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SSS Rules

IMPLEMENTING RULES AND REGULATIONS OF REPUBLIC ACT NO. 11199 OR THE

SOCIAL SECURITY ACT OF 2018

RULE 12 Definition of Terms

SEC 3. EMPLOYER - Any person, natural or juridical, domestic or foreign, who carries
on in the Philippines any trade, business, industry, undertaking, or activity of any kind
and uses the services of another person who is under his/her orders as regards the
employment, except the Philippine Government and any of its political subdivisions,
branches or instrumentalities, including corporations owned or controlled by the
Philippine Government, provided that a selfemployed person shall be both employee and
employer at the same time. [Sec 8, (c)]

SEC 4. EMPLOYEE - Any person who performs services for an employer in which either
or both mental or physical efforts are used and who receives compensation for such
services, where there is an employer-employee relationship, provided that a self-
employed person shall be both employee and employer at the same time. [Sec 8, (d)] As
a general rule, the determination of the existence or non-existence of an
employeremployee relationship for the purpose of determining the coverage in the SSS
shall be within the sole jurisdiction of the Commission. [SSS Office Order 2017-032 (29
May 2017)]

SEC 10. EMPLOYMENT. – Any service performed by an employee for his/her employer,
except the following:

iii. Service performed in the employ of a foreign government or

international organization, or their wholly-owned instrumentality. 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. The terms of such agreement shall conform with
the provisions of the Social Security Act of 2018 on coverage and amount of
payment of contributions and benefits and the provisions of the Social
Security Act of 2018 Act shall be supplementary to any such agreement; [Sec
8, (j), (3)]

RULE 14 Coverage of Overseas Filipino Workers

SEC 1. COMPULSORY OFW COVERAGE. - 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. [Sec 9-B, (a), 1st par]

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 i. An OFW refers to a person who is to be engaged, is engaged or has been
engaged in a remunerated activity in a State of which he/she is not a
citizen, or on-board a vessel navigating the foreign seas other than a
government ship used for military or noncommercial purposes, or on an
installation located offshore or on the high seas. A “person to be engaged
in a remunerated activity” refers to an applicant worker who has been
promised or assured employment overseas.

ii. An OFW shall be allowed to register for initial coverage with the SSS up
to the day of his/her 60th birthday.

PhilHealth

REPUBLIC ACT No. 11223

An Act Instituting Universal Health Care for All Filipinos, Prescribing Reforms in
the Health Care System, and Appropriating Funds Therefor

Section 1. Short Title. - This Act shall be known as the "Universal Health Care Act".

CHAPTER II
UNIVERSAL HEALTH CARE (UHC)

Section 5. Population Coverage. - Every Filipino citizen shall be automatically included

into the NHIP, hereinafter referred to as the Program.

CHAPTER III
NATIONAL HEALTH INSURANCE PROGRAM

Section 8. Program Membership. - Membership into the Program shall be simplified into
two (2) types, direct contributors and indirect contributors, as defined in Section 4 of
this Act.

Section 9. Entitlement to Benefits. - Every member shall be granted immediate eligibility

for health benefit package under the Program: Provided, That PhilHealth Identification
Card shall not be required in the availment of any health service: Provided, further, That
no co-payment shall be charged for services rendered in basic or ward
accommodation: Provided, furthermore, That co-payments and co-insurance for
amenities in public hospitals shall be regulated by the DOH and PhilHealth: Provided,
finally, That the current PhilHealth package for members shall not be reduced.

PhilHealth shall provide additional Program benefits for direct contributors, where
applicable: Provided, That failure to pay premiums shall not prevent the enjoyment
of any Program benefits: Provided, further, That employers and self-employed
direct contributors shall be required to pay all missed contributions with an
interest, compounded monthly, of at least three percent (3%) for employers and not
exceeding one and one-half percent (1.5%) for self-earning, professional practitioners,
and migrant workers.

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 PAG-IBIG

Implementing Rules and Regulations of Republic Act No. 9679

RULE I

PRELIMINARY PROVISIONS

Section 1. Title. These Rules shall be referred to as the Rules and Regulations
Implementing Republic Act 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. Constructio
RULE V

FUND COVERAGE AND MEMBERSHIP

Section 1. Mandatory Coverage and Membership of Employees. Coverage under and

membership in the Fund shall be mandatory for the following:

a. All employees who are compulsorily covered by the SSS; Provided, that for purposes
of mandatory coverage in the Fund of persons who are compulsorily covered by the SSS,
the term employee shall be understood the manner by which the SSS defines it, and
shall include, but not limited to:

1. A Private employee, whether permanent, temporary or provisional, who is not over 60

years old.

2. A household-helper earning at least P1,000 a month. A household-helper is any

person who renders domestic services exclusively to a household such as driver,
gardener, cook, governess, and other similar occupations.

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 shipowner, act as
employers.

4. A self-employed person, regardless of trade, business or occupation, with an income

of at least P1,000 a month and not over 60 years old. This includes, but not limited to;
self-employed professionals; business partners, single proprietors and board directors;
actors, actresses, directors, scriptwriters and news reporters who are not under an
employer-employee relationship; professional athletes, coaches, trainers and jockeys;
farmers and fisherfolks; and workers in the informal sector such as cigarette vendors,
watch-your-car boys, among others. Provided, that a self-employed person subject to
compulsory coverage by the SSS shall be treated by the Fund as both employee and
employer at the same time, and shall therefore be required to pay both the employee
and the corresponding employer contributions.

Provided finally, that actual membership in the SSS shall not be a condition precedent
for mandatory coverage in the Fund, it being sufficient that the person ought to be
covered compulsorily by the SSS.

b. All employees who are subject to mandatory coverage by the GSIS, regardless of their
employment status.

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c. 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.

d. Filipinos employed by foreign-based employers. Coverage under the Fund shall

be mandatory for Filipinos employed by foreign-based employers whether
deployed here or abroad, or a combination thereof, but whose respective
employers are exclusively based outside of the Philippines. The employers shall not
be subject to mandatory coverage. Provided, that if the employer maintains an office or
agent in the Philippines that effectively acts as an employer of the Filipino, then such
office or agent shall be deemed an employer subject of mandatory coverage under R.A.
9679.

Section 2. Mandatory Coverage of Employers. Coverage under the Fund shall be

mandatory for the following:

a. Employers of employees compulsorily covered by the SSS. These shall include private
employers previously granted waiver or suspension of coverage for whatever reason
under Presidential Decree 1752, as amended. Provided, that manning agencies together
with the foreign ship owners shall be considered jointly and severally as the employers
of Filipino Seafarers. Provided finally, that a self-employed person subject to compulsory
coverage by the SSS shall be treated by the Fund as both employee and employer at the
same time.

b. Employers of employees subject of mandatory coverage by the GSIS.

c. The Armed Forces of the Philippines, the Bureau of Fire Protection, the Bureau of Jail
Management and Penology, and the Philippine National Police.

FOR

MEDICAL INSURANCE

MEDICINE SUBSIDY

ACCIDENT AND TERRORISM INSURANCE

The named benefits are all covered by Non-Diminution of benefits under the labor code
of the Philippines