Case study:

An established South African employer would like to introduce a medical aid scheme for their permanent employees only. The new medical aid will offer the employees tailored benefits and an easy claims process. The medical aid is optional, and every employee will have to register for the medical aid scheme via the HR platform. The monthly deductions will be done automatically before salaries are paid out. Refundable claims that are paid by the employee will be paid directly into the employee

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s bank account only.

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Keeping it simple

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is the motto of the new medical aid director who has recently approved just three medical aid options. These are Single

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for staff with no dependants

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Family

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for employees with spouse and child dependants

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and Family Plus

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for employees with family dependants plus other adult dependants such as parents

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A new claims portal will be created. This will serve as the front end of the medical aid system, where employees can submit claims, such as for doctors

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visits

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medication from a pharmacy, and so on

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A service integration layer will also be added for healthcare facilities, including doctors, dentists, and hospitals, to claim directly.

The employer

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s current employee call centre will be extended by adding a new division to handle medical aid claims and queries.

Create an ArchiMate model to represent the rollout of the Employer Medical Aid Scheme. In general terms, the rollout process includes three main phases:

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Medical aid registration

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Integration to the

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rd Party systems for claims

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Re

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engineering the existing call centre to include support for the medical aid functions.

Your task is to first get an understanding of how the rollout process is implemented from a technology perspective. Based on this understanding, you need to model the process on the following three ArchiMate levels:

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Business layer

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Application layer

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Technology layer

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