Document Code: SayProP257
Approved By: Neftaly Malatjie, Chief Executive Officer
Last Reviewed: 02 March 2025
Next Review Date: 02 August 2025
1. Overview
The SayPro Human Capital Insurance Management Policy outlines the procedures and guidelines for managing employee insurance benefits provided by SayPro. This policy ensures that SayPro’s insurance programs are compliant with legal requirements and align with the company’s goal of providing competitive and comprehensive benefits to its employees.
2. Objectives
- To ensure compliance with relevant insurance laws and regulations.
- To provide accessible and affordable insurance coverage to all eligible employees.
- To educate employees about the insurance options available to them.
- To streamline the claims process and ensure that employees are supported throughout the process.
- To manage insurance policies in a way that minimizes financial risks to the company and its Human Capital.
3. Scope
This policy applies to:
- All SayPro Human Capital employees, including permanent, temporary, and contract staff.
- SayPro’s Human Capital and Finance teams responsible for managing the insurance policies.
- Insurance providers with which SayPro has contractual agreements.
4. Types of Insurance Offered
SayPro provides the following types of insurance for its employees:
- Life Insurance
- Coverage provided for employees in the event of death or permanent disability due to illness or accident.
- SayPro will provide group life insurance for all employees, with optional additional coverage that can be chosen by the employee at their own cost.
- Health Insurance
- Comprehensive health insurance for employees and their eligible dependents, covering medical expenses, hospitalization, and outpatient care.
- SayPro partners with a reputable health insurance provider to offer a range of health plan options.
- Disability Insurance
- Provides financial assistance to employees who are unable to work due to short-term or long-term disabilities.
- Both short-term disability and long-term disability insurance are available to qualifying employees.
- Retirement and Pension Plans
- Employees are eligible to enroll in a retirement savings plan through SayPro, which may include a company contribution based on the employee’s salary.
- Funeral Insurance
- Provides coverage for the employee’s funeral expenses or those of their immediate family members.
- Critical Illness Insurance
- Provides financial support to employees diagnosed with certain life-threatening illnesses, including cancer, stroke, and heart attack.
5. Insurance Enrollment Process
5.1 Eligibility
- New Employees: All new employees are eligible for insurance benefits after completing their probationary period (usually 3 months).
- Dependents: Employees may opt to add their spouse, children, or other dependents to health and life insurance coverage, subject to eligibility criteria and additional costs.
5.2 Enrollment Process
- Upon employment, employees will receive an Insurance Enrollment Package, which includes details about the available insurance plans.
- Employees must complete the Insurance Enrollment Form (SayProF257-01) to indicate their chosen plans and optional coverage.
- The Human Capital Department will verify employee details and process the enrollment with the insurance provider.
- After enrollment, employees will receive a confirmation of their insurance coverage.
5.3 Changes to Coverage
- Employees may modify their coverage during the annual open enrollment period or when there is a qualifying life event (e.g., marriage, birth of a child, or changes in health).
- To request changes, employees must submit a completed Insurance Change Request Form (SayProF257-02) to Human Capital for processing.
6. Insurance Premiums and Contributions
- Employee Premiums: Employees may be required to contribute a portion of the premiums for certain types of insurance (e.g., life insurance, disability insurance, and family health insurance).
- Employer Contributions: SayPro will pay the full premium for employee-only coverage for health, life, and disability insurance. Additional contributions for dependents may be the responsibility of the employee.
- Premiums are deducted from employees’ monthly salaries.
7. Claims Process
Employees who experience qualifying events, such as death, disability, or medical emergencies, may file claims with the respective insurance provider.
7.1 Filing a Claim
- Obtain Claim Forms: Employees should contact Human Capital to obtain the Insurance Claim Form (SayProF257-03), which must be completed in full.
- Submit Required Documents: Employees will need to provide supporting documentation, such as medical reports, proof of death (in the case of life insurance), or accident reports, as required by the insurance provider.
- Submit Claim Form: The completed claim form and documentation should be submitted to Human Capital, who will forward it to the insurance provider for processing.
- Follow-Up: Human Capital will track the status of the claim and assist the employee in providing additional information if required by the insurance provider.
7.2 Claim Approval and Payout
- Once the claim is processed and approved by the insurance provider, employees will be notified of the payout amount and the timeline for receiving benefits.
- In cases where the claim is denied, the employee will receive an explanation and may appeal the decision as per the insurance provider’s procedures.
8. Roles and Responsibilities
8.1 SayPro Chief Human Capital Officer (CHCO)
- Oversee the management and administration of the insurance program.
- Ensure compliance with all applicable insurance regulations and company policies.
- Coordinate with the insurance provider to ensure smooth claims processing.
8.2 Human Capital Team
- Administer employee insurance enrollments, changes, and claims processing.
- Ensure accurate documentation and timely submissions to insurance providers.
- Assist employees in understanding their insurance benefits and claims processes.
8.3 Payroll Department
- Deduct employee premiums from monthly salaries as required for optional coverage and employee contributions.
- Ensure that employer contributions for insurance are made to the insurance provider.
8.4 Insurance Providers
- Process insurance claims in a timely manner.
- Provide SayPro with regular updates on claim statuses and coverage changes.
8.5 Employees
- Complete insurance enrollment forms during onboarding and when making coverage changes.
- Submit timely claims and provide necessary documentation.
- Review and update personal information regularly to ensure coverage remains accurate.
9. Evaluation and Monitoring
9.1 Insurance Reviews
- SayPro will review insurance providers and policies annually to ensure employees have access to competitive and comprehensive coverage.
- Employee feedback will be collected during the annual review to gauge satisfaction with insurance options and coverage.
9.2 Monitoring Compliance
- The Human Capital Department will monitor compliance with insurance procedures, ensuring timely premium payments and claims submissions.
- Annual audits of insurance premiums, claims, and records will be conducted to ensure the integrity of the program.
10. Templates and Documents
- Insurance Enrollment Form (SayProF257-01)
- Insurance Change Request Form (SayProF257-02)
- Insurance Claim Form (SayProF257-03)
- Employee Insurance Benefits Summary (SayProF257-04)
- Insurance Premium Deduction Form (SayProF257-05)
11. Compliance and Review
- Legal Compliance: All insurance management activities must comply with South African insurance laws and any other applicable regulations.
- Policy Review: This policy will be reviewed at least once every 12 months or sooner if required by changes in legislation or company needs.
- Non-compliance: Non-compliance with this policy will be addressed in line with SayPro’s disciplinary procedures.
Approved By:
Neftaly Malatjie
Chief Executive Officer
Date: 02 March 2025
