[ PHILHEALTH CIRCULAR NO. 57, S. 1999, May 28, 1999 ]

TURN-OVER OF THE NATIONAL HEALTH INSURANCE PROGRAM (FORMERLY MEDICARE) COLLECTION AND MEMBERSHIP FUNCTIONS FROM THE SOCIAL SECURITY SYSTEM (SSS) TO THE PHILIPPINE HEALTH INSURANCE CORPORATION (PHILHEALTH)



Effective July 1, 1999, Medicare collection and membership functions being performed by the Social Security System (SSS) for the private sector members shall now be assumed by the Philippine Health Insurance Corporation (PhilHealth). The said functions include:
  1. Receiving, processing, evaluating and approving of National Health Insurance Program (Medicare) membership applications of private sector employees and self-employed members pursuant to existing rules and procedures; and

  2. Collection and receipt of NHIP contribution of private sector employees and self-employed members as well as voluntary members based on existing rules and procedures.

I. MEMBERSHIP REGISTRATION/RECORDING UPDATING

On Medicare Membership of SSS Members

All private sector members who registered with the SSS before July 1, 1999 are deemed automatic members of the NHIP. Their membership records with the PhilHealth shall be updated by accomplishing the Members Data Record Form M1a.

On Enrollment

Those who are not yet enrolled with the National Health Insurance Program are enjoined to register with PhilHealth according to the procedures and guidelines outlined in Annex A* .

II. COLLECTION AND CONTRIBUTION PROCESSING

On Remitting Premiums

All private sector members of the Medicare are hereby directed to remit their succeeding monthly NHIP premium contributions to PhilHealth through its Accredited Collecting banks (ACBs) and their branches nationwide. Procedures and guidelines are outlined in Annex B* . These banks were accredited to allow members access and convenience when remitting their premium contributions on the schedules provided for.

Penalty Provisions

Employer and/or members who fail or refuse to remit NHIP premiums shall be subjected to the penal provisions of the National Health Insurance Act of 1995 or RA 7875, or to the provisions of Article 315 of the Revised Penal Code and other pertinent laws.

PhilHealth Membership Registration and Remittance forms are available at the PhilHealth Central and Regional Offices and PhilHealth-designated information centers.

Attached are the following for your guidance and easy reference:

  1. Guidelines and Procedures on Membership Registration (Annex A);
  2. Guidelines and Procedures on Premium Remittance (Annex B);
  3. Directory of Regional Health Insurance Offices (Annex C* ).

Please be guided accordingly.

Adopted: 28 May 1999

(SGD.) ENRIQUE M. ZALAMEA
President and CEO



* Text Available at Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City