subcategory must have CMS accreditation. Brokerages that contract with Medical Schemes to provide services must be accredited as an organisation and the advisors, who are representatives, must be accredited as individuals.

The CMS, which governs the Medical Schemes industry, prescribes the fees and accreditation requirements for advisors and brokerages. Here is how you and (your brokerage) can gain accreditation, as prescribed in terms of the Medical Schemes Act (Act No. 131 of 1998):

Individual Broker Application

If you have healthcare consulting and marketing experience and can provide written references from Medical Scheme/s confirming two years’ relevant experience, you may apply for accreditation as a Healthcare Advisor. If you have less than two years of experience, the CMS will list you as an apprentice advisor until you can apply for regular accreditation after two years of practice.

You also need:

1. A certified copy of your ID or passport.
2. A certified copy of your highest academic qualification (with a minimum of matric).
3. A copy of contract/s agreement/s you have entered into with the Medical Schemes concerned.
4. Original certificate of good standing from the South African Revenue Service.
5. References from Medical Schemes as an employer substantiating the period during which you conducted broker services.
6. Documentary evidence signifying the accredited supervising broker’s consent.
7. Proof of payment of the prescribed non-refundable application fee. Currently R1400.
8. Any other information the CMS may reasonably request.

Accredited advisors receive a certificate and a “BR” number. The certificate is valid for two years. It is important to remain accredited, as you otherwise cannot be remunerated for your services.

Brokerage Application:

The CMS must accredit a brokerage before they can apply to the Financial Sector Conduct Authority to be authorised for the product subcategory “Health Service Benefits”

Application requirements for accreditation:

1. CV of the person who heads up the brokerage.
2. Copies of broker agreements between the applicant and Medical Schemes OR letters of intent from Medical Schemes indicating their business offers to contract with the applicant to provide broker services.
3. Audited financial statements (including notes to the financial statements), for the financial year preceding the application. If the entity is a new company, a letter from the auditor must be submitted to confirm no trading was conducted.
4. Tax clearance certificate.
5. Original SARS certificate of good standing, confirming the entity has not contravened any provision of the Income Tax Act.
6. Proof of payment of the prescribed non-refundable application fee, which is currently R1400.
7. A copy of the organisation’s B-BBEE certificate, if available (for statistical purposes).
8. Any other information the CMS may reasonably request.

An approved brokerage receives a certificate from the CMS with an “Org” number. Certificates must be renewed every two years. If accreditation lapses with the CMS, payment of commission will cease. Renewal applications must be submitted at least 3 months before the accreditation expiry date.

To renew accreditation, a brokerage must provide:

1. A copy of the audited financial statements (including notes for the financial statements) for the financial year preceding the application.
2. B-BBEE certificate, if available (for statistical purposes only).
3. Proof of payment of the prescribed non-refundable application fee.
4. Any additional information that may impact the evaluation of the application.
5. Any other information the CMS may reasonably request.

Moving to another FSP (Financial Services Provider)

If you move to another FSP, the CMS needs to be informed. Send an email to the CMS with your current FSP name and licence number and instruct the CMS to update the details with the new FSP name and licence number. Keep a record of all correspondence as proof of submission.

Turnaround Time

The CMS takes 21 working days to process applications. If you have not received your certificate by then, send an email to accredit@medicalschemes.com to escalate your request.

If you are applying for a new FSP licence, first submit all documents to the CMS, as the FSCA will not issue your licence with the relevant CMS accreditation (i.e.BR and/or Org number).

CMS contact details

Customer Care Centre: 0861 123 267/ 0861 123

CMS Reception: (021) 431 0500

Enquiries: information@medicalschemes.co.za