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Each PolicyHolder (employer) will be registered in openIMIS.
Each PolicyHolder will have access to some schemes.
The PolicyHolder would have the possibility to add insurees with a contract period, default pricing parameters (e.g., income) and the contribution plan bundle to use.
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Business Processes
The process bellow will respect the location scope of the users, meaning that, to add a PolicyHolder for a region, the scheme clerk must have access to that very region.
The enrollment process that will be supported is defined by Nepal requirements. Althrough we try to make it broader, it might not support all the enrollment processes of all group insurances.
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Use cases
PolicyHolder (employer)
The first step before enrolling insuree under a PolicyHolder, one needs to make sure that the PolicyHolder is defined in openIMIS. Read right is required to have access to the search/list screen. Managing PolicyHolders will be the role of the Clerk.
Web application
UC7-1: Search: PolicyHolder List > use the search box > search, the default list will show only the active PolicyHolders
UC7-2: Add: PolicyHolder List > "Add" PolicyHolder > fill the details on the PolicyHolder page > Save
UC7-3: Update: PolicyHolder List > "Select" PolicyHolder > update the details on the Policy holder page > Save
UC7-4: Delete: PolicyHolder List > "Select" PolicyHolder > Delete (this role should be only available to admin, others should only archive by setting the DateValidTo)
PolicyHolder User
Web application
UC7-5: Search users: PolicyHolder List > "Select" PolicyHolder > User List > search, the default list will show only the active PolicyHolder's users
UC7-6: Add users: PolicyHolder List > "Select" PolicyHolder > User List > add user > add details (validity dates) > Save
UC7-7: Update users: "Select" PolicyHolder > UserList > (Search user) >Select User > change details (validity dates) > Save
UC7-8: Delete user: "Select" PolicyHolder > UserList > (Search user) >Select User > change details > Delete
PolicyHolder insuree
Managing PolicyHolder's insure insurees will be possible from the PolicyHolder page. This should be possible for the PolicyHolderClerk and the SchemeClerkClerk roles.
Web application
UC1-1: Search: PolicyHolder List > "Select" PolicyHolder > Insuree tab > use the search box > search, the default list will show only the active policy holder insuree
UC1-2: Add: PolicyHolder List > "Select" PolicyHolder > Insuree tab > 'add' insure > fill the details on the PolicyHolder insuree page > save
UC1-3: Update (error): PolicyHolder List > "Select" PolicyHolder > Insuree tab > update the details on the PolicyHolder page > save
UC1-4: Replace: (new version) PolicyHolder List > "Select" PolicyHolder > Insuree tab > update the details on the Policy holder page > create new version > add ValidityTo
UC1-5: Delete: PolicyHolder List > "Select" PolicyHolder > Insuree tab > "Select" an insuree> Delete (this role should be only available to admin, other should only archive by setting the DateValidTo)
PolicyHolder contribution plan bundle
Managing Policy holder contribution plan bundle, this should be possible for the SchemeClerk Clerk or SchemeAdmin.
Web application
UC11-1: Search: PolicyHolder List > "Select" PolicyHolder > contribution plan tab > use the search box > search, the default list will show only the active contribution plan
UC11-2: Add: PolicyHolder List > "Select" PolicyHolder > contribution plan tab > 'add' contribution plan bundles > fill the details on the Policy holder insuree page > save
UC11-3: Replace (new version)
:> "Select" PolicyHolder > contribution plan tab > "Select" a contribution plan bundles > update the contribution plan > create a new version > add ValidityTo
UC11-4: Delete: PolicyHolder List > "Select" PolicyHolder > contribution plan tab > "Select" a contribution plan bundles > Delete
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Backend
UC11-5: Replacing / removing propagation to
policyholder insurePolicyHolder insuree contribution plan bundle
Authorities
To manage the group insurance several The following authorities will be added , the for group insurance management (existing authorities have a "*") :
PolicyHolder
C/R/U/D (4 authorities)
PolicyHolderInsuree
C/R/U/D (4 authorities)
Approve (TBC)
PolicyHolderUser
C/R/U/D (4 authorities)
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Entity definition
PolicyHolder
UUID (char(24))
Code (varchar)
Version (integer - to be used for optimistic locking)
TradeName (varchar)
LocationsUUID (fk tblLocations)
Not limited to one level
Address (varchar)
Phone (varchar)
Fax (varchar)
Email (varchar)
ContactName (varchar)
LegalForm (configEnum:legalForm)
ActivityCode (configEnum:activity)
AccountancyAccount (varchar)
PaymentReference (varchar)
DateValidFrom (date)
DateValidTo (date)
isActive (bool)
Json_ext (json)
DateCreated (date)
DateUpdated (date)
UserUpdatedUUID (fk users)
UserCreatedUUID (fk users)
PolicyHolderInsuree
UUID (char(24) )
Version (integer - to be used for optimistic locking)
PolicyHolderUUID (fk policyHolder)
InsureeUUID (fk Insuree)
ContributionPlanBundleUUID (fk_contributionPlanBundle)
LastPolicyUUID (fk Policy)
Json_ext (json)
DateCreated (date)
DateUpdated (date)
UserUpdatedUUID (fk users)
UserCreatedUUID (fk users)
isActive
DateValidFrom (date)
DateValidTo (date)
PolicyHolderContributionPlanBundle
UUID (char(24) )
Version (integer - to be used for optimistic locking)
ContributionPlanBundleUUID (fk_contributionPlanBundle)
PolicyHolderUUID (fk policyHolder)
Json_ext (json)
DateCreated (date)
DateUpdated (date)
UserUpdatedUUID (fk users)
UserCreatedUUID (fk users)
isActive (bool)
DateValidFrom (date)
DateValidTo (date)
PolicyHolderUser
UUID (char(24) )
UserUUID (fk_user)
PolicyHolderUUID (fk policyHolder)
Json_ext (json)
DateCreated (date)
DateUpdated (date)
UserUpdatedUUID (fk users)
UserCreatedUUID (fk users)
isActive (bool)
DateValidFrom (date)
DateValidTo (date)
Details design
Back end Backend module
Because openIMIS can already have an adapter to read the openIMIS roles and authority, no business function will be required outside the database updates and profile replacements.
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See models section above
Services
CRUD services
- replacePolicyolder
replacePolicyHolder
replacePolicyHolderInsuree
replacePoicyHolderContributionPlanBundle
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Frontend
The list of PolicyHolder of PolicyHolders should use the same layout as other existing list in openIMIS (claims, insuree ...).
Menu
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Policyholder menu itme item should be located under the main menu "Insuree and policy".
PolicyHolder search pages
List of the search criteriascriteria:
- code
Code (string)
Tradename (string)
Location (4 Select, one per level)
LegalForm (configEnum:legalForm ) (Select)
ActivityCode (configEnum:activity) (Select)
DateValidFrom (date) - Date picker
DateValidTo (date) - Date picker
List of the columns in the search result:
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Display name (
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Code - Tradename )
Location
LegalForm (configEnum:legalForm )
ActivityCode (configEnum:activity)
DateValidFrom (date)
DateValidTo (date)
Delete button at the end of the line (see Location module)
MaterialUI + 
to add a policy holder.
Double click to update a PolicyHolder.
The PolicyHolder card
General Information
Once a policyholder open PolicyHolder view/update page opens from the search list, the "General information" section or tab is displayed with those fields (editable for the one with enough rights)
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:
Code (varchar) (Mandatory)
TradeName (varchar) (Mandatory)
LocationsUUID (fk tblLocations) (Mandatory)
Search for location with Level - Code - Name (all strings)
Address (varchar/json):
mutlilinemultiline Box String OR (Address line 1, line2 , post code, city)
Phone (varchar): string + configurable Regex for validation/constraint
Fax (varchar): + configurable Regex for validation/constraint
Email (varchar): + std email field validation
ContactName (varchar/json)
LegalForm (configEnum:legalForm )
ActivityCode (configEnum:activity)
AccountancyAccount (varchar) + configurable Regex for validation/constraint
?bankAccount (json)
PaymentReference (varchar) + configurable Regex for validation/constraint
DateValidFrom (date) (Mandatory)
DateValidTo (date)
PolicyHolder Users
This pages/section/tab will link
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interactive (openIMIS) user to
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PolicyHolder, in order to allow them
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to access the PolicyHolder’s data on the
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PolicyHolder portal (show only user with one of portal authorities - PolicyHolderClerk).
This page or section could be in different form:
a tab in the
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PolicyHolder page
a dedicated page, access from the
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PolicyHolder page via a link that
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prefills PolicyHolder search criteria
a new "menu" that have the name of the
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PolicyHolder
PolicyHolder Users search
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criteria
option to show inactive user
other search should be location on the column header (TBC)
user search (contribution_fe ?)
PolicyHolder Users result column
(User name /
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firstname /
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lastname) Contribution of fe user module, Dropdown for new and value (or readonly dropdown preselected) for existing
DateValidFrom (date) (input field)
DateValidTo (date) (input field)
Delete (will put it inactive, change the DateValidTo) (+ add button in place of delete)
an An empty line at the top of the list with the add button in place of delete, once filled, new empty line should be displayed.
The material (Save) UI buttom button will save all the changes made on the list.
PolicyHolder Insurees
This pages/section will link the
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PolicyHolder and a given insuree, and will enable the addition of data on that relationship (contribution plan bundle and calculation rules parameters).
This page or section could be in different form:
a tab in the Policyholder card
a dedicated page, access from the
policyholderPolicyHolder card via a link that
prefill policyholderprefill PolicyHolder search criteria
a new "menu" that have the name of the
policy holderPolicyHolder
PolicyHolder insuree search
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criteria
option to show inactive user
other search should be location on the column header (TBC)
insuree search (contribution_fe ?)
contribution plan bundle search (contribution_fe ?)
PolicyHolder insuree result column
(Insuree data) contribution_fe insure module, Dropdown for new and value for existing
(contribution plan bundle data) contribution_fe "contribution plan bundle" module, Dropdown of
PHCPB forPHCPB for new and value for existing
(calculation data) contribution_fe "calculation/rules" module, (inputs fields)
DateValidFrom (date) (input field)
DateValidTo (date) (input field)
Delete (will put it inactive, change the DateValidTo)
an An empty line at the top of the list with the add button in place of delete, once filled, new empty line should be displayed.
The material (Save) UI buttom button will save all the changes made on the list.
PolicyHolder Contribution plan bundle
a tab for the PHCPB or a
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link simple pre-filtered for the PHCPB search
option to show inactive PHCPB
link CPB to PolicyHolder to
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allow access on that
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PolicyHolder data to that user (show only user with one of portal authorities)
(CPB data) contribution_fe CPB module, Dropdown for new and value for existing
(calculation data) contribution_fe "calculation/rules" module, (inputs fields)
Delete button
an An empty line at the top of the list with the add button in place of delete, once filled, new empty line should be displayed.
The material (Save) UI buttom will save all the changes made on the list.
Link to entity of existing modules
a possibility to add
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tab with (will be the case for the contract and payment):
a simple pre-filtered for the contribution search → select/double click will lead to contribution pages (made by
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Bluesquare) TBD
a simple pre-filtered for the policy search → select/double click will lead to contribution pages (made by
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Bluesquare) TBD
Link to other entities
place holder for other tab / link to search pages → those should be added by contribution_fe
Front end Frontend Configuration
Get Backend Configuration for the dropdown/enums or duplicate it
configurable Regex for validation/constraint for the phone and FAX (Nice to have)
configurable Regex for validation/constraint for AccountancyAccount (Nice to have)
configurable Regex for validation/constraint PaymentReference (Nice to have)
When a tab is opened, only the id and the name of the policy holder PolicyHolder will be displayed in a top ribbon (as bread crumbs) . or Prefilled search fields
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