For an open medical aid scheme, the maximum subsidy provided was R1 014, whereas, with GEMS, the subsidy provided was R2 600 for four people. GEMS was well marketed in the Public Service; with the state providing a better subsidy for GEMS than the other medical aid schemes. It was important to note that the state and members were represented on GEMS board. This ensured that the state and members would remain priorities for GEMS. Neither the state nor public servants enjoyed the same level of focus and say in the private medical aid schemes. An example of how GEMS was looking after the interests of the state was the monitoring of the use of medical aid benefits in order to verify sick leave taken by public servants in specific departments. This was in order to monitor the abuse of sick leave by public servants, especially in government departments where there is high risk or exposure to stress that can result in depression, anxiety, and alcoholism. The Department was working with GEMS to monitor the situation.