This page is a space to discuss and define the business process and required functionalities to cover formal sector members of a health financing scheme.
Jira ticket
https://openimis.atlassian.net/browse/OSD-28
Jiri proposal
Commented by Micheal
RfC_XX_support_of_formal sector_20180715_SB_MS.docx
Commented by Micheal and Patrick
RfC_XX_support_of_formal sector_20190701_PD.docx
Patrick draft for the formal sector structure:
- Use a generic name for
- Insurance taker: actor taking the insurance (e.g. employer)
- Insuree: Person who has a insurance policy on his name
- Beneficiary: Person covered by an insurance policy (on it's name or not)
- Contribution payer: the actor that pays the policies contribution/ premium
- programmatic approach:
- Insuree covered (e:g: employee) by an insurance taker are coming for an API (enter in APP/portal/ third party app)
- policy are generated from the "insuree covered" on a recurrent basis (doesn't have to generate all policies every time, only the new/renew one), the contribution rate will help to define the "price" of the policy (parameter that should be used in the calculation defined on the insurance product level )
- Policy Payment report per insurance taker
The source file for this drawing (Formal sector.drawio) can be read and edited on https://www.draw.io/.