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

Open

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.

Open

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 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:

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