2. Product Issues

1. When can members change their Options on Selfmed?

On 1 January of every year, after having given the Scheme 30 days' advance notice.

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2. Are Option changes allowed during the year?

Yes, but only under the following circumstances and only during the first 9 months of the year, where the Scheme has received 30 days' notice and the Scheme has approved the request:

• If members are retrenched or retire, they will be given the opportunity to change their option
  
• In the case of the principal member's death
  

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3. What is a threshold and to which Options does it apply?

A threshold is a set value to be reached before claims for day-to-day medical expenses are paid out by the Scheme. All day-to-day medical claims are processed and will accumulate towards reaching this threshold. Once the accumulated claims reach the family's threshold value, the Scheme will start to pay further day-to-day claims at specified rates and subject to certain limits.

A threshold only applies to certain of Selfmed's option.

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4. How will a member's threshold be affected if he adds a dependant to or removes a dependant from his/her membership during a year?

The threshold will be adjusted for the duration of the year. The same applies where a minor dependant's status changes to adult dependant

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5. At what rate will claims accumulate to threshold?

The percentage of the tariff as specified in the Rules will accrue to threshold.

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6. Will all claims paid from own pocket accumulate to threshold?

No, only those claims in respect of which the Scheme would allow a benefit after threshold.