PolicyHolders Module
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
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.
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 ...).
Menu
Policyholder menu item should be located under the main menu "Insuree and policy".
PolicyHolder search page
PolicyHolder search criteria
Code (string) with
icontains
field lookupTradename (string) with
icontains
field lookupLocation (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:
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
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