QuestionsQuestions (PHIC OFFICE ORDER NO. 92)
The Order is meant to address low collection of the LGU premium counterpart contribution by tightening rules on when PhilHealth ID cards may be released, since the PhilHealth ID card serves as the member’s “passport” for availing Medicare benefits and reflects coverage for a particular period.
It refers to the 30 calendar days after expiration of membership validity for the LGU to remit their premium counterpart.
Non-delinquent LGUs/Donors have no outstanding balance or have at least paid 75% of the total LGU premium counterpart of the previous year. Delinquent LGUs/Donors have more than 25% balance on the previous year’s total LGU premium counterpart.
It is the premium subsidy for indigent members that may be paid solely by an LGU, by a donor on behalf of an LGU, or shared among LGUs (e.g., barangay/municipal/provincial) or with other donors (e.g., private, legislators, national government agencies).
PhilHealth requires payment of LGU premium counterpart contributions to the LGUs based on their preferred mode of remittance. If IDs are requested prior to payment, the LGU/Donor must submit a Certificate of Budget Allocation and a notarized Promissory Note for at least one (1) quarter premium within 30 days after release of IDs.
IDs should be released at least fifteen (15) days prior to expiration of the previous year’s membership coverage.
To facilitate timely encoding and ID generation, the Local Social Welfare Development Officer (LSWDO) shall submit and certify only the list of indigent members to be replaced and their replacement indigent family; names not reflected on the list are automatically renewed.
They must submit (1) a Certificate of Budget Allocation and (2) a notarized Promissory Note for payment of the first quarter premium counterpart of the current year within the grace period.
They must: (1) fully pay the balance of the previous year’s account and submit a certified true copy of the Official Receipt as proof of payment; (2) submit a Certificate of Budget Allocation; and (3) sign a notarized Promissory Note for the payment of the first quarter premium within the grace period.
PhilHealth shall suspend the provision of Medicare benefits in the territorial jurisdiction of the delinquent party.
They must submit a Certificate of Budget Allocation and a notarized Promissory Note for payment of at least one (1) quarter premium counterpart within the 30 days grace period after release of IDs.
The Order requires submission of a Certificate of Budget Allocation and payment of at least one (1) quarter premium counterpart. (Unlike Non-delinquent, the text does not explicitly require a notarized Promissory Note in the delinquent expansion section.)
IDs for enrolled indigent families are released upon submission of a copy of the legislator’s PDAF proposal duly approved by the House Committee on Appropriation or a copy of the SARO; PhilHealth coordinates to ensure release of the Notice of Cash Allotment (NCA) with the Office of the Legislator and DBM.
They are required to pay the LGU premium counterpart contribution for the release of IDs. If they insist on releasing IDs prior to payment, they must submit a Certificate of Budget Allocation and a notarized Promissory Note for payment of at least one (1) quarter premium within 30 days after release.
It means non-remittance of premiums may result in withholding of PCF, linking ID release/payment compliance to the funding mechanism governed by the earlier Office Order.
The LGU may opt to change the IDs’ effectivity date provided no member availed of in-patient benefits during the period.
It takes effect immediately.