SOCIAL LEGISLATION

REPORTING
RA 7875 as amended by RA 9241, RA 11036 and PD 1752

Submitted By:
Jennica Gyrl Delfin
Mikael Mamaril
Joseph Artfel Lazo
Lovella Tacder
Stephanie Santoalla
Dale Angelique Lapulapu
Alexa Danielle Dayanghirang
Manuel Alameda
Ada Dalian
Erick Jay Inok
Jerell Leonida
Hector Domici Sistual
NATIONAL HEALTH INSURANCE OF 2013 (RA 7875 AS AMENDED BY 9241)

BRIEF HISTORY:
The National Health Insurance Program (NHIP) administered by the Philippine Health Insurance
Corporation (PhilHealth) was established in 1995 with the passage of Republic Act (RA) 7875 which was
approved by President Fidel V. Ramos. PhilHealth took over the Medicare functions previously
administered by the Philippine Medical Care Commission (PMCC) since 1972. The law paved the way for
the creation of the Philippine Health Insurance Corporation (PhilHealth), mandated to provide social health
insurance coverage to all Filipinos in 15 years' time.
GENERAL OBJECTIVES:
This Implementing Rules and Regulations of RA 7875 seeks to attain the objectives of the Act which are
to:
a. Provide all citizens of the Philippines with the mechanism to gain financial access to health services;
b. Establish the Program to serve as the means to help the people pay for health care services.
The National Health Insurance Program was established to provide health insurance coverage and ensure
affordable, acceptable, available and accessible health care services for all citizens of the Philippines. It
shall serve as the means for the healthy to help pay for the care of the sick and for those who can afford
medical care to subsidize those who cannot. It shall initially consist of Programs I and II or Medicare and
be expanded progressively to constitute one universal health insurance program for the entire population.
The program shall include a sustainable system of funds constitution, collection, management and
disbursement for financing the availment of a basic minimum package and other supplementary packages
of health insurance benefits by a progressively expanding proportion of the population. The program shall
be limited to paying for the utilization of health services by covered beneficiaries. It shall be prohibited
from providing health care directly, from buying and dispensing drugs and pharmaceuticals, from
employing physicians and other professionals for the purpose of directly rendering care, and from owning
or investing in health care facilities.

PHILHEALTH MEMBERSHIP CATEGORIES TO AVAIL HEALTH BENEFITS:

Group Premiums Enrollment Payment

Formal Economy Members: Employer and As of hire 3 months

Employees, business owners, employee will each date
household workers, and family pay half of the
drivers. premium. The
contribution is
2.75% of the
employee’s income.

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Group Premiums Enrollment Payment

Kasambahay (house helper) Premium As of hire 3 months

contributions of the date
kasambahay shall be
shouldered solely by
the household
employer. However,
if the kasambahay is
receiving ₱5,000
monthly salary or
above, the
kasambahay shall
pay his/her
proportionate share.

Indigent (NHTS): Poor families ₱2,400 annually National None

selected by the DSWD using the Government
National Household Targeting
System for Poverty Reduction
(NHTS-PR or Listahanan).

Sponsored Members: Members ₱2,400 annually Local None

whose contributions are paid by a Government
sponsor like the local government, fully
government agency or private subsidizes
individual or agency. It includes enrollment
low earning individuals that are annually.
not considered as indigents like
barangay health workers, nutrition
scholars, etc. Orphans, abandoned
kids, out-of-school-youth, street
children, Person with Disabilities
(PWDs), abused and pregnant
women under the custody of the
DSWD is also registered here.

Lifetime Members: Members age Free lifetime Retirees and None

60 and above and retired coverage Pensioners
employees that contributed not
less than 120 months in Philhealth
contributions.

Senior Citizen: Under the Non Paying (RA Age 60 years None
Expanded Senior Citizen Act (RA 10645), Free and up
10645), all Filipinos age 60 and Lifetime coverage
above is already covered by
Philhealth.

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 Group Premiums Enrollment Payment

Informal Economy Members (or ₱2,400 annually for Enrollment None

voluntary/individually paying): members earning date
Includes Overseas Filipino ₱25,000 and below
Workers (OFWs), self-earning ₱3,600 annually for
individuals, naturalized Filipinos members earning
and foreigners living in the more than ₱25,000
Philippines.

OFW (Landbased) ₱2,400 annually Emigration No subsidy.

date Payment is
on
emigration
date then
annually.

OFW (Seabased) Employer and As of hire 3 months

employee will each date
pay half of the
premium. The
contribution is
2.75% of the
employee’s income.

The following also enjoy PhilHealth coverage without additional premiums:

 Legitimate spouse who is not a member;

 Child or children - legitimate, legitimated, acknowledged and illegitimate (as appearing in birth
certificate) adopted or stepchild or stepchildren below 21 years of age, unmarried and unemployed.
 Children who are twenty-one (21) years old or above but suffering from congenital disability, either
physical or mental, or any disability acquired that renders them totally dependent on the member for support,
as determined by the Corporation;
 Foster child as defined in Republic Act 10165 otherwise known as the Foster Care Act of 2012;
 Parents who are sixty (60) years old or above, not otherwise an enrolled member, whose monthly
income is below an amount to be determined by PhilHealth in accordance with the guiding principles set forth
in the NHI Act of 2013; and,
 Parents with permanent disability regardless of age as determined by PhilHealth, that renders them
totally dependent on the member for subsistence.

Qualified dependents shall be entitled to a separate coverage of up to 45 days per calendar year. However,
the 45 days allowance shall be shared among them.

REGISTRATION:
It is done in any PhilHealth Office with the following procedure:
Enrollment of Formal Economy Members:

 Fill out two (2) copies of the PhilHealth Member Registration Form (PMRF)
 Submit PMRF to the HR Department of employer

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 Await Member Data Record and PhilHealth ID card from employer

For Newly Hired Employees With PIN:

 Report your PIN to your employer for them to indicate the same in their ER2

Premium Requirements:

 Premium contributions are shared by the employee and the employer, the amount of which is determined
using the table of contributions. After deducting half of the premium requirement from your monthly salary,
total premiums are remitted by your employer to PhilHealth.

Enrollment of Indigent / Sponsored Members

Philhealth Members Sponsored by LGUs, National Government, congress and Indigents belonging to the
lowest 25% of the Philippine population can become Sponsored Members by submitting the usual
requirements to their sponsors or at any PhilHealth office.

How do Lifetime Members enroll to PhilHealth?

 Fill-out two (2) copies of the PhilHealth Member Registration Form (PMRF)
 Submit PMRF to the nearest PhilHealth Local Health Insurance Office (LHIO) together with the following
documents:
 Two (2) 1×1 latest ID picture,
 Two valid IDs; and
 Any of the following documents:

For SSS pensioners Photocopy of Death, Disability and Retirement (DDR)

indicating the date of retirement and effective date of pension

Photocopy of the Retiree/Pensioner Certification indicating

the effective date of retirement

For GSIS pensioners Photocopy of Service Record issued by the employer showing
rendered services of not less than 120 months

Photocopy of Certification/Retirement Gratuity from the

employer indicating services of not less than 120 months

Photocopy of retirement voucher issued by GSIS

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 For Uniformed personnel of AFP, Photocopy of General/Special or Bureau Order indicating
PNP, BJMP and BFP effective date of retirement

Photocopy of Certification/Letter of Approval of Retirement

from the GSIS indicating services of not less than 120 months

Photocopy of Statement of Services issued by previous

employer showing service of not less than 120 months

GSIS Disability Pensioner / SSS Photocopy of Death, Disability and Retirement (DDR)
Permanent Total Disability indicating the date of retirement and effective date of pension
Pensioner before March 4, 1995
Photocopy of Disability Pensioner Certification issued by
SSS/GSIS indicating effective date of pension or the period of
coverage for disabled pensioner.

SSS Survivorship Pensioner before Photocopy of Death, Disability and Retirement indicating the
March 4, 1995 type of survivorship in nature and the effective date of pension

Photocopy of Survivorship Pensioner Certification indicating

the effective date of pension

Other individuals who are not under Photocopy of official receipts of premium payments to
the above mentioned categories PhilHealth

Any other documents indicating the months of premium

payments to PhilHealth

 Await Member Data Record (MDR) and PhilHealth ID Card

Employer Registration:

All government and private sector employers are required to register with PhilHealth to enable them to
provide social health insurance coverage to their employees.

Private sector employers (including those of household helps) who have registered with the SSS prior to
July 1, 1999 are automatically registered but are required to update their records with PhilHealth.
Procedures and requirements

Employers may register through the Philippine Business Registry (PBR). Once registered in this system,
they will no longer be required to submit documents. However, if the employer fails to register through the
PBR, the following shall be submitted:

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 Nature of Entity Additional Documents Required

Single proprietorships Department of Trade and Industry (DTI) Registration

Partnerships and corporations Securities and Exchange Commission (SEC)

Registration

Foundations and non-profit organizations Securities and Exchange Commission (SEC)

Registration

Cooperatives Cooperative Development Authority (CDA)

Registration

Backyard industries/ventures and micro-business Barangay Certification and/or Mayor's Permit

enterprises

Enrollment of Senior Citizens to PhilHealth

 There are two options to enroll as a Senior Citizen member of PhilHealth.

Via Office for the Senior Citizens

Via PhilHealth Local Health Insurance Office (LHIO)
Affairs (OSCA)

Fill out two (2) copies of the Fill out two (2) copies of the PhilHealth Member
PhilHealth Member Registration Form Registration Form (PMRF);
(PMRF);
Attach 1 x 1 photo taken within the last six months;
Submit duly accomplished PMRF to
the OSCA in the city or municipality Present Senior Citizens’ Identification Card issued by
where the elderly resides the OSCA in the city or municipality where the elderly
resides or a valid government issued ID.
Await Member Data Record and
Identification card issued by PhilHealth Submit duly accomplished PMRF
through OSCA
Await Member Data Record and PhilHealth
Identification Card

 Premium Contributions
o The premium contributions of those who will be enrolled under the Senior Citizen category shall be sourced
from the proceeds of Republic Act No. 10351, commonly known as the Sin Tax Law.

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 Benefits
o In hospitals with installed HCI Portal, Senior Citizens only need to present their senior citizen card, MDR
or any accepted proof of identity and age. The hospital shall print a PhilHealth Benefit Eligibility Form
(PBEF). A PBEF that says “YES” means that the patient is entitled to the benefits and shall serve as a basis
for automatic deduction.
o In case the hospital has no HCI portal installed, or the PBEF says “NO”, or the senior citizen was not able
to enroll before discharge, the following should be attached to the usual claim documents:
 Duly accomplished PhilHealth Member Registration Form (PMRF); and
 An acceptable proof of status as a senior citizen, including but not limited to the Senior Citizens’
Identification Card.

Enrollment of an Individually Paying member to Philhealth:

Persons who are unemployed of self-employed may register as an Individually Paying Member which is
also referred to as “Voluntary Member”.

The following are its requirements:

 Visit any of the Local Health Insurance Offices or PhilHealth Express outlets nationwide.
 Fill out (2) copies of the PhilHealth Member Registration Form (PMRF)
 Submit PMRF to the LHIO or PhilHealth Express
 Await Member Data Record (MDR) and PhilHealth ID Card
 Pay the necessary premium contribution using your PhilHealth ID number

Premium Requirements

 Individually Paying Members (IPMs) earning an average monthly income of ₱25,000 and below pay ₱200
monthly or ₱2,400 per year, while those earning above ₱25,000 pay ₱300 monthly or ₱3,600 per year.
Premium contributions may be paid monthly, quarterly, semi-annually or annually.

Enrollment of OFWs to Philhealth:

For OFWs (Overseas Filipino Workers), you can register and pay your contributions once you register at
the POEA as an OFW:

 If currently in the Philippines, visit the nearest PhilHealth Regional Office, Local Health Insurance Office,
PhilHealth Business Center or PhilHealth Express outlet in your locality.
 If currently overseas,
o Visit any branch of PhilHealth’s accredited collecting partners iRemit and Ventaja Corporation
o Access the Electronic Registration facility and follow the step-by-step procedure
o Download the PhilHealth Member Registration Form, fill it out and email to ofp@philhealth.gov.ph

CONTRIBUTION:

According to Philhealth’s 2018 contribution table, members of the formal economy (kasambahay, family
drivers, seabased OFWs) and employees of both public and private sectors will have the following monthly

OFWs or those under the Overseas Workers’ Program (OWP) shall pay ₱2,400.00 as their annual premium
contribution to PhilHealth. This is also applicable to land-based OFWs, whether documented or

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 undocumented. Payments may be made in two increments (₱1,200 every six months) or a one-time
payment of the full amount amounting to ₱2,400.

PhilHealth Contribution for Self-employed, Individually Paying Members:

 Members with monthly income of ₱25,000 and below shall pay ₱2,400 per year.
 Members with monthly income above ₱25,000 shall pay ₱3,600 per year.
 Sponsored Program Members: Whether fully or partially subsidized by the sponsor, members under this
category shall pay an annual premium of ₱2,400.

Benefits to PhilHealth:

Benefit Package Members and their dependents are entitled to the following minimum services, subject to
the limitations specified in the Act and as may be determined by the Corporation:

a. In-patient care:

1. Room and board;

2. Services of health care professionals;

3. Diagnostic, laboratory, and other medical examination services;

4. Use of surgical or medical equipment and facilities;

5. Prescription drugs and biologicals, subject to the limitations of the Act; and,

6. Health Education. 19 Implementing Rules and Regulations of Republic Act 7875 As Amended Otherwise
Known As the National Health Insurance Act of 2013

b. Out-patient medical and surgical care:

1. Services of health care professionals;

2. Diagnostic, laboratory and other medical services;

3. Personal preventive services;

4. Prescription drugs and biologicals, subject to the limitations of the Act; and,

5. Health Education.

c. Emergency and transfer services;

d. Health Education Packages; and,

e. Such other health care services that

Claims under Philhealth:

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The benefits will be paid by PhilHealth in terms of Case Rates whereas every illness or operation has price
allotment to be divided to the hospital and the doctor. This way, the member can already determine how
much will be covered by PhilHealth before hospitalization. In case of member’s death, the dependents of
the deceased shall continue to avail of the benefits for the unexpired portion of the coverage or until the end
of the calendar year, whichever comes first.

Benefits of Members and their Dependents Confined Abroad Members and/or their dependents shall
be eligible to avail of benefits for confinement/s outside the country: Provided, that the conditions for
entitlement under this Rules are met and the following requirements are submitted within one hundred
eighty (180) calendar days from the date of discharge: a. Official receipt or any proof of payment and/or
statement of account from the health care institution where the member/dependent was confined; and, b.
Certification of the attending physician as to the final diagnosis, period of confinement and services
rendered. The benefits to be granted shall be paid to the member in the equivalent.

The following provider payment mechanisms shall be allowed in the Program:

a. Fee-for-Service payments;

b. Case Rate payments;

c. Capitation of health care professionals and institutions, or networks of the same including HMOs,
medical cooperatives, and other legally formed health service groups;

d. Global budget; and,

e. Such other provider payment mechanisms that may be determined and adopted by the Corporation.

Guidelines on Claims Payment The following are the guidelines for the claims payment:

a. The health care provider shall submit the prescribed and completely filled up PhilHealth claim
forms and other documents required for processing.

1. The claim sent through mail or courier, the date of mailing as stamped by the post office of origin
or date received by the courier service shall be considered as the date of filing.

2. If the delay in the filing of claims is due to natural calamities or other fortuitous events, the health
care provider shall be accorded an extension period of sixty (60) calendar days.

3. If the delay in the filing of claim is caused by the health care provider and the benefits had already
been deducted, the claim will not be paid. If the benefits are not yet deducted, it will be paid to the
member chargeable to the future claims of the health care provider.

4. For any other means of filing of claims, such as but not limited to electronic submission, the
Corporation shall issue specific guidelines for the purpose.

b. The health care provider shall deduct from the total charges all expenses reimbursable by the
Corporation upon discharge of the patient. The payment of benefits shall be made directly to the
health care provider.

c. Health care providers are not allowed to charge for PhilHealth forms and processing fees from the
member when claiming reimbursement from the Corporation.

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d. Direct filing of claims and payment to the member shall be allowed only for confinements abroad,
claims for adjustment of reimbursement, emergency in non-accredited facitlities or such other
conditions as may be determined by the Corporation. 22 Implementing Rules and Regulations of
Republic Act 7875 As Amended Otherwise Known As the National Health Insurance Act of 2013

e. The Corporation shall penalize health care providers for claims attended by any but not limited to
the following circumstances:

1. Over-utilization of services;

2. Unnecessary diagnostic and therapeutic procedures and intervention;

3. Irrational medication and prescriptions;

4. Fraudulent, false or incorrect information as determined by the appropriate office;

5. Gross, unjustified deviations from currently accepted standards of practice and/or treatment protocols;

6. Inappropriate referral practices;

7. Use of fake, adulterated or misbranded pharmaceuticals, or unregistered drugs;

8. Use of drugs other than those recognized in the latest PNF and those for which exemptions were granted
by the Board; and,

9. Failure to comply without justifiable cause with the pertinent provisions of the law, IRR and any
issuances of the Corporation.

f. When the claim is denied, the amount of claim shall not be recovered from the member. g. All claim
applications for drugs and medicines shall be in generic terminology in conformity with DOH
regulations and the law.

h. When the claims filed by a private health care institution indicate that its bed occupancy rate
exceeds its accredited bed capacity, such claims must be justified in a notarized document, the
contents of which shall be prescribed by the Corporation. Otherwise, the same shall not be processed.

i. Any operation performed beyond the accredited capability shall be considered a violation and a
claim for such shall be denied by the Corporation, except when the same is done in an emergency
case or when referral to a higher category health care institution is physically impossible.

j. Primary care facilities shall be compensated only for certain medical and simple surgical
operations as determined by the Corporation.

k. All claims for services filed by a health care institution after its category is downgraded/ upgraded
pursuant to this Rules shall be paid based on rates for such downgraded/upgraded category.

l. All completed claims, except those under investigation, shall be paid within sixty (60) calendar days
from receipt of the Corporation. m. Confinements of less than twenty-four (24) hours shall only be
compensated under the following instances:

1. If the patient is transferred to another health care institution;

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2. In emergency cases as defined by the Corporation;

3. If the patient expired; or,

4. Other cases as may be determined by the Corporation.

n. Claims of members confined in a non-participating health care institution shall be compensated;

Provided, that all of the following conditions are met:

1. The health care institution is licensed by DOH;

2. The case is emergency as determined by the Corporation; and,

3. When physical transfer/referral to an accredited health care institution is impossible as determined by the
Corporation.

ACCREDITATION

Accreditation is a process whereby the qualifications and capabilities of health care providers are verified
in accordance with the guidelines, standards and procedures set by the Corporation.
Purpose of Accreditation:

To participate in the National Health Insurance Program.

To assure that health care services rendered by them are of the desired and expected quality.

Process for professional providers:

Who May Apply?

 Physicians
 Dentists
 Midwives
 Registered Nurses

When To Apply?

 Initial or Re-accreditation - Anytime

 Renewal
 Not later than 45 days prior to their birthday to ensure their continuous accreditation to NHIP

Process for institutional providers:

Who May Apply?

 Hospitals
 Ambulatory Surgical Clinics (ASCs)
 Free Standing Dialysis Clinics (FSDCs)
 Rural Health Units/Health Centers (RHUs/HCs) as providers of the Out Patient Benefit Package
for sponsored members of PHIC
 Maternity Care Clinics - for low risk, normal spontaneous deliveries

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  Anti-TB/DOTS Clinics

When To Apply?

 Initial or Re-accreditation - ANYTIME

 Renewal
 Hospitals, ASCs and FSDCs: January 1 to 31 of the succeeding year
 OPB, Maternity Care and Anti-TB/DOTS Package Providers: September 1 - 30 of the current year.

The following requirements shall apply to Health Care Institutions in appropriate cases:
a. They must have been operating for at least three (3) years prior to initial application for accreditation,
with a good track record in the provision of health care services. The date of reckoning of the three-year
operation requirement shall be the effectivity date of either the initial license, clearance to operate,
certificate, or other proof of operation issued by the DOH or other pertinent government agencies if
applicable.
b. They must be licensed / certified by the DOH, as applicable;
c. They must comply with the provisions of the performance commitment. They must have their own
ongoing formal program of quality assurance that satisfy the Corporation’s standards;
d. Any other requirements that may be determined by the Corporation.

The following health care institutions shall be exempted from the three (3) year operation
requirement:

a. Primary Care Benefit Providers with or without out-patient malaria package;

b. TB DOTS providers;

c. Non-hospital maternity care package providers;

d. Animal bite treatment providers; and,

e. Such other health facilities as may be determined by the Corporation

Claim of PhilHealth Benefits:

Step 1: Conditions

To be eligible to the PhilHealth benefits when hospitalized, the following conditions must be met:

 Payment of at least 3 months’ worth of premiums within the immediate 6 months of confinement. For
pregnancies, the new born care package, dialysis, chemotherapy, radiotherapy and selected surgical
procedures, 9 months’ worth of contributions in the last 12 months is needed.
 Confinement in an accredited hospital for 24 hours due to illness or disease requiring hospitalization.
Attending physician(s) must also be PhilHealth accredited.
 Claim is within the 45 days allowance for room and board.

Step 2: Required documents

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 You’ll also need to submit the following documents before being discharged from the hospital for automatic
deduction:

 A clear, updated copy of your Member Data Record (MDR). If you are dependent, make sure that you are
listed in the MDR.
 An original copy of PhilHealth Claim Form 1, which you can get at PhilHealth, the hospital or your
employer. Submit the original copy signed by your employer.
 Receipt of premium payments. Employees only need to submit the Certificate of Premium Payments with
OR numbers.
 Your PhilHealth ID and a valid ID.

Ask the hospital regarding their PhilHealth submission rules. If you can’t submit the claim form personally,
have an authorization letter and a valid ID ready for your representative.

Step 3: Claiming and post-claims

 As direct filing is no longer needed, submission of the documents to the hospital before the end of your stay
means automatic deduction of your benefits from your total bill.

 Once your benefits have been automatically deducted, PhilHealth will send a benefit payment notice to the
address declared in your MDR. This details the actual payments made by PhilHealth relative to your claim
or confinement.

Keeping your PhilHealth up-to-date is important, remember that updated premiums is key to enjoy your
entitlements. It is also essential for you to keep your updated premium payment receipts safe and within
easy reach for emergencies. You will definitely need them in asking the hospital billing section to deduct
your benefits from your total charges.

Claim for Philhealth Reimbursement or Refund:

1. Submission of PhilHealth documents to the hospital on the day of admission.

2. Hospital will file member’s claim with PhilHealth which will be deducted from the hospital
bill.
3. Philhealth Coverage must be deducted from the hospital bill prior to discharge.
4. Member will receive a mailed or courier-delivered Benefit Payment Notice (BPN) from
Philhealth.
Changes to Membership Profile:

Filing of PhilHealth Mmembership Registration Form and to be submitted to the nearest PhilHealth Office
in case there is a need for additional dependents or change in civil status.

TYPES OF PHILHEALTH ID CARD:

5. Regular Philhealth ID Card
- It is given to Philhealth members without any fees and can be used at any hospitals
to subsidize their hospital expenses.

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 6. Philippine Insurance ID Card - it sis a digitized ID issued to all registered members of
Philhealth which is optional and can cost some fees, but it has more use than the regular
ID card.

Regular Philhealth ID vs Philhealth Insurance card

Philhealth Regular ID Philhealth Insurance card

Valid id x /

Access to discounts x /

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Can be used for hospitalization / /

Can be used by dependents x /

No additional fees to process / x

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An Act Instituting Universal Health Care For Filipinos, Prescribing Reforms in the Health Care
System and Appropriating Funds Therfor (RA 11223)
Universal Health Care Act
It will ensure that every Filipino citizen will be entitled to a healthy living, working, and schooling
conditions and access to a comprehensive set of health services without any financial hardships. It will
provide financial assistance for medical emergencies, hospital admission, and all other medical routines
that focus on treatment and rehabilitation.
Distinction: National Health Insurance of 2013 and Universal Health Care Act
1. Automatic and simplified membership to all Filipinos under UHC, whereas, it is not for RA 7875.
2. There are only two types of membership under UHC which are direct and indirect contributors,
whereas members under RA 7875 may avail the any of these categories: Formal Economy member,
Kasambahay, Indigent, Sponsored Members, Lifetime Members, Senior Citizen, Informal
Economy Members, OFW (landbased or seabsed)
3. No need for identification cards under UHC and no co-payments shall be charged for services
rendered in basic accommodation. These privileges are not present under RA7875.
4. Under the UHC, the philhealth board of directors shall have a maximum of 13 members consisting
of the following: (1) five ex officio members , namely the Secretary of Health, Secretary of Social
Welfare and Development, Secretary of Budget and Management, Secretary of Finance, Secretary
of Labor and Employment and (2) three expert panel members with expertise in public health ,
management and finance, health economics, (3) five sectoral panel members, representing the
direct contributors, indirect contributors, employers group, health care providers to be endorsed by
their national associations of health care institutions and health care professionals, and
representative of the elected chief executives to be endorsed by the League of Provinces of the
Philippines, provided that at least one of the expert panel members and at least two of the sectoral
panel members are women. On the other hand, under RA 7875, the Corporation shall be governed
by a Board of Directors hereinafter referred to as the Board, composed of eleven members as
follows: The Secretary of Health; The Secretary of Labor and Employment or his representative;
The Secretary of the Interior and Local Government or his representative; The Secretary of Social
Welfare and Development or his representative; The President of the Corporation; A representative
of the labor sector; A representative of employers; The SSS Administrator or his representative;
The GSIS General Manager or his representative; A representative of the self-employed sector; and
A representative of health care providers. The Secretary of Health shall be the ex officio
Chairperson while the President of the Corporation shall be the Vice Chairperson of the Board.
5. Participation of the DOH (to make framework strategy for health promotion, DepEd (formulate
programs and modules on health literacy) and the LGU (to enact stricter ordinances and broaden
existing health policies) under the UHC where, there is none under RA 7875.
6. Basis of benefit claim under UHC is through a Health Technology Assessment, whereas the basis
for RA 7875 is the member’s contributions.
7. Basis of funds under UHC is the total incremental sin tax collections as provided for in RA 10351
(Sin Tax Reform Law). On the other hand, basis of funds under RA 7875 is the contributions from
program members.
THINGS TO KNOW UNDER THE UNIVERSAL HEALTH CARE ACT”
1. Simplified membership

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PhilHealth members will be identified into two (2) groups:
 Direct contributors – Paying members who are by default deducted for the premium through their
payroll.
 Indirect contributors (non-contributors) – Non-paying members, basically everyone who isn’t a
member of Philhealth. This will be fully subsidized premium from tax collections.
PhilHealth will be using the civil registration data of the Philippine Statistics Authority to regularly validate
and update PhilHealth membership.

Benefits of direct and indirect contributors

Direct Indirect

No co-payments shall be charged for No co-payments shall be charged for services

services rendered in basic accommodation. rendered in basic accommodation.

Entitled to no-balance billing in any basic Entitled to no-balance billing in any basic
accommodation. accommodation.

PhilHealth shall provide additional NHIP Premium subsidy shall be gradually adjusted and
benefits, where applicable. included annually in the General Appropriations
Act (GAA).

Failure to pay premiums shall not prevent

the enjoyment of any NHIP benefits.

Premium contributions will be according to

a set salary floor and ceiling, rate, and
schedule.

2. Population and individual-based healthcare initiatives

This law will utilize the different agencies to deliver different healthcare services according to their
classified scope or function: population or individual healthcare services.
Population based Health Services shall be funded by the National Government. Individual based health
Services shall be financed primarily through prepayment mechanisms such as social health insurance,
private insurance and HMO plans.
Department of Health (DOH)
 To conduct population-based health interventions.
 Their main role is to finance population-based services, set standards and integrate a whole-of-
society as well as whole-of-government approach.
 Their tasks include delivery of health interventions to the community as a whole like community
healthcare programs such as vaccination and medical missions, health awareness campaigns, and

17 | P a g e
 basically streamline the delivery process and standards to all community-based healthcare service
providers (community health centers and hospitals).
 Improve the doctor-to-patient ratio and increase the number of hospital beds and equipment. It also
calls for the establishment of hospitals in remote areas.
Philhealth
 Focused on individual-based health interventions.
 Their main role is to finance all individual-based level services as a single, national purchaser
 Scope includes delivery of the following but not limited to individual hospitalization, rehabilitation,
and emergency healthcare provision.
 The amount of provision will be determined through a fair and transparent technology assessment
process.
 Individual-based health services will be financed primarily through prepayment mechanisms such
as social health insurance, private health insurance, and HMO plans to ensure predictability of
health expenditure.

18 | P a g e
G.R. No. 210761
Kilusang Mayo Uno vs Aquino and PHIC
DECISION
This is a petition for certiorari assailing PhilHealth Circular Nos. 0027, 0025, and 0024, all
series of 2013. The circulars, which adjusted the premium contribution rates for the National
Health Insurance Program, were allegedly issued with grave abuse of discretion.
In the 1987 Constitution, the State adopted an integrated and comprehensive approach to health
development. It also undertook to make essential goods and medical services available to the public
at a low cost, and to provide free medical care to paupers. On February 7, 1995, Congress passed
Republic Act No. 7875, the National Health Insurance Act (NHIA), establishing the National
Health Insurance Program (NHIP/the Program) and creating the Philippine Health Insurance
Corporation (the Corporation/PhilHealth) to administer the Program. The Program covers all
citizens of the Philippines in accordance with the principles of universality and compulsory
coverage. PhilHealth is a government corporation attached to the Department of Health (DOH) for
policy coordination and guidance. Among its notable powers and functions are:
SEC. 16 Powers and Functions. - The Corporation shall have the following powers and functions:
a. to administer the National Health Insurance Program; b. to formulate and promulgate
policies for the sound administration of the Program; c. to set standards, rules, and
regulations necessary to ensure quality of care, appropriate utilization of services, fund
viability, member satisfaction, and overall accomplishment of Program objectives; d. to formulate
and implement guidelines on contributions and benefits; portability of benefits, cost
containment and quality assurance; and health care provider arrangements, payment methods, and
referral systems; x x x (emphasis supplied)
At the start of respondent President Benigno Simeon Aquino III's administration in 2010, the DOH
launched the Aquino Health Agenda (AHA/the Agenda). The objective was to implement
comprehensive reform in the health sector and, ultimately, to provide universal access to health
care for all Filipinos including the poor. The Board, through Resolution No. 1571, Series of 2011,
approved increases in annual premium contributions for the Calendar Year (CY) 2012 to enhance
the NHIP benefit packages and to support the implementation of the Universal Health Care
program.
1.The minimum annual contribution of members in the Individually Paying
Program (IPP) and Overseas Workers Programs (OWP) was increased to Php2,400.00.
However, members who paid their contributions within the first semester of CY 2012 or signed a
policy contract within the first semester of 2012 and committed to pay their contributions for two
consecutive years would have their annual premium contribution computed at only Php1,200.00.
2. For the Employed Sector, the premium rate was to be computed at 3% of the salary base with
the lowest salary bracket pegged at a monthly salary base of Php7,000.00. Thus, the minimum
annual contribution was computed at Php2,520.00. Finally, the monthly salary ceiling was pegged
at Php50,000.00.
Lastly, the annual contribution of all National Household Targeting System for Poverty
Reduction (NHTS-PR) poor families identified by the Department of Social Welfare and
Development (DSWD) under the Sponsored Program was set at Php2,400.00 effective January 1,
2012.

19 | P a g e
On September 25, 2012, the Corporation further postponed the premium increase to January 1,
2013, after a series of dialogues with informal sector groups.15
On November 22, 2012, PhilHealth made a partial deferral of the premium rate increase until the
end of CY 2013. 16 From January to December 2013, the minimum annual premium contribution
rate for IPP and OWP members was pegged at Php l,800.00, instead of the full Php2,400.00.
For the members enrolled in the Employed Sector, the premium rate was computed at 2.5% of the
salary base. Because the lowest salary base was pegged at Php7 ,000.00, the minimum annual
premium contribution was computed at Php2,100.00. Finally, the monthly salary bracket ceiling
was pegged at a salary base of Php35,000.00.
On September 2013, PhilHealth issued the three assailed circulars fully implementing the new
premium rates for 2014:
1. PhilHealth Circular No. 0024, s. 201317 was issued on September 30, 2013, increasing the
minimum annual premium rate for the IPP to Php2,400.00 for members with a monthly income of
Php25,000.00 and below.
2. PhilHealth Circular No. 0025, s. 201J 18 was issued on September 30, 2013, adjusting the
annual premium rate for the OWP to Php2,400.00 for all land-based OFWs, whether documented
or undocumented.
3. PhilHealth Circular No. 0027, s. 2013 19 was also issued on September 30, 2013, for the
Employed Sector. It retained 2.5% at the premium rate and the Php35,000.00 salary bracket ceiling.
However, it consolidated the two lowest salary brackets 20 resulting in a minimum annual rate of
Php2,400.00.
Thus, the Corporation adjusted the minimum rates for members to Php2,400.00 to ensure financial
sustainability of the Program
On January 30, 2014, petitioners Kilusang Mayo Uno (KMU), National Federation of Labor Unions
- KMU NAFLU-KMU filed the present petition for certiorari with an application for a Temporary
Restraining Order and/or a Preliminary Injunction against the implementation of the new rates. The
petitioners (KMU, et al.) claim that the assailed circulars were issued with grave abuse of discrtion,
arguing: (1) that PhilHealth breached the limits to its delegated rule-making power because the new
contribution schedule is neither reasonable, equitable, nor progressive as prescribed by the
NHIA; 23 (2) that the rate increase is unduly oppressive and not reasonably necessary to attain the
purpose sought; 24 and (3) that the new rates were determined without an actuarial study as required
by the NHIA.
The Petitioners-in-Intervention (Migrante, et al.) adopt all of the petitioners' argun.ients. They add
that Circular No. 0025, s. 2013 violated the Migrant Workers and Overseas Filipinos Act27 which
prescribed the non-increase of fees charged by any government office on Overseas Filipino
PhilHealth, through the Office of the Government Corporate Counsel (OGCC), claims that the
increases in premium contributions were supported by three actuarial studies conducted in
2010,30 2011,31 and 2012.32 Moreover, it consulted World Bank representatives 33 and the affected
stakeholders before implementing the increase.
The Php2,400.00 minimum annual contribution for all members is equivalent to the amount that
the Government annually incurs to maintain coverage for the poorest of the poor. Php1,000.00 is
allotted for drugs and medicine, Php300.00 for administrative costs, Php500.00 for consultation,
and Php600.00 for in-patient services.34

20 | P a g e
As the premium rate for '"the poorest of the poor" was set at Php2,400.00, the rates for the
Employed Sector, the OWP, and the IPP were likewise increased to avoid a situation where the
poorest would contribute a premium higher than that contributed by an employed member, an
OFW, or an individually paying member.35
PhilHealth counters that not only did it defer the rate increase to relieve the public of the
simultaneous burden of increases in fees, tolls, taxes, and social security contributions, but it even
introduced the corresponding enhancements in the benefit packages in 2012 before the premium
rates were increased.
ISSUE : WON the Petitioner’s petition is meritorious
HELD: No
We DISMISS the petition for lack of merit.
Under the NHIA, all citizens of the Philippines are required to enroll in the Program;
membership is mandatory. In other words, the NHIP covers all Filipinos in accordance with the
principles of universality and compulsory coverage.45 Ultimately, every Filipino is affected by an
increase in the premium rates. Thus, the petitioners have sufficient legal standing to file the present
suit.
Even if the procedural issues are disregarded, the petitions still failed to show that PhilHealth
gravely abused its discretion in issuing the assailed circulars. On the contrary, PhilHealth acted
with reasonable prudence and sensitivity to the public's needs. It postponed the rate increase several
times to relieve the public of the burden of simultaneous rate and price increases. It accommodated
the stakeholders and heard them through consultation. In the end, it even retained a lower salary
bracket ceiling (Php35,000.00 instead of Php50,000.00) and a lower rate (2.5% rather than the
planned 3%).
PhilHealth has the mandate of realizing the State's vision of affordable and accessible health
services for all Filipinos, especially the poor. To realize this vision and effectively ad1ninister the
Program, PhilHealth is empowered to promulgate its policies, and to formulate a contribution
schedule that can realistically support its programs.
PhilHealth justified the increase in annual premium rates with the enhanced benefits and the
expanded coverage of medical conditions. This reasonabie decision to widen the coverage of the
program - which led to increased premium rates - is a business judgment that this Court cannot
interfere with.
Moreover, the contribution schedule, as a whole, remains equitable and progressive. The salary
base and the premium contributions increase as a member's actual salary increases. A member who
earns Php9,000.00 is required to contribute much less than a member who earns Php3l,000.00 but
they both enjoy the same coverage. This satisfies the standard of a reasonable, equitable, and
progressive contribution schedule.
Section 36 of the Migrant Workers and overseas Filipino Act does no apply to premium
contributions under the National Health Insurance Program
The NHIP is a social insurance program. It is the government's means to allow the healthy to help
pay for the care of the sick, and for those who can afford medical care to provide subsidy to those
who cannot The premium collected from members is neither a fee nor an expense but an enforced
contribution to the common insurance fund.

21 | P a g e
From this perspective, the petitioners cannot invoke the non-increase clause under Section 36 of
the Migrant Workers and Overseas Filipinos Act. There is no valid distinction between migrant
workers and the rest of the population that would justify a lower premium rate for the former. It
would unduly burden the other PhilHealth contributors in favor of Overseas Filipino Workers.
Any distinctions between OFW s and all the other sectors are not germane to the NHIA' s purpose
of ensuring affordable, acceptable, available, and accessible health care services for all citizens of
the Philippines. Therefore, the application of Section 36 of the Migrant Workers and Overseas
Filipinos Act to obstruct the increase of premiums under the NHIP amounts to
an unreasonable classification, in violation of the equal protection clause.
Furthermore, the premium rate for indigent members was pegged at Php2,400.00 - the lowest in
the salary bracket for the Employed Sector. Pursuant to Section 28 of the NHIA, contributions
made in behalf of indigent members cannot exceed the minimum contributions for employed
members. A non-increase in the minimum premium contribution of OFWs would create a
ridiculous situation where the poorest of the poor are required to contribute more than a member
employed abroad. This violates the standard of a progressive and equitable contribution scheme.

22 | P a g e
MENTAL HEALTH BILL (REPUBLIC ACT No. 11036)
“People who die by suicide don't want to end their lives, they want to end their pain.”

The Numbers

Since Philippine Independence, We were among the countries which did not have legislation which
supports mental health. The Philippines lagged behind our prosperous neighbors in directing their attention
towards a solution to our countrymans ails with mental health crisis for 3/4ths of a century. Before RA
11036, we were among the the last ¼ of nations yet to implement a mental health bill. We did not give
enough credit or took the issue seriously. The recent rise in suicides is attributed to poor mental health.
Hence, Philippines took steps to answer the issue of mental health for the nation.

According to the World Health Organization, the outstanding number of people who choose to end their
lives goes as high as 800,000 suicides every year in a study conducted in August 2017. In the Philippines
among the latest statistics available to us, It has been shown that 6 out of every 100,000 men and 2 out of
every 100,000 females choose to commit suicide. These numbers may seem small, however, These numbers
are reflective only those reported cases of attempted or confirmed suicides. The number may even be under
reported taking into consideration that the Philippines is a predominantly Catholic country which view the
taking of ones life as a taboo.

In an attempt to help our suffering Filipino brothers and sisters, Republic Act No. 11036 or the Mental
Health Bill was signed into law by the President on June 20, 2018 and took effect on July 5, 2018.

Before RA 11036

There is also a lack of information or understanding about the topic of mental health. Particularly, A layman
would easily associate a mentally ill person to manifest signs of aggression, violence, unstable of mind ,
crazy or exhibit socially disadvantageous traits which affect their marriage and work. This is a cause of
worry for the patient because they do not want to be associated or labeled as such by their family, friends
or co-workers. There have also been instances, even now, where a mentally ill person is thought to be
possessed by malignant spirits or supernatural forces. These people are unfortunately subjected to treatment
through magical/mystical means by the local/resident “albolaryo”, or religious approaches( no offense
intended; like exorcisms) and in some cases the rubbing of your grandparents patented herb infused oils or
“lana” or vix vapor rub to the forehead of the afflicted person. These treatments in fact are a clear
manifestation of a lack of understanding or information on the subject of mental health.

There was also limited Mental Illness treatment available. Some of those services which touch upon mental
health then are;
1 PhilHealth insurance covered a mental health patient’s hospitalization as long as the event was caused
by extreme or acute episodes of mental or behavioral disorders. Moreover, the package was only at a very
minimum rate of PhP 7,800. Additionally,

23 | P a g e
2 In 2016, The government dedicated a national mental health hotline, together with resources that
provided access to psychiatrists and other assistance options. However, this was doomed to fail, due to
multiple complaints, inaccessibility or lack of a 24/7 availability and “appathetic” operators who are ill-
equipped to deal with callers under mental health crisis

What is RA 11036?

A law that aims to establish a national mental health policy directed towards improving the health of
the population in schools, workplaces and communities.
The law recognizes, Mentel health issues as a disability, making “Magna Carta for Disabled Persons” ( RA
7277) applicable to those afflicted.( Sec 2 )
and provides that Mental Health shall be a inclusive in the policy-making and nation building, to strengthen
present healthcare, through the implementation/creation of mental health system, spreading of information
regarding mental health through integration of mental health in schools and in the workplace. To increase
awareness and knowledge about the mental health in hopes that patients are alleviated or suffer minimally
from societies stigma and discrimination while undergoing treatment(Sec. 3, 23,24 & 25 )
The Law highlights the delivery of mental health services (community-based and hospital-based) with
more focus on persons with psychiatric, neurologic, and psychosocial health needs (including Drug
Dependents (Sec 43), And grants protection to persons availing psychiatric, neurologic and psychosocial
health services by recognizing their right to access evidence-based mental health services at all levels of
the national health care system free from stigma and discrimination; ( Sec. 2, 3, 5)
The service users (patients) are vested all rights provided by the Constitution , law recognized under
internationally accepted laws under the UN Universal Declaration of Human Rights and other relevant
international and regional human rights conventions and declaration (sec. 5)
The rights Family members, caregivers, or appointed legal representatives of persons availing psychiatric,
neurologic and psychosocial health services rights are recognized to receive appropriate psychosocial
support and participate in all activities involving the service user (patient); As well as providing,
confidentially to all service users pertaining to information obtained during the treatment(Sec 6)
The Law reinforce the mental health professional’s right to a safe and supportive environment, and to
participate in continuous professional development programs to ensure that there is progressive
development of treatments and services in the Mental Health sector and to prevent stagnating, or discard
ineffective and outdated treatments. (Sec. 7, 26,27 & 28)
The law also provides that consent is required from the service user ( patient) before undergoing treatment,
recognizing their right to express their view on matters affecting themselves. (Sec. 8) The service users is
also given the choice of his preferred treatment through a notarized directive (sec. 9) and instances where
assigning a legal representative is needed by the patient undergoes treatment (sec. 10 - 11)

The law also provides the type of mental health services are included. It is good to note that there is a
particular emphasis placed by the proponents of the law in the use of evidence-based treatments and
professional staffs for mental health service users. The medical and scientific approach and use of proven
effective treatments, depending on the needs of the users (Sec 14). Additionally, law intends to make mental
health services available to all levels through the creation of specialized establishment and facilities or the

24 | P a g e
upgrade of hospitals to be able to provide appropriate mental health care services within the premises (sec
15- 16 and 18)
The law also indents extend their services with suicide prevention and provide for mechanism for its cause
including ta 24/7 hotline similar to a project which was previously launched back in 2016.
For the effective and smooth implementation of the Act, The law provides that the Department of Health
(DOH), Commission on Human Tights (CHR), Department of Education( DepED), Commission on Higher
Education (CHED), Technical Education and Skills Development Authority (TESDA), Department of
Labor and Employment (DOLE), Civil Service Commission (CSC), Department of Social Welfare and
Develpment (DSWD) and the Local Government Units (LGU) to work together for the development of
mental health and other related services in addition or as part of their duty. (Sec 30-38)
Also, The law establishes the Philippine Council for Mental Health (PCMH) a policy-making advisory
body, mandated to develop a national multi-sectoral strategic plan mental health and to ensure its
implementation through a`` monitoring and evaluation of policies and guidelines. (Sec. 39)

The Council is chaired by the DOH, with other government agencies such as the Departments of Education,
Labor and Employment, Interior and Local Government, the Commissions on Human Rights (CHR), and
Higher Education, as members. More importantly, sectoral representatives from the academe/research,
medical or health professional groups and non-government organizations involved in mental health issue
will form part of the Council. (Sec. 41 & 42)

Lastly, According to the Mental Health Law’s proponents and its supporting coalition, RA 11036 is actually
the very first legislation that was written to protect the rights as well as the welfare of Filipinos with mental
health conditions.
Most importantly, the law is the first to acknowledge measures that directly shifts the focus of care,
primarily to the community, emphasizing the importance of access to services and integration of mental
health in both the national school curricula and countrywide workplace regulations

MISCELLANEOUS PROVISIONS
RA 11036 provides for penalties for the failure to comply with above mentioned provisions. Particularly

(Sec. 44)
(a) Failure to secure informed consent of the service user, unless it falls under the exceptions
provided under Section 18 of this Act;
(b) Violation of confidentiality of information, as defined under Section 4(c) of this Act;
(c) Discrimination against a person with mental-health condition, as defined under Section 4(e) of this Act;
and
(d) Administering inhumane, cruel, degrading or harmful treatment not based on medical or
scientific evidence as indicated in Section 5(h) of this Act;

25 | P a g e
RA 11036 is among the steps taken by the Philippine Government to improve the quality of life by providing
services for mental health in tandem with existing programs of Physical health. The law places the well-
being of the people in mind and hopes for a healthier

“It is called a mental illness for a reason, like all illnesses, it can be treated”

26 | P a g e
Home Development Mutual Fund Law of 1980 (HDMF)

History:

The birth of the Home Development Mutual Fund (HDMF), more popularly known as the Pag-IBIG Fund,
was an answer to the need for a national savings program and an affordable shelter financing for the Filipino
worker. The Fund was established on 11 June 1978 by virtue of Presidential Decree No. 1530 primarily to
address these two basic yet equally important needs. Under the said law, there were two agencies that
administered the Fund. The Social Security System handled the funds of private employees, while the
Government Service Insurance System handled the savings of government workers.

Less than a year after on 1 March 1979, Executive Order No. 527 was signed. The order directed
transferring the administration of the Fund to the National Home Mortgage Finance Corporation, which
was one of the operating agencies of the then Ministry of Human Settlements.

Seeing the need to further strengthen the stability and viability of the two funds, Executive Order No. 538
was issued on 4 June 1979, merging the funds for private and government personnel into what is now
known as the Pag-IBIG Fund. However, it was only on 14 December 1980 when Pag-IBIG was made
independent from the NHMFC with the signing of PD 1752, which amended PD 1530. With the improved
law in effect, the Fund's rule-making power was vested in its own Board of Trustees. Likewise, PD 1752
made Pag-IBIG membership mandatory for all SSS and GSIS member-employees.

Republic Act No. 7742

After eight years as a voluntary fund, the nature of Pag-IBIG membership reverted to mandatory on 17 June
1994 when President Fidel V. Ramos signed Republic Act 7742. The new law became effective on 1
January 1995.

Today, more than a decade after the universal Pag-IBIG coverage law was implemented, the Pag-IBIG
Fund continues to be a strong partner in realizing Filipino workers' dreams. Over the years, it initiated more
programs and projects, particularly those that address the needs of members belonging to the bottom
economic level. The Fund has established special housing partnerships with teachers and uniformed men,
among others. The Rent-to-Own Program was introduced, providing members another affordable way of
homeownership.

The Fund's efforts towards housing the Filipino did not go unnoticed. During the World Habitat Day
celebration in October 2006, Pag-IBIG was given the prestigious Scroll of Honour Awards by the United
Nations Human Settlements Program (UN-Habitat) for "making the dream of affordable housing a reality
for hundreds of thousands of households." Pag-IBIG is the first Philippine government agency to be
awarded such recognition.

27 | P a g e
The Fund likewise strengthened its partnership with accredited developers by way of its various institutional
lending programs, among which is the much-sought after program for the development of medium and
high-rise condominium buildings. The program provides a ready inventory of condominium units for sale
at affordable prices, and allows members to experience condominium style living in areas close to their
places of work.

In recent years, the Fund has embarked on its successful bid in the financial market, moving a step closer
to its vision of becoming a premier and globally competitive provident financial institution. In 2001, the
Fund floated P2 billion-worth of Pag-IBIG Housing Bonds to generate additional funds for its shelter
financing programs, which was warmly received by both institutional and individual investors. The bonds
matured in late 2006.

HDMF Law of 2009

Recognizing HDMF's contributions through the years and the need to further strengthen its capability as
the biggest source of housing finance in the country to date, President Gloria Macapagal-Arroyo signed
into law Republic Act No. 9679 or the Home Development Mutual Fund Law of 2009. The law was signed
on 21 July 2009.

Under the new HDMF law, membership to the Pag-IBIG Fund is made mandatory for all SSS- and GSIS-
covered employees; uniformed members of the AFP, BFP, BJMP and PNP; as well as Filipinos employed
by foreign-based employers. Now more than ever, Filipino workers will enjoy the benefits that are available
only to Pag-IBIG members.

Likewise, the law grants the HDMF exemption from tax payments like other government provident
institutions. With its tax-exempt status reinstated, Pag-IBIG will have more funds to finance housing and
short-term loans as well as investments in government securities. Income from these endeavors is
distributed exclusively to Pag-IBIG members in the form of dividends.

The HDMF Law of 2009 also gives the Board of Trustees the authority to set the contribution rates, thereby
paving the way for members to save more for their future. Similarly, this will bolster the Fund's resources
for home financing.

Pag-IBIG is an acronym which stands for Pagtutulungan sa Kinabukasan: Ikaw, Bangko, Industria at
Gobyerno. To this day, the Pag-IBIG Fund continues to harness these four sectors of the society to work
together towards providing Fund members with adequate housing through an effective savings scheme.

Membership:

28 | P a g e
Membership to the fund is exclusive to all Filipino citizens who are or ought to be covered by the Social
Security System (SSS), provided that actual membership in the SSS shall not be a condition precedent to
the mandatory coverage in the fund. It shall include, but are not limited to:

1. A private employee, whether permanent, temporary, or provisional who is not over sixty (60) years old;
2. A household helper earning at least ₱1,000 a month. A household helper is any person who renders
domestic services exclusively to a household such as a driver, gardener, cook, governess, and other similar
occupations;

3. A Filipino seafarer upon the signing of the standard contract of employment between the seafarer and
the manning agency, which together with the foreign ship owner, acts as the employer;

4. A self-employed person regardless of trade, business or occupation, with an income of at least ₱1,000.00
a month and not over sixty (60) years old;

5. An expatriate who is not more than sixty (60) years old and is compulsorily covered by the Social Security
System (SSS), regardless of citizenship, nature and duration of employment, and the manner by which the
compensation is paid. In the absence of an explicit exemption from SSS coverage, the said expatriate, upon
assumption of office, shall be covered by the Fund.

6. An expatriate shall refer to a citizen of another country who is living and working in the Philippines.

7. All employees who are subject to mandatory coverage by the Government Service Insurance System
(GSIS), regardless of their status of appointment, including members of the judiciary and constitutional
commissions;

8. Uniformed members of the Armed Forces of the Philippines, the Bureau of Fire Protection, the Bureau
of Jail Management and Penology, and the Philippine National Police;

9. Filipinos employed by foreign-based employers, whether they are deployed locally or abroad or a
combination thereof.

Voluntary Membership

Membership is also extended to individuals of at least 18 years old but not more than 65 years old under
their voluntary membership program. However, the said individual shall be required to comply with the set
of rules and regulations for Pag-IBIG members including the amount of contribution and schedule of

29 | P a g e
payment. In addition, they shall be subject to the eligibility requirements in the event of availment of loans
and other programs/benefits offered by the Fund.

The following shall be allowed to apply for voluntary membership:

1. Non-working spouses who devote full-time to managing the household and family affairs, unless they
also engage in another vocation or employment which is subject to mandatory coverage, provided the
employed spouse is a registered Pag-IBIG member and consents to the Fund membership of the non-
working spouse;
Filipino employees of foreign government or international organization, or their wholly owned
instrumentality based in the Philippines, in the absence of an administrative agreement with the Fund;
2. Employees of an employer who is granted a waiver or suspension of coverage by the Fund under RA
9679;

3. Leaders and members of religious groups;

4. A member separated from employment, local or abroad, or ceased to be self-employed but would like to
continue paying his/her personal contribution. Such member may be a pensioner, investor, or any other
individual with passive income or allowances;

5. Public officials or employees who are not covered by the GSIS such as Barangay Officials, including
Barangay Chairmen, Barangay Council Members, Chairmen of the Barangay Sangguniang Kabataan, and
Barangay Secretaries and Treasurers;

6. Such other earning individuals/groups as may be determined by the Board by rules and regulations.

Benefits:

Pag-IBIG Fund guarantees the refund of member's total accumulated savings (TAV), which consists of the
member's accumulated contributions, the employer counterpart contributions, if any, and the dividend
earnings credited to the member's account upon occurrence of any of the following grounds for withdrawal:

1. Membership maturity - The member must have remitted at least 240 monthly membership contributions
with the Fund. For Pag-IBIG Overseas Program (POP) members, membership with the Fund shall be at the
end of five (5), ten (10), fifteen (15), or twenty (20) years depending on the option of the member upon
membership registration.

30 | P a g e
2. Retirement - The member shall be compulsorily retired upon reaching age 65. He may however, opt to
retire upon the occurrence of any of the following:

a. Actual retirement from the SSS, the GSIS or a separate employer provident/retirement plan, provided the
member has at least reached age 45.

b. Upon reaching age 60.

3. Permanent and Total Disability or Insanity - The following disabilities shall be deemed total and
permanent:

a. Temporary total disability lasting continuously for more than 120 days;

b. Complete loss of sight of both eyes;

c. Loss of two limbs at or over the ankle or wrist;

d. Permanent complete paralysis of two limbs;

e. Brain injury resulting in incurable imbecility or insanity; and

f. Such other cases which are adjudged to be total and permanent disability by a duly licensed physician
and approved by the Board of Trustees.

4. Separation from the service due to health reason\

5. Permanent departure from the country

6. Death. In case of death, the Fund benefits shall be divided among the member's legal heirs in accordance
with the New Civil Code as amended by the New Family Code.

Loans:

31 | P a g e
Similar to the Government Service Insurance System (GSIS) and Social Security System, the HDMF also
offers financial assistance to qualified member by granting short term loan. There are two types of loans
members are qualified to avail:

Multi-Purpose Loan (MPL)

This program aims to provide financial assistance to Pag-IBIG members for purposes of minor home
improvement, livelihood, medical, educational, purchase of appliance and furniture and other needs.

Borrower Eligibility

New Loan

1. With at least twenty-four (24) monthly contributions.

2. An active member at the time of loan application, with at least one (1) monthly contribution for the last
six (6) months.

3. Member-applicant’s net take home pay shall not fall below the minimum requirement of the General
Appropriations Act (GAA) or company policy, whichever is applicable.

4. If with existing calamity loan, a member shall be allowed to avail of the MPL only after payment of at
least six (6) monthly amortizations. The outstanding balance, together with any accrued interests, penalties
and charges, shall be deducted from the proceeds of the MPL.

Loan Renewal

1. With payment of at least six (6) monthly amortizations. The outstanding balance, together with any
accumulated interests, penalties and charges, shall be deducted from the proceeds of the new loan.

2. An active member at the time of loan application, with at least one (1) monthly contribution for the last
six (6) months.

3. Member-applicant’s net take home pay shall not fall below the minimum requirement of the General
Appropriations Act (GAA) or company policy, whichever is applicable.

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Calamity Loan

For members affected by unforeseen calamity like flood, fire, tropical cyclones/ typhoons, volcanic eruption
and other similar cases. Members can borrow up to 80% of their Total Accumulated Value (TAV) subject
to the terms and conditions of the program. Calamity Loan Interest rate is 5.95% per annum. The loan is
amortized over 24 months, with a grace period of 3 months. Paying period begins on the 4th month
following their check date.

Provident Savings:

Membership contributions to the Pag-IBIG fund is a member's individual savings, which a member
can withdraw at the maturity date. Pag-IBIG Fund makes clear that members' contributions, plus that their
employer will earn dividend. All that money, called Total Accumulated Value (contributions plus dividend)
will be available when it reaches maturity. Unlike the money in a bank regular savings where the interest
rate is given, member's earnings in the fund is not readily foreseen ahead of time. It essentially participating
in an investment and membership earnings will depend on the overall performance of that investment.

The calamity loan program is open to any Pag-IBIG member who:

1. Has made at least 24 monthly savings;

2. Is an active member with at least 5 monthly savings for the last 6 months as of month prior to the date of
loan application; and

3. Resides in an area which is declared by the Office of the President or the Local Sanggunian concerned
as under a state of calamity. If the member has an existing Housing Loan, Multi-Purpose Loan (MPL)
and/or Calamity Loan, the account must not be in default as of date of loan application.

If the member has an existing Housing Loan, Multi-Purpose Loan (MPL) and/or Calamity Loan, the account
must not be in default as of the date of the loan application.

An eligible member may borrow up to a maximum of 80% of his Total Accumulated Value (TAV)
subject to the terms and conditions of the program.
The current interest rate for the Calamity Loan is 5.95% per annum.

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The Calamity Loan is amortized over a period of 24 months with a grace period of 3 months. Said member
shall start paying his loan on the 4th month following the date of his DV/Check date.

In no case, however, will the aggregate short-term loan (MPL and Calamity Loan) exceed 80% of the
borrower’s TAV.

If, in addition to an outstanding MPL, the member also has an outstanding calamity loan in the amount of
P2,000, in the example above, the member is still granted a new calamity loan of P3,000 but will only
receive P1,000 because the P2,000 will pay off the existing calamity loan balance. This means that at any
given time, a member can have both MPL and calamity loan, but only one calamity loan.

Eligible borrowers must avail of the Calamity Loan within a period of 90 days from the declaration of a
state of calamity.

Eligibility:

You must meet the following requirements before you apply for housing loan in HDMF.

1. Must be a Pagibig active member and have contributed of at least 24 months of contributions. What if
you already had the 24 months of contributions but you’re no longer an active member? Just resume being
active and you can apply. What if you’re a new member? Pay lump sum payment to complete the required
24 months and submit the PFR (Pagibig Fund Receipt) upon filing of loan application.

2. You must attend a seminar about the application of housing loan. They will discuss all the processing
steps and they will tackle all requirements and points regarding your housing loan application.

3. Submit 3 sets of the following requirements in folders:

a. Housing Loan Application Form – paste your recent 1X1 photo

b. Membership Status Verification Slip – attach photocopy of your 2 valid IDs

c. Proof of Income Documents:

For Locally Employed, any of the following

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a. Notarized Certificate of Employment and Compensation (Employer’s Format) and for government
employees 1 month payslip, within 3 months prior to the date of loan application

b. Latest ITR for the year immediately preceding the date of loan application – attach W2 form, stamped
received by the BIR/Certificate of Tax Withheld (BIR Form 2316)

For Self-employed / Other Sources of Income, any of the following

a. ITR, Audited Financial Statements and Official Receipt of Tax Payment from bank supported with DTI
Registration and Mayor’s Permit/Business Permit
b. Commission Vouchers reflecting the issuer’s name and contact details (for the last 12 months)

c. Bank Statements or passbook for the last 12 months (in case income is sourced or derived from foreign
remittances, pensions, etc.)

d. Copy of Lease of Contract and Tax Declaration (if income is derived from rental payments)

e. Certified True Copy of Transport Franchise issued by appropriate government agency (LGU for
tricycles, LTFRB for other Public Utility Vehicle (PUVs)

f. Certificate of engagement issued by owner of business

g. Other document that would validate source of income or funds

For OFWs, any of the following

a. Employment Contract (with English translation if in foreign language)

b. Original Employer’s Certificate of Income (with English translation if in foreign language). If document
submitted is photocopy, it shall be duly certified/initiated by Pagibig Fund Information Officer assigned in
the country where the member works.

c. Other Proofs of Income, whether original or photocopy, shall be duly certified/initiated by Pagibig Fund
information officer assigned in the country where the member works.

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4. Photocopy (back-to-back) of 1 primary valid ID of Principal Borrower and Spouse, Co-borrower and
Spouse, Seller and Spouse and Developer’s authorized representative and Attorney-in-Fact, if applicable.

5. Authorization to Conduct Credit/Background Investigation (download it here)

6. For OFWs, Special Power of Attorney notarized prior to date of departure or duly certified and
authenticated by the Philippines Embassy or Consulate in the country where the member is staying, if
abroad. If SPA is without the Red Ribbon of Consulate Office, the SPA must have duly stamped notarial
seal.

7. Health Insurance Coverage

a. Health Statement Form (Medical Questionnaire)

OFW members over 60 years old

Loans over 2 Million pesos to 6 Million pesos and for borrowers aged up to 60 years old
b. Health Statement Form (Medical Questionnaire) and Full Medical Examination

Borrowers over 60 years old

8. Marriage Contract (for all married borrowers, co-borrower/s, spouse, family member/s included on the
computation of aggregate income)

9. Birth Certificate of or any proof of relationship, if with co-borrower/s or family member/s included on
the computation of aggregate income.

10 Certified True Copy of Transfer Certificate of Title (TCT) – from Registry of Deeds

12. Photocopy of Updated Tax Declaration and Updated Real Estate Tax Receipt – from Municipal’s
Assessor’s Office

13. Location Plan and Vicinity Map

14. Approved letter request to re-avail of a Pagibig housing loan – for members with housing loan that was
foreclosed, cancelled, bought back due to default or subjected to dacion en pago).

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Contributions:

It is mandatory for employees to pay Pagibig Fund contributions every payroll or whenever they
receive their salaries. This is automatic and done by the employer every payroll. It is also important for
employers to remit and submit reports to Pagibig regarding all their employees’ contributions. Knowing
the latest Pagibig contribution table helps in awareness of each member, thus we are sharing here the latest
contributions.

Every employee, employer, members, OFWs must take note the latest Pagibig Contribution Table
2019 below to aid and be aware how much you are paying to Pagibig Fund every month. The usual payment
is P100 following the maximum compensation set to 5,000.

The maximum monthly compensation allowed to compute each employee’s Pagibig contribution is
currently set at P5,000. This means that the maximum contribution a member can pay per month is currently
P100 and the employer’s share applied to that maximum contribution is also P100.

If you are employed and you are receiving more than 5,000 every month, you will be deducted 100 every
month to cover your employee share. Your employer will also pay 100 to your Home Development Mutual
Fund (employer share).

Pagibig Contributions Land-based OFW

An OFW whose employer is not subject to mandatory coverage shall contribute an amount
equivalent to 2% of his or her monthly salary. Said employee may opt to pay the employer counterpart
according to HDMF circular 391.

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38 | P a g e
G.R. No. 130584 June 27, 2006
YAZAKI TORRES MANUFACTURING, INC., Petitioner,
vs.
THE COURT OF APPEALS, THE HOME DEVELOPMENT MUTUAL FUND
FACTS :
The Home Development Mutual Fund (HDMF) is the government agency tasked with the administration
of the PAG-IBIG2 Fund (Fund) created under Presidential Decree (P.D.) No. 1530, signed into law on June
11, 1978. The Fund has been intended for housing purposes to be sourced from voluntary contributions
from its members.
On December 14, 1980, P.D. No. 1530 was amended by P.D. No. 1752 providing that membership in the
Fund is mandatory for all gainfully-employed Filipinos.
On June 17, 1994, P.D. No. 1752 was amended by Republic Act (R.A.) No. 7742 which took effect on
January 1, 1995. Under the new law, the coverage of the Fund extends to all members of the Social Security
System and Government Service Insurance System, as well as their employers. However, membership is
voluntary for employees earning less than P4,000.00 a month.
Yazaki Torres Manufacturing, Inc., petitioner herein, a corporation organized under Philippine laws,
applied for and was granted by the HDMF a waiver from the Fund coverage for the period from January 1
to December 31, 1995. The HDMF found that petitioner’s retirement plan for its employees is superior to
that offered by the Fund.
On September 1, 1995, the HDMF Board of Trustees amended Rule VII of the Rules and Regulations
implementing R.A. No. 7742. The amended Rule provides:
SEC. 1. Waiver or Suspension Because of Existing Provident/Retirement and Housing Plan. – An employer
with a plan providing both for a provident/retirement and housing benefits for all his employees and existing
as of December 14, 1980, the effectivity date of Presidential Decree No. 1752, may apply with the Fund
for waiver or suspension of the coverage. The provident/retirement aspect of the plan must be qualified
under Republic Act No. 4917 and actuarially determined to be sound and reasonable by an independent
actuary duly accredited by the Insurance Commission. The provident/retirement and housing benefits as
provided for under the plan must be superior to the provident/retirement and housing benefits offered by
the Fund.
Such waiver or suspension may be granted by the Fund on the basis of actual certification that the waiver
or suspension does not contravene any collective bargaining agreement, any other existing agreement or
clearly spelled out management policy and that features of the plan or plans are superior to the Fund and
continue to be so.
Provided further, That the application must be endorsed by the labor union representing a majority of the
employees or in the absence thereof by at least a majority vote for all the employees in the said
establishment in a meeting specifically called for the purpose; Provided furthermore, That such a meeting
be held or conducted under the supervision of an authorized representative from the Fund.
The certificate of waiver or suspension of coverage issued herein shall only be for a period of one (1) year
effective upon issuance thereof. No certificate of waiver issued by the President of the Fund shall have
retroactive effect. Application for renewal must be filed within sixty (60) days prior to the expiration of the
existing waiver or suspension and such application for renewal shall only be granted based on the same
conditions and requirements under which the original application was approved.

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Pending the approval of the application for waiver or suspension of coverage or the application for renewal,
the employer and his covered employees shall continue to be mandatorily covered by the Fund as provided
for under Republic Act No. 7742.
xxx
SEC. 3. Effects of Waiver or Suspension; Existing Provident or Retirement/Housing Plan. – Waiver or
suspension of coverage granted to an employer under Section 1 shall likewise apply to his employees who
are members of the employer’s private plan; Provided, That such members are not member-borrowers of
the Fund. A member-borrower shall continue to pay and remit to the Fund his monthly contributions
together with the employer contribution to be shouldered by him. A member-saver may opt to remain in
good standing by remitting to the Fund his monthly contributions with or without employer contributions.
Notwithstanding the certificate of waiver or suspension granted to the employer, it is still the obligation of
the employer to service this type of contributing employee-member by deducting through salary deductions
and remitting to the Fund the contribution as required herein.
Employees who are non-members of the employer’s private plan at the time the certificate of waiver or
suspension of coverage is granted shall continue to be mandatorily covered by the Fund and their employer
is required to set aside and remit to the Fund the employee contributions together with the employer’s
required contributions.
xxx
After its waiver from the Fund coverage lapsed, petitioner applied for a renewal. The ground relied
upon was once again its "superior retirement plan" to that of the Fund.
On February 16, 1996, the HDMF Chief Executive Officer disapproved petitioner’s application on the
ground that its retirement plan is not superior to that provided by the Fund. Petitioner was then directed "to
register its employees with the Fund and to remit their monthly contributions together with the mandatory
employer’s share."
The September 1, 1995 amendment to the rules requiring both provident/retirement and housing
plans to the employees in order that the employer may be granted a waiver or suspension of the Pag-
ibig Fund coverage is in harmony with WHEREAS clauses of Presidential Decree No. 1752, thus:
WHEREAS, the Government, in pursuit of the Constitutional mandates on the promotion of public welfare
through ample social services, as well as its humanist commitment to the interests of the working group, in
relation particularly to their need for decent shelter has established the Home Development Mutual Fund,
under Presidential Decree 1530, a system of employee – employer contributions for housing purposes; and
WHEREAS, there is need to strengthen the Home Development Mutual Funds and make it more effective
both as savings generation and home building program for the gainfully-employed members of the
Philippine society; (Emphasis supplied)
The governing law which is Section 19 of Pres. Decree No. 1752 states:
SEC. 19. Existing Provident/Housing Plans – An employer and/or employee – group who, at the time this
Decree becomes effective have their own provident and/or employee – housing plans, may register with the
Fund, for any of the following purposes:
(a) For annual certification of waiver or suspension from coverage or participation in the Fund, which shall
be granted on the basis of verification that the waiver or suspension does not contravene any effective
collective bargaining agreement and that the features of the plan or plans are superior to the Fund or
continue to be so; or x x x x x x x x x

40 | P a g e
x x x The grant of the certification of waiver to the petitioner was only for a specific period, i.e., from
January 1, 1995 to December 31, 1995 but subject to the condition that the same may be renewed for another
year upon the filing of the proper application within 60 days prior to the expiration of the existing waiver
or suspension. The grant is merely a privilege which the State in the exercise of its police power has the
right not to renew the same as the exigency of the case warrants. After the lapse of the specified period, the
HDMF is not automatically required to enter another contract with the petitioner as long as the latter applies
for renewal of certification. To reiterate, Section 1 of the original HDMF rules, the law in force at the time
of the granting of the certification of waiver to the petitioner, provides "[s]uch waiver or suspension may
be granted by the President of the Fund on the basis of verification that the waiver or suspension does not
contravene any effective collective bargaining or other existing agreement and that the features of the plan
or plans are superior to the Fund and continue to be so." The word "may" is merely permissive and operates
to confer discretion upon a party (Capati v. Ocampo, 113 SCRA 794 [1982]). The disapproval of the
petitioner’s application for renewal of waiver from the Pag-ibig Fund coverage was by reason that the
petitioner’s retirement plan was not superior to Pag-ibig Fund (Annex "D", Petition, p. 30, Rollo). It is well-
settled principle that the finding of facts by the administrative bodies which has acquired the expertise in
the field is entitled to great respect and, should not be disturbed on appeal unless it is shown that it has
patently misappreciated the facts. Petitioner however failed to prove by sufficient evidence that the findings
of the President of the Fund was patently erroneous.3

Petitioner filed its Motion for Reconsideration, but it was denied in a Resolution dated June 17, 1997.

ISSUE: WON the CA acted with Grave abuse of discretion in upholding the HDMFs Resolution
HELD : NO,
In this case, there is no showing that the HDMF arbitrarily, whimsically or capriciously denied petitioner’s
application for renewal of its waiver. It conducted the necessary investigation, comparison, evaluation, and
deliberation of petitioner’s retirement plan vis-à-vis the Fund. This Court thus holds that the Court of
Appeals committed no grave abuse of discretion amounting to lack or excess of jurisdiction when it affirmed
the denial of petitioner’s application for renewal of waiver by the HDMF.

Moreover, the grant of waiver or exemption from the coverage of the Fund is but a mere privilege granted
by the State. A privilege is a particular and peculiar benefit or advantage enjoyed by a person, company, or
class beyond the common advantages of other citizens. Like any other privilege or exemption, it may be
withdrawn by the State on a finding that the recipient is no longer entitled to it. There is no provision
whatsoever in R.A. No. 7742 or its Implementing Rules and Regulations that the HDMF shall automatically
renew a waiver from the Fund coverage upon an application for renewal. The task of determining whether
such application should be granted is best discharged by the HDMF, not by the courts. Absent a showing
that the denial of petitioner’s application by the HDMF is tainted by caprice, arbitrariness, or despotism,
this Court will not interfere in the exercise of its discretion.

Petitioner claims that under the original Implementing Rules and Regulations of the HDMF, superior
retirement plan and superior housing plan were separate and alternative grounds for the waiver of the Fund
coverage. However, under the Amended Rules and Regulations, superior retirement plan and superior
housing plan are joint requirements. Since petitioner does not have a housing plan, this is the reason
why its retirement plan was not considered superior to that of the Fund. Hence, its application for

41 | P a g e
renewal of waiver was denied. Consequently, it insists that the HDMF exceeded its authority when it
amended its original Rules and Regulations.

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