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February 2012: Increase OFW contribution for Philhealth

posted Jan 27, 2012, 9:28 PM by Daloy Kayumanggi   [ updated Jan 27, 2012, 9:34 PM ]

Philippine Health Insurance Corporation (www.philhealth.gov.ph)

A) Philhealth Circular 022,s-2011

Premium Contributions to the National Health Insurance Program (NHIP) in Support for the Attainment of Universal Health Care and Millennium Development Goals

I.  RATIONALE AND OBJECTIVES
In line with the implementation of the Universal Health Care or Kalusugan Pangkalahatang Program, the Philippine Health Insurance Corporation (PhilHealth) aims to support the attainment of universal health care by eventually having all Filipinos assigned and taken care by a Primary Care Provider and members and their qualified dependents are given the option to avail of no balance billing health care services. Furthermore, the Corporation will support the attainment of the Millennium Development Goals (MDGs) health targets by 2015.


To implement enhancements in the NHIP benefit packages, the PhilHealth Board, through Resolution No. 1571, series of 2011, approved the increases in the annual premium contribution effective CY 2012.

II. NEW PREMIUM CONTRIBUTION

A.    Sponsored Program
The premium contribution of all National Household Targeting System for Poverty Reduction (NHTS-FR.) identified poor families of the Department of Social Welfare and Development (DSWD) under the Sponsored Program shall be Two Thousand Four Hundred Peso (PhP2,400.00) per year, effective 01 January 2012. The Sponsored Program identification card that will be issued to the intended NHTS-PR beneficiaries shall have a two-year validity period. This is with the expectation for the National Government to sustain its subsidy until CY 2013.

B. Partial Subsidy Scheme

Premium contributions under the Partial Subsidy Scheme shall be increased to Two Thousand Four Hundred Pesos (PhP2,400.00) per year effective 0 1 July 2012: Provided, That:

    1.
For LGUs/Sponsors who enroll following the calendar year and pays their contribution within the First Semester of CY 2012, the annual premium contribution shall be computed at an annual premium of One Thousand Two Hundred Pesos (PhPl,200.00);

    2.
For LGUs/Sponsors who enroll following the calendar year within the First Semester of CY 2012, sign a Memorandum of Agreement and commit to pay their contribution for two (2) consecutive years, the annual premium contribution shall be computed at One Thousand Two Hundred Pesos (PhPl,200.00);and

    3.
Applicable terms and conditions of the Memorandum of Agreement executed among and between the various Local Government Units and/or Sponsors prior to CY 2012 to implement the Sponsored Program shall he recognized by the Corporation until CY 2012.


C. Individually Paying and Overseas Workers Programs

Self-employed individuals under the Individually Paying and Overseas Workers Programs shall pay the minimum annual premium contribution of Two Thousand Four Hundred Pesos (PhP2,400.00) effective 01 July 2012: Provided, That:
    
    1.
For members who pay their contributions within the First Semester of CY 2012, the annual premium contribution shall be computed at an annual premium contribution of One Thousand Two Hundred Pesos (PhP 1,200.00);

    2.
For members who sign a policy contract within the First Semester of CY 2012 and commit to pay their contributions for two (2) consecutive years, the annual premium contribution shall be computed at One Thousand Two Hundred Pesos (PhP 1,200.00); and

    3.
Self-employed professionals earning an average monthly income of more than Twenty-Five Thousand Pesos (PhP25,000.00) shall continue to pay their annual premium contribution of 1 Three Thousand Six Hundred Pesos (PhP3,600.00).


D. Employed Sector

Premium contributions from the Formal Sector employees and their employers shall be computed at three percent (3%) of the basic monthly salary of the employee effective 01 January 2013 and shall be continually shared equally by its employer: Provided, That the monthly salary base is determined at Seven Thousand Pesos (PhP7,000.00) with the minimum annual contribution of Two Thousand Five Hundred Twenty Pesos (PhP2,520.00) and the  monthly salary ceiling is determined at Fifty Thousand Pesos (PhP50,000.00).


III. BENEFITS
All Case Rate Packages may be availed by all NHIP members provided they comply with the requirements for benefit availment.

Sponsored Program and Partial Subsidy Scheme members and their qualified dependents shall be entitled to the Primary Care (then Outpatient Consultation and Diagnostic) Benefit Package and the regular NHTP benefits including the No Balance Billing policy.
 

IV. EFFECTIVITY

This Circular shall take effect upon publication in any newspaper of general circulation and shall be deposited thereafter with the National Administrative Register at the University of the University of the Philippines Law Centre.
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