1

ER Employer
EE - Employee
XPT - Except
Governing Law
&
EE
Amendments
NATURE
COVERED by the
Act

Bianca Alana Hizon Limjuco

GSIS

SSS

PHILHEALTH

PAG-IBIG
(HDMF)

RA8291

RA8282

RA10606
RA7875
RA9241

RA9679
PD1752
RA7742

1. ER Any person who carries

on in the Philippines any trade,
business, industry, undertaking, &
uses the services of another
person who is under his orders as
regard the employment, XPT

Mandatory Coverage. All

citizens of the Philippines shall
be covered by the National
Health Insurance Program. In
accordance with the principles of
universality & compulsory
coverage enunciated in Section
2(b) & 2(l) hereof,
implementation of the Program
shall ensure sustainability of
coverage & continuous
enhancement of the quality of
service: Provided, That the
Program shall be compulsory in
all provinces, cities &
municipalities nationwide,
notwithstanding the existence of
LGU-based health insurance
programs: Provided, further,
That the Corporation,
Department of Health (DOH),
local government units (LGUs),
& other agencies including
nongovernmental organizations
(NGOs) & other national
government agencies (NGAs)
shall ensure that members in
such localities shall have access
to quality & cost-effective health
care services.

Membership to the Fund shall

be mandatory for the
following:
a. All EEs, workers,
professionals, officers &
companies who are
compulsorily covered by the
SSS & GSIS
b. Uniformed members of the
AFP, the Bureau of Fire
Protection, the Bureau of Jail
Management & Penology, &
the PNP;
c. OFWs
d. Filipinos employed by
foreign-based ERs, whether
deployed locally or abroad.

1. ER National government,
its political subdivisions,
branches, agencies or
instrumentalities, including
government-owned or
controlled corporations with
original charters.
2. EE any person receiving
compensation while in the
service of an ER as defined
herein, whether by election or
appointment, including
Barangay & Sangguinian
officials.

THOSE UNDER THE GSIS

2. EE Any person who performs

services for an ER who receives
compensation for such services,
where there is an ER-EE
relationship.
3. Self-Employed considered as
both ER & EE

Agrarian Law & Social Legislation

Membership to the Fund is

also open to the following:
a. Non-working spouses of
Pag-IBIG members;
b. Filipino EEs of foreign
government or international
organization, or their whollyowned instrumentality based
in the Philippines, in the
absence of an administrative
agreement with the Fund;
c. EEs of an ER who is
granted a waiver or
suspension of coverage by the
Fund under RA 9679;
d. Leaders & members of
religious groups;
e. A member separated from
employment, local or abroad,
or ceased to be self-employed
but would like to continue
paying his/her personal
contribution;
f. Public officials or EEs who
are not covered by the GSIS

Atty. Berne Guerrero

Membership
Qualifications/
Eligibility

Compulsory for all EEs

receiving compensation who
have not reached the
compulsory retirement age.

EXEMPTION from
coverage

1. members of AFP & PNP;

2. Contractual EEs, who have
no ER-EE relationship with the
agency they serve; &
3. Members of Judiciary &
Constitutional Commission,
who shall be covered only by
life insurance coverage.
4. Purely casual EEs.

Benefits
&
Rules on Entitlement

1. Monthly pensions;
2. Retirement benefits;
3. Permanent disability benefits;

Bianca Alana Hizon Limjuco

1. Compulsory upon all EEs not

over (60) yrs of age & their ERs.
2. Spouses who devote full time
to managing the household &
family affairs, unless they are also
engaged in other vocation or
employment which is subject to
mandatory coverage, may be
covered by the SSS on a
voluntary basis.
3. Filipinos recruited by
foreignbased ERs for
employment abroad may be
covered by the SSS on a
voluntary basis.
4. All selfemployed professionals
5. Partners & single proprietors of
businesses
6. Actors & actresses, directors,
scriptwriters & news
correspondents who do not fall
within the definition of the term
"EE"; in Sec. 8 (d) of this Act
7. Professional athletes, coaches,
trainers & jockeys
8. Individual farmers & fishermen
1. Employment purely casual &
not for the purpose of occupation
or business of the ER;
2. Services performed on or in
connection with an alien vessel by
an EE if he is employed when
such vessel is outside the
Philippines;
3. Service performed in the
employ of the Philippine
government, instrumentality or
agency thereof;
4. Service performed in the
employ of a foreign government,
international organization, or their
wholly-owned instrumentality; &
5. Services performed by
temporary EEs, which may be
excluded by regulation of the
Commission

Agrarian Law & Social Legislation

such as barangay officials; &

g. Filipinos naturalized in other
countries.
Membership in the Fund shall
be for a period of (20) yrs,
XPT when earlier terminated
by reason of retirement,
disability, insanity, death,
departure from the country or
other causes as may be
Provided for by the Board of
Trustees: Provided, That
those who become members
of the Fund after the effectivity
of this Act may withdraw the
total accumulated value of
their contributions to the Fund
after the tenth or the
15th year of continuous
membership: Provided,
further, That said members
have no outstanding housing
loans with the Fund: Provided,
finally, That this option may be
exercised only once & shall
not prejudice the members
continuing membership in the
Fund.
The following need not pay the
monthly contributions to be
entitled to the Programs
benefits:
(a) Retirees & pensioners of the
SSS & GSIS prior to the
effectivity of this Act; &
(b) Lifetime members.

Atty. Berne Guerrero