Promotion of Access to Information Act Manual

Unless the context clearly indicates otherwise, the following terms shall have the meanings assigned to them hereunder, namely –

2.1. “Data Subject” means the person to whom the Personal Information relates;

2.2. “Information Officer” means the person acting on behalf of OMSMAF and discharging the duties and responsibilities assigned to the Principal Officer of OMSMAF by the Act. The Information Officer is duly authorised to act as such and such authorisation has been confirmed by the Principal Officer of OMSMAF in writing;

2.3. “Manual” means this manual published in compliance with Section 51 of the Act;

2.4. “Old Mutual Staff Medical Aid Fund (OMSMAF)” means a medical aid fund incorporated in terms of the Medical Schemes Act;

2.5. “Personal Information” means information about a Data Subject’s race, gender, sex, pregnancy, marital status, nationality, ethnic or social origin,
sexual orientation, age, physical or mental health, disability, religion, conscience, belief, culture, language, education, medical information, financial information, criminal or employment history, an identifying number, e-mail address, physical address, telephone number, blood type, biometric information, personal opinions, views or preferences of a Data Subject; correspondence of a private or confidential nature; and the name of the person if it appears with other personal information relating to the Data Subject, but excludes information about an individual who has been dead for more than 20 years;

2.6. “Personnel” means any person who works for or provides services to or on behalf of OMSMAF and receives or is entitled to receive any remuneration. This includes, without limitation, Trustees, the Principal Officer, all permanent, temporary and part-time staff as well as contract workers;

2.7. “Principal Officer” shall mean the principal officer appointed by, and who reports to, the OMSMAF Board of Trustees;

2.8. “Record” means any recorded information, regardless of form or medium, which is in the possession of or under the control of OMSMAF, irrespective of whether it was created by OMSMAF;

2.9. “Request” means a request for access to a record of OMSMAF;

2.10. “Requester” means any person, including a public body or an official thereof, making a request for access to a record of OMSMAF and includes any person acting on behalf of that person;

2.11. “SAHRC” means the South African Human Rights Commission;

2.12. “Special Personal Information” means —

2.12.1. the religious or philosophical beliefs, race or ethnic origin, trade union membership, political persuasion, health or sex life or biometric information of a Data Subject; or

2.12.2. the criminal behaviour of a Data Subject to the extent that such information relates to—
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2.12.2.1. the alleged commission by a Data Subject of any offence; or

2.12.2.2. any proceedings in respect of any offence allegedly committed by a Data Subject OR THE DISPOSAL OF SUCH PROCEEDINGS.

3.1. Unless a contrary intention clearly appears, words signifying:-

3.1.1. the singular includes the plural and vice versa;

3.1.2. any one gender includes the other genders and vice versa; and

3.1.3. natural persons include juristic persons.

3.2. Terms defined in the Act shall have the same meaning in this Manual.

A copy of this Manual is available on our website www.omsmaf.co.za , alternatively by sending a request for a copy to the Information Officer by email or from our head office situated at Mutualpark Building, Jan Smuts Drive, Pinelands, 7405.

5.1. Requests for access to records held by OMSMAF must be made on the request forms that is available from the SAHRC website (www.sahrc.org.za) or the Department of Justice and Constitutional Development (www.doj.gov.za) (under “regulations”).

5.2. For the convenience of requesters, copies of such forms are included in the version of this manual available at our head office and on our website. Please note that requesters are also required to make payment of the prescribed fees. This issue is dealt with fully below.

5.3. Requests for access to records must be made to our Information Officer at the address or electronic mail address provided herein.

5.4. The requester must provide sufficient detail on the request form to enable the Information Officer to identify the record and the requester. The requester should also indicate which form of access is required and indicate if he or she wishes to be informed in any other manner and state the necessary particulars to be so informed.

5.5. The requester will be notified within 30 days of the receipt of the completed request forms, whether their request for access has been granted or denied. The request will be evaluated by the Information Officer. OMSMAF reserves the right to notify the requester of an extension period that is required to access the requested information. The said notice will include reasons for such extension, the required extension period which will not exceed 60 days as well as the requester’s right to approach a court via application proceedings for relief in the event that the requester is against the extension and/or the procedure. OMSMAF may notify the requester whether a deposit is required. This deposit will be determined by factors such as, the format and/or volume of the information requested as well as the time required for the searching and preparation of the records. The notice will set out the required deposit amount as well as the requester’s right to approach a court via application proceedings for relief in the event that the requester is against the payment of the required deposit and/or the procedure.

5.6. Requesters are informed that OMSMAF can only provide access to records that are in the possession of OMSMAF.

5.7. The requester must identify the right that he or she is seeking to exercise or protect and provide an explanation of why the requested record is required for the exercise or protection of that right.

5.8. If a request is made on behalf of a person, the requester must then submit proof, in the form of an affidavit or letter of consent, of the capacity in which the requester is making the request to the satisfaction of the Information Officer.

5.9. The standard form that must be used for the making of requests is attached as Annexure 1. Not using this form could cause your request to be refused (if you do not provide sufficient information or otherwise) or delayed.

5.10. The requester is required to pay a fee for evaluating the request and then providing the records requested, including the requirement to pay a deposit in certain circumstances. The list detailing the prescribed fees payable to OMSMAF in respect of requests and the fees in respect of access to records (if the request is granted) is attached as Annexure 2.

5.11. Annexures 1 and 2 are included in copies of this manual available on OMSMAF website and at our head office but need not and are not included in the copy of this manual delivered to the SAHRC.

5.12. Kindly note that all requests to OMSMAF will be evaluated and considered in accordance with the Act. Publication of this manual and describing the categories and subject matter of information held by OMSMAF does not give rise to any rights (in contract or otherwise) to access such information or records except in terms of the Act.

5.13. If it is reasonably suspected that a requester has obtained access to OMSMAF records through the submission of materially false or misleading information, legal proceedings may be instituted against such requester.

6.1. The details of the Information Officer are as follows:

Name of Fund –Old Mutual Staff Medical Aid Fund

Registration number of Fund – CMS Registration number 1214

Street address – 2nd Floor, C-Block, Mutualpark, Jan Smuts Drive, Pinelands, Cape Town, South Africa

Postal address – PO Box 90, Howard Place, Cape Town, 7450

Telephone number – +27(0) 21 509 0773

E-mail address  – OMSMAF_Office@oldmutual.com

Fund’s website – www.omsmaf.co.za

Call Centre – +27(0) 860 100 076

Contact person of fund name (Principal Officer and Information Officer) – Pamela Botha

E-mail address –OMSMAF_Office@oldmutual.com

Telephone number – +27(0)21 509 0773

6.2. The details of the Information Regulator are as follows:

Name – Information Regulator

Postal address – PO Box 31533, Braamfontein, Johannesburg, 2017

Physical address – 33 Hoofd Street, Forum iii, 3rd Floor, Braampark

Telephone number – 010 23 5207

E-mail address – inforeg@justice.gov.za

Website – www.justice.gov.za/inforeg

6.3. The details of the SAHRC are as follows:

Name – South African Human Rights Commission

Postal address – Private Bag 2700, Houghton, 2041

Physical address – 33 Hoofd Street, Forum iii, 3rd Floor, Braampark

Telephone number – 011 877-3600

E-mail address – paia@sahrc.org.za

Website – www.sahrc.org.za

7.1. The Guide can be obtained from the SAHRC. Please direct any queries to:

The South African Human Rights Commission

PAIA Unit

The Research and Documentation Department

Physical Address – Braampark Forum 3, 33 Hoofd Street, Braamfontein, 2017

Postal Address – Private Bag 2700, Houghton, 2041

Telephone – +27 11 877-3600

Fax – +27 11 403-0625

Website – www.sahrc.org.za

E-mail – paia@sahrc.org.za

Information is retained in terms of the below-mentioned legislation. The information retained in terms of this legislation will only be made available to the persons or entities specified in the legislation:

8.1. Medical Schemes Act 131 of 1998

8.2. Companies Act 71 of 2008

8.3. Income Tax Act 58 of 1962

8.4. Value Added Tax Act 89 of 1991

8.5. Labour Relations Act 66 of 1995

8.6. Basic Conditions of Employment Act 75 of 1997

8.7. Employment Equity Act 55 of 1998

8.8. Unemployment Insurance Act 63 of 2001

8.9. Unemployment Contributions Act 4 of 2002

8.10. Compensation for Occupational Injuries and Health Diseases Act 130 of 1993

8.11. Occupational Health & Safety Act 85 of 1993

8.12. Prevention AND COMBATING OF CORRUPT ACTIVITIES ACT 12 OF 2004.

9.1. OMSMAF maintains records on the categories and subject matters set out below. However, please note that recording a category or subject matter in this Manual does not imply that a request for access to such records would be granted.

9.2. All requests for access will be evaluated on a case by case basis in accordance with the provisions of the Act.

9.3. In the event that there is no extension period or deposit required then the requester will be notified within 30 days of the outcome of their request. If the request is successful then the requester will be notified of the access fee payable upon gaining access to the record (if any), an indication of the form in which the access will be granted as well as a notice of the requester’s right to approach a court via application proceedings for relief in the event that the requester is against the payment of the required access fee and/or the procedure.

9.4. If the record requested contains information about a third party, OMSMAF is obliged to inform them of such request. This serves to allow the third party the opportunity to respond by either granting consent to the access request or to provide reasons why the request should be denied. The reasons provided by the third party either for consent or denying access will be considered by OMSMAF Information Officer in making a final decision regarding whether access should be granted or refused.

9.5. All records in the possession of OMSMAF that comprise Special Personal Information shall only be provided to the person to whom the Special Personal Information pertains. In the event that the requester is not the subject of the Special Personal Information, then the requester must submit proof of consent to request such record for their use or on behalf of the Data Subject.

9.6. OMSMAF may legitimately refuse to grant access to records that fall within certain categories. The grounds to refuse access to a particular record/s include:

9.6.1. records containing Personal Information of a third party which must be protected from unreasonable disclosure including records of a deceased person;

9.6.2. records containing third party commercial information that must be protected from unreasonable disclosure;

9.6.3. if disclosure of a record would result in a breach of a duty of confidence owed in terms of an agreement to a third party;

9.6.4. if disclosure of a record would result in an individual’s life or physical safety being endangered;

9.6.5. if disclosure of a record would prejudice or impair the security of property;

9.6.6. if disclosure of a record would prejudice or impair the protection of a person under witness protection;

9.6.7. if disclosure of a record would prejudice or impair public safety;

9.6.8. if disclosure of a record is privileged in terms of legal proceedings, unless such privilege has been waived by the person entitled to the privilege;

9.6.9. if disclosure of a record would harm the commercial and financial interests of the OMSMAF; and

9.6.10. if disclosure of a record would put OMSMAF at a disadvantage in contractual or other negotiations or prejudice it in commercial competition.

9.7. In the event that the requested record cannot be located and it is believed that the record does not exist,, then OMSMAF will inform the requester by way of affidavit or affirmation of the reason for delay or inability to locate the record.

10.1. The following is a list of subjects on which OMSMAF holds records and the categories into which these falls:

10.1.1. Medical Schemes Act Records
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10.1.1.1. Records relating to the registration of OMSMAF as a medical scheme;

10.1.1.2. The Rules of OMSMAF and Rule amendments;

10.1.1.3. Minutes of meetings of OMSMAF Board of Trustees (“the Board”);

10.1.1.4. Minutes of Meetings of Board Committees;

10.1.1.5. Board Resolutions;

10.1.1.6. Board and Committee action lists;

10.1.1.7. Annual Reports;

10.1.1.8. Statutory Returns; and

10.1.1.9. Fraud Forum Records.

10.1.2. Trustee and Independent Committee Member Records

10.1.2.1. Trustees’ personal details;

10.1.2.2. Records on the appointment and election of Trustees and Independent Committee Members; Trustee and Independent Committee Member Remuneration records; and

10.1.2.3. Attendance registers.

10.1.3. Management Records

10.1.3.1. Internal and external correspondence;

10.1.3.2. OMSMAF policies and procedures; and

10.1.3.3. Management reports.

10.1.4. Financial Records

10.1.4.1. Monthly Management Accounts;

10.1.4.2. Annual Financial Statements;

10.1.4.3. Auditor’s reports;

10.1.4.4. Banking records;

10.1.4.5. Investment reports;

10.1.4.6. Invoices; and

10.1.4.7. Records regarding insurance held by OMSMAF in respect of movable and immovable property.

10.1.5. Income Tax Records

10.1.5.1. Documents issued to members for income tax purposes; and

10.1.6. Service Providers / Suppliers and Reimbursement:

10.1.6.1. Agreements with healthcare providers and other providers including administration, managed care, chronic medication designated service provider, and professional services providers;

10.1.6.2. Details of healthcare providers participating in the OMSMAF networks;

10.1.6.3. OMSMAF current and previous tariff files; and

10.1.6.4. Fraud investigation records.

10.1.7. Member Records

10.1.7.1. Membership details;

10.1.7.2. Member claim statements;

10.1.7.3. Member contribution statements;

10.1.7.4. Member and dependant medical records;

10.1.7.5. Member ex gratia applications and decisions; and

10.1.7.6. Fraud Investigation Records.

10.2. The procedure in terms of which the above records may be requested from OMSMAF is set out in paragraph 0 of this Manual.

11.1. At this stage no notice has been published on the categories of records that are automatically available from OMSMAF without a person having to request access thereto on terms of the Act.

12.1. Personal information of a data subject will be processed according to the provisions of POPIA.

12.2. A data subject, having provided adequate proof of identity, has the right to-

12.1.1 request a responsible party to confirm, free of charge, whether or not the Responsible party holds personal information about the data subject; and

12.1.2 request from a responsible party the record or a description of the personal information about the data subject held by the responsible party, including information about the identity of all third parties, or categories of third parties, who have, or have had, access to the information—

a) within a reasonable time;

b) at a prescribed fee, if any;

c) in a reasonable manner and format; and

d) in a form that is generally understandable.

12.3. If, in response to a request in terms of paragraph 12.2, personal information is communicated to a data subject, the data subject must be advised of the right in terms of section 24 of POPIA to request the correction of information.

12.4. If a data subject is required by a responsible party to pay a fee for services provided to the data subject in terms of paragraph 8.2.2 to enable the responsible party to respond to a request, the responsible party—

(i) must give the applicant a written estimate of the fee before providing the services; and

(ii) may require the applicant to pay a deposit for all or part of the fee.

12.5. A responsible party may or must refuse, as the case may be, to disclose any information requested in terms of paragraph 12.2 to which the grounds for refusal of access to records set out in the applicable sections of Chapter 4 of Part 2 and Chapter 4 of Part 3 of the PAIA apply.

12.6. The provisions of sections 30 and 61 of PAIA are applicable in respect of access to health or other records.

12.7. If a request for access to personal information is made to a responsible party and part of that information may or must be refused, every other part must be disclosed.

13.1. A data subject may, in the prescribed manner, request a responsible party to –

13.1.1 correct or delete personal information about the data subject in its possession or under its control that is inaccurate, irrelevant, excessive, out of date, incomplete, misleading or obtained unlawfully; or

13.1.2 destroy or delete a record of personal information about the data subject that the responsible party is no longer authorised to retain in terms of section 14 of POPIA.

13.2. On receipt of a request in terms of subsection (1) a responsible party must, as soon as reasonably practicable—

13.1.3 correct the information;

13.1.4 destroy or delete the information;

13.1.5 provide the data subject, to his or her satisfaction, with credible evidence in support of the information; or

13.1.6 where agreement cannot be reached between the responsible party and the data subject, and if the data subject so requests, take such steps as are reasonable in the circumstances, to attach to the information in such a manner that it will always be read with the information, an indication that a correction of the information has been requested but has not been made.

13.3. If the responsible party has taken steps under paragraph 9.2 that result in a change to the information and the changed information has an impact on decisions that have been or will be taken in respect of the data subject in question, the responsible party must, if reasonably practicable, inform each person or body or responsible party to whom the personal information has been disclosed of those steps.

13.4. The responsible party must notify a data subject, who has made a request in terms of paragraph 13.1, of the action taken as a result of the request.

A request by the data subject to access to his/her personal information must be made in the manner set out in paragraph 5 of this policy and sent to the information officer.

OMSMAF may update this manual every 12 months or at such intervals as may be deemed necessary.

Click here to complete a request form.

Copies of PAIA Manual

Copies of the OLD MUTUAL STAFF MEDICAL AID FUND PAIA manual are chargeable as per the fees table below:

Copies of PAIA Manual

Copies of the OLD MUTUAL STAFF MEDICAL AID FUND PAIA manual are chargeable as per the fees table below:

An access fee is payable in all instances where a request for access to information is granted, except in those instances where payment of an access fee is specially excluded in terms of the PAIA Act or an exclusion is determined by the minister in terms of section 54 (8) of the PAIA Act.

Where the OMSMAF receives a legitimate request for access to information held on a person other than the requester himself/herself and the Information Office, upon receipt of the request, is of the opinion that the preparation of the required record of disclosure will take more than 6 (six) hours, a deposit is payable by the requester.
The amount of the deposit is equal to 1/3 (one third) of the amount of the applicable access fee.

Note: In terms of regulation 8, value added tax (VAT) must be added to all fees prescribed in terms of the regulations.

These fees are subject to amendment without notice.