Concepts

Each PolicyHolder (employer) will be registered in openIMIS.
Each PolicyHolder will have access to some contribution plan attached to insurance product.
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.

The PolicyHolder will have user (Accountant, assistant … ) that will be able to connect on the policyholder portal

openIMIS > PolicyHolders Module > worddav877d2c5cbc14fa8a5908b9f41b6b4123.png

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. Although we try to make it broader, it might not support all the enrollment processes of all group insurances.

openIMIS > PolicyHolders Module > formal-sector-enrolment.png

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 (not deleted and today between dateValidFrom/TO)
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 (not deleted and today between dateValidFrom/TO)
UC7-6: Add users: PolicyHolder List > "Select" PolicyHolder > User List > add user > add details on create popup (validity dates) > Save
UC7-7: Update users: "Select" PolicyHolder > UserList > (Search user) >Select User > change details on edit popup (validity dates) > Save
UC1-4: Replace users: "Select" PolicyHolder > User List > (Search user) >Select User > click on the replace button > create new version popup > conf : This will set the ValiditTo of previous to ValidityFrom of the new
UC7-8: Delete user: "Select" PolicyHolder > UserList > (Search user) >Select User > change details > Delete > confirmation popup

PolicyHolder insuree

Managing PolicyHolder's insurees will be possible from the PolicyHolder page. This should be possible for the PolicyHolderClerk and the Clerk 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 (not deleted and today between dateValidFrom/TO)
UC1-2: Add: PolicyHolder List > "Select" PolicyHolder > Insuree tab > 'add' insure > fill the details on the PolicyHolder insuree create popup > save
UC1-3: Update (error): PolicyHolder List > "Select" PolicyHolder > Insuree tab > update the details on the PolicyHolder insuree edit popup > save
UC1-4: Replace: (new version) PolicyHolder List > "Select" PolicyHolder > Insuree tab > click on the replace button > new version popup > conf : This will set the ValiditTo of previous to ValidityFrom of the new
UC1-5: Delete: PolicyHolder List > "Select" PolicyHolder > Insuree tab > "Select" an insuree> Delete> confirmation popup

PolicyHolder contribution plan bundle

Managing Policy holder contribution plan bundle, this should be possible for the SchemeClerk 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(not deleted and today between dateValidFrom/TO)
UC11-2: Add: PolicyHolder List > "Select" PolicyHolder > contribution plan tab > 'add' contribution plan bundles >fill the details on create popup > save
UC11-3: Replace (new version) > "Select" PolicyHolder > contribution plan tab > "Select" a contribution plan bundles > click on the replace button > new version popup > conf : This will set the ValiditTo of previous to ValidityFrom of the new
UC11-4: Delete: PolicyHolder List > "Select" PolicyHolder > contribution plan tab > "Select" a contribution plan bundles > Delete > confirmation popup
UC11-5(should have): Update(error) > "Select" PolicyHolder > contribution plan tab > "Select" a contribution plan bundles > click on the edit button > fill the details on edit popup > Save

Backend

UC11-5: Replacing / removing propagation to PolicyHolder insuree contribution plan bundle

Details design

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.

Mutations

Mutation as part of the schema file:

Authorities

The following authorities will be added for group insurance management, the Prefix will be 150

PolicyHolder, the Prefix will be 1501
- Search → 150101
- Create → 150102
- Update → 150103
- Delete → 150104
PolicyHolderInsuree, the Prefix will be 1502
- Search → 150201
- Create → 150202
- Update → 150203
- Delete → 150204
- Replace → 150206
PolicyHolderUser, the Prefix will be 1503
- Search → 150301
- Create → 150302
- Update → 150303
- Delete → 150304
- Replace → 150306
PolicyHolderContributionPlanBundle, the Prefix will be 1504
- Search → 150401
- Create → 150402
- Update → 150403
- Delete → 150404
- Replace → 150406

Roles

The following roles need to be created or updated with the new authorities (new roles have * ):

SchemeClerk (Clerk)
- PolicyHolder
  - C/R/U
- PolicyHolderInsuree
  - C/R/U/D
  - Approve (TBC)
- PolicyHolderUser
  - C/R/U/D
SchemeAdmin
- PolicyHolder
  - C/R/U/D
- PolicyHolderInsuree
  - C/R/U/D
  - Approve (TBC)
- PolicyHolderContributionPlan
  - C/R/U/D
- PolicyHolderUser
  - C/R/U/D
PolicyHolderClerk*
- PolicyHolderInsuree
  - C/R/U

Models

mandatory fields have *

Technical fields have **

PolicyHolder (HistoryBusinessModel)

Code (varchar 32)*
TradeName (varchar 256)*
LocationsID (fk tblLocations)
- Not limited to one level
Address (json 1024)
Phone (varchar 16)
Fax (varchar 16)
Email (varchar 256)
ContactName (json)
LegalForm (configEnum:legalForm)
ActivityCode (configEnum:activity)
AccountancyAccount (varchar 64)
bankAccount (json)( validation: (^.+$))
PaymentReference (varchar 128)

PolicyHolderInsuree (HistoryBusinessModel)

Version (integer - to be used for optimistic locking)
PolicyHolderUUID (fk policyHolder)*
InsureeID (fk Insuree)*
ContributionPlanBundleUUID (fk_contributionPlanBundle)
LastPolicyID (fk Policy)

PolicyHolderContributionPlanBundle (HistoryBusinessModel)

ContributionPlanBundleUUID (fk_contributionPlanBundle)*
PolicyHolderUUID (fk policyHolder)*

PolicyHolderUser (HistoryBusinessModel)

UserUUID (fk_user)*
PolicyHolderUUID (fk policyHolder)*

Services

CRUD services
replacePolicyHolderUser
replacePolicyHolderInsuree
replacePoicyHolderContributionPlanBundle

Frontend

The list of PolicyHolders should use the same layout as other existing list in openIMIS (claims, insuree ...).

PolicyHolder search page

PolicyHolder search criteria

Code (string) with icontains field lookup
Tradename (string) with icontains field lookup
Location (4 Select, one per level)
LegalForm (configEnum:legalForm ) (Select)
ActivityCode (configEnum:activity) (Select)
DateValidFrom (Today by default) - Date Picker
DateValidTo - Date Picker
checkbox to show deleted
Launch search button
reset search button
(nice to have in R4) search per insuree
(nice to have in R4) search per contribution plan bundle

The PolicyHolder result columns

Display name (Code - Tradename )
Location
LegalForm (configEnum:legalForm )
ActivityCode (configEnum:activity)
DateValidFrom (date)
DateValidTo (date)
Delete (Trash) and Edit (Pen) buttons at the end of the line (see Location module)

MaterialUI to add a policy holder by opening an empty PH card.

Double click or click on Edit button to update a PolicyHolder.

Backend Configuration

configEnum:legalForm

[{ “value“: “1”,
“label“: {“en”: “Personal Company”,
“fr”:”Persone physique”}
}, {“value“: “2”,
“label“: { “en”: “Limited Risk Company”,
“fr”:”Société à risque limité”}
}, {“value“: “3”,
“label“: { “en”: “Association”,
“fr”:”Association”}
}, {“value“: “4”,
“label“: { “en”: “Government”,
“fr”:”Gouvernement”}
}, {“value“: “5”,
“label“: { “en”: “Union”,
“fr”:”Syndicat”}
}]

configEnum:ActivityCode

[{ “value“: “1”,
“label“: {“en”: “Retail”,
“fr”:”Vente au détails”}
}, {“value“: “2”,
“label“: { “en”: “Industry”,
“fr”:”Industrie”}
}, {“value“: “3”,
“label“: { “en”: “Building”,
“fr”:”Construction”}
}, {“value“: “4”,
“label“: { “en”: “Sailing”,
“fr”:”Maritime”}
}, {“value“: “5”,
“label“: { “en”: “Services”,
“fr”:”Services”}
}]

Phone

default :

"phoneValidation": {
  "regex": /^[0-9]*$/,
  "regexMsg": {
      "en": "Invalid phone number",
      "fr": "Numéro de téléphone invalide"
  }
}

Fax

default:

"faxValidation", {
    "regex": /^[0-9]{8,9}$/,
    "regexMsg": {
        "en": "Invalid fax number",
        "fr": "Numéro de fax invalide"
    }
}

PaymentReference

default:

"paymentReferenceValidation", {
    "regex": /.+/,
    "regexMsg": {
        "en": "Invalid payment reference",
        "fr": "Référence de payement invalide"
    }
}

AccountancyAccount

default:

"accountancyAccountValidation", {
    "regex": /.+/,
    "regexMsg": {
        "en": "Invalid accountancy account",
        "fr": "Numéro de compte comptable invalide"
    }
}

The PolicyHolder card

General Information

Once a 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):

Code (varchar) (Mandatory, not editable once created)
TradeName (varchar) (Mandatory)
LocationsUUID (fk tblLocations) - (location contribution_fe) (Mandatory)
Address (json): multiline TextInput
Phone (varchar): string + configurable Regex for validation/constraint
Fax (varchar): + configurable Regex for validation/constraint

Email (varchar): + std email field validation

"regex": /^[^\s@]+@[^\s@]+\.[^\s@]+$/,
"regexMsg": {
    "en": "Invalid email",
    "fr": "Couriel invalide"
}

ContactName (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)

The material (Save) UI button will save the changes, when no change are detected the same button should be greyed out

(should have) The tab content (User, insuree, CBP) should be editable after the policy holder is saved (i.e. not before ), reloading the page should be avoided if possible.

on Policyholder create

all fields should be editable

On PolicyHolder update

all fields but Code and dateValidFrom should be editable

“isDeleted“ Policy holder cannot be updated

PolicyHolder Users

This page will link interactive (openIMIS) user to PolicyHolder, in order to allow them to access the PolicyHolder’s data on the PolicyHolder portal.

PolicyHolder Users search criteria

option to show deleted user
Launch search button
reset search button
DateValidFrom (Today by default)
DateValidTo
user search (contribution_fe ?)

PolicyHolder Users result column

(User name / firstname / 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 button

It should be possible to sort the result per column in ASC or DESC order.

PolicyHolder Users create

A button on bottom right of the page. Clicking it results in a popup to add the user.
Fields:
- User (User picker, required)
- Policy Holder (Policy Holder picker, required)
- Date Valid From (Date picker, required),
- Date Valid To (Date picker)

PolicyHolder Users replace

All fields could be changed

PolicyHolder Users edit

All fields but the user could be changed

The material (Save) UI button will save all the changes made on the list.

Journal messages

Create: <UserLabel> is added on <PHlabel>
Delete: <UserLabel> is removed from<PHlabel>
Update: <UserLabel> - <PHlabel> is updated
Replace: <UserLabelNew> is replacing <UserLabelOld> on <PHlabel>

NTG done: PHUser tab in PH

tab showed if the user have the PHuser rights or the PHPortalUser right + link to PH in PHUser

PolicyHolder Insurees

This pages/section will link the 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 PolicyHolder card via a link that prefill PolicyHolder search criteria
a new "menu" that have the name of the PolicyHolder

PolicyHolder insuree search criteria

option to show deleted user
Launch search button
reset search button
insuree search (contribution_fe ?)
contribution plan bundle search (contribution_fe ?)
DateValidFrom (Today by default)
DateValidTo

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" for new, and “value” for existing
(calculation data) contribution_fe "calculation/rules" module, (inputs fields)
DateValidFrom (date) (input field)
DateValidTo (date) (input field)
replace, edit and Delete button

It should be possible to sort the result per column in ASC or DESC order

PolicyHolder insuree create

mandatory fields
- DateValidFrom

PolicyHolder insuree replace

All fields but insuree could be changed

PolicyHolder insuree edit

Only dateValidTo can be changed

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.
Or a button will be on the top right of the table + a popup to add the insuree.

The material (Save) UI button will save all the changes made on the list.

PolicyHolder Contribution plan bundle

This page/section will link the CPB to PolicyHolder, only CPB part of that list will selectable on the PHInsuree page/section

This page or section could be in different form:

a tab in the Policyholder card
a dedicated page, access from the PolicyHolder card via a link that prefill PolicyHolder search criteria
a new "menu" that have the name of the PolicyHolder

PolicyHolder Contribution plan bundle search criteria

Launch search button
reset search button
option to show inactive PHCPB
contribution plan bundle search (contribution_fe ?)
DateValidFrom (Today by default)
DateValidTo

PolicyHolder Contribution plan bundle result columns

(CPB data) contribution_fe CPB module, Dropdown for new and value for existing
(calculation data) contribution_fe "calculation/rules" module, (inputs fields, if any)
replace, edit and Delete button (TBC)
DateValidFrom
DateValidTo

It should be possible to sort the result per column in ASC or DESC order

PolicyHolder PHCPB create

All fields could be changed but the PH which is define by the parent page
- CPB*
- DateValidFrom*
- DateValidTo

PolicyHolder PHCPB replace

All fields could be changed but the PH which is define by the parent page
- CPB*
- DateValidFrom*
- DateValidTo

PolicyHolder PHCPB edit

Only dateValidTo can be changed

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.>
Or a button will be on the top right of the table + a popup to add the PHCPB.

The material (Save) UI button will save all the changes made on the list.

PolicyHolder payment

Same filter As payment, only an addtionnal filter that will be hidden to have only payment with payment details that are linked to PHCPD when a Payment Query $

NTG done: PHPayment tab in PH

tab showed if the user have the PHPayment rights or the PHPortalPayment right + link to PH in PHUser

Solution

Idea to make this additionnal filter within the payment module (i.e the payment tab could be a contribution from payment)

implement “Dynamic“ parameter in the Query
1. adapt the payment payment query to be able take “dynamic“ filters (I hope this is possible), but don’t use it in the payment module BUT enable the “pre_query“ signals to add filters in the query set
2. in PH be module, register a signal on the payment “pre_query“, check if there is an PH uuid on the mutation “dynamic“ params, if it is the case and if the user have either the Payment right or (the payment portal right + have a link to PH in PH user table ) then add the filters to retrieve only payment with payment details that are linked to CPD link to PH contracts
3. the Payment module, should block the query if the user have no right or if there is no additional filter on the query
4. (Nice to have)in the contract be module, register a signal on the payment “pre_query“, check if there is a contract uuid on the query “dynamic“ params, if it is the case and if the user have either the Payment right or (the payment portal right + have a link to contract PH in PH user table ) then add the filters to retrieve only payment with payment details that are linked to CPD

openIMIS > PolicyHolders Module > image-20210330-081519.png

Link to other entities

place holder for other tab / link to search pages → those should be added by contribution_fe
- 1 tab from the contract module
  - shows the contract for the PH
- 1 tab form the payment module (NTHD):
  - shows the payment related to the contract
- 3 tab from the policy module (Nice to have):
  - a tab for the contribution search
  - a tab for the policy search
  - a tab for the insureePolicy

Frontend Configuration

Get Backend Configuration for the dropdown/enums or duplicate it
configurable Regex for validation/constraint for the phone and FAX (NTHD)
- plus message when the constraint is not respected (in different languages)
configurable Regex for validation/constraint for AccountancyAccount (Nice to have)
- plus message when the constraint is not respected (in different languages)
configurable Regex for validation/constraint PaymentReference (Nice to have)
- plus message when the constraint is not respected (in different languages)

When a tab is opened, only the id and the name of the PolicyHolder will be displayed in a top ribbon (as bread crumbs) or Prefilled search fields

Concepts

Business Processes

PolicyHolder (employer)

Web application

PolicyHolder User

Web application

PolicyHolder insuree

Web application

PolicyHolder contribution plan bundle

Web application

Backend

Details design

Backend module

Mutations

Authorities

Roles

Models

PolicyHolder (HistoryBusinessModel)

PolicyHolderInsuree (HistoryBusinessModel)

PolicyHolderContributionPlanBundle (HistoryBusinessModel)

PolicyHolderUser (HistoryBusinessModel)

Services

Frontend

Menu

PolicyHolder search page

PolicyHolder search criteria

The PolicyHolder result columns

Backend Configuration

The PolicyHolder card

General Information

PolicyHolder Users

This page will link interactive (openIMIS) user to PolicyHolder, in order to allow them to access the PolicyHolder’s data on the PolicyHolder portal.

PolicyHolder Users search criteria

PolicyHolder Users result column

PolicyHolder Users create

PolicyHolder Users replace

PolicyHolder Users edit

Journal messages

NTG done: PHUser tab in PH

PolicyHolder Insurees

This pages/section will link the PolicyHolder and a given insuree, and will enable the addition of data on that relationship (contribution plan bundle and calculation rules parameters).

PolicyHolder insuree search criteria

PolicyHolder insuree result column

PolicyHolder insuree create

PolicyHolder insuree replace

PolicyHolder insuree edit

PolicyHolder Contribution plan bundle

PolicyHolder Contribution plan bundle search criteria

PolicyHolder Contribution plan bundle result columns

PolicyHolder PHCPB create

PolicyHolder PHCPB replace

PolicyHolder PHCPB edit

PolicyHolder payment

NTG done: PHPayment tab in PH

Solution

Link to other entities

Frontend Configuration