ESI member letter on year end



November 2011

Dear Life Esidimeni Employee- Discovery Health member

DISCOVERY HEALTH MEDICAL SCHEME CHANGES FOR 2012

Discovery Health Medical Scheme recently made their 2012 benefits and contributions available and you are once again given the opportunity to change your plan option with effect from 1 January 2012. You therefore need to consider your healthcare requirements for the following year and decide if you have the cover appropriate to your needs. You are under no obligation to change your plan option however if you want to change your current plan option, you would need to submit your new plan option information to your FPA (Frontline Payroll Administrator)/ payroll administrator, within 5 days from your business unit’s presentation. Option changes will not be accepted after the 25th November 2011.

CHANGING YOUR PLAN OPTION

Discovery Health Medical Scheme will send you a brochure on behalf of Alexander Forbes Health containing a detailed summary of the 2012 benefits and rates – after carefully studying the changes for 2012 you will need to decide whether you wish to change your plan option.

Please note that if you do not notify your FPA / payroll administrator of your plan option prior to the above deadline date, by completing the attached option change form (Annexure D), you will remain on your current option and only be afforded another opportunity to change your option in November 2012 for January 2013.

ASSISTANCE WITH CHOOSING YOUR PLAN OPTION

There are four channels of assistance available to you:

1. Member Presentations

Presentations will be held in the following regions between the 31st October 2011 and 25 November 2011. Please watch your notice boards for details of venues, dates and times.

| Region |No Of Presentations |

|Bloemfontein |13 |

|East London |24 |

|Gauteng East |33 |

|Gauteng North |24 |

|Gauteng West |39 |

|Kwazulu Natal |44 |

|Port Elizabeth |22 |

|Western Cape |24 |

|Other |43 |

|Total |264 |

2. Discovery Health Medical Scheme

Members may contact the Discovery Health Medical Scheme for general plan information by:

• Phoning 0860 100 694;

• Browsing the website discovery.co.za

• Making use of the national walk-in centres

• DvD – training dvd’s will be available from your FPA

• Vitality magazine (Spring edition)

3. Alexander Forbes Health

Alexander Forbes Health consultants will be available at the member presentations to assist you to make the right plan option choice and to provide advice. You can also contact a consultant on:

|Alexander Forbes Health office |Tel number |Email address |

|Sandton office |011 269 2690 |hcclientservices@aforbes.co.za |

|Stellenbosch office |021 809 3777 |clientspecialist@aforbes.co.za |

4. Healthcare Website

You may also access the healthcare website on your Company’s intranet for all the 2012 benefit information, or log onto afhealth.co.za/esi

CONTRIBUTIONS

We believe that Discovery Health Medical Scheme’s average contribution increase, effective 1 January 2012, of 8.9% reflects a positive view of the Scheme’s sound operating position as well as that of the overall industry environment at this time. The increase is applicable to all plan options, however as a result of rounding differences a few variations exist. Please refer to Annexure A for the 2012 contributions as well as the increased threshold levels on the Priority, Comprehensive and Executive plan options. Medical savings as a percentage of total contributions remained unchanged for 2012.

Discovery Health has reviewed their Adult Dependant Eligibility Criteria and as a result only the following dependants will qualify for the adult dependant contribution.

• spouses

• ex-spouses

• full-time students up to the age of 25 or

• financially dependent disabled child dependants.

All other adult dependants, e.g. parents, children over the age of 25 will be charged the same contribution as a principal member. This will lead to significant contribution increases for those members affected. Discovery Health will be communicating directly with all affected existing members as part of Discovery Health’s year-end member communication process. This communication will request that proof of eligibility should be returned to Discovery by the 9th December 2011 this may include proof that the main member is responsible for the medical aid contributions (e.g. ex spouse/partner); registration documents recognised by law/custom (additional spouses); medical proof of disability (financially dependent disabled children) etc. Discovery Health will charge the principal member rate for these dependants and will only amend the contributions on the first of the month following the month in which proof has been received, i.e. no backdating or refunds will be granted. A copy of this proof must be provided to your FPA / payroll administrator for record purposes. Contributions for non eligible adult dependants will be deducted via payroll for existing dependants but no future non eligible adult dependants will be deducted via payroll.

BENEFIT CHANGES

The majority of benefits will increase in line with the contribution increase of 8.9%, however the benefit limits for prescribed medication, internal prosthesis and oncology remain unchanged. The limits for external medical appliances and devices will increase with surgical inflation.

HOSPITALISATION BENEFITS

Networks

Refer to Annexure C for the list of hospitals applicable to the KeyCare and Delta plan options. Please note that no changes were announced on the Delta Hospital Network however the KeyCare Hospital Network has seen the Moot Hospital (Pretoria) being removed and the Clinix Phalaborwa Private Hospital has been added. The KeyCare 2012 Day Surgery Network has also been extended.

Deductibles

Members participating on Priority plans should note that the defined deductibles for in-hospital procedures will range from R1 750 to R8 600 in 2012. Please refer to Annexure B for more details.

Members participating on Delta plans should note that the deductible has increased to R4 550 per planned hospital admission if you do not make use of the Delta network of hospitals (Refer to Annexure C).

You should take note of the increases in the deductibles, refer table below, if you consider having in-hospital dentistry treatment during 2012:

| |Hospital |% change |Day Clinic |% increase |

| |2011 |2012 | |2011 |2012 | |

|Member older than 13 |R3 000 |R3 300 |10% |R2 000 |R2 200 |10% |

DAY-TO-DAY BENEFITS

Members participating on Core plans do not have access to day-to-day benefits. With the exception of the KeyCare Plus plan which offers limited benefits through network providers, all other plans provide day to day cover through the Medical Savings Account and Above Threshold Benefit (where applicable).

INSURED BENEFIT

This benefit extends day-to-day cover once funds in the Medical Savings Account are depleted. Discovery Health will cover consultations, as follows, provided you visit a general practitioner (GP) in the Discovery Health GP Network.

|Plan | |Single member |Family |

|Saver Plans |Classic and Coastal |3 consultations |6 consultations |

| |Essential |2 Consultations |4 consultations |

|Priority, Comprehensive and |This GP benefit is unlimited on the above mentioned plans as long as the member goes to a GP in Discovery |

|Executive Plans |Health’s network. This benefit also covers pathology at specific network providers however your GP or |

| |specialist must request the tests by completing the Discovery Health pathology form (available on |

| |discovery.co.za). |

THE ALLIED AND THERAPEUTIC BENEFIT

Discovery Health has redesigned the allied health benefits on the Executive, Comprehensive and Priority plans. The following limits will apply for allied and therapeutic services from 2012, subject to available funds in the Medical Savings Account and Above Threshold benefit:

|Health Professional |2011 Benefit |2012 Benefit |

|Psychiatrists | |Covered as a specialist out-patient consultation, with no sub-limit |

|Registered counselors |Mental Health Benefit: R12|Cover provided through the Allied and Therapeutic Benefit: |

| |000 to R16 000 | |

| | | |

| | |Executive |

| | |Comprehensive |

| | |Priority |

| | | |

| | | |

| | | |

| | |Classic |

| | |Essential |

| | |Classic |

| | |Essential |

| | | |

| | |M |

| | |R12 500 |

| | |R10 000 |

| | |R6 000 |

| | |R6 000 |

| | |R4 000 |

| | | |

| | |M+1 |

| | |R15 000 |

| | |R13 500 |

| | |R8 500 |

| | |R8 500 |

| | |R6 000 |

| | | |

| | |M+2 |

| | |R17 500 |

| | |R16 500 |

| | |R11 000 |

| | |R11 000 |

| | |R7 500 |

| | | |

| | |M+3 |

| | |R21 000 |

| | |R19 000 |

| | |R13 000 |

| | |R13 000 |

| | |R9 000 |

| | | |

|Psychometrists | | |

|Education Psychologists | | |

|Clinic Psychologists | | |

|Stoma sister |Home nursing benefit: R6 | |

| |650 per family | |

|Wound care sister | | |

|Registered nursing sister | | |

|Chiropractors | | |

|Homeopaths |Covered through the Above | |

| |Threshold Benefit with no | |

| |sub-limits | |

|Podiatrists | | |

|Speech Therapists | | |

|Occupational Therapists | | |

|Physiotherapists | | |

Please note that these changes are not applicable to the Saver, Core and KeyCare plans.

THE ALLIED AND THERAPEUTIC EXTENDER BENEFIT

This has been introduced to cater for members who meet specific clinical entry criteria and who exceed the above limits. The benefit, available on application, will provide additional cover for allied healthcare services for a list of serious conditions (e.g. Autism, Cerebral Palsy, Parkinsons Disease, Multiple Sclerosis, Muscular Dystrophy etc).

CHRONIC MEDICATION (PREFERRED PROVIDERS)

You have cover for a defined list of chronic conditions according to your plan choice; the medication for these conditions is subject to Discovery Health’s approved medicine list. If you take medication that is not available on Discovery Health’s medicine list there is a set monthly amount available to cover your medicine costs. Discovery Health will pay medicine up to the Discovery Health Medicine Rate. Chronic conditions need to be approved by Discovery Health in order for the condition to be covered from the Chronic Illness Benefit.

When you utlilize MedXpress, Discovery’s medicine delivery service, you will not be required to fund any delivery or administration fees. Discovery’s qualified service agents can also advise you on the most cost-effective alternatives and you will be charged at the Discovery Health Medicine Rate or less – minimising co-payments. All major pharmacy chains, including Clicks, Dis-Chem and MediRite, as well as over 1 200 community pharmacies are contracted to charge Discovery Health members at this rate.

DISCOVERY HEALTH MEDSAVER BENEFIT

From January 2012, you will qualify for up to 25% cash back on all schedule 1 and 2 medicines purchased from any Clicks store countrywide. You must activate the benefit on discovery.co.za and complete a Vitality Check (screening tests) in the Vitality Pharmacy Network or at a Wellness Day. All spouses and/or adult dependants on the membership will need to complete a Vitality Check to earn 25% cash back at Clicks. The MedSaver cash back will be paid back into your DiscoveryCard™ or a nominated bank account on a monthly basis. The minimum amount that will be paid as a cashback benefit to you is R50. If the accumulated cashback is less than R50 the payment will be held until such time that it exceeds R50.

KEYCARE PLANS

The KeyCare income bands remain unchanged for 2012. As a result some members may move into a higher income bracket and thus experience an increase in excess of the 8.9%.

The casualty fee for ALL KeyCare casualty units for 2012 is R185, therefore the preferred casualty network falls away and the flat rate will apply at all KeyCare hospitals with a casualty unit.

Discovery Health has added additional day case procedures which will be covered through the enhanced KeyCare Day Surgery network. The details will be included in your Discovery plan information which will be distributed early in 2012.

New exclusions applicable to KeyCare plans include arthroscopies, removal of varicose veins and bunions.

VITALITY AND KEYFIT BENEFIT

Refining the key Vitality benefits

From 1 April 2012, the number of compulsory gym visits will increase from 24 to 36 visits in a rolling 12 month period, which equates to 3 times a month. The penalty for not meeting the minimum requirement will reduce the monthly discount from 80% to 50% for members who joined the gym after 1 January 2011.

You will earn booster Vitality points, if the results of your Vitality Check and fitness assessment are within the healthy range. If the results are not within a healthy range, you will earn fewer points in 2012.

The Pick n Pay DiscoveryCard benefit has been integrated with the Pick n Pay Smart Shopper card. You will continue to receive up to a maximum of 25% cash back on your HealthyFood™ purchases, and will therefore no longer have the option to increase your savings to 75% by opting to have the cash back paid into the Medical Savings Booster.

The additional discount you receive for paying with your DiscoveryCard at Pick n Pay will be replaced with Smart Shopper points, depending on your Vitality status.

Building on the HealthyFood™ Benefit

Discovery Vitality has introduced the Clicks HealthyCare™ and the Adidas HealthyGear™ Benefits.

|HealthyCare™ Benefit |You can save up to 25% on all products in the HealthyCare™ Product range available from Clicks after activating |

| |the benefit and completing a Vitality Check (screening tests). The saving is in addition to the existing 5% to |

| |15% Clicks Cash-back rewards you already receive depending on your Vitality status. |

|HealthyGear™ Benefit |You can save up to 25% on Adidas active gear and sports equipment available at all Adidas Stores and Totalsport |

| |Stores after activating the benefit and completing a fitness assessment. The discount is also in addition to |

| |the existing Vitality partner discount at Totalsports of up to 20% depending on your Vitality status. |

You also have access to the social networks, facebook and twitter for the information on the Vitality benefit. The process to register is as follows: Log onto discovery.co.za click on the Vitality drop down menu/scroll to the bottom of the page and click on the “interact with us” link with facebook or twitter.

If on facebook click the “like” button to join the page and if on twitter, once the page opens click on “follow”. You will then be subscribed and receive notifications from Discovery Vitality.

ONLINE TOOLS

Discovery Health has developed a range of tools to guide you through the system and to identify when you can expect benefits to be reimbursed in full i.e. Hospital Advisor (used when going to hospital); MaPS Advisor (for visiting the doctor); Med Advisor (when buying medicine); Benefit Advisor (for day-to-day medical expenses).

HOW MUCH WILL YOUR COMPANY PAY TOWARDS YOUR MEDICAL AID?

Company Subsidy Policy

Remember, it is compulsory for you to belong to the Company’s approved medical aid scheme unless you are a dependant on your spouse or partners medical aid scheme.

In order to assist you in meeting the costs of your medical aid cover, the Company will contribute towards the cost of your medical aid cover (medical aid subsidy).

Who will the Company Subsidise?

The Company will subsidise a specific amount for yourself (the Principal Member), one spouse/partner dependant and up to a maximum of 2 children.

Dependants over the age of 21, who are studying, will be charged by the scheme at an adult dependant rate, but the Company will only provide a subsidy at the child rate – as long as proof of studies is provided.

The child subsidy will also only apply whilst the child is studying in a tertiary institution, and proof is provided as such, but will not be extended beyond 25 years of age. Physically or mentally handicapped children, who are reliant on the parent for support, may qualify for a subsidy subject to Executive approval.

Children over the age of 21 who are not studying will be billed at a principal member rate, the Company does not subsidise these dependants.

How Much will the Company Subsidise?

The Company subsidy has increased by 7.0% for all options

The Company subsidy is dependent on your family size and the option that you choose. The table below depicts the Company subsidy table for 2012:

|Plan Option |PM |SP |CD 1 |CD 2 |

|Maximum Subsidy |R1134 |

|KeyCare Plus |R276 |R276 |R80 |R80 |

|(All Income Categories) | | | | |

|PM : Principal Member; |

|SP : Spouse |

|CD 1: Child Dependant 1 |

|CD2: Child Dependant 2 |

GAP COVER INSURANCE – ADMEDGAP

The AdmedGap contribution will increase from R97 (2011) to R103 per family per month with effect from

1 January 2012. This is a voluntary membership and is payable directly from your bank account by debit order.

AdmedGap is a short term insurance policy that covers the difference between the doctors private costs (e.g. anaesthetists, surgeons, other specialists and GP’s) and the Admed Tariff for procedures done in hospital, subject to a maximum of four times the Admed Tariff. It is important to note that most medical schemes such as Discovery Health have adopted their own internal rates of reimbursement (internal tariffs) and that these may not necessarily agree with the Admed Tariff rate. The AdmedGap benefits will continue to be linked to the Cost of the Practitioner as it is not possible to set benefits that are linked to all the various internal tariffs adopted by the many medical schemes registered in South Africa.

No changes have been made to the policy benefits, exclusions and waiting periods for 2012. The policy limits have however been increased to R200 000 per insured person and R2 000 000 per family per calendar (policy) year. Details of the general exclusions and waiting periods can be obtained from Alexander Forbes Health or the Admed website on admed.co.za.

An excess will be applicable to all claims in respect of claiming members who are 60 years of age or older. This excess will amount to 5% of the benefit payable, subject to a minimum of R250.00. All principal members of AdmedGap automatically qualify for Personal Accident cover amounting to R25 000.00.

Existing employees/medical scheme members who have not yet joined AdmedGap may join on 1 January 2012. An application form needs to be completed and can be obtained from your FPA / payroll administrator or on the healthcare website – refer page 1. Please use the Application for Debit Order Membership. Due to this option being voluntary, waiting periods and exclusions will apply.

Finally, we wish you good health in 2012!

Alexander Forbes Health Consultants and Actuaries

Live without regret.

Annexures

A – Standard 2012 Discovery Health rates

B – Priority Series - Deductibles

C – Delta and KeyCare Network of hospitals

D – Plan Option Change Form

[pic]Disclaimer: While all reasonable care has been taken by Alexander Forbes Health in compiling this communication, we have relied upon the accuracy and completeness of the information made available to us and subsequently cannot accept any liability or any errors or omissions that may arise as a result of the reliance of such information.

DISCOVERY HEALTH 2012

Total monthly contributions

|Series |Plan |Principal Member |Adult |Child |

| | | |Dependant** |Dependant * |

|Comprehensive |Classic Comprehensive |2 760 |2 609 |552 |

| |Essential Priority |1 590 |1 249 |635 |

|Saver |Classic Saver |1 652 |1 300 |660 |

| |Classic Delta Core |984 |773 |393 |

| |Essential Core |1 056 |791 |422 |

| |Essential Delta Core |844 |633 |339 |

| |Coastal Core |892 |669 |356 |

|KeyCare |KeyCare Plus (R8 301+) |1 211 |1 211 |324 |

| | |Annual |Monthly |Annual |Monthly |Annual |Monthly |

|Comprehensive |Classic |8 280 |690 |7 824 |652 |1 656 |138 |

| |Essential |2 856 |238 |2 244 |187 |1 140 |95 |

|Saver |Classic |4 956 |

|Principal member |10 090 |9 300 |

|Per adult |10 090 |9 300 |

|Per child* |1 900 |1 750 |

* A maximum of 3 children are counted when calculating the Annual Threshold

Priority plans

| |Annual Threshold |Above Threshold Limit |

|Principal member |8 200 |7 000 |

|Per adult |6 150 |4 950 |

|Per child* |2 690 |2 400 |

* A maximum of 3 children are counted when calculating the Annual Threshold and Above Threshold Limit

VITALITY & KEYFIT CONTRIBUTIONS

| |Single Member |Member with one dependant |Member with two or more |

| | | |dependants |

|Vitality |136 |158 |167 |

|KeyFIT |29 |36 |45 |

|Vitality & KeyFIT |145 |172 |193 |

LATE JOINER PENALTIES

Please note these rates are the standard Discovery Health rates and do not take into account any late joiner penalties (LJP) that may be applied to an applicant or to the adult dependant of an applicant older than age 35.  Depending on the number of years they have not belonged to a registered South African medical scheme, an additional penalty (a percentage of the contribution) may be added to the member's monthly contribution, as shown in the table below:

|Penalty bands |Maximum penalty |

|1 – 4 years |0,05 X contributions |

|5 – 14 years |0,25 X contributions |

|15 – 24 years |0,5 X contributions |

|25+ years |0,75 X contributions |

The LJP is calculated as follows: A = B minus (35 + C)

Where:

A = the number of years in the first column

B = the age of the applicant at the time of application

C = the number of years of creditable cover

Members need to pay an amount upfront to the hospital when the member is admitted for one of the following procedures:

|DEDUCTIBLE AMOUNT |PROCEDURE |

|R1 750 |Adenoidectomy |

| |Conservative back and neck treatment |

| |Myringotomy (grommets) |

| |Tonsillectomy |

|R2 350 |Colonoscopy |

| |Cystoscopy |

| |Gastroscopy |

| |Proctoscopy |

| |Sigmoidoscopy |

|R4 250 |Arthroscopy |

| |Endometrial ablation |

| |Functional Nasal Procedures |

| |Hysterectomy (except for pre-operatively diagnosed cancer) |

| |Hysteroscopy |

| |Laparoscopy |

|R8 600 |Joint replacements |

| |Nissan fundoplication (reflux surgery) |

| |Spinal (back and neck) surgery |

If the procedure can be done out of hospital, for example in the doctor’s rooms, and the member doesn’t go to hospital, the member won’t have to pay a deductible. It is recommended that members contact Discovery Health directly on 0860 100 694 prior to the procedure in order to confirm their benefits.

GAUTENG

|Arwyp Medical Centre |

|Life Bedford Gardens Hospital |

|Netcare Bougainville Private hospital |

|Life Brenthurst Clinic |

|Life Carstenhof Clinic |

|Clinix Private hospital – Lesedi |

|Clinix Private hospital – Sebokeng |

|Clinton Clinic |

|Emfuleni Medi-Clinic |

|Life Fourways hospital |

|Legae Private hospital |

|Lenmed Clinic Limited |

|Little Company of Mary |

|Louis Pasteur hospital |

|Midvaal Private hospital |

|Morningside MediClinic |

|Life Robinson Private hospital |

|Life Roseacres Clinic |

|Suikerbosrand Clinic |

|The Donald Gordon Medical Centre |

|Life Wilgeheuwel Hospital |

EASTERN CAPE

|Life New Mercantile Hospital |

FREE STATE

|Life Rosepark Hospital |

|Universitas Private Hospital |

KWA-ZULU NATAL

|Life Chatsmed Gardens Hospital |

|Life Entabeni Hospital |

|Ethekwini Hospital |

|Life Westville Hospital |

|Midlands Medical Centre (Pietermaritzburg) |

WESTERN-CAPE

|Cape Town MediClinic |

|Life Claremont Hospital |

|Life Kingsbury Hospital |

|Mitchell’s Plain Medical Centre |

|Panorama MediClinic |

|Vergelegen MediClinic |

Please note that the list of hospitals is subject to change. You can go to discovery.co.za for the latest list of hospitals.

The list does not include the day clinics where members can get treatment without paying an amount upfront.

EASTERN CAPE

|East London |Life Beacon Bay Hospital |

|East London |St James Operation theatres |

|East London |East London Private hospital |

|East London |St Dominic’s Private hospital |

|Humansdorp |Isivivana Private hospital |

|Port Elizabeth |Life New Mercantile Hospital |

|Queenstown |Life Queenstown Private hospital |

|Uitenhage |Netcare Cuyler clinic |

|Umtata |Life St Mary's Private hospital |

FREE STATE

|Bethlehem |Hoogland MediClinic |

|Bloemfontein |Bloemfontein Eye Centre |

|Bloemfontein |Netcare Pelonomi Private hospital |

|Bloemfontein |Life Rosepark Clinic |

|Bloemfontein |Life Pasteur Hospital |

|Bloemfontein |Netcare Universitas Private hospital |

|Welkom |Ernest Oppenheimer Hospital |

|Welkom |Hydromed MediClinic |

|Welkom |St Helena Hospital |

GAUTENG

|Benoni |Life The Glynwood-Hospital |

|Boksburg |Botshelong Empilweni-clinic (Clinix |

| |Vosloorus) |

|Boksburg |Sunshine Centre |

|Brakpan |Life Dalview Clinic |

|Germiston |Life Roseacres Clinic |

|Heidelberg |Life Suikerbosrand Clinic |

|Johannesburg |Netcare Rand Clinic |

|Johannesburg |Johannesburg Eye Clinic |

|Johannesburg |Netcare Garden City Clinic |

|Johannesburg |Life Brenthurst Clinic |

|Kempton park |Arwyp Medical Centre |

|Lakefield |Netcare Optiklin Eye Hospital |

|Lenasia |Lenmed Clinic |

|Midrand |Life Carstenhof Clinic |

|Pretoria |Netcare Bougainville Private Hospital |

|Pretoria |Centurion Eye Hospital |

|Pretoria |Life Eugene Marais Hospital |

|Pretoria |Netcare Jacaranda Hospital |

|Pretoria |Legae MediClinic |

|Pretoria |Louis Pasteur Hospital |

|Pretoria |Medforum MediClinic |

|Pretoria |Muellmed Hospital |

|Pretoria |Pretoria-Eye Institute |

|Pretoria |Zuid Afrikaans Hospital |

|Randfontein |Life Robinson Hospital |

|Randfontein |Sir Albert Medical Centre |

|Soweto |Clinix Soweto (Tshepo Themba) |

GAUTENG cont.

|Soweto |Lesedi Clinic |

|Springs |Life Springs Parkland Clinic |

|Springs |Life St Mary’s Women’s Clinic |

|Thembisa |Zamokuhle Private hospital |

|Vanderbijlpark |Emfuleni MediClinic |

|Vanderbijlpark |Ocumed |

|Vanderbijlpark |Netcare Vaalpark hospital |

|Vereeniging |Clinix-Private, Sebokeng |

|Vereeniging |Midvaal Private Hospital |

|Westgate |Medgate Day Clinic |

KWA-ZULU NATAL

|Amanzimtoti |Kingsway Hospital |

|Chatsworth |Life Chatsmed Garden Hospital |

|Durban |Life City Hospital |

|Durban |Life Entabeni Hospital |

|Durban |McLord Hospital |

|Empangeni |Life Empangeni Garden Clinic |

|Isipingo |Life Isipingo Clinic |

|Kokstad |Kokstad Private hospital |

|Ladysmith |La Verna Hospital |

|Newcastle |Newcastle Private hospital |

|Phoenix |Life Mount Edgecombe |

|Pietermaritzburg |Midlands Medical Centre |

|Pietermaritzburg |St Anne’s |

|Pinetown |Life Crompton Hospital |

|Port Shepstone |Hibiscus Hospital |

|Richards Bay |Netcare The Bay Hospital |

|Sydenham |Nu Shifa Hospital |

|Tongaat |Victoria Private hospital |

LESOTHO

|Lesotho |Willies Hospital |

LIMPOPO

|Bela Bela |St Vincent's Hospital |

|Phalaborwa |Clinix Phalaborwa Private |

|Polokwane |Limpopo MediClinic |

|Thabazimbi |Thabazimbi MediClinic |

|Tzaneen |Tzaneen MediClinicl |

MPUMALANGA

|Barberton |Barberton MediClinic |

|Ermelo |Ermelo Private hospital |

|Middelburg |Life Middelburg Private hospital |

|Nelspruit |Nelspruit Private hospital |

|Trichardt |Highveld MediClinic |

|Witbank |Life Cosmos Hospital |

|Witbank |Emalahleni Day hospital |

NORTH-WEST

|Carletonville |Leslie Williams Private Hospital |

|Carletonville |Western Deep Clinic |

|Klerksdorp |Life Anncron Clinic |

|Mafikeng |Victoria Private hospital |

|Orkney |West Vaal Clinic |

|Potchefstroom |Potchefstroom MediClinic |

|Rustenburg |Life Peglerae-Hospital |

NORTHERN CAPE

|Kathu |Kathu MediClinic |

|Kimberley |Kimberley MediClinic |

|Upington |Upington Private hospital |

|Vryburg |Vryburg Private hospital |

WESTERN CAPE

|Bellville |Bellville Medical Centre |

|Bellville |Louis Leipoldt MediClinic |

|Cape Town |Netcare Christiaan Barnard Memorial |

| |Hospital |

|Cape Town |Netcare UCT Medical Centre |

|Ceres |Ceres Private hospital |

|Gatesville |Gatesville Medical Centre |

|George |Geneva Clinic |

|George |George MediClinic |

|Hermanus |Hermanus MediClinic |

|Kuilsriver |Netcare Kuilsriver Private hospital |

|Milnerton |Milnerton MediClinic |

|Mitchells Plain |Mitchells Plain Medical Centre |

|Mossel Bay |Bayview Hospital |

|Oudtshoorn |Cango Day clinic |

|Oudtshoorn |Klein Karoo MediClinic |

|Paarl |Paarl MediClinic |

|West Coast |Life West Coast Private Hospital |

|Worcester |Worcester MediClinic |

Please note that the list of hospitals is subject to change. You can go to discovery.co.za for the latest list of hospitals and casualty units.

E&OE

CURRENT DETAILS

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PLAN CHANGE FOR 2012

MEDICAL SCHEME - - Please insert a X in the respective box of your plan choice for 2012

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* For members residing in coastal provinces only

**The Delta plans make use of a network of hospitals

*** KEYCARE PLUS members ONLY: Please complete if you want to change your service provider as from 1.1.2012 (Provider list/names available from discovery.co.za or 0860 100 694.

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LOYALTY PROGRAMME - - Please insert a X in the respective box if you would like to join

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I hereby declare that full product information has been made available to me by Discovery Health and/or Alexander Forbes Health which enabled me to make an informed decision with regard to selecting / changing my benefit option. I also confirm that should I require advice or assistance I will have full access to my Alexander Forbes Health consultant. In terms of the Rules of the Medical Scheme, I hereby apply to change my medical scheme option as indicated above. I understand the rules, benefits and financial implications of this option selection.

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This form must be completed and returned to your FPA / payroll administrator by 25 November 2011

(If no changes are required, please do not complete the form)[pic]

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