Section 1 of Executive Order (EO) No. 192 (s. 2015)^[1]   provides that jurisdiction over HMOs shall be transferred from the Department of Health (DOH) to the Commission. Additionally, Section 4 authorizes the Commission to: (a) issue rules and regulations, with respect to the establishment of HMO minimum capitalization, net worth, reserve funds and security deposit requirements, as well as the procedure for the submission of reportorial and/or examination requirements; and (b) regulate, supervise and monitor the operations and management of HMOs to ensure compliance with the EO, as well as existing laws, rules, regulations and other directives issued by the Commissioner. In order to implement EO No. 192, Circular Letter (CL) No. 2016-41 was issued, prescribing the minimum capitalization and financial capacity requirements for HMOs. Section 2.1 of CL No. 2016-41 requires all HMOs to submit their AFS, together with the supporting documents, on or before the 31st May of each year.

Pursuant to the above-quoted provisions, all HMOs are required to submit their respective 2017 AFS, together with the items enumerated in Annex œA *  on or before 31 May 2018. The prescription of the guidelines in the CL is without prejudice to the power of the Commission under Section 4(f) of EO No. 192 to require other relevant information that may come to its attention in the regulation, supervision and monitoring of the operations and management of HMOs.

A Filing Fee of Twenty Thousand Pesos (P20,000.00) plus Two Hundred Pesos (P200.00) representing Legal Research Fund (LRF) shall be imposed upon the submission of the said requirements.

Failure to submit the necessary documents within the prescribed deadline shall cause the imposition of Penalty of Five Thousand Pesos (P5,000.00) per day of delay in accordance with Section 2.3 of CL No. 2016-41, dated 29 July 2016  and  pursuant  to  Section  4  (c)  of  EO  No.  192,  which  authorizes  the Commission  to  fix,  assess  and  collect  fees  and/or  charges  as  it  may  find reasonable in the exercise of regulatory powers.

Submission  which  are  not  in  accordance  with  the  required  pro-forma template and with missing data/information and incomplete attachments shall not be accepted.

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^[1] Entitled, "Transferring the Regulation and Supervision over Health Maintenance Organizations (HMOs) from the Department of Health to the Insurance Commission, Directing the Implementation thereof, and for other Purposes. 

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