Insurance Commission

Ignacio 11:20 AM, Oct 09, 2023

October 9, 2023

Dear Ms. Alegria,

Thank you for your request dated Oct 06, 2023 under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch, regarding data on HMO use of Filipinos.

We received your request on Oct 06, 2023 and will respond on or before Oct 27, 2023 04:32:54 PM, in accordance with the Executive Order's implementing rules and regulations.

Should you have any questions regarding your request, kindly contact me using the reply function on the eFOI portal at https://www.foi.gov.ph/requests/aglzfmVmb2ktcGhyHAsSB0NvbnRlbnQiD0lDLTI3OTUxNzEzNzE1NAw, for request with ticket number #IC-279517137154.

Thank you.

Respectfully,

Edmar Ignacio
FOI Officer

Vinzon 10:39 AM, Oct 13, 2023

October 13, 2023

Dear Ms. Alegria,

Greetings!

Thank you for your request dated Oct 06, 2023 04:32:54 PM under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch.

Your Request

You asked for HMO use of Filipinos.

Response to Request

In relation to your request, please be informed of the following responses as advised by our Statistics and Research Division and Actuarial Division:

Question No. 1.  HMO use of Filipinos -The Insurance Commission's (IC) Key Statistical Data published in IC’s website contains the total number of Filipinos with HMO as of 2021 – please see the last page on enrollment data for HMOs: https://www.insurance.gov.ph/summary-from-2017-2021-preliminary-figures/.
Kindly note that, data for 2022 and 2023 are not yet available. 

Question No. 2. Illnesses covered by HMOs - Illnesses/coverages provided by HMOs are enumerated under the Schedule A of both Annexes A and B as attached to IC Circular letter (CL) No. 2017-19. These breakdowns of coverages are an expansion of Section 3.e. of the said Circular relative to Benefit Features of HMO Products. CL No. 2017-19 may be accessed through: https://www.insurance.gov.ph/wp-content/uploads/2022/09/CL2017_19.pdf    

To provide a further overview of these illnesses/coverages, you may also check Section I - Definition of Terms (defining illnesses, etc.), Section II - Benefit Provisions, Section - III Pre-existing Conditions and Section V - Exclusions and Limitations provisions under both Annexes A and B of the same Circular Letter. 

Question No. 3. Ages that HMOs served/cover - Principal members who have attained the age of eighteen (18) but not more than a specified maximum age (as set by the HMO) may be covered by HMOs. Dependents, on the other hand, may be covered as early fifteen (15) days old up until sixty-five years old. You may refer to Section VI of both Annexes A and B of IC CL 2017-19 for more information. 

HMOs may also create new HMO products that have coverages beyond the usual covered ages. 

For further inquiries, you may contact our Statistics and Research Division at 8523 8461 local 122 and Actuarial Division at 8523 8461 local 121.

For your information and guidance.

If you are unhappy with this response to your FOI request, you may ask us to carry out an internal review of the response by email at icrecords-foi@insurance.gov.ph. Your review request should explain why you are dissatisfied with this response, and should be made within 15 calendar days from the date when you received this letter. We will complete the review and tell you the result within 30 calendar days from the date when we receive your review request.

If you are not satisfied with the result of the review, you then have the right to appeal to the Office of the President under Administrative Order No. 22 (s. 2011).

The quality of services you deserve matter to us. To help the Insurance Commission monitor the progress in improving its services, we appreciate accomplishing the Customer Satisfaction Surveys (CSS) through the following link: https://bit.ly/ICCustomerSatisfactionSurvey

Thank you.

Respectfully,

Atty. Albert Lawrence Vinzon
FOI Decision Maker