GEMS Explains Stance On 2026 Contribution Increases Rejected By Public Sector Unions 

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Johannesburg – The Government Employees Medical Scheme (GEMS) has moved to explain its stance on the 2026 contribution adjustments and also dispelled suggestions of two contribution increases.

GEMS, the largest restricted membership medical scheme in SA, with over 890 000 principal members and more than 2.4 million beneficiaries, said on Tuesday, 17 February 2026, that it noted the weekend media briefing held by the Trade Unions in the Public Service Coordinating Bargaining Council (PSCBC).

Moving to clarify the 2026 contribution adjustments that were discussed at the briefing, GEMS said these are not two separate increases; rather, a 9.5% adjustment that became effective on 1 February 2026. “

“The 9.8% figure mentioned was already approved for January by the Regulator due to statutory implementation timelines, and the only change effective from 1 April 2026 relates to the employer subsidy, a government-managed process, and is not a further GEMS contribution increase,” the scheme said in a statement made available to The Bulrushes.

“The 9.5% adjustment for 2026 was approved by the Council for Medical Schemes after GEMS resubmitted a request for further reduction of the 9.8% increase after consultations with organised labour.”

Dr. Stan Moloabi, GEMS Principal Officer, further explained that this level of increase was necessary to ensure GEMS can continue to pay future claims amidst “rising healthcare inflation and fraudulent claim pressures we are dealing with”.

Addressing the concerns regarding governance and operational costs, Dr. Moloabi said GEMS maintains one of the lowest non-healthcare and administrative cost ratios in the medical scheme industry.

“The scheme’s use of outsourced administration and managed care services is a strategic model designed to leverage specialised expertise efficiently, and any insinuation of wastage is simply not true,” said Dr. Moloabi.

“GEMS’ track record of 18 consecutive unqualified audits bears testimony to our prudence in managing Scheme finances.

“Furthermore, GEMS has actively worked to shield members from rising costs, utilising over R10 billion in reserves during the Covid-19 years to keep contribution increases below healthcare inflation and industry trends.

“The scheme also wishes to correct misrepresentations regarding the Tanzanite One benefit option changes implemented for 2026.”

Dr. Moloabi stated that GEMS has not acted unilaterally.

“These proposed changes were presented at several PSCBC working group meetings, and an extensive member education campaign is currently underway, including SMS notifications, infographics, and social media outreach, to ensure all beneficiaries understand these 2026 benefit design changes on Tanzanite One,” said Dr. Moloabi.

“GEMS members on Tanzanite One are still able to use private hospitals for prescribed minimum benefits conditions.

“So, it is not correct to say Tanzanite One members cannot use the private hospitals anymore.”

Dr. Moloabi said the scheme remains open to constructive dialogue and will continue to approach the unions for these consultative meetings to take place as soon as possible.

“It is important to note that a planned engagement workshop for 16 February was unfortunately cancelled after organised labour withdrew a week away from the scheduled date,” said Dr. Moloabi, adding that GEMS was appealing that all stakeholders, specifically organised labour, return to the established formal forum to resolve these matters constructively.

“We take the concerns raised by the unions seriously, particularly regarding the financial pressure on public service employees,” said Dr. Moloabi.

“We must, however, balance these concerns with the responsibility all of us have to keep the scheme solvent.

“We remain committed to transparency and appeal with organised labour representatives to engage with GEMS directly to deal with these complex matters and work together in the best interest of our members.”

Meanwhile, Trade unions in the Public Service Coordinating Bargaining Council have indicated that they are planning to protest against the GEMS’ recent monthly medical aid contribution increases.

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