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2015 MEDICAL GAP COVER

SENATE GROUP

Zestlife Zestlife is management owned started in 2009.

Operates as an insurer using Guardrisk cell captives.

Employs 100 staff and has 90 0000 policies mainly life and health.

JV with Liberty who sell the Zestlife gap cover under Liberty brand.

Healthcare Landscape

Private Sector Expensive•Specialist 24.5%•Hospitals 35.3%

Public Sector •Poor Quality

Medical Schemes

Gap Cover

PMB in full

No National Tariff

DSP

Choose Specialist

Covers shortfalls

Funding

Gap Claims

The Solution

Zestlife Gap will protect the members against these shortfalls for in-hospital procedures and a defined list of 50 out-patient procedures by;

•Covering the shortfall (Gap) resulting from any Medical Practitioner charging above the Medical Aid Tariff; No annual limit.

•Covering co-payments with no annual limit

•Covering excess of sub limit on internal prosthesis up to R30 000

Extra Benefits;

•R25 000 benefit on first diagnosis of cancer

•R20 000 mastectomy

•Accidental death and disability insurance of R25000 with emergency services

•Access to Hello Doctor

This is affordable and essential insurance for every medical scheme member at R207.

Market Differentiators

Products with similar benefits to Zestlife Gap. Stratum Comprehensive R205Zestlife R207Turnberry Extend a Care R212Sirago Ultimate R220Complimed Gap Shield Co-PayR235Stratum Elite R244 Average Gap Premium Sirago Elite R255 Complimed Gap Select R275Ambledown R275Sirago Cancer R278Turnberry Execucare R282

Premium discount for employer groups.Average age and number of members for a quote.

Market Differentiators

Adult Dependants, Child Dependants and Age Limits

Most other Gap Providers:•Exclude Adult Dependants or charge extra premium per dependant;•Limit the number of children covered or the age up to which children are covered•Impose entry age limits and provide a “Senior’ product if older than 70 or no cover.

All dependants on the medical scheme are covered under Zestlife Gap regardless of age or number.

Market Differentiators

Co-Payments

All the gap products cover co-payments but most of them have an annual maximum or an incident limit.

Zestlife has no incident limit or annual maximum and as with most other products MRI and CT scans are covered.

Zestlife covers co payments for using Non DSP hospital.

Market Differentiators

Cancer Benefits

Most other gap products cover cancer by paying the shortfall over a certain limit or excess up to a maximum annual amount.

Zestlife Gap Standard Cancer Benefit pays:•Lump sum payment of R25 000 on first diagnosis of cancer.•Lump sum benefit of R20 000 benefit for reconstruction of the non-affected breast in the event of a single mastectomy•20% co-payment cover payable when oncology limit is exceeded limited to R250 000 per annum per beneficiary.•Treatment shortfalls on chemotherapy and radiotherapy

ZESTLIFE HAS CANCER EXTENDER OPTION AT TOTAL PREMIUM OF R255

Optional Benefits 2015

Cancer Extender Total cancer cover R100 000 per beneficiary

Optional cancer extender benefit of an additional R75 000 for all cancers.

The term Cancer for the purposes of this Cover is defined as the presence of one or more tumours classified as malignant cells and with the invasion of normal tissue. Hodgkin’s disease and the Leukaemia’s are included in this definition, but excluded are all skin tumours and/or carcinoma-in-situ

There is a medical history question on previous cancers in the application form and there is a termination age of 65 and 6 month waiting period.

The additional premium for the cancer extender is R48 which covers the whole family on the medical scheme.

Optional Benefits 2015

Dentistry Benefit

The dentistry benefit covers the principal member and the dependants for emergency, accidental and specialised dentistry.

The Dental Gap Cover option will have a six-month waiting period (except in the event of an accident) and a termination age of 65.

The additional premium for Dental Gap Cover is R238 per month, which covers the whole family on the medical scheme.

Market Differentiators

Dentistry Benefit

There is a pre-existing condition exclusion for the first 12 months of the policy.

If the insured is aware of a condition requiring specific treatment plan before commencement of the Policy which has been diagnosed and written up by a dental practitioner then such treatment is deemed to be a pre-existing condition.

Benefit is paid on the occurrence of an insured event regardless of the treatment that is required.

Extended Dentistry Cover

Gap Cover Premiums and Benefits 2015

Accreditation

Short Term Insurance annually renewable policy.

Short Term FSP is required.

Zestlife can appoint FA as a representative.

Appointed approximately 2000 representatives.

Commission is 20% of premium paid on the 15th day of the month following the previous months premium collection.

Opportunity to build annuity income as well as being a great door opener.

Commission

Assume you sell 5 policies a month. 1 with dentistry and cancer and 2 with cancer. Lapse rate of 12% per year and 15% annual premium increase.

After 12 months 56 policies and R3188 per month;

After 24 months 106 policies and R6915 per month;

After 36 months 150 policies and R11 265 per month;

After 60 months 224 policies and R22 222 per month;

Total commission earned in 5 years R629 898.

Commission

Thank You