Legal Framework and Regulatory Authority - Saudi Finance

Legal Framework and Regulatory Authority



Health insurance in Saudi Arabia is governed by the Cooperative Health Insurance Law. The sector is regulated by the Council of Health Insurance (CHI), formerly known as CCHI. This body sets the standards for the "Unified Policy," which defines the minimum benefits that every mandatory insurance policy must provide.

Compliance is linked directly to the government’s digital systems. For expatriates, the issuance and renewal of residency permits (Iqama) are technically blocked until a valid health insurance policy is uploaded to the central database.

Employer Obligations (Private Sector)

For private sector companies, providing health insurance is not optional. It is a statutory requirement.

  • Who Pays: The employer is legally responsible for paying 100% of the insurance premiums. They cannot deduct this cost from the employee's salary.

  • Coverage Scope: The employer must provide coverage for:

    • The employee (both Saudi nationals and expatriates).

    • The employee's spouse (if resident in the Kingdom).

    • Male children up to the age of 25.

    • Unmarried female children (with no age limit).

  • Probation Period: Employers are required to cover employees during their probation period. A common violation involves delaying insurance until after the probation ends, which is illegal.

  • Transfer of Sponsorship: When an expatriate transfers to a new employer, the new company assumes responsibility for insurance from the day the sponsorship transfer is finalized.

Domestic Workers

Regulations regarding domestic workers (housemaids, private drivers, gardeners) have recently tightened.

  • Mandatory Requirement: Sponsors are required to provide health insurance for their domestic workers.

  • Household Limit: While initially rolled out for households with a high number of staff (e.g., more than 4 workers), the requirement applies broadly to ensure all workers have access to medical care.

Visitor Insurance

Individuals visiting Saudi Arabia on tourist, family, or business visas are subject to a different set of rules.

  • Visa Linkage: Health insurance is mandatory for visa issuance. It is typically purchased automatically as a bundled fee when applying for the visa online or through Enjaz.

  • Scope: Unlike residency insurance, visitor insurance is designed primarily for emergencies. It covers hospitalization for acute illness, accidents, and medical evacuation, but generally excludes routine checkups, dental care, or treatment for pre-existing chronic conditions.

The Unified Policy Standards

Any mandatory policy issued in the Kingdom must meet the CHI's "Unified Policy" minimums. If an employer buys a "cheap" policy, it still must legally cover:

  • Examination, diagnosis, and treatment at clinics and hospitals.

  • Hospitalization and surgeries.

  • Maternity care (minimum limits apply).

  • Dental and optical care (subject to specific sub-limits).

Penalties for Non-Compliance

The government enforces these rules through the Ministry of Human Resources and Social Development and the CHI.

  • Fines: Employers found without valid insurance for their staff face fines that can exceed the cost of the premiums they avoided.

  • Iqama Renewal: The Ministry of Interior’s system (Absher/Muqeem) will automatically reject any request to renew a residency permit if the expatriate’s insurance record is invalid or expired.

  • Suspension of Services: Companies that consistently fail to insure employees may face a suspension of their computer services, preventing them from issuing visas or performing other government transactions.

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