From Stability to Curatorship: What Employers Can Learn from Sizwe-Hosmed

How Did We Get Here?
Sizwe-Hosmed Medical Scheme was placed under provisional curatorship in September 2025 after its solvency ratio declined to just over 6% by mid-2025. (Download the CMS Article Here) The decline followed the 2021 merger which initially reported a combined solvency ratio of 36.5%. Factors contributing to the reduction in reserves to the reduction in reserves included underpriced benefits, challenges in financial forecasting, and a R162 million claims shortfall.

By 2023, the scheme’s solvency had fallen below the regulatory minimum, leading to several interventions by the Council for Medical Schemes (CMS). When recovery efforts did not achieve the necessary improvements, the Gauteng High Court dissolved the Board and appointed a curator to oversee the scheme and safeguard member interests.

This situation highlights the importance of effective governance, appropriate pricing strategies, and transparent financial management in maintaining the sustainability of medical schemes, especially within a high-cost healthcare environment. Employers and members should regularly monitor scheme performance to support long-term viability.

👉 For employers and employees currently participating in Sizwe, here are key watch-points:

· Solvency – Track curator and CMS updates as low reserves remain a risk

· Benefits – Confirm claims are paid and monitor any changes to cover

· Contributions – Prepare for possible premium increases or benefit restructuring

· Governance – Stay alert to curator-led decisions

· Member Confidence – Communicate clearly to reassure employees

· Alternatives – Explore backup scheme options should recovery fail.

On 11 September 2025, the appointed curator, Lebogang Grace Mpakati, held an engagement session to provide updates on the investigation into the scheme’s operations. A recovery plan is being developed and will be shared with members at the upcoming Annual General Meeting. The curator’s primary responsibility is to ensure that the scheme meets its statutory requirements. Historically, schemes in similar circumstances have increased contributions and/or adjusted benefits to restore solvency.

Some healthcare providers have adjusted their billing practices during the curatorship period, including requesting upfront payment from Sizwe-Hosmed members. Given these developments, ASI advises employers to review their healthcare arrangements to ensure adequate protection for employees.

ASI will continue to monitor the situation and provide updates as further information becomes available