​The Council of Cooperative Health Insurance (CCHI) reiterated that it is mandatory for the employer of any business to conclude a unified health insurance policy that covers all workers and their dependents, including those in the probation period that may range between 3-6 months, as per the agreement between the employer and work, and in accordance with Article No. 53 of the Labor Law.
“The unified policy is aimed mainly to control the performance of the health insurance market, through eliminating unreal insurance and ensure that the insured receive all of their insurance rights under the Cooperative Health Insurance Law, the Implementing Regulations and the unified health insurance policy,” said CCHI Spokesman Yasser Al-Maarek.
He noted that Article No. 2 of the Implementing Regulations has defined the categories that fall under the mandatory health insurance, including non-Saudi workers in the non-governmental sector, as well as members of their families who are subject to the health insurance system. The Law also defined the family members who are covered by the employee’s health insurance policy, namely his wife and all male children blow 25 of age and unmarried female children.
The maximum benefit provided by the cooperative health insurance policy amounts to 500,000 Saudi Riyals, for the whole year, divided into various packages, each of which cover expenses of medication and health care needed by the insured who shall not be required to provide payments to the provider of health care services as defined by the insurance company. Furthermore, in the event that the insured received health care outside the network of approved service providers, the insurance company shall indemnify him on the basis of allowance, as per the terms and conditions of the policy, within a period not exceeding 30 days from the date of claim application and at prevailing prices.
Al-Maarek noted that the Law does not allow, under any circumstances, the issuance of a health insurance policy with benefits below what is stipulated in such a policy. He also said the number of insured Saudi employees reached (1,089,189), while the number of insured non-Saudi employees reached (6,200,220), who receive cooperative health insurance services via (5216) endorsed health care service providers, (27) qualified health insurance companies and (10) qualified claims management companies.