6/7/2020
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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;[7] x x x (emphasis supplied)
Its President and Chief Executive Officer (CEO) is directly appointed by the President of
the Republic while its Board of Directors (the Board) is composed of several cabinet
secretaries (or their permanent representatives) and representatives of different
stakeholders.[8]
At the start of respondent President Benigno Simeon Aquino III's administration in
2010, the DOH launched the Aquino Health Agenda (AHA/the Agenda)[9] 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.
In line with the Agenda for a truly Universal Health Care program, PhilHealth adopted a
new mission "to ensure adequate financial access of every Filipino to quality health care
services through the effective and efficient administration of the National Health
Insurance Program."[10]
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.[11]
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.
For the Employed Sector, the premium rate was to be computed at 3% of the
salary base with the lowest salary bracket[12] 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.
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