Premium is the amount of money determined by the insurance company or reinsurance company and approved by the Policyholder to be paid based on the insurance agreement or reinsurance agreement, or the amount of money determined based on the provisions of laws and regulations underlying the mandatory insurance program to obtain benefits.
Contribution is the amount of money determined by the sharia insurance company or sharia reinsurance company and approved by the Policyholder to be paid based on the sharia insurance agreement or sharia reinsurance agreement to obtain benefits from the tabarru' fund and/or the Participant's investment fund and to pay management fees or the amount of money determined based on the provisions of laws and regulations underlying the mandatory insurance program to obtain benefits.
The Health Social Security Organizing Agency, hereinafter referred to as BPJS Kesehatan, is a public legal entity established to organize the health insurance program as stipulated in the Law concerning social security organizing agencies.
Health Service Facility is a tool and/or place for health services used to organize health service efforts, whether promotive, preventive, curative, rehabilitative, and/or palliative, organized by the government, regional government, and/or the community.
The Medical Advisory Board, hereinafter abbreviated as DPM, is a board that will assist the Company in providing advice or proposals on medical services provided by Health Service Facilities.
Third Party Administrator, hereinafter referred to as TPA, is a third-party administrative service in assisting the Company with administrative services, including claims management, Insurance Policy management, and other administrative functions.
Utilization Review is an evaluation of the appropriateness of the use of health services provided to the Insured or Participant, conducted to control costs and monitor service quality.
Coordination Between Guarantee Organizers, hereinafter abbreviated as KAPJ, is coordination carried out between the Company and BPJS Kesehatan and other guarantee organizers in providing health service benefits.

Article 2

The strengthening of the health insurance ecosystem aims to:

strengthen effective governance, risk management, and supervision to protect the rights and interests of Policyholders, Insured, or Participants and related parties in the health insurance ecosystem;
encourage collaboration among parties involved in the national health insurance ecosystem;
ensure the creation of a stable, healthy, and competitive health insurance ecosystem; and
prioritize the principle of consumer protection in the organization of health insurance.

Article 3

In realizing the objectives of strengthening the health insurance ecosystem as referred to in Article 2, the Financial Services Authority coordinates with:

the ministry responsible for government affairs in the health sector;
associations of Health Service Facilities;
BPJS Kesehatan and other guarantee organizers.

organizers of other guarantees;\n

professional associations in the health sector; and

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