Question & AnswerQ&A (PhilHealth Circular No. 016-2015)
The legal basis is Rule V, Section 3 of the Implementing Rules and Regulations of Republic Act 10361, which mandates household employers to register themselves and their Kasambahays with SSS, PhilHealth, and Pag-IBIG, and Section 21, Rule IV of the IRR of Republic Act 7875, as amended (National Health Insurance Act of 2013).
This circular applies to all Household Employers and their Kasambahays as defined under Republic Act 10361 and its Implementing Rules and Regulations.
They must submit the following forms: Household Employer Unified Registration Form (PPS-HEUR1), Household Employer Unified Report Form (PPS-HEUR2), and Kasambahay Unified Registration Form (PPS-KURF) if the Kasambahay is not yet enrolled with PhilHealth, SSS, or Pag-IBIG.
Household Employers must register themselves and their Kasambahays with PhilHealth, submit the required forms, pay and remit the prescribed monthly premium contributions on or before the due date, and submit separation reports within 30 days from the Kasambahay's separation date.
The Household Employer becomes liable for reimbursement of payment for properly filed claims made by the Kasambahay or dependents and may face other penalties.
Premium contributions are shouldered solely by the Household Employer, except when the Kasambahay earns Php5,000.00 or above monthly; in that case, the Kasambahay pays the proportionate share as per the premium schedule for the employed sector under the formal economy.
Premium contributions must be paid or remitted on or before the 25th calendar day of the month following the month for which payment is due. If the deadline falls on a weekend or holiday, payment is made on the next working day.
Kasambahays are entitled to inpatient hospital care benefits including case rate packages and catastrophic illness packages, outpatient and special benefit packages, the No Balance Billing privilege in accredited health care institutions, and for those 60 years or older, primary care benefits under the TSeKaP program.
A Letter of Authorization from the Household Employer, valid IDs of both the Household Employer and the authorized representative are required.
Within 30 days from the date of separation, the Household Employer must submit a duly accomplished PPS-HEUR2 form to PhilHealth indicating the date of separation and other required information.
Yes, premium contributions can be paid in advance but not to exceed two calendar years.
PhilHealth assigns a unique and permanent PhilHealth Employer Number (PEN) to Household Employers and a PhilHealth Identification Number (PIN) to Kasambahays upon registration.
The PhilHealth Payment Slip (PPS) must be filled out for each Kasambahay when paying premiums under the Individual Kasambahay Payment Scheme.
The Household Employer is liable to reimburse the payment of the claim and may also face additional penalties.