Article 5 of the Saudi Cooperative Health Insurance Law
المادة 5 من نظام الضمان الصحي التعاوني
The article sets the powers of the Council of Health Insurance in supervising the Law's application, including preparing the regulations, setting stages, covered persons and contribution rates, qualifying insurers and accrediting facilities.
Official text (Arabic)
This article has not been amended since the law was issued.
يتولى مجلِس الضمان الصحي الإشراف على تطبيق هذا النِظام، ولهُ على وجه الخصوص ما يأتي:
أ - إعداد مشروع اللائحة التنفيذية لهذا النِظام.
ب - إصدار القرارات اللازِمة لتنظيم الأمور المُتغيرة بشأن تطبيق أحكام هذا النِظام بما في ذلك تحديد مراحِل تطبيقه، وتحديد أفراد أُسرة المُستفيد المشمولين بالضمان وكيفية ونِسبة مُساهمة كُلٍ مِن المُستفيد وصاحِب العمل في قيمة الاشتِراك في الضمان الصحي التعاوني، وكذلك تحديد الحد الأعلى لتلك القيمة بناءً على دِراسة مُتخصِّصة تشتمل على حِسابات التأمين.
ج - تأهيل شركات التأمين التعاوني للعمل في مجال الضمان الصحي التعاوني.
د - اعتِماد المرافِق الصحية التي تُقدِّم خدمات الضمان الصحي التعاوني.
هـ - تحديد المُقابِل المالي لتأهيل شركات التأمين التعاوني للعمل في هذا المجال، والمُقابِل المالي لاعتِماد المرافِق الصحية التي تُقدِّم خدمات الضمان الصحي التعاوني وذلك بعد أخذ رأي وزارة المالية والاقتِصاد الوطني.
و - إصدار اللائحة المالية لإيرادات مجلِس الضمان الصحي ومصروفاتِه، بما في ذلك أجور العاملين فيه ومُكافآتِهم، بعد أخذ رأي وزارة المالية والاقتِصاد الوطني.
ز - إصدار اللائحة الداخلية لتنظيم سير أعمال المجلِس.
ح - تعيين أمين عام للمجلِس بناءً على ترشيح من وزير الصحة ، وتشكيل أمانة عامة، وتحديد مهماتِها.
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 5 explained in plain English
This article sets out the powers of the Council of Health Insurance, the council established by Article 4 under the chairmanship of the Minister of Health and with membership of representatives of a number of ministries and sectors. The Council supervises the application of the Law, and in particular it:
- Prepares the draft Implementing Regulations of the Law.
- Issues the decisions needed to organize the changing matters, including determining the stages of application, determining the beneficiary's family members who are covered, how and in what proportion the beneficiary and the employer contribute to the premium, and the maximum amount of that premium on the basis of a specialized study that includes insurance calculations.
- Qualifies cooperative insurance companies to work in the field of health insurance.
- Accredits the health facilities that provide its services.
- Determines the fee for qualifying insurance companies and for accrediting health facilities, after obtaining the opinion of the Ministry of Finance and National Economy.
- Issues the financial regulation for the Council's revenues and expenses, including the wages and rewards of its employees, after obtaining the opinion of the Ministry of Finance and National Economy.
- Issues the internal regulation organizing the conduct of the Council's work.
- Appoints a secretary general on the nomination of the Minister of Health, and forms a general secretariat and determines its tasks.
The phrase "in particular" means that this list consists of prominent examples of the supervisory authority, not an exhaustive list of it.
This article shows that many practical details, such as which family members the insurance covers and the amount of the worker's and employer's contributions, are determined by decisions of the Council and not by the text of the Law. The revenues collected under paragraph (e) cover the Council's expenses under Article 6.
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 5 of the Saudi Cooperative Health Insurance Law
What is the Council of Health Insurance and what is its role?
A council that supervises the application of the Cooperative Health Insurance Law; its powers include preparing the draft regulations, qualifying insurance companies and accrediting health facilities.
Who determines the share of the worker and the employer in the insurance?
The Council of Health Insurance, under paragraph (b) of this article, which also sets the maximum premium amount on the basis of a specialized study.
Who accredits hospitals and centers for health insurance?
Accrediting the health facilities that provide cooperative health insurance services is among the powers of the Council of Health Insurance.
Who qualifies health insurance companies?
The Council of Health Insurance is the body competent to qualify cooperative insurance companies to work in this field.
More articles on Health Insurance Council
- Article 6
The Council of Health Insurance's expenses, and the wages and rewards of its employees, are covered from the revenues collected under paragraph (e) of Article 5, as agreed between the Ministry of Health and the Ministry of Finance.
تُغطى المصروفات اللازِمة لأداء مجلِس الضمان الصحي لأعمالِه وأجور العاملين فيه ومُكافآتِهم مِن الإيرادات التي يتم تحصيلُها بموجب الفقرة (هـ) من المادة الخامسة، و
- Article 18
The Minister of Health must issue the Implementing Regulations of the Cooperative Health Insurance Law within a maximum of one year from the date the Law was issued.
يُصدِر وزير الصحة اللائحة التنفيذية لهذا النِظام في مُدة أقصاها سنة من تاريخ صُدورِه.
- Article 19
The Law is published in the Official Gazette and implementation begins 90 days after its Implementing Regulations are issued, while the provisions on the Council of Health Insurance take effect from publication.
يُنشر هذا النِظام في الجريدة الرسمية ، ويبدأ تنفيذُه بعد تسعين يوماً مِن صدور اللائحة التنفيذية ، أمَّا الأحكام المُتعلِقة بإنشاء مجلِس الضمان الصحي واختِصاصاتِ
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.

