March/April
2006
Contribution
Rate Increase and Benefit Review
We are committed
to providing our members with very competitive benefits compared
to other funds and our stronger financial performance in 2005
now allows us to;
1. Hold down the
level of contribution increase for 2006
2. Increase the
levels on a number of our ancillary benefits
Health insurance premiums
and benefits are reviewed on an annual basis by all health
funds and are subject to examination and approval by the Commonwealth
Government as well as requiring assessment by an independent
Actuary. This process ensures that any premium increases and
benefit changes to products are appropriate to ensure the
fund remains financially viable into the future, while remaining
competitive.
Benefit Increases
We have taken this
opportunity to further improve the value of membership by
providing increases in some benefits effective from 1 April
2006. These increases are designed to provide benefit improvements
for as wide a range of members as possible, and are summarised
in the following table.
|
What's
Changed? |
Category
|
Product
Affected |
Description
of change |
Dental
|
Rewards
Plus
Ancillary Plus
Triple S
BHP Health Plan
|
Increases
in benefits for dental items in the Diagnostic, Preventive,
and Basic Restorative categories (increased by approximately
18% across these categories). The level of increase
applied to each item number varies. |
Item
Examples |
Old
Benefit |
New
Benefit |
011
Consultation
022 X- Ray
121 Fluoride
114 Scale / Clean
532 Restoration
|
$30
$19
$45
$23
$72
|
$32
$22
$52
$24
$90
|
Value
Plus
Basic Ancillary
|
Increase
in the overall dental benefit limit from $500 per person
to $550 per person. |
Optical
|
Rewards
Plus
Ancillary Plus
BHP Health Plan
|
Increase
the benefit payable from “80% of Cost” to “100% of Cost”,
up to the same annual limits |
Value
Plus
Basic Ancillary
|
Increase
the benefit payable from “75% of Cost” to “100% of Cost”,
up to the same annual limits |
Surgical
Equipment / Health Aids |
Rewards
Plus
Ancillary Plus
BHP Health Plan
|
Increase
the benefit payable by adding a Year 1 entitlement of:
50% of cost up to $400 limit per person per financial
year. Benefits for years 2 to 5+ remain unchanged. |
What's
New |
Triple
S |
Category
|
Description
of new benefit |
| Natural
Therapies |
Add natural therapy benefits,
payable on recognised services provided by fund registered
providers as follows: |
Initial
Consultation - $35 (max. one per year)
Subsequent consultations
- $25 each
Overall Limit
- $170 per single member per financial year |
| Remedial Massage has
been removed from the Physiotherapy & Chiropractic
limit, and is now included under the Natural Therapies
annual limit. |
| Pharmacy
|
Add
non-PBS pharmaceutical benefits as follows : |
Benefit
- 75% of the charge, after deducting $30 per prescription
item from the cost, to a maximum of $50 per prescription
Overall Limit
- $350 per single member per financial year |
| Exclusions : Contraceptives,
and any item normally available without a doctor's prescription.
|
| Lifestyle
|
Add
Lifestyle (health management) benefits for goods and
services that are part of a health management program
approved by the fund, or are rendered on the advice
of a health professional approved by the fund, which
is intended to prevent or control a specific health
condition(s).
Examples include:
approved fitness / exercise classes, Lifestyle improvement
programs, stress management, quit smoking, weight control
and health screening services. |
Benefit
- 80% of the cost
Overall Limit
- $100 per single member per financial year |
| Exclusions : Goods or
services that are primarily for the purpose of sport,
recreation or entertainment, are not eligible for benefits.
|
|
BHP
Health Plan (closed to new members) |
| Category
|
Description
|
| Gap
Cover |
Add
Access Gap cover benefits – this scheme pays higher
benefits towards the cost of medical services for in-hospital
procedures; the Fund currently has around 20,000 medical
providers registered with the Access Gap scheme across
Australia. Access Gap benefits reduce or eliminate out-of-pocket
costs of medical services provided by participating
medical providers during a hospital stay, and provides
for certainty for any out of pocket costs.
You will have
either no out-of-pocket expenses to pay, or you will
know exactly how much you will have to pay for the agreed
medical services before treatment begins. Participating
doctors can also bill Lysaght Peoplecare directly, reducing
the amount paperwork needed to be undertaken by members.
|
|
Contribution Increases
While the underlying growth
in medical and hospital costs remains in the order of 8% per year
across the industry (and Lysaght Peoplecare is no exception to this),
the strong financial performance of the fund in the past year means
that we can reduce the level of contribution rate increase that
would otherwise be needed, to an average of 3.43% across all products
in the fund.
The contribution increases
applied to individual products will however vary from the average
quoted above due to different claiming patterns and experience for
each product. Indeed 10% of members will not have any increase this
year and 80% of members will have an increase of less than 3%.
A contribution rate increase
notification letter has been issued to all members highlighting
the increased rate that is applicable for each individual cover.
If you have any queries regarding your notification, please call
the fund on 1800 808 690.
Contribution Rate
Protection
All contribution rate increases
take effect from 1 April 2006, however if your contributions are
paid in advance of that date (provided we receive your payment by
31 March 2006), you will also receive the benefit of "Rate Protection"
for that advance payment. Rate protection means that the new contribution
rate will not apply until the date your next contribution payment
is due after 1 April 2006. The maximum period that Rate Protection
is applied is 12 months i.e. not beyond 31 March 2007.
If you need further explanation of what benefits
are now payable, call us on 1800 808 690.
|
