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Health Insurance Waiver Template for Indonesia

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Key Requirements PROMPT example:

Health Insurance Waiver

"I need a Health Insurance Waiver document for our Jakarta-based tech company, specifically designed for foreign employees who already have international health coverage, ensuring compliance with both BPJS regulations and expatriate insurance requirements."

Document background
The Health Insurance Waiver is a critical document used in Indonesian business operations when an employee or individual chooses to decline supplementary health insurance coverage offered by their employer or organization. This document becomes necessary when an individual has alternative coverage or chooses not to participate in additional health insurance programs beyond the mandatory BPJS Kesehatan system. The waiver serves multiple purposes: it documents the individual's informed decision to decline coverage, protects the organization from future liability, ensures compliance with Indonesian healthcare regulations, and maintains proper documentation for both insurance and human resources purposes. It's particularly important in the Indonesian context due to the dual system of mandatory national health insurance (BPJS) and optional private coverage, requiring clear distinction between what is being waived and what must be maintained by law.
Suggested Sections

1. Parties: Identification of the parties involved: the organization offering the health insurance and the individual waiving the coverage

2. Background: Context explaining the offering of health insurance and the option to waive coverage

3. Definitions: Clear definitions of key terms including 'Health Insurance Coverage', 'Waiver Period', 'BPJS Kesehatan', and other relevant terms

4. Acknowledgment of Offered Coverage: Details of the health insurance coverage being offered and declined

5. Waiver Declaration: Clear statement of the individual's voluntary decision to waive the offered health insurance coverage

6. BPJS Compliance Statement: Explicit statement that this waiver only applies to additional/supplemental insurance and does not affect mandatory BPJS coverage

7. Understanding of Risks: Acknowledgment of the potential risks and consequences of waiving health insurance coverage

8. Duration and Validity: Period for which the waiver is valid and conditions for renewal or termination

9. Reinstatement Rights: Conditions under which the individual can enroll in the health insurance program in the future

10. Declarations and Signatures: Final declarations and signature blocks for all parties

Optional Sections

1. Alternative Coverage Declaration: Section to declare alternative health insurance coverage, if applicable

2. Dependent Coverage: Section addressing the impact on dependent coverage, if relevant

3. Employer Contribution: Details about any monetary compensation in lieu of insurance, if offered

4. Special Circumstances: Provisions for special circumstances or exceptions that might allow for mid-period enrollment

5. Foreign National Provisions: Special provisions for foreign nationals working in Indonesia, if applicable

Suggested Schedules

1. Schedule A - Description of Waived Benefits: Detailed listing of all insurance benefits being waived

2. Schedule B - Premium Information: Information about the premium costs being waived and any financial implications

3. Appendix 1 - Insurance Plan Summary: Summary of the insurance plan being waived for reference

4. Appendix 2 - Required Documentation: List of required supporting documents (e.g., proof of alternative coverage if applicable)

5. Appendix 3 - BPJS Information: Information about mandatory BPJS coverage and compliance requirements

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok成人版 | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions






























Clauses




















Relevant Industries

Healthcare

Insurance

Manufacturing

Technology

Education

Retail

Construction

Professional Services

Hospitality

Mining

Agriculture

Transportation

Relevant Teams

Human Resources

Legal

Compliance

Risk Management

Employee Benefits

Payroll

Corporate Administration

Finance

Executive Leadership

International Operations

Relevant Roles

Human Resources Manager

HR Director

Benefits Administrator

Compensation Specialist

HR Business Partner

Legal Counsel

Compliance Officer

Risk Manager

Employee Relations Manager

HR Operations Manager

Global Mobility Manager

Payroll Manager

Corporate Secretary

Managing Director

Chief Financial Officer

Chief Human Resources Officer

Industries







Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks, 聽Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination, 聽Severance Pay, Governing Law, Entire Agreemen

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