The Template has 3 sheets:
Info Sheet – basic info about the company
Principals – masterlist of principals/employees that are enrolling
Dependents – masterlist of dependents that are enrolling
Principals Sheet
Philhealth – indicate “Required” (all employees were assumed Philhealth members and are required to file their Philhealth incases of confinement)
Rider – leave blank. I will fill this up myself
The plan of choice (Silver, Gold, Platinum)
- could be uniform for all principals and dependents (eg. Everyone under Gold Plan)
- according to the position of the company, let’s say Platinum for President/Owner, Gold for Managers, Silver for Staff
- The dependents plan could either be uniform for all dependents of the company or consistent with the position of the principals. Let’s say, All dependents of the President/Owner are under Platinum, All dependents of Managers are under Gold and all dependents of the Staff are under Silver
- The plans per employee should also be consistent. Let’s say a Male Manager has 3 dependents. It cannot be if his wife is under Gold Plan and the kids are under Silver. They should be the same.
- Note: Company can choose from any of the plan types from any of the 6 options BUT all plan types must come from one (1) option only.
Example:
Executives - Platinum
Managers - Gold
Rank and File – Silver
But they should come from one (1) option only
Dependents Sheet:
The total number of dependents must be equal to at least 75% of the population of the principals/employees
For example: 5 employees x .75 = 4 dependents even if all 4 dependents came from 1 person only
Hierarchy of Enrollment and Age Limit
For married principals
1st - spouse (must be 65 & below)
2nd - eldest child (must be 21 & below)
3rd - up to the youngest child (must be 21 & below)
For single principals
1st - mother (must be 65 & below)
2nd - father (must be 65 & below)
3rd - eldest sibling (must be 21 & below)
4th - youngest sibling (must be 21 & below)
Thus, if a married principal would like to enroll 1 dependent, he MUST enroll his wife first. If he wants to enroll 2 dependents, he MUST enroll his spouse and his eldest child. The same principle is applied for the single applicants based on the hierarchy stated above.
Exemptions from the Hierarchy
A dependent can be exempted or excluded from the hierarchy. The principal applicant can then now skip and proceed to the next eligible dependent.
Examples:
- Wife is currently enrolled with another HMO
- Mother is already deceased
- Husband is working abroad
- Father is over aged
Should by any chance, you are only able to submit 4 principal names, your company’s application as a group account will not be processed unless the minimum number of 5 applications is submitted and approved by Maxicare’s underwriting
Thank you.
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