Namfisa Sets Cap on Medical Aid Contribution Increases in Namibia

Windhoek – The Namibia Financial Services Supervisory Authority (Namfisa) has announced a temporary cap on annual contribution increases for medical aid funds, limiting them to a maximum of 9.99 percent. This decision, detailed in a statement released on Friday, comes as a response to escalating medical aid contribution rates and aims to balance member well-being with the sustainability of the industry.

According to Namibia Press Agency (NAMPA), Namfisa’s decision follows the registrar’s observations of discrepancies between actual and forecasted solvency figures in medical aid funds over the past three to four years. These variances have often led to adjustments in contribution rates and benefits for members, raising concerns about the funds’ solvency forecasts during the 2024 Rule Amendment Approval process.

Kenneth Matomola, CEO of Namfisa, stated that in light of rising healthcare costs, the authority encourages medical aid funds to seek innovative solutions to lessen financial strains on individuals and families. Matomola emphasized the need for collaborative efforts between medical service providers and administrators to establish a new balance of affordability and sustainability in pricing.

The CEO highlighted the potential of technology in enhancing the efficiency of the medical aid industry. He urged funds and administrators to adopt automation, modernization, and data analysis technologies. These advancements could streamline operations, improve fraud management, and reduce administrative expenses, benefiting both members and service providers.

Namfisa also stressed the importance of transparency and accountability in the sector, advocating for the adoption of the International Classification of Diseases, Tenth Revision (ICD-10) coding structure by 2025. This standardized system is expected to improve pricing accuracy, enable detailed trend analysis, enhance fraud detection, and support efforts to reduce over-servicing.

Namfisa has set a deadline of 20 March 2024 for medical aid funds to submit additional contribution increase applications, accompanied by realistic strategies for long-term sustainability.