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Medical Aid

Medical Schemes Act

Medical Schemes Act 131 of 1998

The legislation that governs medical schemes, including PMBs, solvency, and member rights.

The Act establishes the entire framework: the Council for Medical Schemes, mandatory PMBs, scheme governance, solvency requirements (Regulation 29 requires schemes to hold reserves of at least 25% of annual contributions), and the rules around broker commissions. It's the single most important piece of healthcare legislation in South Africa.

SA example: Regulation 28 caps medical aid broker commission at R125.86 + VAT per member per month (or 3% of contributions, whichever is lower) effective 1 January 2026.