Pertinent Laws, Rules and Regulations on SSS, PhilHealth, and Pag-IBIG

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Also, the matters contained in the following were written in accordance with the law, rules, and jurisprudence prevailing at the time of writing and posting, and do not include any future developments on the subject matter under discussion.

AT A GLANCE:

The pertinent laws, rules and regulations on SSS are:

Republic Act (R.A.) No. 11199 or the “Social Security Act of 2018”,
IRR of R.A. No. 11199, and
R.A. No. 10361 otherwise known as “Batas Kasambahay”.

The pertinent laws, rules and regulations on PhilHealth are:

R.A. No. 7875 as amended by R.A. No. 9241 and 10606 or “National Health Insurance Act of 1995”,
Revised IRR of R.A. No. 7875 as amended by R.A. No. 9241 and 10606, and
R.A. No. 10361 otherwise known as “Batas Kasambahay”.

The pertinent laws, rules and regulations on Pag-IBIG are:

Presidential Decree (PD) No. 1530,
PD No. 1752, Amending the Act Creating the Home Development Mutual Fund,
R.A. No. 9679 or the “Home Development Mutual Fund Law of 2009, otherwise known as Pag-IBIG (Pagtutulungan sa kinabukasan: Ikaw, Bangko, Industriya at Gobyerno) Fund”, IRR of R.A. No. 9679, HDMF Circular No. 274 or the “REVISED GUIDELINES ON Pag-IBIG FUND MEMBERSHIP”

SOCIAL SECURITY SYSTEM (SSS)

I. Applicable Laws, Rules, and Regulations

Republic Act (R.A.) No. 11199 or the “Social Security Act of 2018”

R.A. No. 11199 or the Social Security Act of 2018, signed by President Duterte on February 07, 2019, expressly repealed R.A. No. 8282.

Section 2. Declaration of Policy. – It is the policy of the State to establish, develop, promote, and perfect a sound and viable tax-exempt social security system suitable to the needs of the people throughout the Philippines which shall promote social justice through savings, and ensure meaningful social security protection to members and their beneficiaries against the hazards of disability, sickness, maternity, old age, death, and other contingencies resulting in loss of income or financial burden. Towards this end, the State shall endeavor to extend social security protection to Filipino workers, local or overseas, and their beneficiaries.

In the pursuit of this policy, a social security program shall be developed emphasizing the value of “work, save, invest and prosper”. The maximum profitability of investible funds and resources of the program shall be ensured through a culture of excellence in management grounded upon sound and efficient policies employing internationally recognized best practices.

IRR of R.A. No. 11199
R.A. No. 10361 otherwise known as “Batas Kasambahay”

Under said law, a Kasambahay who has rendered at least one (1) month of service shall be covered by the Social Security System (SSS), Employees Compensation Commission (ECC), Philippine Health Insurance Corporation (PhilHealth), and Home Development Mutual Fund or Pag-IBIG, and shall be entitled to all the benefits in accordance with their respective laws, rules and regulations.

II. Coverage of the Social Security Act of 2018

1. Compulsory SSS Coverage

a. Employees And Their Employers (Sec. 1, Rule 13, IRR)

Coverage in the SSS shall be compulsory upon all employees including domestic workers or “kasambahays” not over sixty (60) years of age (up to the day of his/her 60th birthday) and their employers.

b. Covered Employees with Private Benefit Plans (Sec. 2, Rule 13, IRR)

The benefit already earned by the employees under private benefit plans existing at the time of the approval of the Social Security Act of 2018 shall not be discontinued, reduced or otherwise impaired. Private benefit plans which are existing and in force at the time of compulsory coverage shall be integrated with the plan of the SSS.

c. Self-Employed Person (Sec. 3, Rule 13, IRR)

Self-employed persons, including but not limited to the following:

All self-employed professionals;
Partners and single proprietors of businesses;
Actors and actresses, directors, scriptwriters and news correspondents who do not fall within the definition of the term “employee” in Section 8 (d) of the Social Security Act of 2018;
Professional athletes, coaches, trainers and jockeys;
Individual farmers and fishermen.

d. Overseas Filipino Workers (OFW) (Sec. 1, Rule 14, IRR)

Coverage in the SSS shall be compulsory upon all sea-based and land-based OFWs as defined under R.A. No. 8042 or the Migrant Workers and Overseas Filipinos Act of 1995 as amended [by R.A. No. 10022], provided they are not over sixty (60) years of age (par 1., Sec 9-B, [a])

2. Voluntary SSS Coverage

A spouse of a member who devotes full time to managing the household and family affairs, but does not engage in other vocation or employment which is subject to compulsory or mandatory coverage;
An OFW upon the termination of his/her employment overseas;
A covered employee who was separated from employment who continues to pay his/her contributions; and
A self-employed member who realizes no income in any given month who continues to pay his/her contributions.

A voluntary member (VM) shall pay his/her contribution in accordance with the guidelines on payment deadline applicable to self-employed members.

3. Exclusions

a. Employers excluded from the coverage [Sec. 8(c), R.A. No. 11199]

The government and any of its political subdivisions, branches or instrumentalities, including corporations owned or controlled by the Government

b. Services excluded from the coverage [Sec. 8(c), R.A. No. 11199]

(1) Services where there is no employer-employee relationship in accordance with existing labor laws, rules, regulations and jurisprudence;

(2) Service performed in the employ of the Philippine Government or instrumentality or agency thereof;

(3) Service performed in the employ of a foreign government or international organization, or their wholly-owned instrumentality: Provided, however, That this exemption notwithstanding, any foreign government, international organization or their wholly-owned instrumentality employing workers in the Philippines or employing Filipinos outside of the Philippines, may enter into an agreement with the Philippine Government for the inclusion of such employees in the SSS except those already covered by their respective civil service retirement systems: Provided, further, That the terms of such agreement shall conform with the provisions of this Act on coverage and amount of payment of contributions and benefits: Provided, finally, That the provisions of this Act shall be supplementary to any such agreement; and

(4) Such other services performed by temporary and other employees which may be excluded by regulation of the Commission. Employees of bona fide independent contractors shall not be deemed employees of the employer engaging the service of said contractors.

PhilHealth

I. Applicable Laws, Rules, and Regulations

1. R.A. No. 7875 as amended by R.A. No. 9241 and 10606 or “National Health Insurance Act of 1995”

The said law was signed by President Fidel V. Ramos on February 14, 1995. 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.

SEC. 2. Declaration of Principles and Policies. – Section 11, Article XIII of the 1987 Constitution of the Republic of the Philippines declares that the State shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all the people at affordable cost. Priority for the needs of the underprivileged, sick, elderly, disabled, women, and children shall be recognized. Likewise, it shall be the policy of the State to provide free medical care to paupers.

2. Revised IRR of R.A. No. 7875 as amended by R.A. No. 9241 and 10606

3. R.A. No. 10361 otherwise known as “Batas Kasambahay”

II. Coverage (Rule I, Revised IRR of R.A. No. 7875 as amended by R.A. No. 9241 and 10606)

Section 5. Nature and Scope. The Program shall cover the following members and their dependent/s:

a. Members in the Formal Economy – those with formal contracts and fixed terms of employment including workers in the government and private sector, whose premium contribution payments are equally shared by the employee and the employer

Government Employee – an employee of the government, whether regular, casual or contractual, who renders services in any of the government branches, military or police force, political subdivisions, agencies or instrumentalities, including government-owned and-controlled corporations, financial institutions with original charter, Constitutional Commissions, and is occupying either an elective or appointive position, regardless of status of appointment.
Private Employee – an employee who renders services in any of the following:
1. Corporations, partnerships, or single proprietorships, NGOs, cooperatives, non-profit organizations, social, civic, or professional or charitable institutions, organized and based in the Philippines including those foreign owned;
2. Foreign governments or international organizations with quasi-state status based in the Philippines which entered into an agreement with the Corporation to cover their Filipino employees in PhilHealth;
3. Foreign business organizations based abroad with agreement with the Corporation to cover their Filipino employees in PhilHealth. (Sec. 5, Revised IRR of R.A. No. 7875 as amended by R.A. No. 9241 and 10606)

Pag-IBIG

I. Applicable Laws, Rules, and Regulations

Presidential Decree (PD) No. 1530
PD No. 1752, Amending the Act Creating the Home Development Mutual Fund
R.A. No. 9679 or the “Home Development Mutual Fund Law of 2009, otherwise known as Pag-IBIG (Pagtutulungan sa kinabukasan: Ikaw, Bangko, Industriya at Gobyerno) Fund”

Section 2. Declaration of Policy. — It is the policy of the State to establish, develop, promote, and integrate a nationwide sound and viable tax-exempt mutual provident savings system suitable to the needs of the employed and other earning groups, and to motivate them to better plan and provide for their housing needs, by membership in the Home Development Mutual Fund, with mandatory contributory support of the employers in the spirit of social justice and the pursuit of national development.

IRR of R.A. No. 9679
HDMF Circular No. 274 or the “REVISED GUIDELINES ON Pag-IBIG FUND MEMBERSHIP”

II. Membership Coverage (HDMF Circular No. 274)

1. Mandatory Coverage

1.1. All employees 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:

1.1.1. A private employee, whether permanent, temporary, or provisional who is not over sixty (60) years old;

1.1.2. A household helper earning at least P1,000.00 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;

1.1.3. 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;

1.1.4. A self-employed person regardless of trade, business or occupation, with an income of at least P1,000.00 a month and not over sixty (60) years old;

1.1.5. An expatriate who is not more than 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. An expatriate shall refer to a citizen of another country who is living and working in the Philippines.

1.2. 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;

1.3. 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;

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

2. Voluntary Coverage

An individual at least 18 years old but not more than 65 years old may register with the Fund under voluntary membership. However, said individual shall be required to comply with the set rules and regulations for Pag-IBIG members including the amount of contribution and schedule of 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:

2.1. 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;

2.2. 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;

2.3. Employees of an employer who is granted a waiver or suspension of coverage by the Fund under RA 9679;

2.4. Leaders and members of religious groups;

2.5. 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;

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

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

Existing Membership and Coverage

All records and documents, as well as the amounts and benefits already accrued to the members covered by the Fund under PD 1752, as amended, shall be transferred, continued, and integrated into the member’s coverage under RA 9679.

All rights vested, duty imposed, penalties accrued, and/or proceeding commenced under PD 1752, as amended, particularly those under RA 7742, shall continue to subsist and shall be enforced under the provisions of RA 9679 and its IRR.

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Alburo Alburo and Associates Law Offices specializes in business law and labor law consulting. For inquiries regarding legal services, you may reach us at info@alburolaw.com, or dial us at (02)7745-4391/ 0917-5772207/ 09778050020.

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