CHARTERED ACCOUNTANTS (SA) MEDICAL AID FUND PROMOTION OF ACCESS TO INFORMATION ACT NO 2 OF 2000 PRIVATE BODY MANUAL
1. INTRODUCTION
CAMAF was established in 1951, and is registered as a restricted medical scheme with the Council for Medical Schemes under the Medical Schemes Act, 1998.
The purpose of this manual is to comply with section 51 of the Promotion of Access to Information Act, number 2 of 2000 (the Act).
The Act was passed to give effect to the constitutional right of access to any information held by the State and any information that is held by another person and that is required to the exercise or protection of any rights. CAMAF is a private body in terms of the Act.
The right to information under the Act is not absolute, and any requester is required (a) to show that the record is required for the exercise or protection of any rights, (b) to comply with the procedural requirements in the Act. Access to information requested must not be restricted under chapter four of part three of the Act examples of such restrictions are protection of privacy, protection of commercial, confidential or privileged information etc.
2. CONTACT DETAILS
Name: Chartered Accountants (SA) Medical Aid Fund Head of the fund Linky Olivier (Principal Officer)
Postal address: P O Box 2964, Randburg 2125
Physical address: Wedgefield Office Park, 17 Muswell Road South, Bryanston.
Telephone: 27 (0) 861 700 600 Telefax 27 (0) 861 113 676
Website: www.camaf.co.za E-mail [email protected]
3. GUIDE OF THE SOUTH AFRICAN HUMAN RIGHTS AND COMMISSION
In terms of section 10 of the Act, the South African Human Rights Commission is required to compile a guide to assist a person wishing to exercise any right contemplated in the Act.
The contact details of the Human Rights Commission are as follows:
The South African Human Rights Commission; PAIA Unit Research and Documentation Department: Private Bag 2700, Houghton, 2041
Telephone: 011 484 8300
Telefax: 011 484 0582
Website: www.sahrc.org.za
e-mail: [email protected]
4. RECORDS AVAILABLE IN TERMS OF THE MEDICAL SCHEMES ACT, 1998 WITHOUT A PERSON HAVING TO REQUEST ACCESS IN TERMS OF THE ACT
4.1 Copies the following records of CAMAF are available on request by a beneficiary (as defined in the Medical Schemes Act) of CAMAF, after payment of any fees determined by the rules of CAMAF:
4.1.1 the rules of the fund (section 41 (1) (a));
4.1.2 the audited annual financial statements of CAMAF together with the report of the Board of Trustees to the Registrar (section 41 (1) (b) read with section 37(1) and 37 (5));
4.1.3 the management accounts (which accompanied the annual financial statements) in respect of every benefit option offered by the medical scheme indicating the financial performance thereof and the number of members enrolled per option. (section 41 (1) (c) read with section 47 (4) (d)).
4.2 In terms of section 41 (2) of the Medical Schemes Act, a beneficiary is entitled to inspect, without charge, at the registered office of the medical scheme the documents referred to in clause 4.1 above and to make extracts therefrom.
4.3 In terms of section 41 (3) of the Medical Schemes Act, any person may, upon payment of the prescribed fee, inspect at the office of the Registrar any document referred to in clause 4.1 above and may make an extract thereof. This Act provides for the Registrar to exempt any person from payment of this fee if the document is required for the purpose of furthering the public interest.
The registrar’s contact details are as follows:
Registrar of Medical Schemes Address: Block A, Eco Glades 2 Office Park, 420 Witch – Hazel Avenue, Eco Park, Centurion, 0157 Telephone: (012) 431 0500
Telefax: (012) 430 7644
Website: www.medicalschemes.com
5. DESCRIPTION OF RECORDS HELD BY CAMAF
5.1 Scheme records
5.1.1 rules of the fund;
5.1.2 the latest audited financial statements;
5.1.3 the latest management accounts;
5.1.4 contract with service providers, such as administrators, managed health care organisations, auditors, attorneys, actuaries, investment managers and other providers of service;
5.1.5 employment contracts;
5.1.6 sundry contract such as nondisclosure agreements;
5.1.7 insurance contracts;
5.1.8 agendas and minutes of trustee/board meetings and subcommittee meetings;
5.1.9 attendance registers for meetings;
5.1.10 the procedure for the disputes committee;
5.1.11 correspondence with members and other parties.
5.2 Records of beneficiaries
5.2.1 personal details relating to beneficiaries, including but not limited to name, address, employer, date of birth, number of dependents, benefit option. selected, claims histories, marital status and gender;
5.2.2 medical claim details relating to beneficiaries, including but not limited to date of treatments, amount claimed, nature of treatments, medication prescribed and hospital admissions. Certain of the above records and, in particular those containing personal information relating to beneficiaries of CAMAF and agreements with CAMAF, may be subject to an obligation of confidentiality or to the confidentiality requirements of the Medical Schemes Act and/or the Act. In terms of section 57 (4) of the Medical Schemes Act, the Board of Trustees of CAMAF is obliged to take all reasonable steps to protect the confidentiality of medical records concerning any member’s state of health.
6. THE REQUEST PROCEDURES
6.1 Forms and fees
6.1.1 a request for information must be made in the prescribed form, must be addressed to the Principal Officer of CAMAF, and must be submitted together with the prescribed fee.
6.1.2 The prescribed request form and details regarding the prescribed fees are available from the Principal Officer of CAMAF and from the South African Human Rights Commission, whose contact details are set out above.
6.2 Form of request.
6.2.1 The requester must use the prescribed form to make the request for access to a record. This must be made to the Principal Officer of CAMAF. This request must be made to the address, fax number or electronic mail address of CAMAF.
6.2.2 The requester must provide sufficient detail on the request form to enable the Principal Officer to identify the record and the requester. The requester should also indicate which form of access is required. The requester should also indicate if it requires notice of the decision of the Principal Officer in any manner, other than in writing.
6.2.3 The requester must identify the right that is sought to be exercised or to be protected and provide an explanation of why the requested record is required for the exercise or protection of that right.
6.2.4 If a request is made in behalf of another person, the requester must submit proof of the capacity in which the requester is making the request to the satisfaction of the Principal Officer of CAMAF.
6.3 Fees
6.3.1 The Act provides for two types of fees:
6.3.1.1 A request fee, which will be a standard fee; and
6.3.1.2 An access fee, which must be calculated by taking into account reproduction costs, search and preparation time and cost, as well as postal costs.
6.3.2 A requester who seeks access to a record containing personal information about that requester is not required to pay the request fee. Every other requester, who is not a personal requester, must pay the required request fee.
6.3.3 The Principal Officer of CAMAF must by notice, require the requester to pay the prescribed fee, if any, before further processing the request.
6.3.4 The requester may lodge an application to court relating to the payment of these request fees.
6.3.5 After the Principal Officer of CAMAF has made a decision on the request, the requester must be notified in the required form.
6.3.6 If the request is granted then a further access fee must be paid for the search, reproduction, preparation and for any time, in excess of the prescribed hours, required to search and prepare the record for disclosure.
6.4 Availability of the manual.
6.4.1 This manual is available for inspection at the offices of CAMAF, free of charge. It can also be accessed using the universal resource locator, www.camaf.co.za.
6.4.2 It should be noted that the manual accessible on CAMAF’s website, does not include the request forms all the fee structure. The request forms and fee structure can be obtained via the SAHRC website, details of which are set out above, or via the website of the Department of Justice and Constitutional Development, which website can be accessed using universal resource locator, www.justice.gov.za
