GCR upgrades Discovery Health Medical Scheme’s rating to AAA(ZA); Outlook Stable

13 Apr 2018 In Rating Notifications

GCR upgrades Discovery Health Medical Scheme’s rating to AAA(ZA); Outlook Stable

Johannesburg, 13 April 2018—Global Credit Ratings has today upgraded the national scale claims paying ability rating assigned to Discovery Health Medical Scheme to AAA(ZA) from AA+(ZA), with the rating outlook accorded as Stable.

 

SUMMARY RATING RATIONALE

Global Credit Ratings (“GCR”) has accorded the above credit rating to Discovery Health Medical Scheme (“DHMS”) based on the following key criteria:

The upgrade of DHMS’s rating to AAA(ZA) follows the removal of the previous industry ceiling of AA+(ZA), given that the scheme has maintained a very strong credit profile in the face of potential systematic challenges. In this regard, DHMS has demonstrated very strong financial profile management as evidenced by stability of the claims ratio in the face of potential earnings volatility. In turn, this has underpinned a consistent strengthening in the statutory solvency margin above regulatory requirements, which GCR views to significantly mitigate potential for regulatory intervention.

DHMS’s membership base is viewed to reflect a material rating strength, stemming from the risk pool’s exceptionally large scale and diversification. DHMS is the largest medical scheme in the open industry, covering just over 2.7m total lives (accounting for a sizeable 56% of total open industry scheme principal members). This is supported by the scheme’s sustained high membership retention rates, while intermediary and client concentrations are contained at very low levels. Furthermore, the member pool displays a favourable risk profile, with the average principal and beneficiary member ages remaining fairly stable at 44.9 years and 34.8 years respectively.

The ability to effect a higher average annual contribution rate increase for FY17 (compared to recent years) in response to a higher claims experience (in FY16), while still growing the membership base, attests to the flexibility inherent within the scheme structure, and strong brand. Furthermore, the scheme’s very large annual contributions (FY17: R59.7bn) and asset base (FY17: R25.7bn) provide a high degree of loss absorption capability, while persistency within the membership base and proven risk management protocols support a high level of claims predictability. Combined, the aforementioned factors have resulted in strong benefit and price alignment, supporting operational targets.

Strong operational effectiveness has translated into very strong earnings control, as reflected by a well contained claims ratio resulting in consistent net healthcare surpluses. In this regard, net healthcare margins have persistently exceeded the open scheme average, registering at a very healthy 2% in FY17 (3Q F17 open scheme average: 0.8%). The scheme will continue to target net healthcare results within a thin but sustainable margin, with reserve accumulation expected to be augmented by DHMS’s capacity for continued generation of healthy investment returns.

Attainment of operational targets have supported sustained strengthening in reserves, with the statutory solvency margin registering at a review period high of 27.4% at FY17 (FY16: 26.3%). While the scheme does not target excessive reserve build, strong performing years (as was the case in FY17) enhance loss absorption capacity and allow for greater operational flexibility in subsequent years. The reserve management strategy is likely to see solvency metrics maintained at strong levels going forward, preserving an adequate buffer above the regulatory minimum.

Very strong liquidity is supported by the sizeable cash portfolio (FY17: R14.8bn), which covered average monthly claims by a higher 2.9 months (FY16: 2.3 months). Additionally, strong cash flow management (attributed to very large monthly contributions), coupled with a highly tradable investment portfolio, offer considerable liquidity support. While there may be some rebalancing of the investment portfolio towards higher risk assets in FY18, liquidity is likely to be maintained at very strong levels given the scale and tradability of the investment base.

The national scale claims paying ability rating is at its ceiling. Downward rating pressure may arise from the statutory solvency margin falling below the required minimum, and/or a severe weakening in key operating and liquidity metrics.

 

 

NATIONAL SCALE RATINGS HISTORY
 
Initial rating (April 2000)
Claims paying ability: AA-(ZA)
Outlook: Stable
 
Last rating (March 2017)
Claims paying ability: AA+(ZA)
Outlook: Stable

 

ANALYTICAL CONTACTS

Primary Analyst
Vinay Nagar
Senior Credit Analyst
(011) 784-1771
.(JavaScript must be enabled to view this email address)
 
Committee Chairperson
Susan Hawthorne
Senior Credit Analyst
(011) 784-1771
.(JavaScript must be enabled to view this email address)

 

APPLICABLE METHODOLOGIES AND RELATED RESEARCH

Criteria for Rating Medical Schemes, updated July 2017

Discovery Health Medical Scheme rating reports, 2000-2017

 

RATING LIMITATIONS AND DISCLAIMERS

ALL GCR’S CREDIT RATINGS ARE SUBJECT TO CERTAIN LIMITATIONS AND DISCLAIMERS. PLEASE READ THESE LIMITATIONS AND DISCLAIMERS BY FOLLOWING THIS LINK: http://GLOBALRATINGS.NET/UNDERSTANDING-RATINGS. IN ADDITION, GCR’S RATING SCALES AND DEFINITIONS ARE ALSO AVAILABLE FOR DOWNLOAD AT THE FOLLOWING LINK:  http://GLOBALRATINGS.NET/RATINGS-INFO. GCR’S CODE OF CONDUCT, CONFIDENTIALITY, CONFLICTS OF INTEREST, PUBLICATION TERMS AND CONDITIONS AND OTHER RELEVANT POLICIES AND PROCEDURES ARE ALSO AVAILABLE AT http://GLOBALRATINGS.NET.

 

SALIENT FEATURES OF ACCORDED RATINGS

GCR affirms that a.) no part of the rating was influenced by any other business activities of the credit rating agency; b.) the rating was based solely on the merits of the rated entity, security or financial instrument being rated; c.) such rating was an independent evaluation of the risks and merits of the rated entity, security or financial instrument; and d.) the validity of the rating is for a maximum of 12 months, or earlier as indicated by the applicable credit rating document.

Discovery Health Medical Scheme participated in the rating process via face-to-face management meetings, teleconferences and other written correspondence. Furthermore, the quality of information received was considered adequate and has been independently verified where possible.

The credit rating has been disclosed to Discovery Health Medical Scheme with no contestation of the rating.

The information received from Discovery Health Medical Scheme and other reliable third parties to accord the credit rating included:

  • The unaudited financial statements to 31 December 2017
  • Four years of comparative audited financial statements to 31 December
  • Full year budgeted financial statements to 31 December 2018
  • Other relevant documents

The rating above was solicited by, or on behalf of, the rated client, and therefore, GCR has been compensated for the provision of the rating.

 

GLOSSARY OF TERMS/ACRONYMS USED IN THIS DOCUMENT AS PER GCR’S INSURANCE GLOSSARY

Assets A resource with economic value that a company owns or controls with the expectation that it will provide future benefit.
Beneficiary Nominated person or institution in the policy document that is entitled to receive the proceeds stated in the policy.
Capacity The largest amount of insurance available from a company. In a broader sense, it can refer to the largest amount of insurance available in the marketplace.
Cash Funds that can be readily spent or used to meet current obligations.
Cash Flow The inflow and outflow of cash and cash equivalents. Such flows arise from operating, investing and financing activities.
Claim A request for payment of a loss, which may come under the terms of an insurance contract.
Diversification Spreading risk by constructing a portfolio that contains different investments, whose returns are relatively uncorrelated. The term also refers to companies which move into markets or products that bear little relation to ones they already operate in.
Experience A term used to describe the relationship, usually expressed as a percent or ratio, of premiums to claims for a plan, coverage, or benefits for a stated time period.
International Scale Rating LC International local currency (International LC) ratings measure the likelihood of repayment in the currency of the jurisdiction in which the issuer is domiciled. Therefore, the rating does not take into account the possibility that it will not be able to convert local currency into foreign currency or make transfers between sovereign jurisdictions.
Intermediary A third party in the sale and administration of insurance products.
Investment Portfolio A collection of investments held by an individual investor or financial institution.
Liquidity The speed at which assets can be converted to cash. The ability of an insurer to convert its assets into cash to pay claims if necessary. Market liquidity refers to the ease with which a security can be bought or sold quickly and in large volumes without substantially affecting the market price.
Loss The happening of the event for which insurance pays.
Pool An organisation of insurers or reinsurers through which particular types of risk are underwritten and premiums, losses and expenses are shared in agreed-upon amounts.
Portfolio All of the insurer’s in-force policies and outstanding losses, with respect to described segments of its business.
Rating Horizon The rating outlook period
Reserve (1) An amount representing actual or potential liabilities kept by an insurer to cover debts to policyholders. (2) An amount allocated for a special purpose. Note that a reserve is usually a liability and not an extra fund. On occasion a reserve may be an asset, such as a reserve for taxes not yet due.
Retention The net amount of risk the ceding company keeps for its own account.
Retention Rate The net amount of risk the ceding company keeps for its own account as a percentage of GWP.
Risk The chance of future uncertainty (i.e. deviation from expected earnings or an expected outcome) that will have an impact on objectives.
Risk Management Process of identifying and monitoring business risks in a manner that offers a risk/return relationship that is acceptable to an entity’s operating philosophy.
Solvency With regard to insurers, having sufficient assets (capital, surplus, reserves) and being able to satisfy financial requirements (investments, annual reports, examinations) to be eligible to transact insurance business and meet liabilities.
Statutory Required by or having to do with law or statute.
Statutory Solvency Margin Gives an indication as to whether the minimum regulatory solvency margin is being met, based on the net statutory assets to statutory net premiums ratio.
Upgrade The assignment of a higher credit rating to an insurer by a credit rating agency. Opposite of downgrade

For a detailed glossary of terms please click here

 

 

 

 

 

 

 

ALL GCR CREDIT RATINGS ARE SUBJECT TO CERTAIN LIMITATIONS, TERMS OF USE OF SUCH RATINGS AND DISCLAIMERS. PLEASE READ THESE LIMITATIONS, TERMS OF USE AND DISCLAIMERS BY FOLLOWING THIS LINK:HTTP://GLOBALRATINGS.NET/UNDERSTANDINGRATINGS. IN ADDITION, RATING SCALES AND DEFINITIONS ARE AVAILABLE ON GCR’S PUBLIC WEB SITE AT WWW.GLOBALRATINGS.NET/RATINGSINFORMATION. PUBLISHED RATINGS, CRITERIA, AND METHODOLOGIES ARE AVAILABLE FROM THIS SITE AT ALL TIMES. GCR'S CODE OF CONDUCT, CONFIDENTIALITY, CONFLICTS OF INTEREST, COMPLIANCE, AND OTHER RELEVANT POLICIES AND PROCEDURES ARE ALSO AVAILABLE FROM THE UNDERSTANDING RATINGS SECTION OF THIS SITE.

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