Returning COVID-19 claims savings

During the COVID-19 pandemic, GMHBA set aside funds to pay for claims we anticipated would be delayed, but not all claims that we planned for have been made. This has resulted in us generating additional claims savings which we’re giving back to members.

COVID-19 claims savings will be returned to eligible active memberships from 30 September 2024. On this date, the paid-to date for most eligible active policies will be moved forward 7 weeks. We’re working hard on getting these savings back to members and will send a reminder in September.

To qualify for the upcoming return of COVID-19 claims savings, GMHBA members need to hold an active private health insurance policy on 25 September 2024 and remain active on 30 September 2024.

Members with suspended or terminated GMHBA policies who are not classified as active on 25 September 2024 and 30 September 2024 will not qualify for the 7-week contribution.

The 7-week contribution will be calculated on 25 September 2024 and based on the weekly net premium amount for your cover. If there are any changes to your cover after this date, including to rebates, loadings or discounts applied to your membership, then your premium contribution may no longer be precisely 7 weeks.

If your policy is classified as active on 25 September 2024 and 30 September 2024, your paid-to date will still be moved forward 7 weeks (even if in arrears).

Throughout the pandemic, GMHBA returned value to members through freezing premiums and other COVID-19 support initiatives, including:   

• freezing premium increases for six months in 2020, 2022 and 2023
• returning claims savings to active members in 2022 and to suspended and former members in 2023
• providing telehealth benefits for a wide range of extras services to support continuity of care at home 
• partnering with Kieser to bring physiotherapy and related strength training direct to our eligible extras members with no out-of-pocket expenses (until 31 March 2021)
• providing a deferred elective surgery support program for physiotherapy and psychology consultations available to affected members (until 30 September 2022)
• waiving the minimum suspension period, so members who were eligible for a policy suspension could reactivate their cover at any time.  

Get more information on COVID-19 member support.

The funds we return through the return of COVID-19 claims savings are specifically in relation to savings made throughout the period that the COVID-19 pandemic impacted access to healthcare treatments for members.

The reason why health insurance premiums are reviewed is because health care costs increase year-on-year. Health care costs are driven by a number of factors outside of the industry’s control, including:

• increased cost of health service delivery with things like new medical technologies and treatments
• an ageing population and people living longer
• growing rates of chronic conditions

As a health fund, we have a responsibility to address and react to these rising costs and prepare for the future, to ensure our members continue to get access to the care they require. While we do need to make changes to premiums, as a member-based health fund we continually try to put value back into our products for the benefit of all members.

GMHBA has previously provided members who held active cover during the COVID-19 lockdown period with a one-off payment, as the ability to fully use their cover was impacted during this time.

COVID-19 claims savings were returned to eligible active memberships in December 2022 as a one-month contribution, and returned to eligible suspended and former memberships in May-June 2023 as a one-off payment.

To have been eligible for a payment, members must have held an active resident policy for a minimum of 3 months between 1 April 2020 and 30 November 2022.

The amount received by those with suspended or former memberships was based on product holding and tenure during the eligibility period. This payment was made to the policy holder on behalf of all members covered on the policy.

GMHBA covered the normal member payment for one months’ health insurance for eligible active resident policies from 10 December 2022 for eligible active members.

The contribution was made on 10 December 2022 for eligible active members. On this date, the paid to date on most active resident private health insurance policies was moved forward one month. If a member had pre-paid a policy 12 months in advance, a one month refund was processed.

Members with suspended resident policies that weren't classified as active on 30 November 2022 didn't qualify for the one-month contribution. Suspended members received a one-off payment in May-June 2023.

Please refer to your communication for your specific payment method, or reach out if you need more information.

You can view the Return of Surplus one month contribution received in the Premium payment history page in your member area.

If you are an eligible suspended or former member and haven’t received your payment – either via direct credit or cheque – after 31 July 2023, there may have been an issue with the account details we had on file for you. If you have had any issues receiving your payment, please get in touch.