PPS Healthcare Administrators (PPSHA) About PPSHA PPSHA is a wholly-owned subsidiary of PPS Insurance. We offer medical aid administration and managed healthcare services to several open and restricted medical schemes in addition to other tailored solutions that enhance the medical scheme offering. The medical schemes in our portfolio include: • Profmed, a closed scheme for graduate professionals. We provide core administration and managed healthcare services to Profmed. • KeyHealth, an open scheme that services local government employees and a growing number of private members. We provide core administration and managed healthcare services to Keyhealth. • Regular Force Medical Continuation Fund, a prefunded medical scheme that funds healthcare treatment for retired members of the South African National Defence Force. We provide core administration and managed healthcare services to this scheme • De Beers Benefit Society, a closed medical scheme specifically for the employees of De Beers. We provide managed healthcare services to this scheme. • SEDMED, a closed medical scheme specifically for the employees of the Seventh Day Adventist Church. We provide managed healthcare services to this scheme. • We also provide services to other smaller nonregulated medical schemes. As each of these schemes caters for different member needs, we provide customised solutions rather than a one-size-fits-all packaged service. We differentiate ourselves from our competitors through our high-service quality model. Performance As South Africa’s fourth-largest medical schemes administrator, our fees track within the industry average range. We have consistently paid dividends to PPS members and contributed to their PPS ProfitShare Accounts. Members who hold qualifying PPS life products and belong to Profmed earn additional Profit-Share, which is reflected on their Profit-Share Account statements. They also earn additional allocations through the PPS Profit-Share CrossHoldings Booster if they hold a combination of PPS life products and products from PPS subsidiaries – in this instance PPSHA. In 2021, our business continued to be affected by the ongoing COVID-19 pandemic. As in 2020, many scheme members lost their jobs or came under financial pressure for various reasons. Despite this, our membership increased during the year. These included members who had been retrenched by employers that operate closed schemes as well as members who had to resign their memberships of open schemes for financial reasons. The schemes experienced a high number of COVID19-related deaths, especially during the second and third waves of the pandemic, and this contributed significantly to net attrition rates. In addition, many members were either ill themselves or were deeply affected by the loss of loved ones, all of which led to unusually high claim volumes. As part of our response to this, we increased the capacity of our call centres to ensure that we could continue to deliver the high level of service we are renowned for. When vaccines became available during the first half of 2021, we introduced a vaccination concierge service, which involved consultants proactively contacting members to offer assistance in the process of registering to have the vaccination as well as booking a vaccine appointment. This initiative was very well received, especially by the elderly and high-risk members. In early 2021, in a partnership with BrandMed, we introduced a digitally-enabled, outcomes-based managed care solution. It provides a single-view, digital ecosystem that empowers patients to optimally manage their health and wellbeing needs in conjunction with their GP. Apart from many other benefits, this reduces unnecessary expenditure on certain tests, which results in the depletion of medical benefits. For related reasons, the schemes we administer and manage continued to cover telehealth consultations for routine ailments and conditions as a way of minimising potential exposure to the coronavirus. Coverage for enhanced telehealth services, such as consultations with specialists, psychologists and psychiatrists, remained in place. These services are now regarded by many members as an added-value component of their healthcare benefits. At operational level, we continued to use the hybrid on-site/remote working model we introduced in the wake of the first lockdown. This has proven to be both efficient and effective. Our staff embraced the changes to our way of working from the very start. The success of the new model has, in no small part, been due to the involvement of our Employee Assistance Programme, which has been on hand throughout the pandemic to help individuals with both work-related and personal issues. PPS Integrated Report 2021 PPS Group performance at a glance | 72
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