Wellness Fund Health Plan

Improved NBCRFLI Health Plan Benefits under new Service Provider (valid as of 1 January 2015)

The National Bargaining Council for the Road Freight and Logistics Industry (NBCRFLI) is pleased to announce the appointment of a new service provider, Affinity Health, for its Wellness Fund Health Plan. This appointment, which came into effect on 1 January 2015, means that all eligible NBCRFLI employee members will receive even better benefits and health services.

These include the following:

GP Consultations per eligible members and spouses are unlimited with pre-authorisation required after the sixth consultation. For assistance to find your network GP before your 1st consultation, call Affinity Health on 0861 00 11 31. You can also send a “please call me” to 079 409 1834 and Affinity Health will call you back.

Radiology and Pathology are linked to GP consultations as you must be referred by a doctor for this benefit. Only approved x-rays and blood tests, as per the formulary, will be covered for eligible members and spouses.

Acute Medication is limited, per eligible member and spouses, to a maximum of R1 000 for every 12 months. Only medication approved by Affinity Health, and according to formulary reference pricing, will be covered. Please call Affinity Health Customer Care at 0861 00 11 31 so we may direct you to the nearest pharmacy.

Chronic medication is subject to formulary reference pricing per eligible member and spouse, as approved by Affinity Health. You must be registered as a Chronic member in order to obtain this benefit. To confirm if your chronic condition is covered, you can contact the Affinity Health Customer Care line.

Chronic disease management is available for members that are registered for Chronic medication. Through support, we hope to assist you in bringing your condition under control and being able to live a normal life.

Dentistry is covered up to a maximum of R500 per insured incident and a maximum of R1 500 for every 24 months, per eligible member and eligible spouse. In the event of injury requiring dental treatment, there is a limit of R1 500 per insured incident and R3 000 for every 24 months.

Optometry is only available through a Specsavers outlet. A basic pair of frames and clear plastic single vision or bifocal lenses are available every 24 months, per eligible member and eligible spouse.

Emergency Services are available by phoning the number provided on the membership card. If another service provider is used, costs may not be covered if deemed non-emergent. This benefit includes repatriation of mortal remains if death occurs away from normal place of residence, per eligible member, eligible spouse and eligible children.

Hospital Illness Benefit will ensure that you receive some income while you are in hospital. After the first 24 hours you will receive R500, for the second day you will receive R400 and thereafter, up to a maximum of 21 days, you will receive R250. If you are in ICU or High Care, a benefit equal to R1 000 per day will apply. You do need to notify the pre-authorisation department when you are admitted; per eligible member only.

Accidental Injury Benefit (casualty rooms) is for injuries sustained as a result of an accident and is applicable only to eligible members. It is limited to treatment received in a hospital emergency unit and limited to R12 000 per incident. Please phone the pre-authorisation number for a Guarantee of Payment.

Hospital Indemnity Benefit is for actual costs of hospitalisation, if admitted due to an accident, up to the maximum amount of R75 000 per incident. Please phone the pre-authorisation number for a Guarantee of Payment, per eligible member, eligible spouse and eligible children.

Funeral Assistance Benefit of R10 000 is payable in the event of the death of the eligible member. This benefit shall be limited to the eligible member only, and excludes the eligible spouse.

New Cards
All eligible Health Plan members will be issued with new Health Plan cards. The new cards will be ready by the end of January 2015 and couriered to employers for distribution to their employees. Please note that active members are allowed to use their current Health Plan cards while the new ones are being dispatched.

Please remember to keep your personal membership card in your wallet or purse so that it is readily available, should you need it.

Queries regarding new benefits:
Should you have any queries regarding your membership or require a copy of the full product guide, please contact Affinity Health on 0861 00 11 31 or at info@nbcrflihealth.co.za. You can also send a “please call me” to 079 409 1834 and Affinity Health will call you back.

For further information about the new Health Plan, please go to www.nbcrfli.org.za or to www.nbcrflihealth.co.za. You may also use www.nbcrflihealth.co.za to register for the Health Plan.

Health Plan Benefits Brochure