I. RATIONALE AND OBJECTIVES

PhilHealth Board Resolution (PBR) No. 1553, s. 2011 prescribed the increase of the minimum annual premium contribution for the Employed, Individually Paying, Overseas Workers and Sponsored Programs at TWO THOUSAND FOUR HUNDRED PESOS (P2,400.00) effective CY 2012. However, the Local Government Units (LGUs) had difficulty finalizing their enrollment due to the arrangement provided in the General Appropriations Act of CY 2012 where the national government shall only provide subsidy to those indigents determined under the National Household Targeting System for Poverty Reduction (NHTSPR) of the Department of Social Welfare and Development (DSWD). In response to the clamor of the LGUs to defer implementation of the increase in premium rate and to sustain coverage of the NHTSPR and LGU identified poor, the Board approved the provision of special annual premium contribution rate of ONE THOUSAND TWO HUNDRED PESOS (P1,200.00) to LGUs/Sponsors that enroll or committed to enroll their identified beneficiaries within the First Semester of CY 2012 and for a two-year coverage ending December 31, 2013 through PBR No. 1571, s. 2011.

This Circular is being issued to implement the provisions of PBR No. 1533, s. 2011 prescribing the minimum annual contribution for the Sponsored Program members to P2,400.00 in CY 2014.

In relation to the said premium, all sponsored members and their qualified dependents shall be entitled to identified in-patient hospital care (including the Z Benefit Package), out-patient care services, and other health care services provided by accredited health care providers. They shall also be entitled to the No Balance Billing (NBB) policy for health care services provided in accredited government health facilities in a non-private accommodation. Likewise, they shall be entitled to the Primary Care Benefit 1 (PCB1) Package to be provided by their accredited Primary Care Benefit Provider where they are assigned and enlisted.

II. SPECIFIC PROVISIONS

A. Premium Contribution

The annual premium contribution per Sponsored member shall be at TWO THOUSAND FOUR HUNDRED PESOS (P2,400.00) effective January 1, 2014.

B. Coverage

This shall cover all Sponsored Program members who are not included in the NHTS PR list and whose premium contributions are fully or partially subsidized by their sponsors, i.e., Local Government Units, Legislators, Private Entities, and National Government Agencies, among others.

III. EFFECTIVITY

This Circular shall take effect 15 days after its publication in any newspaper of general circulation and shall be deposited with the National Administrative Register at the University of the Philippines Law Center. All provisions of previous issuances inconsistent herewith shall be deemed amended and/or repealed accordingly, while provisions that were not affected thereby shall remain in full force and effect.

For your information and guidance.

(SGD) ALEXANDER A. PADILLA
President and Chief Executive Officer