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(NAR) VOL. 14 NOS. 3-4 / OCTOBER - DECEMBER 2003

[ PHIC PHILHEALTH CIRCULAR NO. 32, S. 2003, October 06, 2003 ]

PREMIUM REMITTANCES AND AVAILMENT OF EMPLOYED MEMBERS WHO ARE ON LEAVE WITHOUT PAY AND SEASONAL EMPLOYEES NOT GAINFULLY EMPLOYED FOR A CERTAIN PERIOD OF TIME



The issuance pertains to premium remittances and availment of employed members who are on leave without pay and seasonal employees not gainfully employed for a certain period of time.

I. COVERAGE

Members above mentioned shall be able to continue to remit or pay their NHIP premium to ensure continuous entitlement to benefits, through the following procedures:

A. Premium Rate and Applicable Period

Said members may pay or remit their premium contribution in the amount equivalent to the Individually Paying Members (IPM) rate, which is Php 100.00 per month or Php 300.00 per quarter. As such, should said member be on leave for six (6) months, he or she may only pay or remit Php 600.00 (Php 100.00 x 6 months).

B. Period of Payment

In accordance with the provisions of PhilHealth Circular No. 24 series 2003, dated 11 July 2003, premium(s) covering the period(s) wherein the employee-member is not receiving any compensation or income from his or her employer should be remitted on or before the last working day of the calendar quarter to which the payment is due and applicable. If the member fails to remit his/her premium contributions within the calendar quarter, he/she shall be given a grace period of one (1) calendar quarter immediately following the unpaid month(s) or quarter, to retroactively remit his/her premium, without necessarily complying with the sufficient regularity rule.

C. Supporting Documents

The following supporting documents should be presented to any PhilHealth Office during payment of the required premium/s:

  1. Regular Employees who are on leave of absence without pay:

    [a] Employer's Quarterly Remittance Report (RF1) duly certified by his/her employer indicating therein the period when he/she is on official leave without pay;
    [b] Contribution Payment Report (ME5) duly signed by the paying employee-member.

  2. Employees who are in seasonal employment and not gainfully employed in a particular period:

    [a] Any proof or document showing that he/she is not receiving any income/compensation from his/her employer;
    [b] Duly accomplished Membership Amendment Form (M2); and
    [c] Contribution Payment Report (MI-5) duly signed by the paying member.

D. Venue of Payment

To facilitate monitoring of payments of premiums of the members under these circumstances, employee-members are required to pay, using the appropriate Contribution Premium Return, only through any PhilHealth Offices.

II. ELIGIBILITY OF BENEFITS

Any member who can comply with the above requirements including their dependents shall be entitled to avail of the NHIP benefits subject to the payment of at least three (3) monthly premium contributions within the immediate six (6) months prior to the month of confinement. During availment, the member concerned should present to the accredited health care provider/s the applicable validated Contribution Payment Report - ME5/M15 or Official Receipt.

This Circular shall take effect immediately.

Adopted: 06 Oct. 2003

By Authority of the President and CEO:

(SGD.) LORNA O. FAJARDO, CESO III
Chief Operating Officer
OIC, Office of the President and CEO

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