1. The Saudi Indian Company For Co operative Insurance is a joint Saudi company established under the vice minister order No,233 date 16-9-1427\9-10- 2006 and the Royal order No,m/60 date 18-9-1427\11- 10-2006.The company capital is 100,ooo,ooo (1oo million SR) divided to 10 millions stocks with 10 SR per stock and after the end of joining and holding the establishing general association of the company, claims will be sent to the Minister of Trade and Industry to declare establishing the company which will be held from the date of the ministry order to establish it.

2. The coverage limits The minimum limt for any document by the insurance company is the co op health insurance document and there are other documents by the company include its covers and the benefits limits are like the benefits at the document of the health insurance and the more these benefits and the coverage limits are, the more price of applying to this document will be. These benefits and coverage limits depend on the client needs. 1-The benefits and the coverage limits for the maximum benefit to the insured according to the unite document of the Health Insurance Council:250,000 SR and can be more up to the client request. 2-The out patient clinic treatment charges: Deductions/portability: The percentage paid by beneficiary when consulting the physician is 20% and it differs according to the client request and they can ‘ t be cancelled. The physician fees:100 SR according to the health insurance document and can increase at the other documents which the company issues according to the client request. The daily stay and board limit : 350 SR maximum and on the client need, he can ask for a single room so the price will increase. The hard existing diseases like diabetes, high pressure, cancer, ….etc.

3. The Co oprative Health Insurance Document The Document Schedule The Insured Name / The Insurance company: ……………… Code: ………. … The Document Number: ……………………… The Document Holder Code: ………. The Document Holder Name: ……………………………………………………….. Post Address: ………………………………………………………………………… Phone No: ………….Fax No: ………………………………………………………… The Insurance Type : The Obligatory Co op Health Insurance The document Duration / The Insurance Duration: From: D …..M …..Y ……….. To :D …..M …..Y ……….. The Date of renewal of the document : D …..M …..Y ……….. The Annual Membership: ……………………………………………………… SR The Qualified For Insurance All the existing employees already at the labor who are included and their ages under 65years are applicable to insurance conditions starting of the document date, but the employees who apply for the service of the document holder and their ages under 65years are applicable to insurance conditions starting of the document date or their arrival date to the Kingdom. Husband/Wife-Maximum :65 years Children-Minimum :from the birth date Sons-Maximum:18 years ( The insurance coverage at this document includes the employees' daughters who aren ‘ t married,widows, the not working divorced female workers and those who depend on the this employee and this is for the maximum limit to the age of the employee.

4. The benefits and limits of coverage for the document The maximum limit of benefit per person at the document year 250,000 SR Out patient clinic treatment charges : Deductions/portability: The percentage paid by beneficiary when calling on a physician including consultations, examinations and medicine required ( in one divisible lot ) The maximum limit for the physician consultations fees : The General Physician: 50 SR The consultant (sent from the general physician ):150 SR The consultant (not sent from the general physician ):50 SR The accommodation expenses at the hospital: Deductions/portability: not found The daily stay and board limit (double room at maximum 350 SR per night )

5. Maternity and pregnancy cover limit: Maximum 10,000 SR during the document duration (In case that the employee has the benefit of a married contract) Prematurely born child: The maximum limit Dental Cover:2ooo SR maximum during the document duration Optical Cover:250 SR maximum during the document duration Hearing Cover :1500 SR maximum during the document duration Morgue & Repatriation to native country Cover:10,000 SR maximum during the document duration Area of coverage: The Kingdom of Saudi Arabia The registration type The employee ………………….SR The husband/wife …………….SR Children…………………………..SR The document holder has read the terms and conditions of this document with its schedule and agreed on it Date…………The document holder signature ………………..The insurance company signature………………

6. The Insurance expenses and Ways of Discretion The health insurance expenses depend on many factors : 1-The number of the employees applied for insurance :The more this number is, the less expenses will be. 2-The coverage limits and benefits : The more these required benefits and the -coverage limits sums are, the more expenses will be. 3-The expenses of the service providers (hospitals and medical centers ):The -more services are, the more expenses will be. 4-The history of the health insurance for the company applying to this service :If this company documents make loses at last because of the more money it pays, the expenses will increase. Note: There are many factors differ from company to another like the employees sex (male or female) and how cultured these employees of the insurance policies are.

7. The terms and procedures followed by the company at the- health sector 1-The client asks for a health insurance application stating in it the numbers of the laborers and information about the company and the details of the employees like ( age – gender – nationality – families – children ). 2-The application then will be studied and the prices will be shown if it is accepted. 3-After paying the money of the insurance, the healthy insurance document will be issued to the employees and their families. 4-The employee in charge will check then the medical service centers available at the health services providers for the insurance company. 5-If the service is out the coverage area, the patient will receive the treatment pills. 6-In case of adding or cancelling the insured employees as the manager of the company ordered, it will be considered that the rest of the money will paid. 7-If the insurance document is over, it will be renewed after paying the money again and the agreement of the company.

8. The policy will not cover claims arising out of the following: Injury caused deliberately by the person Injury caused deliberately by the person Treatment related to pregnancy and delivery for a women on single status contract. Treatment related to pregnancy and delivery for a women on single status contract. Free of charge treatment of injured person. Free of charge treatment of injured person. Rest, general body health programmes and treatment at social welfare houses. Rest, general body health programmes and treatment at social welfare houses. Any illness or injury resulting directly from profession of the insured. Any illness or injury resulting directly from profession of the insured. Hair falling, baldness or wigs. Hair falling, baldness or wigs.

9. Psychotherapy, mental or neurotic disorders excluding acute cases. Psychotherapy, mental or neurotic disorders excluding acute cases. Allergy tests of whatever nature excluding those related to drugs, diagnosis or treatment. Allergy tests of whatever nature excluding those related to drugs, diagnosis or treatment. treatment of acne or any other treatment relating to obscenity or overweight. treatment of acne or any other treatment relating to obscenity or overweight. Transplant of organs taken from other persons bone marrow and artificial limbs replacing any organ in the body. Transplant of organs taken from other persons bone marrow and artificial limbs replacing any organ in the body.

10. Tests for correction of sight &hearing and audio- visual aids, unless ordered by a licensed physician. Tests for correction of sight &hearing and audio- visual aids, unless ordered by a licensed physician. Plastic surgery or treatment unless necessitated by an accidental bodily injury not excluded in this part. Plastic surgery or treatment unless necessitated by an accidental bodily injury not excluded in this part. Treatment of genital diseases and the medically recognized diseases usually communicated by sexual intercourse. Treatment of genital diseases and the medically recognized diseases usually communicated by sexual intercourse. Expenses of transportation of an insured by local or authorized ambulances or by ambulances belonging to the saudi red. Expenses of transportation of an insured by local or authorized ambulances or by ambulances belonging to the saudi red.

11. Area of coverage Area of coverage Kingdom of saudi arabia only Name of TPA Globe med saudi Maximum benefit limit for each person per year 250,000 SR Coverage as from DAY 1 Maximum insurable age 65 years inclusive In patient Benefits In patient Benefits Daily room and board limit 350 SR per day Emergency treatment anywhere in the world not applicable Period of cover not applicable Deductible Emergency treatment in native country not applicable Morgue & repatriation to native country following covered hospital confinement 10,000 SR

12. Pre existing cases & chronic conditions covered covered Vaccination as per MOH schedule covered covered Parent accommodation Covered: one parent can accompany a child aged 12 years or below out patient clinic treatment charges Deductions / portability the percentage paid by beneficiary when calling on physician including consultations, examination and medicine required (in one divisible lot ) 20%of claim amount subject to a maximum of SR 100 Dental covered: * Benefits Cover is limited to teeth and gingival diseases * annual financial limitation per insured per years * annual financial limitation per insured per years 2000 SR Optical cover: * annual financial limitation per insured per years 250 SR

13. Hearing aids annual financial limitation per insured per years 1500 SR 1500 SR Maternity cover not applicable Normal including mis-carriage /abortion not applicable Complicated maternity not applicable Prematurely born child not applicable Prepar: Abdullh AL-Otibe Talal AL-Qahtani Talal AL-Qahtani