Article 13 of the Saudi Cooperative Health Insurance Law
المادة 13 من نظام الضمان الصحي التعاوني
The Council of Health Insurance may, by decision, exempt institutions and companies that own qualified private medical institutions from subscribing for the services they provide to their personnel.
Official text (Arabic)
This article has not been amended since the law was issued.
يجوز بقرار مِن مجلِس الضمان الصحي إعفاء المؤسسات والشركات التي تملك مؤسسات طبية خاصة مؤهلة من الاشتِراك في الضمان الصحي التعاوني عن الخدمات التي تُقدِّمُها لمنسوبيها.
This is the official Arabic wording, the only legally binding version. We do not translate the law itself; the explanation below is ours. Official source: Bureau of Experts at the Council of Ministers
Article 13 explained in plain English
This article deals with the case of companies that own their own medical facilities. It is permissible, by decision of the Council of Health Insurance, to exempt institutions and companies that own qualified private medical institutions from subscribing to cooperative health insurance.
This exemption has clear limits in the text:
- It is discretionary; it is not an automatic right of the company, but requires a decision of the Council.
- The medical institution the company owns must be qualified.
- The exemption is for the services it provides to its personnel, that is, within the limits of those services.
The article did not specify the criteria for qualification or the procedures for requesting the exemption; these are learned from the Council's decisions and the regulations.
This article comes after Article 12, which provides that employees of government entities who are contracted directly with them and under their sponsorship, and whose contracts state their right to treatment, are treated in government health facilities. The two articles deal with cases in which treatment is available to workers from a source other than the insurance policy.
A company that has not obtained an exemption remains under its obligation. Article 14 provides that an employer who does not subscribe, or does not pay the premiums, for a worker with him to whom the Law applies and for his family members covered with him is required to pay all the premiums due with a fine not exceeding the value of the annual subscription for each individual.
Practical example
A large industrial company in Jubail owns a qualified private hospital that treats its employees. It can ask the Council of Health Insurance to exempt it from subscribing to cooperative health insurance for the services its hospital provides to its employees, and the decision on that rests with the Council.
Translated from our Arabic explanation with machine assistance. For guidance only; it does not replace advice from a lawyer on your situation.
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Frequently asked questions about Article 13 of the Saudi Cooperative Health Insurance Law
Can a company be exempted from health insurance for its employees?
The Council of Health Insurance may, by decision, exempt institutions and companies that own qualified private medical institutions, for the services they provide to their personnel.
Is the exemption automatic if the company has a hospital?
No. The exemption is discretionary and requires a decision of the Council of Health Insurance, and the medical institution must be qualified.
Does the exemption cover all health services?
The exemption is for the services the medical institution provides to the company's personnel.
More articles on Persons Covered by Health Insurance
- Article 1
The article sets the Law's objective: providing and organizing health care for all non-Saudi residents in the Kingdom, with the option of applying it to citizens and others by decision of the Council of Ministers.
يهدف هذا النِظام إلى توفير الرعاية الصحية وتنظيمِها لجميع المُقيمين غير السعوديين في المملكة، ويجوز تطبيقُه على المواطنين وغيرِهم بقرار مِن مجلس الوزراء .
- Article 2
Cooperative health insurance coverage includes everyone to whom the Law applies and their family members, as the Council of Health Insurance determines under paragraph (b) of Article 5.
تشمل التغطية بالضمان الصحي التعاوني جميع من ينطبق عليهم هذا النِظام وأفراد أُسرِهم وِفقاً لما جاء في الفقرة (ب) مِن المادة الخامسة.
- Article 3
Anyone who sponsors a resident must subscribe to cooperative health insurance for him, and a residence permit is not granted or renewed without a policy covering the period of residence.
مع مُراعاة مراحِل التطبيق المُشار إليها في الفقرة (ب) من المادة الخامسة، وما تقضي بِه المادتان الثانية عشرة والثالثة عشرة مِن هذا النِظام، يلتزم كُل من يكفل مُق
- Article 12
Employees of government entities covered by the Law, and their families, are treated in government health facilities if they are contracted directly with those entities and under their sponsorship and their contracts state a right to treatment.
يكون علاج العاملين في الجِهات الحُكومية المشمولين بهذا النِظام وأفراد أُسرِهم في المرافِق الصحية الحُكومية متى كانوا مُتعاقدين مُباشرة مع هذه الجِهات وتحت كفالت
- Article 15
A resident who is not under a work sponsorship takes the employer's place in the obligations the employer would otherwise bear under the Cooperative Health Insurance Law.
يحل المُقيم غير المشمول بكفالة عمل محل صاحِب العمل في الالتِزامات المُترتِبة على هذا الأخير بموجب هذا النِظام.
The texts are reproduced from the official website of the Bureau of Experts at the Council of Ministers for reference; where they differ, the officially published Arabic text prevails. This content is not legal advice.