Objectives

This project aims to develop the "formal sector" features requested by institutions in charge of developing health financing schemes in NEPAL, in particular the management of enrollment of the insuree as part of an insurance group.
Here are the high-level use case to be covered by this design

• Manage  group insurance

  • UC1 - The scheme administrator wants to manage its policyholder insuree and their policy entitlement.

  • UC3 - The scheme administrator wants to manage the policyholder contract.

  • UC4 - The scheme administrator wants to manage the policy holder contract payment.

  • UC5 - the scheme administrator wants policyholders insuree policies covered by a contract to auto activate based on policyholders contract payment

  • UC6 - The scheme administrator wants to manage the policy holder payment

  • UC7 - The scheme administrator wants to manage policyholders.

• Contribution Plan and Contribution Plans Bundle

• to manage the Policy Value

  • UC8 - The scheme administrator wants to add a Contribution plan (pricing rules linked to an insurance product)

  • UC9 - the scheme administrator wants to be able to configure the calculation parameters in the Contribution plan

  • UC10 - The scheme administrator wants to add a Contribution plan bundle.

  • UC11 - the scheme administrator wants to enable some Contribution plan bundles per policyholder

• Policy holder Portal

  • UC12 - The policy holder wants to manage its policyholder insuree and their policy entitlement

  • UC13 - Policyholder wants to manage its users.

  • UC14 - Policyholder wants to manage its contracts.

• Not Functional

  • UC16 – Manage the calculations

Modules

Solution Architecture