Insurance Commission

Ignacio 10:57 AM, Oct 09, 2023

October 9, 2023

Dear Mr. Doering,

Thank you for your request dated Oct 05, 2023 under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch, regarding information on HMOs losses.

We received your request on Oct 05, 2023 and will respond on or before Oct 26, 2023 08:49:37 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/aglzfmVmb2ktcGhyHAsSB0NvbnRlbnQiD0lDLTgzMjg0NTQ1NjQ4Mgw, for request with ticket number #IC-832845456482.

Thank you.

Respectfully,

Edmar Ignacio
FOI Officer

Vinzon 04:52 PM, Oct 10, 2023

October 10, 2023

Dear Mr. Doering,

Greetings!

Thank you for your request dated Oct 05, 2023 08:49:37 PM under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch.

Your Request

You asked for information on HMOs losses.

Response to Request

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

Question No. 1. Regarding age group affected - IC does not have the information requested.
Question No. 2. Reasons for claims – Almost half of the claims are for outpatient services followed by inpatient claims at almost 30%. The rest are for medical professional fees and other medical services.
Question No. 3. Trend - Reports as of the end of every quarter are available in IC’s website through the following link: https://www.insurance.gov.ph/hmo-statistics/
Other information on the trend are also available in IC’s Key Statistical Data, which contains data from the last five years based on annual statement submissions of regulated entities: https://www.insurance.gov.ph/key-data/
Question No. 4. Regarding delay in payment – IC does not have the information requested
Question No. 5. Profits and losses – These are also available in the links provided above as Net Income (Loss). The five-year figures are available in the Key Statistical Data.


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

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