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Employers, take note:

While plaques & accolades are nice to


have…
Filipino workers – more than their
counterparts in Southeast Asia would
rather have job security than recognition
& appreciation
Jobstreet.com Survery November 2007
Jobstreet Online Survey composition:
 20-30 years old (52%)
 30-40 years old (31%)
 40 and above (15%)
Employers, take note:
• Filipinos prefer to have long tenures with their
employers
• 33% saying, 5 years or more is reasonable in contrast to
Malaysians & Singaporeans who lean towards stints of 2-3 years
• Reality though is Filipinos tend to change employers
quite often
• 41% have worked for 3 or more companies in the last 5 years
• 50% are actively looking for a job
• Younger jobseekers (below 25) are keener to explore
new paths while the more mature job seekers were less
inclined
• Late 20s, more concerned on promotion opportunities
• 40 years & older, issues with lack of recognition &
appreciation
Top 5 reasons why Filipinos leave their
jobs
Philippines Singapore Malaysia
Issues with Compensation
(salaries & benefits) 64.4% 44.9% 57.9%
Seeking greater challenges, job
growth and experience 40.6% 41.4% 38.9%
Explore different career path 30.3% 30.4% 29.7%
Promotion opportunities 28.4% 27.5% 32.7%
Seek better job security 26.6% 16.0% 17.3%
Lack of recognition or
appreciation 16.6% 42.7% 33.0%
“A high rate of employee turnover remains
a critical issue for many companies as it
hampers productivity, quality and
profitability”
- Grace Colet
JobStreet.com Country Manager

Employers should proactively address these


concerns by providing a challenging and
rewarding work atmosphere, positive
succession planning and better overall
strategic and operational management
Our alliance…
 not just a supplier/contractor-client relationship
 But of assisting you in providing a healthy & peaceful
atmosphere
We believe…
 The Maxicare name will not just make your benefit
package better
 But contribute to the company’s brand equity as a
whole
TOPICS

Our Corporate Credentials

Our Premium Quality Care Guarantees

Maxicare Premium Services


 Efficient and Effective Healthcare Delivery System
Administrative Services Only Program
Company Profile

Maxicare Healthcare Corporation


 Over 300,000 members nationwide
 More than 528 Accredited hospitals and clinics Nationwide
 Over 10,500 Affiliated Specialists, Fellows and Diplomates
 Most extensive Customer Care Network

Today, our extensive quality Medical Provider Network, responsive


Customer Care Unit, and increasing membership base continue to make us
the preferred healthcare provider in the country.

Ultimately, it is only at Maxicare where you


experience… “healthcare at its finest”
Our MISSION

To help people achieve “PEACE of MIND”


through quality healthcare.

Our VISION

To be the leading Health Maintenance


Organization preferred by customers
because of Superior Services.
People Behind /Stockholders

Over 30 years of healthcare service via Makati Medical Center &


Cebu Doctor’s Hospital
Group of Doctors and Businessmen Provides financial expertise
and tremendous distribution opportunities
Board of Directors

Chairman of the Board Roberto K. Macasaet, MD


Director Mr. Antonio L. Go
President & CEO Mr. Jose Pastor Z. Puno

Mr. Rene L. Buenaventura Ms. Teresita M. Alegre


Mr. Eduardo Katigbak Mr. Pedro Sen
Mr. Federico Leelin, MD Mr. Gertrudo L. Mirasol, MD
Mr. Sostenes L. Campillo, Jr. Amb. Cesar Bautista
Mr. Justice Wenceslao I. Agnir Mr. Darwin Bawar
Ms. Nelia V. Carlos
Years of Service, Extent of Expertise

of SOLID Healthcare Expertise

Cardholders nationwide

HMO of Choice

Best Employers in Asia / Philippines


Top 2,000 Companies in the Country
Value Proposition
Best Employers in Asia/Philippines
Banking & Finance Industry
Business Processing – Outsourcing/
Contact Centers
Manufacturing Industry
Food & Retail Industry
The Maxicare Intelligent Card

 Real-time validation of
membership during availments
 Swipe facility using hospitals and
clinics’ POS units nationwide
 Immediate activation & de-
activation of memberships within
24 hours
 Cards need not be replaced
on a yearly basis
Access to our Vast Network of Providers

Over 500 Accredited Hospitals


and Clinics nationwide
(65% are Tertiary Hospitals)

Over 1,000 Accredited


Dental Clinics nationwide

More than 10,000 Top-Caliber


Accredited Doctors
(Consultants, Fellows &
Diplomates)
Over 500 Affiliated Hospitals & Clinics
1,000 Dental Providers NATIONWIDE

NCR
REGION 1
HOSPITALS 56
HOSPITALS 24
CLINICS 153
CLINICS 6

REGION 3
HOSPITALS 24 REGION 2
CLINICS 4 HOSPITALS 8
CLINICS 1

REGION 4
HOSPITALS 49 REGION 5
CLINICS 15 HOSPITALS 11
CLINICS 7

REGION 6
HOSPITALS 8 REGION 8
CLINICS 3 HOSPITALS 5

REGION 7 REGION 9 REGION 10 REGION 12 REGION 11 REGION 13


HOSPITALS 9 HOSPITALS 4 HOSPITALS 9 HOSPITALS 7 HOSPITALS 15 HOSPITALS 4
CLINICS 6 CLINICS 1 CLINICS 1
Professional and Extensive Customer Care Network

Customer Care
Network

CEBU

DAVAO
24/7 Call Center On-site
BACOLOD Corporate-Based

ILOILO

GENERAL
SANTOS

CAGAYAN
DE ORO

On Call Roving Customer Care Hospital based On-line


Team in key Hospitals Primary & Customer
Care Centers
Primary Care Centers

Makati Med

SM Megamall
De Los Santos

St. Luke’s
MAXICARE
Headquarters
Medical City

Cebu City
Advantages of the On-Line
Maxicare Primary Care Centers

• Exclusive to Maxicare Members Only


• Easy access to Internal Medicine
• Quality lab exams @ the least possible cost
• Unlimited number of consultations
• Efficient & effective “gate-keeping system”
• Strategically & conveniently located @
major hospitals
24/7 Maxicare Access Numbers

24/7 Customer Care Call


Center

Provincial Toll-Free
Number
Maxicare SMS Inquiry
SMS Inquiry Service
0918-889MAXI (0918-8896294)
• accredited providers per area
• accredited doctors per specialization
• doctors’ schedules and contact numbers

1) To register your number in the program 3) To request list of accredited doctors per specialization
Key in: reg <space> Maxicare ID Number per hospital
Example: reg 050123456700 Key in: doc <space> hospital name <slash> specialization
Examples: doc makati med/gastro
2) Inquiry on Accredited Hospital doc riverside/cardio
Key in: prov <space> hos <space> location
Examples: prov hos makati 4) To request doctor’s schedule and contact number per
prov hos bacolod hospital
Key in: sked<day> <space> hospital name <slash>
3) Inquiry on Accredited Clinic doctor’s surname
Key in: prov <space> clinic <space> location Key words for each day: mon, tue, wed, thu, fri, sat, sun
Examples: prov clinic makati Examples: skedmon medical city/flandes
prov clinic ortigas skedsat makati med/genuino
Maxicare Database Management System

Hospitals’ Bills
Processed Data

Linux Java
Solaris
Doctors’ Fees Operating
System
Member
Company

Clinics’ Bills
On Time Utilization Report & Analysis

Utilization Report on . . .
 ICD 10 Coding System for Illnesses
 Per Member Medical History
 Hospitals/Clinics Accessed
 Attending Physicians
 Cost Per Availment
 Date of Availment
 Management Information System
Statistical reports
Health Profile Analysis
… thru Maxicare’s
Claims Management System
“The Flexi-Claims”
Sample Utilization Report & Analysis
BREAKDOWN OF SERVICES PRINCIPAL DEPENDENT TOTAL
Out-Patients & Medical Services
In-Patients
Reimbursement
TOTAL

MONTHLY AVERAGE

ANNUALIZED PROJECTION
*Inclusive of assumption for claims that have not yet been processed

Dental
Statistical Reports, Analysis & Recommendations
(In Tables and Graphs for cost and frequencies)

 Top medical conditions


 Top availers
 Most availed hospitals/clinics/ doctors
 Cost Drivers
 Benefit enhancement opportunities
Sample Utilization Management/Wellness Program
Objectives :
• Design wellness programs for the main drivers of utilization
• Establish a Wellness committee that would spearhead implementation
and sustain the wellness programs.

Wellness Strategies :

1) Health Awareness Campaign through Interactive Sessions & Medical


Bulletins to promote prevention:
a. Common Infectious Diseases: URTI, UTI
b. Cardiovascular diseases: HPN, Vascular headache
c. GI diseases: Acute Gastroenteritis, Acid-related disorders

2) Formulation of “Hypertension Club” - Cholesterol and FBS screening


3) Vaccination events: Flu, pneumonia, typhoid immunization program
4) Overall Health Maintenance of the workforce:
a. Ergonomics program
b. Weight management
c. Smoking Cessation
Lifestyle Partners

up to 20%
Discount

2% Discount

Special Discounts on the following


Vaccines: Influenza, Hepatitis A & B,
Typhoid, Measles/Mumps/Rubella,
Chickenpox/Varicella, etc.
Discounts
corporate vaccination program 10% - 50%
MAXICARE GROUP PROGRAM
Full-Risk Program
(Premium-based, Comprehensive
Healthcare Program)
MAXICARE Healthcare Program

Out-Patient Care
In-Patient Care
Preventive Care
Annual Check-Up
Emergency Care
Special Benefits
Out-Patient Care
 Medically necessary consultations during regular clinic hours, except prescribed
medicines
 Ear, Nose & Throat (ENT) Treatment
 Unlimited Pre & post natal consultations
 Treatment of minor injuries such as lacerations, mild burns, sprains
 Minor surgery not requiring confinement
 X-ray, laboratory exams, routine, and diagnostic procedures as prescribed by an
accredited physician
 Physical/Occupational Therapy covered up to 12 sessions/member/year.
 Sclerotherapy for varicose veins covered up to 5,000/leg/member/year
 Cauterization of warts covered up to 1,000/member/year from head to feet
(except genital warts & condyloma acuminata)
 Therapeutic Procedures ( Chemotherapy, Radiotherapy ( cobalt, iodine,
radioactive cesium, linear accelerator therapy, brachytherapy ) Dialysis up to up
to MBL
 Laser therapy for retinal detachment and glaucoma are covered ( excluding eye
correction e.g. lasik & PRK ) up to 10,000/member/year
Out-Patient Care…cont
 Allergy Testing/ allergy screening and other related examinations up to Php 2,500
/member /year
 Tuberculin Tests up to Php 600 /member /year (reimbursement basis) prescribed
by an Affiliated Physician to be availed at the Maxicare Primary Care Centers
 Speech Therapy for Stroke Patients up to P10,000 /member /year (reimbursement
basis, consultations treated as sessions)
 Annual Check up Coverage for employees and dependents
 Cataract Extraction except cost of lens up to MBL
In-Patient Care
 Room and Board Accommodation
 Use of operating and recovery rooms
 Use of the intensive care unit (ICU)
 Professional fees of the attending doctor/s
 Drugs & medicines for use in the hospital
 Whole blood/human blood products & IV fluids
 X-ray, Laboratory tests & diagnostic tests
 Dressings, casts & sutures
 Anesthesia, Oxygen & its administration
 Standard nursing services and admission kit
 Other supplies/services directly related to the
medical management of the patient
Preventive Care

 Immunization, except the cost of vaccines


 Periodic monitoring of health problems
 Health Education & Counseling on diets and exercise
 Family Planning Counseling
 Anti rabies active and passive vaccines up to
18,000/member/year
 Anti tetanus active and passive vaccines up to
18,000/member/year
 Anti venom active and passive vaccines up to
18,000/member/year
Annual Check-Up
Routine:
 Physical Examination
 Urinalysis
 Fecalysis
 Chest X-ray
 Complete Blood Count
 ECG (for members 35 years & above)
 Pap Smear (for female members 35 yrs & above)
Emergency Care

 Doctor’s Services
 Emergency room fees
 Medicines used for immediate relief & during treatment
 Oxygen, I.V. fluids, whole blood & human blood products
 Dressings, casts, sutures
 X-ray, laboratory & diagnostic exams
 Ambulance Services reimbursable up to Php 2,500 per conduction
(hospital to hospital transfer only)
 Coverage for Passive and Active vaccines for anti venom, anti
tetanus and anti rabies up to P18,000./member/year
 If room assignment is unavailable, upgrading of one higher room is
allowed within 24 hours
Emergency Care (Non-Affiliated)

Within and outside the Philippines


 Maxicare shall reimburse 80% of the Hospital Bills
and Professional Fees based on Maxicare’s rates
incurred during the first 24 hours not to exceed 30,000
per case per member per year
 Ambulance service from non accredited hospital to
accredited hospital reimbursable up to
2,500/conduction
Dental Care
 Oral Prophylaxis once a year
 Simple tooth extractions
 Temporary Fillings - as needed
 2 Permanent Lightcure Fillings
 Emergency Dental Treatment
 Comprehensive Restorative & Prosthodontic
Treatment
 Desensitization of Hypersensitive teeth
 Simple Adjustment of Dentures
 Recementation of loose crowns, inlays or onlays
 Dental Nutrition and Counseling
 Dental Health Education
 Annual oral examination & consultation
Pre Existing Conditions

Principals - Existing
Covered up to MBL
Principals – New & Additional
Covered up to MBL

Dependents – Existing
Covered up to MBL
Dependents – New & Additional
Covered up to MBL
Additional Features

 Lithotripsy and Laparoscopy covered up to MBL


 Coverage for Coronary Angiogram up to MBL
 Coverage for Congenital Illnesses up to Php 20,000/member/year
 Coverage for Scoliosis up to Php 20,000/member/year, whether congenital,
pre-existing or acquired
 Coverage for provoked and unprovoked assault up to MBL.
 Coverage for work-related conditions up to 20,000 based on ECC
 Coverage for Motor Vehicular Accidents up to MBL
 Coverage for Provoked and Unprovoked Asssault up to MBL
 Coverage for accepted modalities up to your P5,000.
 Financial Assistance for Life, Accidental Death and Dismemberment up to P
25,000./year
MEMBERSHIP GUIDELINES
AGE ELIBILITY
 Principals/Employees – 18 to 65 years old
 Adult Dependents – 18 to 65 years old
 Minor Dependents – 90 days up to 21 years old

HIERARCHY OF ENROLLMENT FOR DEPENDENTS


 Married Employees
 Legal spouse followed by the eldest up to the youngest child
 Single Employees
 Mother first, then Father followed by the eldest sibling to the youngest sibling
 Single Parents
 Either children from eldest to the youngest OR Parents, mother first then father

Rates assume that employees are Philhealth Members. Hospitalization expenses are
shared by Philhealth and Maxicare. Non Philhealth members must pay additional
P1,800.00
MEMBERSHIP GUIDELINES

 No processing or additonal fees

 Application Forms are waived

 Medical Requirements are waived

 Requirement for enrollments are:

Masterlist

Signed Conforme
2010 Membership Fees
RATES FOR EMPLOYEES PER HEAD
Principals
Annual Maximum
Plan Room and Semi
Check Benefit Annual Quarterly
Type Board Annual
Up Limit
Platinum 1Suite up to 4,000 Routine 200,000 19,703 10,640 5,517
Platinum 2Large Private Routine 150,000 15,012 8,106 4,203
Gold 1 Regular Private Routine 150,000 13,676 7,385 3,829
Gold 2 Regular Private Routine 100,000 13,258 7,159 3,712
Silver Semi Private Routine 75,000 10,643 5,747 2,980
RATES FOR DEPENDENTS PER HEAD
Maximum
Annual Semi
Plan Type Room and Board Benefit Annual Quarterly
Check Up Annual
Limit
Platinum 1Suite up to 4,000 Routine 200,000 26,736 14,437 7,486
Platinum 2Large Private Routine 150,000 20,237 10,928 5,666
Gold 1 Regular Private Routine 150,000 18,338 9,903 5,135
Gold 2 Regular Private Routine 100,000 17,919 9,676 5,017
Silver Semi Private Routine 75,000 14,091 7,609 3,945

Rates for all types include Makati Medical Center, St. Lukes Hospital,
The New Medical City, Asian Hospital & Cardinal Santos. VAT Inclusive
TO APPLY NOW:
Mark Gastardo, Corporate Account Executive
Telephone: (02) 496 4690
Mobile: (0922) 604 7864
Email: slime_ateneo@yahoo.com
YM: slime_ateneo
http://maxicareinquiry.blogspot.com

Mark Gastardo has been a corporate account executive for a number of years. He
has served numerous individual and family memberships. He has also handled
corporate HMO clients including:

Starbucks (Rustan Coffee), Banco Filipino Mortgage & Savings Bank,


Shopwise (Rustan Supercenters, Inc), Reyes Haircutters, Chikka.com, Sitel
Philippines, Consolidated Industrial Gases, Inc (CIGI), New Iloilo Supermarket,
Tiaong Rural Bank, Better Buildings, Inc, Cara Celine Dormtel, James Hardie,
Fujielastomers Manila Corporation, Direct with Hotels, C&E Publishing, Solutions
Interactions, The Master’s Academy, Biopath Clinical Diagnostics, PIPC
Corporation, AMMIC Corporation & Belden Ship Management, SEO Brand Media,
Magic Potions and Austin Alba Consulting
Thank you very much!