responsible for paying for an extensive package of services
for private sector expatriates.
To meet this growth of several population demands for
health care and to ensure the quality of services provided, the
Saudi government has established in 1999 the Council for
Cooperative Health Insurance (CCHI). The main role of
CCHI is to introduce, regulate and supervise a health
insurance strategy for the Saudi health care market.
The CCHI is an independent government body built by the
above decision to regulate and implement this act through
(Vision and tasks of the Council of Health Services in Saudi
Arabia):
1. Preparing a draft of an executive bylaw for this act.
2. Issuing necessary decisions for regulating changing
matters regarding the implementation of the rules governing this act, including implementation phases, the
family members of the beneficiary to be covered by this
insurance, the way and percentage of contribution by the
beneficiary and the employer in the cooperative health
insurance, and the maximum limit for this amount based
on actuarial and specialist study.
3. Qualifying the cooperative insurance companies to work
in the field of the cooperative health insurance.
4. Accrediting the health institutions to provide cooperative
health insurance services.
5. Determining the financial compensation for qualifying
the cooperative health insurance companies to work in
this field, and the financial compensation for the
accreditation of health institutions to provide cooperative
health insurance services, after consulting the ministry of
finance and national economy.
The implementation of Cooperative Health Insurance was
planned over 3 phases. In the first phase, the Cooperative
Health Insurance was implemented for non-Saudis and
Saudis working in the private sector, wherein their
employers should pay the cost of insurance. In the second
phase, the Cooperative Health Insurance is to be implemented for Saudis and non-Saudis working in the government sector. The government will reimburse the collective
health insurance charges for this group of workers. In the last
stage, the Cooperative Health Insurance will be implemented
for other clusters, such as, pilgrims (Alsharif 2008). The first
phase has only been applied at the time of research.
2 Implementing Private Health Insurance
for Employees of the Private Sector
and their Dependents
The first phase covered companies with 500 or more
employees while the second phase applied to employers with
more than 100 workers. The third phase included employees
of all companies in KSA as well as domestic workers. The
Saudi government is now working systematically to apply
the remaining two stages for employees in the government
sector and pilgrims before they privatize the state-owned
healthcare facilities. No information is available yet
regarding the cooperative health insurance scheme for the
Saudi citizens other than employees and expatriates. While
the market for cooperative health insurance in the Kingdom
of Saudi Arabia started with only one company in 2004, it
currently has 27 companies in 2017 (Middle East Insurance
Review; Council of Cooperative Health Insurance Annual
Report).
The introduction of the scheme is intended to decrease the
financial burden on the KSA government due to the costs
associated with providing heath services free of charge. It
will also give citizens more opportunity to choose the health
services they need. According to this expansion of health
insurance business and the availability of private health
insurance coverage for more than 10 million people (Saudi
and non-Saudi), the demand on the medical care will
increase, and the utilization of these medical services will
increase as well among the insured people (According to the
yearly Annual Reports of the CCHI (Council of Cooperative
Health Insurance Annual Report)).
The accessibility to medical care providers and hospitals
will be easy for the privately insured people compared to
noninsured people that will increase the utilization of services. Private health insurance will give an insured chance to
receive health care in proper and less waiting time before
receiving the service. Waiting time before receiving treatment represents a significant issue for non-privately insured
and publicly insured individuals because of the extended
waiting period in the governmental hospital.
Moral hazards associated with the availability of private
health insurance is one of the major issues, which can affect
directly the utilization of medical services. Individual who
has private health insurance will behave differently than
non-privately insured one. There are several factors causing
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M. H. Ahmed and T. Abdullah AL Amri
for private sector expatriates.
To meet this growth of several population demands for
health care and to ensure the quality of services provided, the
Saudi government has established in 1999 the Council for
Cooperative Health Insurance (CCHI). The main role of
CCHI is to introduce, regulate and supervise a health
insurance strategy for the Saudi health care market.
The CCHI is an independent government body built by the
above decision to regulate and implement this act through
(Vision and tasks of the Council of Health Services in Saudi
Arabia):
1. Preparing a draft of an executive bylaw for this act.
2. Issuing necessary decisions for regulating changing
matters regarding the implementation of the rules governing this act, including implementation phases, the
family members of the beneficiary to be covered by this
insurance, the way and percentage of contribution by the
beneficiary and the employer in the cooperative health
insurance, and the maximum limit for this amount based
on actuarial and specialist study.
3. Qualifying the cooperative insurance companies to work
in the field of the cooperative health insurance.
4. Accrediting the health institutions to provide cooperative
health insurance services.
5. Determining the financial compensation for qualifying
the cooperative health insurance companies to work in
this field, and the financial compensation for the
accreditation of health institutions to provide cooperative
health insurance services, after consulting the ministry of
finance and national economy.
The implementation of Cooperative Health Insurance was
planned over 3 phases. In the first phase, the Cooperative
Health Insurance was implemented for non-Saudis and
Saudis working in the private sector, wherein their
employers should pay the cost of insurance. In the second
phase, the Cooperative Health Insurance is to be implemented for Saudis and non-Saudis working in the government sector. The government will reimburse the collective
health insurance charges for this group of workers. In the last
stage, the Cooperative Health Insurance will be implemented
for other clusters, such as, pilgrims (Alsharif 2008). The first
phase has only been applied at the time of research.
2 Implementing Private Health Insurance
for Employees of the Private Sector
and their Dependents
The first phase covered companies with 500 or more
employees while the second phase applied to employers with
more than 100 workers. The third phase included employees
of all companies in KSA as well as domestic workers. The
Saudi government is now working systematically to apply
the remaining two stages for employees in the government
sector and pilgrims before they privatize the state-owned
healthcare facilities. No information is available yet
regarding the cooperative health insurance scheme for the
Saudi citizens other than employees and expatriates. While
the market for cooperative health insurance in the Kingdom
of Saudi Arabia started with only one company in 2004, it
currently has 27 companies in 2017 (Middle East Insurance
Review; Council of Cooperative Health Insurance Annual
Report).
The introduction of the scheme is intended to decrease the
financial burden on the KSA government due to the costs
associated with providing heath services free of charge. It
will also give citizens more opportunity to choose the health
services they need. According to this expansion of health
insurance business and the availability of private health
insurance coverage for more than 10 million people (Saudi
and non-Saudi), the demand on the medical care will
increase, and the utilization of these medical services will
increase as well among the insured people (According to the
yearly Annual Reports of the CCHI (Council of Cooperative
Health Insurance Annual Report)).
The accessibility to medical care providers and hospitals
will be easy for the privately insured people compared to
noninsured people that will increase the utilization of services. Private health insurance will give an insured chance to
receive health care in proper and less waiting time before
receiving the service. Waiting time before receiving treatment represents a significant issue for non-privately insured
and publicly insured individuals because of the extended
waiting period in the governmental hospital.
Moral hazards associated with the availability of private
health insurance is one of the major issues, which can affect
directly the utilization of medical services. Individual who
has private health insurance will behave differently than
non-privately insured one. There are several factors causing
256
M. H. Ahmed and T. Abdullah AL Amri