7

for at least (1) year prior to

separation.
3 Separation Benefits
payable upon reaching 60 yrs
of age or upon separation,
whichever comes later:
Provided, That the member
resigns or separates from the
service after he has rendered
at least 3 yrs of service but
less than 15 yrs.
4. Permanent Disability
Benefits A member who
suffers permanent disability for
reasons not due to his grave
misconduct, notorious
negligence, habitual
intoxication, or willful intention
to kill himself or another.
5. Survivorship Benefits
(1) basic survivorship pension
is 50% of the basic monthly
pension
(2) dependent children's
pension not exceeding 50% of
the basic monthly pension.
6. Funeral Benefit The
amount of funeral benefit shall
be P12,000 - P18,000.
7. Life Insurance Benefits

Bianca Alana Hizon Limjuco

2. Death Benefits Upon the

death of a member who has paid

at least 36 monthly contributions

prior to the semester of death, his

primary beneficiaries shall be

entitled to the monthly pension:
Provided, That if he has no
primary beneficiaries, his
secondary beneficiaries shall be
entitled to a lump sum benefit
equivalent to 36 times the monthly
pension.
3. Permanent Disability Benefits
Upon the permanent total
disability of a member who has
paid at least 36 monthly
contributions prior to the semester
of disability, he shall be entitled to
the monthly pension: Provided,
That if he has not paid the
required 36 monthly contributions,
he shall be entitled to a lump sum
benefit equivalent to the monthly
pension times the number of
monthly contributions paid to the
SSS or 12 times the monthly
pension, whichever is higher.
4. Funeral Benefit A funeral
grant equivalent to Twelve
thousand pesos (P12,000.00)
shall be paid, in cash or in kind,
to help defray the cost of funeral
expenses upon the death of a
member, including permanently
totally disabled member or retiree.
5. Sickness benefit. (a) A
member who has paid at least 3
monthly contributions in the
12month period immediately
preceding the semester of
sickness or injury & is confined
therefor for more than 3 days in a
hospital or elsewhere with the
approval of the SSS, shall, for
each day of compensable
confinement or fraction thereof,
be paid by his ER, or the SSS, if
such person is unemployed or
selfemployed, a daily sickness
benefit equivalent to 90% of his
average daily salary credit.

Agrarian Law & Social Legislation

monthly contributions to be
entitled to the Programs
benefits:
(a) Retirees & pensioners of the
SSS & GSIS prior to the
effectivity of this Act; &
(b) Lifetime members.

least 240 monthly membership

contributions with the Fund.
For Pag-IBIG Overseas
Program (POP) members,
membership with the Fund
shall be at the end of (5), (10),
(15), or (20) yrs depending on
the option of the member upon
membership registration.
2. Retirement. The member
shall be compulsorily retired
upon reaching age 65. He
may however, opt to retire
upon the occurrence of any of
the following:
a. Actual retirement from the
SSS, the GSIS or a separate
ER provident/retirement plan,
Provided the member has at
least reached age 45.
b. Upon reaching age 60.
3. Permanent & Total
Disability or Insanity. The
following disabilities shall be
deemed total & permanent:
a. Temporary total disability
lasting continuously for more
than 120 days;
b. Complete loss of sight of
both eyes;
c. Loss of two limbs at or over
the ankle or wrist;
d. Permanent complete
paralysis of two limbs;
e. Brain injury resulting in
incurable imbecility or insanity;
&
f. Such other cases which are
adjudged to be total &
permanent disability by a duly
licensed physician & approved
by the Board of Trustees.
4. Separation from the service
due to health reason
5. Permanent departure from
the country
6. Death. In case of death, the
Fund benefits shall be divided
among the member's legal
heirs in accordance with the
New Civil Code as amended
by the New Family Code.

Atty. Berne Guerrero

Procedures of
Availment

Claims for benefits under this

Act XPT for life & retirement
shall prescribe after 4 yrs from
the date of contingency.

Administration

The GSIS shall formulate,

adopt, amend &/or rescind
such rules & regulations as
may be necessary to carry out
the provisions & purposes of
this Act, as well as the effective
exercise of the powers &
functions, & the discharge of
duties & responsibilities of the
GSIS, its officers & EEs.

Bianca Alana Hizon Limjuco

6. Maternity Leave Benefit A

female member who has paid at
least 3 monthly contributions in
the twelvemonth period
immediately preceding the
semester of her childbirth or
miscarriage shall be paid a daily
maternity benefit equivalent to
100% of her average daily salary
credit for 60 days or 78 days in
case of caesarean delivery.
Compulsory coverage of the ER
shall take effect on the first day of
his operation & that of the EE on
the first day of his employment:
Provided, That the compulsory
coverage of the selfemployed
person shall take effect upon his
registration with the SSS.

The SSS shall submit annually

not later than April 30, a public
report to the President of the
Philippines & to the Congress of
the Philippines covering its
activities in the administration &
enforcement of this Act during the
preceding year including
information & recommendations
on broad policies for the
development & perfection of the
program of the SSS.

Agrarian Law & Social Legislation

SEC. 25. Reimbursement &

Period to File Claims. All
claims for reimbursement or
payment for services rendered
shall be filed within a period of
sixty (60) calendar days from the
date of discharge of the patient
from the health care provider.
The period to file the claim may
be extended for such reasonable
causes determined by the
Corporation.

The Corporation shall have the

following powers & functions:
a) to administer the National
Health Insurance Program;
b) to formulate & promulgate
policies for the sound
administration of the Program;
c) to set standards, rules, &
regulations necessary to ensure
quality of care, appropriate
utilization of services, fund
viability, member satisfaction, &
overall accomplishment of
Program objectives;
d) to formulate & implement
guidelines on contributions &
benefits; portability of benefits,
cost containment & quality
assurance; & health care
provider arrangements,
payment, methods, & referral

The Fund shall be private in

character, owned wholly by
the members, administered in
trust & applied exclusively for
their benefit. All the personal
& ER contributions shall be
fully credited to each member,
accounted for individually &
transferable in case of change
of employment. They shall
earn dividends as may be
Provided for in the
implementing rules. The said
amounts shall constitute the
provident fund of each
member, to be paid to him, his
estate or beneficiaries upon
termination of membership, or
from which peripheral benefits
for the member may be drawn.
Section 13. Rule-Making
Power. The Board of Trustees
is hereby authorized to make
& change needful rules &
regulations, which shall be
published in accordance with
law or at least once in a
newspaper of general
circulation in the Philippines,
to provide for, but not limited
to the following matters:
(a) The effective
administration, custody,
development, utilization &
disposition of the Fund or
parts thereof, including
payment of amounts credited
to members or to their
beneficiaries or estates;
(b) Extension of Fund
coverage to other working

Atty. Berne Guerrero