Legal basis and policy intent
- PhilHealth issues the Circular pursuant to PhilHealth Board Resolution No. 553, s. 2003 dated May 8, 2003.
- The stated reason for the revision is to maintain the actuarial viability of the Health Insurance Fund (HIF).
- The revision is connected to the implementation of new benefit package such as the TB Outpatient Benefit Package and Second Normal Delivery.
- The revision is also intended to enable development and introduction of new and more responsive benefits to address the needs of the greater populace.
Scope: who contributes and what is updated
- The Circular revises premium contributions for members of the Employed Sector.
- The Circular revises premium contributions for members of the Sponsored (Indigent) Sector on an annual per-family basis.
- The Circular applies to contributions of employers for the employed sector and to premium payments under the sponsored (indigent) enrollment/renewal process starting January 2004.
- The Circular governs remittance timing and reporting requirements for employers remitting employed-sector contributions.
Employed sector: salary base rules
- For the Employed Sector, the minimum Salary Base (SB) is revised from P3,000 to P4,000 effective January 1, 2004.
- For the Employed Sector, the maximum Salary Base (SB) is revised from P10,000 to P15,000 effective January 1, 2004.
- For the Employed Sector, the maximum Salary Base (SB) is revised from P15,000 to P20,000 effective January 1, 2005.
- The Circular uses Personal Share (PS = SB x 1.25%) and sets the Employer Share (ES) equal to PS for the employed-sector schedule amounts stated per salary bracket.
Employed sector: contribution schedules (January 2004)
- For the Employed Sector effective January 1, 2004, the contribution schedule applies based on the monthly salary bracket and corresponding Salary Base (SB).
- For a salary bracket of P4,999.99 and below with SB = P4,000.00, the total monthly contribution is P100.00, with Personal Share (PS) = P50.00 and Employer Share (ES) = P50.00.
- For the employed schedule, the Circular sets total monthly contributions and splits as follows for each salary bracket:
- P5,000.00 to 5,999.99 (SB P5,000.00) → total P125.00; PS P62.50; ES P62.50.
- P6,000.00 to 6,999.99 (SB P6,000.00) → total P150.00; PS P75.00; ES P75.00.
- P7,000.00 to 7,999.99 (SB P7,000.00) → total P175.00; PS P87.50; ES P87.50.
- P8,000.00 to 8,999.99 (SB P8,000.00) → total P200.00; PS P100.00; ES P100.00.
- P9,000.00 to 9,999.99 (SB P9,000.00) → total P225.00; PS P112.50; ES P112.50.
- P10,000.00 to 10,999.99 (SB P10,000.00) → total P250.00; PS P125.00; ES P125.00.
- P11,000.00 to 11,999.99 (SB P11,000.00) → total P275.00; PS P137.50; ES P137.50.
- P12,000.00 to 12,999.99 (SB P12,000.00) → total P300.00; PS P150.00; ES P150.00.
- P13,000.00 to 13,999.99 (SB P13,000.00) → total P325.00; PS P162.50; ES P162.50.
- P14,000.00 to 14,999.99 (SB P14,000.00) → total P350.00; PS P175.00; ES P175.00.
- P15,000.00 and up (SB P15,000.00) → total P375.00; PS P187.50; ES P187.50.
Employed sector: contribution schedules (January 2005)
- For the Employed Sector effective January 1, 2005, the maximum SB is P20,000.00, and the schedule is expanded beyond the 2004 maximum.
- For the employed schedule effective January 2005, each salary bracket uses its corresponding SB and computes contributions with PS = SB x 1.25% and ES = PS, producing the Circular’s stated totals.
- The Circular sets the following contribution amounts for each salary bracket effective January 1, 2005:
- P4,999.99 and below (SB P4,000.00) → total P100.00; PS P50.00; ES P50.00.
- P5,000.00 to 5,999.99 (SB P5,000.00) → total P125.00; PS P62.50; ES P62.50.
- P6,000.00 to 6,999.99 (SB P6,000.00) → total P150.00; PS P75.00; ES P75.00.
- P7,000.00 to 7,999.99 (SB P7,000.00) → total P175.00; PS P87.50; ES P87.50.
- P8,000.00 to 8,999.99 (SB P8,000.00) → total P200.00; PS P100.00; ES P100.00.
- P9,000.00 to 9,999.99 (SB P9,000.00) → total P225.00; PS P112.50; ES P112.50.
- P10,000.00 to 10,999.99 (SB P10,000.00) → total P250.00; PS P125.00; ES P125.00.
- P11,000.00 to 11,999.99 (SB P11,000.00) → total P275.00; PS P137.50; ES P137.50.
- P12,000.00 to 12,999.99 (SB P12,000.00) → total P300.00; PS P150.00; ES P150.00.
- P13,000.00 to 13,999.99 (SB P13,000.00) → total P325.00; PS P162.50; ES P162.50.
- P14,000.00 to 14,999.99 (SB P14,000.00) → total P350.00; PS P175.00; ES P175.00.
- P15,000.00 to 15,999.99 (SB P15,000.00) → total P375.00; PS P187.50; ES P187.50.
- P16,000.00 to 16,999.99 (SB P16,000.00) → total P400.00; PS P200.00; ES P200.00.
- P17,000.00 to 17,999.99 (SB P17,000.00) → total P425.00; PS P212.50; ES P212.50.
- P18,000.00 to 18,999.99 (SB P18,000.00) → total P450.00; PS P225.00; ES P225.00.
- P19,000.00 to 19,999.99 (SB P19,000.00) → total P475.00; PS P237.50; ES P237.50.
- P20,000.00 and up (SB P20,000.00) → total P500.00; PS P250.00; ES P250.00.
Remittance deadlines and employer liability
- Employers in the public and private sector must remit employed-sector contributions on or before the 10th day of the month following the applicable month.
- Employers must remit contributions at any PhilHealth Offices or through Accredited Collecting Agents and their branches nationwide.
- Failure to deduct and/or consequently remit the contributions makes the employer liable under the penal provisions in Article X of the National Health Insurance Act of 1995 (RA 7875).
- Employers are enjoined to submit Quarterly Remittance Reports in the textfile format on or before the 15th day of the month following the applicable quarter to ensure proper and immediate posting of employees’ contribution payments.
Sponsored (indigent) sector premiums
- The Circular revises premiums for members of the Sponsored (Indigent) Sector from the annual rate of P1,188 to P1,200 per family.
- The revised sponsored premium rate applies effective for enrollment and Renewals commencing January 2004.
Repeal of inconsistent issuances
- Any issuances inconsistent with PHIC PhilHealth Circular No. 22, s. 2003 are repealed or modified accordingly.