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SME Health Insurance Plans

At Saudi Enaya, we cater to the distinct needs of small and medium-sized enterprises. Our insurance products are fully customizable to meet the specific requirements of your business and employees. We provide comprehensive and affordable benefits designed to support the growth and security of your SME. Discover the perfect insurance solution tailored to fit your needs.

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Class	VIP
Table of Benefits	Option 1	Option 1 (Enhanced)	Option 1 (Nil)	Option 2	Option 2 (Enhanced)	Option 2 (Nil)	Option 3	Option 3 (Enhanced)	Option 3 (Nil)
Network	SE_VIP
Room Type	Suite
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	World Wide 2						World Wide 1
Dental Limit (SAR)	SAR 2,000			SAR 4,000			SAR 5,000
Optical Limit (SAR)	SAR 400			SAR 1,000			SAR 2,000
Maternity Limit (SAR)	SAR 15,000			SAR 20,000			SAR 25,000
Minimum Provider Network (MPN)	20% Max 75		Nil	20% Max 75		Nil	20% Max 75		Nil
Outside Hospital Network (OHN)	20% Max 300	20% Max 100	Nil	20% Max 300	20% Max 100	Nil	20% Max 300	20% Max 100	Nil
Outside Clinic Network (OCN)	20% Max 100		Nil	20% Max 100		Nil	20% Max 100		Nil
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	VIP
Table of Benefits	Option 1	Option 1 (Enhanced)	Option 1 (Nil)	Option 2	Option 2 (Enhanced)	Option 2 (Nil)	Option 3	Option 3 (Enhanced)	Option 3 (Nil)
Network	SE_VIP
Room Type	Suite
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	World Wide 2						World Wide 1
Dental Limit (SAR)	SAR 2,000			SAR 4,000			SAR 5,000
Optical Limit (SAR)	SAR 400			SAR 1,000			SAR 2,000
Maternity Limit (SAR)	SAR 15,000			SAR 20,000			SAR 25,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	Nil	20% Max 75	20% Max 75	Nil	20% Max 75	20% Max 75	Nil
Outside Hospital Network (OHN)	20% Max 300	20% Max 100	Nil	20% Max 300	20% Max 100	Nil	20% Max 300	20% Max 100	Nil
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	Nil	20% Max 100	20% Max 100	Nil	20% Max 100	20% Max 100	Nil
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	VIP
Table of Benefits	Option 1	Option 1 (Enhanced)	Option 1 (Nil)	Option 2	Option 2 (Enhanced)	Option 2 (Nil)	Option 3	Option 3 (Enhanced)	Option 3 (Nil)
Network	SE_VIP
Room Type	Suite
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	World Wide 2						World Wide 1
Dental Limit (SAR)	SAR 2,000			SAR 4,000			SAR 5,000
Optical Limit (SAR)	SAR 400			SAR 1,000			SAR 2,000
Maternity Limit (SAR)	SAR 15,000			SAR 20,000			SAR 25,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	Nil	20% Max 75	20% Max 75	Nil	20% Max 75	20% Max 75	Nil
Outside Hospital Network (OHN)	20% Max 300	20% Max 100	Nil	20% Max 300	20% Max 100	Nil	20% Max 300	20% Max 100	Nil
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	Nil	20% Max 100	20% Max 100	Nil	20% Max 100	20% Max 100	Nil
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	A-Gold
Table of Benefits	Option 1	Option 1 (Enhanced)	Option 2	Option 2 (Enhanced)
Network	SE_A
Room Type	Private
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	World Wide 2
Dental Limit (SAR)	SAR 2,000	SAR 2,000	SAR 3,000	SAR 3,000
Optical Limit (SAR)	SAR 400	SAR 400	SAR 1,000	SAR 1,000
Maternity Limit (SAR)	SAR 15,000	SAR 15,000	SAR 20,000	SAR 20,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	20% Max 75	20% Max 75
Outside Hospital Network (OHN)	20% Max 300	20% Max 100	20% Max 300	20% Max 100
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	20% Max 100	20% Max 100
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	A-Gold
Table of Benefits	Option 1	Option 1 (Enhanced)	Option 2	Option 2 (Enhanced)
Network	SE_A
Room Type	Private
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	World Wide 2
Dental Limit (SAR)	SAR 2,000	SAR 2,000	SAR 3,000	SAR 3,000
Optical Limit (SAR)	SAR 400	SAR 400	SAR 1,000	SAR 1,000
Maternity Limit (SAR)	SAR 15,000	SAR 15,000	SAR 20,000	SAR 20,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	20% Max 75	20% Max 75
Outside Hospital Network (OHN)	20% Max 300	20% Max 100	20% Max 300	20% Max 100
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	20% Max 100	20% Max 100
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	A-Gold
Table of Benefits	Option 1	Option 1 (Enhanced)	Option 2	Option 2 (Enhanced)
Network	SE_A
Room Type	Private
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	World Wide 2
Dental Limit (SAR)	SAR 2,000	SAR 2,000	SAR 3,000	SAR 3,000
Optical Limit (SAR)	SAR 400	SAR 400	SAR 1,000	SAR 1,000
Maternity Limit (SAR)	SAR 15,000	SAR 15,000	SAR 20,000	SAR 20,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	20% Max 75	20% Max 75
Outside Hospital Network (OHN)	20% Max 300	20% Max 100	20% Max 300	20% Max 100
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	20% Max 100	20% Max 100
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	B-Silver
Table of Benefits	Option 1	Option 1 (Enhanced)	Option 2	Option 2 (Enhanced)
Network	SE_B
Room Type	Semi-Private
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	KSA & Home Country
Dental Limit (SAR)	SAR 2,000	SAR 2,000	SAR 2,500	SAR 2,500
Optical Limit (SAR)	SAR 400	SAR 400	SAR 750	SAR 750
Maternity Limit (SAR)	SAR 15,000	SAR 15,000	SAR 15,000	SAR 15,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	20% Max 75	20% Max 75
Outside Hospital Network (OHN)	20% Max 300	20% Max 100	20% Max 300	20% Max 100
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	20% Max 100	20% Max 100
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	B-Silver
Table of Benefits	Option 1	Option 1 (Enhanced)	Option 2	Option 2 (Enhanced)
Network	SE_B
Room Type	Semi-Private
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	KSA & Home Country
Dental Limit (SAR)	SAR 2,000	SAR 2,000	SAR 2,500	SAR 2,500
Optical Limit (SAR)	SAR 400	SAR 400	SAR 750	SAR 750
Maternity Limit (SAR)	SAR 15,000	SAR 15,000	SAR 15,000	SAR 15,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	20% Max 75	20% Max 75
Outside Hospital Network (OHN)	20% Max 300	20% Max 100	20% Max 300	20% Max 100
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	20% Max 100	20% Max 100
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	B-Silver
Table of Benefits	Option 1	Option 1 (Enhanced)	Option 2	Option 2 (Enhanced)
Network	SE_B
Room Type	Semi-Private
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	KSA & Home Country
Dental Limit (SAR)	SAR 2,000	SAR 2,000	SAR 2,500	SAR 2,500
Optical Limit (SAR)	SAR 400	SAR 400	SAR 750	SAR 750
Maternity Limit (SAR)	SAR 15,000	SAR 15,000	SAR 15,000	SAR 15,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	20% Max 75	20% Max 75
Outside Hospital Network (OHN)	20% Max 300	20% Max 100	20% Max 300	20% Max 100
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	20% Max 100	20% Max 100
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	C-Bronze		C-Classic
Table of Benefits	C+	C	C LTD	CR
Network	SE_C+	SE_C	SE_C LTD	SE_CR
Room Type	Shared
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	KSA
Dental Limit (SAR)	SAR 2,000	SAR 2,000	SAR 2,000	SAR 2,000
Optical Limit (SAR)	SAR 400	SAR 400	SAR 400	SAR 400
Maternity Limit (SAR)	SAR 15,000	SAR 15,000	SAR 15,000	SAR 15,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	20% Max 75	20% Max 75
Outside Hospital Network (OHN)	20% Max 300	20% Max 300	20% Max 300	20% Max 300
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	20% Max 100	20% Max 100
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	C-Bronze		C-Classic
Table of Benefits	C+	C	C LTD	CR
Network	SE_C+	SE_C	SE_C LTD	SE_CR
Room Type	Shared
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	KSA
Dental Limit (SAR)	SAR 2,000	SAR 2,000	SAR 2,000	SAR 2,000
Optical Limit (SAR)	SAR 400	SAR 400	SAR 400	SAR 400
Maternity Limit (SAR)	SAR 15,000	SAR 15,000	SAR 15,000	SAR 15,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	20% Max 75	20% Max 75
Outside Hospital Network (OHN)	20% Max 300	20% Max 300	20% Max 300	20% Max 300
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	20% Max 100	20% Max 100
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Class	C-Bronze		C-Classic
Table of Benefits	C+	C	C LTD	CR
Network	SE_C+	SE_C	SE_C LTD	SE_CR
Room Type	Shared
Max Annual Limit (SAR)	SAR 500,000
Geographical Coverage	KSA
Dental Limit (SAR)	SAR 2,000	SAR 2,000	SAR 2,000	SAR 2,000
Optical Limit (SAR)	SAR 400	SAR 400	SAR 400	SAR 400
Maternity Limit (SAR)	SAR 15,000	SAR 15,000	SAR 15,000	SAR 15,000
Minimum Provider Network (MPN)	20% Max 75	20% Max 75	20% Max 75	20% Max 75
Outside Hospital Network (OHN)	20% Max 300	20% Max 300	20% Max 300	20% Max 300
Outside Clinic Network (OCN)	20% Max 100	20% Max 100	20% Max 100	20% Max 100
Generic Medication	20% copayment, maximum participation in payment: SAR 30
Branded Medication	50% without maximum participation

Maximum Dental Benefit:

Essential and Preventive Dentistry: 60% of Limit with no copayment
Root Canals & Emergencies: 40% of Limit with 20% copayment & no max amount

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