The Medical Schemes Act of 1998 has promulgated that all medical schemes should have a reserve level of at least 25% (Cash reserves as a % of annual premium income) by the end of 2004. A growing number of schemes meet or exceed this requirement, but to many meeting this requirement remains an ongoing challenge. The Registrar seems to be comfortable as long as there is a positive growth in reserves. 18 of the 41 open schemes did not meet the 25% solvency level end 2006.