Medical insurance operations for employees and their dependents

One of the services available for Tawuniya's integration with Jisr is the management of medical insurance operations for employees and their dependents on Jisr platform as below:

1- Edit basic member information of an employee or dependent:

• Admin can edit the essential information for existing insured employees or dependents. The information that can be edited are:

  1. Name

  2. Nationality

  3. Phone Number

  To do so, follow these steps:

• Go to the Benefits Management page ( Health Insurance tab ).
• Choose the Policies page.
• Select the Health Insurance policy.
• Choose the member for whom you would like to modify their primary data.
• Click on the three vertical dots option.
• Select the ( Edit member ) option.

• Select the information you want to edit (name, nationality, mobile number).
• Click on (Edit) and enter the updated info.

• Attach the appropriate official document to support the modification request based on the selected type.
• Click on the "Submit" button to send the request.

Note:

• Validation of identity by Tawuniya for other ID types, such as Bedoon and GCC, will be through file upload.
•  

You can modify dependent data by clicking the "view dependent details" option.

• Select the dependent whose information you wish to update.
• Click the three vertical dots option and choose ( Edit member ) to modify its data.
• Select the specific information that needs to be edited.

• Click on the "Edit member" option and enter the updated information.
• Click on the "Submit" option to send the modification request.

2- Change the member ID :

Admin will be able to adjust specific ID types to IQAMA ID.

To do so, follow these steps:

• Go to the Benefits Management page ( Health Insurance tab ).
• Choose the Policies page.
• Select the Health Insurance policy.
• Choose the member for whom you would like to update his ID.
• Click on the three vertical dots option.
• Select the ( Change member ID ) option.

• Provide the new ID number along with an attached image of the ID.
• Click on the ( Submit ) option.

Note:

The following ID types are eligible to be converted into IQAMA:

1. Border no
2. Bedoon
3. GCC

3- Change member class ( Upgrade / Downgrade ):

An admin has the ability to either upgrade or downgrade the insurance class of a current member.

To do so, follow these steps:

• Go to the Benefits Management page ( Health Insurance tab ).
• Choose the Policies page.
• Select the Health Insurance policy.
• Choose the member for whom you would like to update his class.
• Click on the three vertical dots option.
• Select the ( Change member class ) option.

• Select a higher / lower class.

• Select the upgrade/downgrade reason.

• Click on the button to fill out the Health Declaration form. (If the employee has dependents, the admin must fill the HD for each dependent).

• Click on the ( Submit ) option. 

Note:

- The change class option only applies to Employees, as dependents will follow any class update that happens to their relevant employees.

- Upgrading / Downgrading an employee class automatically upgrades/downgrades the affiliated dependents.

- In case of selecting the reason for Adjustment by mistake (only valid during the first 30 days after adding the employee).

- In case of selecting the reason for a Job Promotion / Demotion, the admin will be required to upload a Promotion / Demotion Letter.

- The regular payment process will be triggered if the submitted request is approved.

- There’s no HD required step for Class Downgrades, so the step goes directly to Submit, and the change will be effective immediately.

- Unlike the upgrade where the client is required to pay the difference, in downgrades the client will get a partial refund, but it is handled through the Tawuniya side, not Jisr.

 

4- Delete an employee or dependent:

Admin will be able to delete employee's or dependent's insurance records.

To do so, follow these steps:

• Go to the Benefits Management page ( Health Insurance tab ).
• Choose the Policies page.
• Select the Health Insurance policy.
• Choose the member for whom you would like to delete insurance records.
• Click on the three vertical dots option.
• Select the ( Delete ) option.

• Select deletion reason.

• Submit Deletion Request for Review & Approval.

Note:

- Deleting an employee will directly delete all affiliated dependents.

- Certain reasons necessitate the submission of a file to verify a deletion request.

•  

You can delete a dependent by clicking the "view dependent details" option.

• Select the dependent whose membership you wish to delete.
• Click the three vertical dots option and choose ( Delete ).

• Select deletion reason.
• Click on the "Submit" option to send the deletion request.

Note :

The request will be pending for up to 72 hours while Tawuniya validates it.