Healthcare Benefit Policy

Healthcare Benefit Policy





CPP-HR_0208_V3_Healthcare Benefit
VERSION
APPROVAL DATE
AUTHOR
CHANGES
APPROVED BY
3.0
 24 OCTOBER 2018
P. GREGORIO

EXECOM
















1.0 Objective

To assist team members in defraying hospitalization expenses by providing a medical health insurance policy at no cost to team members, which indemnifies hospital and medical expenses arising out of hospital services and out-patient expenses.

2.0 Scope

This policy shall apply to probationary and regular team members (see Section 3.4).

3.0 Provisions

 

3.1 Medical, hospitalization, out-patient consultation and dental services will be provided to all qualified team members. The Plan is covered by pre-existing conditions a year after the enrollment to the accredited HMO. Maternity consultations cover only pre and post-natal check-ups.

3.2 A separate manual shall be provided by the Health Insurance Provider for all procedures covering confinement and standard exclusions and list of accredited hospitals and clinics.

3.3 The Company may avail of the Employee Dependent Coverage under the same insurance company. The premium payments shall be borne by the team member through salary deduction equivalent to twelve (12) months installment.

                        3.3.1     During the time of employment, the team member may enroll a maximum of 2 paid dependents only. 

3.4 The Company shoulders the HMO premium payments of a team member’s dependent/s according to the matrix below:


 



Upon hiring



Upon


regularization



2nd


Anniversary


Date



3rd


Anniversary


Date



SVPs, VPs 



2



 



 



 



Managers



2



 



 



 



Sr Team Leaders, Team Leaders



 1



 



1



 



IT Dev/QA Testers



2



 



 



 



Rest of Team Members



None



None



1



1



            3.5 Team member may enroll their dependents, in order of hierarchy:

3.5.1 For Married Team Member: spouse, eldest child, second child, third child, and so on. Children must be below 21 years old.

3.5.2 For Single Team Member: parents whose age is below 65 years old and single brother or sister below 21 years old.

               3.6 Enrollment Period for additional dependents:

                             3.6.1     New Hires: within 30 days from start date of employment. 

                             3.6.2     Anniversary Hires: within 30 days from anniversary date. 

                             3.6.3     New Born: 30 days from date of birth of child

                             3.6.4     Newly Married: 30 days from date of marriage 
            3.7 Cancellation of Dependent/s within coverage period – Team member must provide necessary documentation needed by the HMO provider for dependent/s to be cancelled and subject for approval by the HMO provider.

4.0        Responsibility

4.1      HR-ER Team is responsible for enrolling eligible team members and their dependents to our accredited HMO.

4.2      HR-ER is responsible for maintaining the HMO Master List, including deletions and additions through the accredited HMO portal.

4.3      Team member must submit needed requirements of dependents to be enrolled to HR ER to be submitted to HMO provider within deadline based on enrollment period. 

          4.4       F&A Team is responsible for payment of premiums in a timely manner.

5.0        Frequency 

              5.1      Enrolment: Upon employment start date (please refer to Section 3.4) 

              5.2      Addition/Deletion: 48 hours upon receipt of email requests
 

6.0 Distribution

HR-ER Team
F&A Team
SVP-Shared Services

7.0        Usage  

            7.1     HR-ER reports the name of the team member to HMO provider/broker. 

          7.2      HR-ER monitors the delivery of the HMO card from the accredited HMO.

7.3      HR-ER releases the HMO card and corresponding brochures to the team member and let the team member signs the log book as proof of receipt.

7.4      HR-ER advises the membership termination of separated team members to the HMO.

7.5      Finance Team processes the corresponding payments and/or deductions to the HMO.

 

 

8.0        References 

Health Insurance Provider’s Members Guidebook

Job Grading Table

Accredited HMO Summary of Benefits, Inclusions and Exclusions

9.0        Records

HMO Master List

HMO Web Portal

          HR Logbook

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