Tag Archive: SSS Maternity Benefits


08 - 16

The SSS Calamity Loan is a special privilege offered by the SSS to members who reside, work, or have properties in areas declared by the government to be under a state of calamity.  This type of loan is not open to all and not readily available unless the government and SSS come to an agreement during emergency situations.  What SSS members can truly count on are the following benefits that are automatically available to members with updated contributions and loans.

For your ready reference, below is a summary of SSS benefits that every member can enjoy:

TYPE OF BENEFIT QUALIFYING CONDITIONS AMOUNT OF BENEFIT
SICKNESS

A daily cash allowance paid for the number of days a member is unable to work due to sickness or injury.

  • The member is unable to work due to sickness or injury and is confined either in a hospital or at home for at least four days.
  • He/she has paid at least three months of contributions within the 12-month period immediately before the semester of sickness or injury.
  • He/she has used up all company sick leaves with pay for the current year and has duly notified his/her employer; or
  • He/she must notify the SSS directly by filing a sickness benefit application if he/she is separated from employment, a self-employed or voluntary member, including overseas Filipino worker OFW) members.
  • The amount of the member’s daily Sickness Benefit allowance is equivalent to 90% of his/her average daily salary credit (ADSC).
  • The Sickness Benefit is granted up to a maximum of 120 days in one calendar year.
Maternity

A daily cash allowance granted to a female member who is unable to work due to childbirth or miscarriage.

  • The member has paid at least three months of contributions within the 12-month period immediately before the semester of her childbirth or miscarriage.
  • If employed, she must have given notification of her pregnancy through her employer, or
  • She must directly notify the SSS if she is separated from employment, a self-employed or voluntary member, including OFW-member.
  • The amount of the daily Maternity Benefit allowance is equivalent to 100% of her ADSC, multiplied by 60 days in case of normal delivery/miscarriage/ ectopic pregnancy without operation/H-mole, or by 78 days for caesarean section delivery/ ectopic pregnancy with operation.
  • The Maternity Benefit is granted up to the first four deliveries or miscarriages only.
Disability

A cash benefit granted – either as a monthly pension or a lump sum amount – to a member who becomes permanently disabled, either partially or totally.

  • The member has paid at least one month contribution before the semester of disability.
  • To qualify for a monthly disability pension, he/she must have paid at least 36 monthly contributions prior to the semester of disability.
  • If with less than 36 monthly contributions, he/she is granted a lump sum amount.
  • If qualified, the member is granted a monthly Disability Pension, plus a P500 monthly Supplemental Allowance.
  • The lowest monthly Disability Pension is P1,000 if the member has less than ten credited years of service (CYS); P1,200 if with at least ten CYS, and P2,400 if with at least 20 CYS.
Retirement

A cash benefit granted either as a monthly pension or a lump sum amount to member who can no longer work due to old age.

  • The member is at least 60 years old (optional retirement), separated from employment or has ceased to be self-employed; and has paid at least 120 monthly contributions prior to the semester of retirement; or
  • The member is 65 years old (mandatory retirement), whether employed or not; and has paid at least 120 monthly contributions prior to the semester of retirement.
  • To qualify for a monthly retirement pension, the member must have paid at least 120 monthly contributions prior to the semester of retirement.
  • If with less than 120 monthly contributions, he/she may be granted a lump sum amount, but will also be given the option to continue paying contributions to complete the 120 months to become eligible for monthly pension.
  • If qualified, the member is granted a monthly Retirement Pension, plus a 13th month pension payable every December.
  • The retiree has the option to receive the first 18 months pension in lump sum, discounted at a preferential rate of interest to be determined by the SSS. This option can be exercised only upon filing of the first retirement claim, and the Dependent’s Pension and the 13th month pension are excluded from the advanced 18 months pension.
  • If the member has dependent minor children, they are given a Dependent’s Pension equivalent to 10% of the member’s monthly pension or P250, whichever is higher.  Only 5 minor children, beginning from the youngest, are entitled a Dependent’s Pension. No substitution is allowed.
  • The lowest monthly Retirement Pension is P1,200 if the member has 120 monthly contributions or at least 10 CYS; or P2,400 if with at least 20 CYS.
Death

A cash benefit granted – either as a monthly pension or a lump sum amount – to the beneficiaries of a deceased member.

  • A monthly death pension is granted to primary beneficiary (legitimate spouse until he/she remarries, and dependent legitimate, legitimated or legally adopted, and illegitimate children)of the deceased member who had paid at least 36 monthly contributions prior to the semester of death.
  • A lump sum amount is granted to the primary beneficiary if the deceased member had less than 36 monthly contributions.
  • If there are no primary beneficiaries, the member’s secondary beneficiaries (dependent parents) shall be given a lump sum amount.
  • If qualified, the member’s primary beneficiary is granted a monthly Death Pension, plus a 13th month pension payable every December.
  • If the member has dependent minor children, they are given a Dependent’s Pension equivalent to 10% of the member’s monthly pension or P250, whichever is higher. Only 5 minor children, beginning from the youngest are entitled to Dependent’s Pension.  No substitution is allowed.
  • The lowest monthly Death Pension is P1,000 if the member had less than 10 CYS; P1,200 if with at least 10 CYS; and P2,400 if with at least 20 CYS.
Funeral

A cash benefit given to whoever paid for the burial expenses of the deceased member.

  • The employee-member was reported for coverage by his/her employer;
  • A self-employed member/OFW/non-working spouse who had at least 1 contributor payment;
  • A voluntary member who was previously covered either as employed/self-employed/OFW and had at least one contribution/payment.
  • The Funeral Benefit is a variable amount ranging from a minimum of P20,000 to a maximum of P40,000, depending on the member’s paid contributions and CYS.
Employees’ Compensation Program (EC)
  • Cash benefit for temporary sickness or disability, permanent partial or total disability, and death.
  • Medical services, appliances, and supplies
  • Rehabilitation Services
  • The EC Program aims to assist those who suffer from work-connected sickness or injury resulting in disability or death. Starting June 1984, the benefits under the EC Program may be enjoyed simultaneously with benefits under the Social Security Program, thus, allowing double compensation for covered members who suffer work-related contingencies.  All SSS-registered employers and their employees are compulsorily covered under the EC Program and need not register again under the EC.
Salary Loan

A cash loan granted to an employed, currently-paying self-employed or voluntary member.  It is intended to meet the member’s short-term credit needs.

  • An employed, currently-paying self-employed or voluntary member who has six posted monthly contributions within the last 12 months prior to the month of filing of loan application.
  • For one-month loan, the member must have 36 posted monthly contributions prior to the month of filing of application.
  • For two-month loan, the member must have 72 posted monthly contributions prior to the month of filing of loan application.
  • If employed, the member’s employer must be updated in the payment of contribution and loan remittances.  The member must also be updated in the payment of other loans with SSS.
  • A one-month loan is equivalent to the average of member’s last 12 monthly salary credits (MSCs), or the amount applied for, whichever is lower.
  • A two-month loan is equivalent to twice the average of the member’s last 12 MSCs posted, rounded to the next higher MSC, or the amount applied for, whichever is lower.
  • The loan shall be charged an interest rate of 10% per annum until fully paid, based on diminishing principal balance, and shall be amortized over a period of 24 months.
  • If the loan is not fully paid at the end of the term, interest shall continue to be charged on the outstanding principal balance until fully paid.
  • In case of default, the arrearages/unpaid loan shall be deducted from the member’s short-term benefit claims (e.g. sickness/maternity), if any, or from his/her final benefit claim (e.g. death, retirement, total disability).
  • The loan can be renewed after payment of at least 50% of the original loan amount and at least 50% of the loan term has lapsed.

Source: https://www.sss.gov.ph

Chips And Nibblers (1)

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07 - 27

Matagal na akong hindi nakapag hulog sa aking SSS / Philhealth account; ngayon, may sakit ako at maco-confine.  Pwede ko bang habulin ang mga nalibanan kong buwan para makapag claim pa din ako ng benefits?

This is a common question we receive from followers.  Apparently, a lot of Filipinos think that paying their monthly contributions for government-mandated insurances is optional.

It isn’t.  We all need to activate our SSS and Philhealth memberships and diligently remit our monthly contributions to ensure that we are protected and covered by benefits.

We summarized SSS and Philhealth’s requirements and needed premium payments before a member can claim his benefits from these government agencies.  We aim to encourage everyone to update and maintain their monthly contributions to ensure hassle-free benefits claim anytime emergency strikes.

Read on.

Philhealth

  • Member must have paid at least three months’ premium contributions within the immediate six-month period prior to the first day of confinement to avail of benefits.
  • Philhealth does not accept retroactive payments for unpaid months.
  • Contributions made on admission date, during the confinement period, or after the member or dependent is discharged from the health care institution will not be counted as qualifying contributions.

What are the requirements for eligibility and when is a member eligible to claim?

Sponsored Members Date of hospitalization/availment must be within the effectivity period indicated in the member’s ID and MDR.
Individually Paying Members 1. There are certain confinement cases wherein three months worth of premium within the last sixmonths (3/6) prior to confinement is acceptable.

2. For pregnancy-related cases, dialysis, chemotherapy, radiotherapy and other selected surgical procedures, the member must have paid nine months worth of premium within the last twelve months.

Lifetime Member The member just has to show their Lifetime ID Card; no need to pay premiums anymore.  This now includes Senior Citizens; in which case, all they need to show is their SC IDs.
Employed Members Three months worth of premium within the last six months (3/6) prior to hospitalization.
Overseas Workers Date of hospitalization/availment must be within the coverage period specified in the member’s MDR.

 

SSS

A. Maternity Benefits

The maternity benefit is offered only to female SSS members.  A member is qualified to avail of this benefit if:

  1. She has paid at least three monthly contributions within the 12-month period immediately preceding the semester of her childbirth or miscarriage.
  2. She has given the required notification of her pregnancy to SSS through her employer if employed; or submitted the maternity notification directly to the SSS if separated from employment, a voluntary or self-employed member.
  3. SSS does not accept retroactive payments for unpaid months.

The maternity benefit shall be paid only for the first four (4) deliveries or miscarriages.

B. Sickness Benefits

The sickness benefit is a daily cash allowance paid for the number of days a member is unable to work due to sickness or injury.

A member is qualified to avail of this benefit if:

  1. He is unable to work due to sickness or injury and confined either in a hospital or at home for at least four days;
  2. He has paid at least three months of contributions within the 12-month period immediately before the semester of sickness or injury;
  3. He has used up all current company sick leaves with pay; and
  4. He has notified the ER, or directly the SSS, if separated from employment, VM or SE regarding his sickness or injury.

C. Retirement

The retirement benefit is a cash benefit paid either in monthly pension or as lump sum to a member who can no longer work due to old age.

A member is qualified to avail of this benefit if:

  1. Member must have paid at least 120 monthly contributions prior to the semester of retirement and is any of the following, whichever is applicable:
    • At least 60 years old and separated from employment or has ceased to be an SE/OFW/Household Helper (optional retirement);
    • At least 65 years old whether still employed/SE, working as OFW/Household Helper or not (technical retirement);
    • At least 55 years old and separated from employment or has ceased to be an SE, if an “underground mineworker” (optional retirement);
    • At least 60 years old whether still employed/SE or not, if an “underground mineworker” (technical retirement); or
    • A total disability pensioner who has recovered from disability and is at least 60 years old (or at least 55 years old, if an underground mineworker).
  2. A former retiree-pensioner whose monthly pension was suspended due to re-employment / self-employment and is now separated from employment or has ceased to be an SE.
  3. A member who is 60 years old and above, but not yet 65, with 120 contributions or more may continue paying as VM up to 65 years old to avail of the higher amount of benefit.

If you have questions regarding benefit claims from Philhealth and SSS, send us a message and we will do our best to find the answers for you.

 

Sources:

www.sss.gov.ph

www.philhealth.gov.ph

Chips And Nibblers (1)

Closet Queen

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05 - 12

This article is for our mom-to-be followers who are wondering if they are qualified to claim for maternity benefits from the SSS.  Often, expectant mothers who only recently began making SSS contributions, or those who missed a month or two prior to their delivery dates, are worried that they would not be able to claim assistance from SSS.

We lifted the official computation and other guidelines from the SSS website to help all female SSS members understand how maternity benefits are determined.

Read on!

The SSS Maternity Benefit

  • For normal delivery and miscarriages: 100% of member’s average daily salary credit multiplied by 60 days.
  • For caesarean section delivery: 100% of member’s average daily salary credit multiplied by 78 days.

Benefit Computation

  1. Exclude the semester of contingency (delivery or miscarriage).
    • A semester refers to two consecutive quarters ending in the quarter of delivery.
    • A quarter refers to three consecutive months ending March, June, September, or December.
  2. Count 12 months backwards starting from the month immediately before the semester of contingency.
  3. Identify the six highest monthly salary credits within the 12-month period.  The monthly salary credit means the compensation base for contributions and benefits related to the total earnings for the month.  The maximum covered earnings or compensation is Php 16,000.00 effective January 1, 2014.
  4. Add the six highest monthly salary credits to get the total monthly salary credit.
  5. Divide the total monthly salary credit by 180 days to get the average daily salary credit.  This is equivalent to the daily maternity allowance.
  6. Multiply the daily maternity allowance by 60 (for normal delivery or miscarriage) or 78 days (for caesarean section delivery) to get the total amount of maternity benefit.

Below is an example:

Let’s say the SSS member will give birth on December 2017, how do we determine the amount of maternity benefit she can expect from SSS?

  1. The semester of contingency is from July 2017 to December 2017.
  2. The 12-month period before the semester of contingency would be from July 2016 to June 2017.
  3. Assuming the six highest monthly salary credits are Php 15,000 each, then the total monthly salary credit would be Php 90,000.00 (Php15,000 x 6).
  4. The daily maternity allowance would be Php 500.00 (Php 90,000 / 180).
  5. To get the total amount of maternity benefit: multiply the daily maternity allowance by the number of days based on the type of delivery:
    • For normal delivery and miscarriages: Php 500 x 60 = Php 30,000.00
    • For caesarian section delivery: Php 500 x 78 = Php 39,000.00

Important Reminders:

  1. The SSS maternity benefit is paid to a female member for the first four deliveries and miscarriages only, by virtue of the Social Security Act of 1997 (RA 8282).
  2. Employed members shall receive the full amount of the maternity benefit within 30 days from the date of filing of the maternity leave application.  This will be given in advance by the employer (who shall then be reimbursed in full by the SSS).
  3. If the employee member gives birth or suffers a miscarriage and the required number of contributions have not been properly remitted by the employer, or if the employer fails to notify the SSS, the employer will be required to pay damages to the SSS.  Such damages shall be equivalent to the benefits that the employee should have been entitled to.
  4. Separated / voluntary / self-employed members shall be paid directly by the SSS.
  5. A female member cannot claim for sickness benefit for a period of 60 days for normal delivery or miscarriage and 78 days for caesarean delivery.  No member can be entitled to two benefits for the same period.

The moment you have confirmed that you are pregnant, notify your employer right away.  If you are a voluntary member, file the necessary papers at the SSS immediately.  This will secure the validity of your claim, whether you carry the child to full term or suffer a miscarriage (anything can happen).  It also pays to create an online SSS account so you can monitor your and your employer’s monthly contribution.

We hope this article helps all new and future mothers!

Source: www.sss.gov.ph

Chips And Nibblers (1)

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10-18

My sister, a private school teacher, gave birth in January 21, 2016 to a healthy baby boy.  I am not sure if her case can be considered a premature delivery since she gave birth three weeks earlier than her scheduled due date.  Nonetheless, her delivery was uneventful and the baby came out healthy and strong.

Less than two months after she gave birth, my sister suffered from a severe case of skin asthma.  It got so bad that she was even prohibited by her doctor to carry or cuddle her baby.  She also had difficulty breathing at night and whenever she is exposed to smoke and dust.  She was confined in the hospital for five days until her rashes cleared out.

A few days after she was discharged from confinement, she filed her sickness benefit claims from the Social Security System (SSS).  Unfortunately, her claim was denied.  This was puzzling to us as she just recently received her maternity benefits from the SSS; she had no difficulty filing and claiming the proceeds.

We tried calling the SSS but no one seems to be able to give us a plausible answer.  I did my own research and these are my findings:

  1. A female SSS member who has successfully claimed her maternity benefits is no longer eligible to claim other types of benefits within a specified period:
    • A female who gave birth through normal delivery, or had a miscarriage, cannot file for sickness benefits claim within 60 days after childbirth or miscarriage.
    • A female who gave birth through caesarean section cannot file for sickness benefits claim within 78 days after childbirth.
  2. By law, an SSS member may only receive / claim one benefit at a given time.

My sister was able to claim her maternity benefits shortly after her baby turned one month old.  This was the reason why her claim for sickness benefits was denied by the SSS.

When we got hold of this information, my sister was able to clarify her concern better with the SSS.  She was then able to confirm that due to her maternity claim, she is not eligible for sickness benefits claims until after the 60-day prescription period.

Most SSS members may not be aware of this policy and it is best that claimants clarify minor details in their claims in order to avoid confusion later on.

Now you know.

Source:

http://www.facebook.com/SSSPh

https://www.sss.gov.ph/sss/appmanager/pages.jsp?page=sicknessapplication

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SSS Maternity Benefits Denied

Our article on the SSS Maternity Benefits Reimbursement gathered a lot of feedback and questions from women wanting to avail of the SSS maternity benefits.  A handful were asking why their claims were denied in spite of following the step-by-step process we posted.

We conducted further research on the reasons why some are not granted the expected maternity benefits and were able to gather the following.  Note that these were collected from various women’s personal experiences when applying for the said benefits from SSS.

a. Child’s birth certificate is not authenticated by the Local Civil Registrar or by the Philippine Statistics Authority PSA (formerly NSO).

You may order for a copy of your child’s birth certificate by calling (02) 737-1111 or order online at psahelpline.com.  You will receive an PSA-authenticated copy of your child’s birth certificate in 2 to 3 days.  You may also get a Certified True Copy of your child’s birth certificate from the LCR where your child’s birth was registered.  The birth certificate issued by the hospital alone will not be honored by the SSS.

b. The Signature on MAT1 is not the same as the signature appearing on MAT2.

This happens when the mother’s personal data in her SSS account is not duly updated; a common reason is that her civil status has not been updated from Single to Married.  Her maiden name is reflected in her MAT1 form while her MAT2 already shows her married name.

When changing your last name while you are processing your claim, wait until the change has taken effect before your submit your MAT2 claim.  You may check your SSS online account regularly to see if your last name has been updated already.

c. Member has paid contributions but employer has failed to remit or has not posted the payments yet.

For employed members, make sure to check that the six monthly contributions to be considered by SSS in computing the benefit are properly posted and reflected in your SSS account.

d. Coverage Status on record is not the same as Coverage Status on member’s claim.

It could be that in the MAT2 form, the member checked his status as VOLUNTARY while her status on her SSS account is employed.  Double-check all entries in your MAT2 form before submitting to the SSS.

e. Clarifications on the child’s Middle and Last Names

In cases when the mother’s last name (if she is married) is not the same as the middle name reflected on the child’s birth certificate or that the child’s last name is not the same as the father’s last name, you will need to submit an Affidavit to Explain Discrepancy in Names.

f. The MAT1 form was not submitted to the SSS prior to child’s birth.

It is important to report your pregnancy to the SSS at the earliest possible time.  If you fail to do so and you give birth before you are able to submit your MAT1 or notify SSS of your pregnancy, your claim may be denied.

If you failed to notify SSS of your pregnancy, attach a letter of explanation to your MAT1 form, along with the ultrasound reports or pregnancy test reports as supporting documents.  Take note that the decision to approve the claim entirely depends on the SSS officer evaluating your claim.

g. Member is not qualified / eligible for maternity benefits.

This happens when the member fails to pay her contributions for at least three of the 12 months before semester of delivery or semester of contingency.  Visit this site to see how the semester of delivery is determined.

h. The member gave birth by Caesarean Section but failed to submit an Operating Room record.

Secure a list of documentary requirements for SSS Maternity Benefits reimbursement before giving birth.  Make a checklist of the documents you already have on hand and those that will be collected from the hospital.  You can actually begin collecting the documents while you are waiting for your due date.

i. Member had a miscarriage and failed to submit the required Histopathology Report and Medical Certificate.

Similar with number 8, you need to make sure that your documentary requirements are complete when claiming for maternity benefits when you had a miscarriage.

j. If the member resigned from work within six months of date of delivery, she needs to submit the following documents when claiming for maternity benefits.  Failure to do so may result to disapproval of claim.

  • Certificate of Separation
    • Date of separation must be included.
  • Certificate of Non-Advancement of Maternity Benefit
    • This will prove that your employer did not give you any amount of maternity benefit.
  • L-501 Form
    • 2 copies of specimen signature card.

On the other hand, if the date of resignation and date of delivery has more than a 6-month gap but less than 1 year, you still need to prepare the said documents as there are officers who may still require these documents.

If you have recently confirmed that you are having a baby, make sure you are well-informed of everything you need to know about claiming your maternity benefits.  The secret is to have a checklist of the documentary requirements and constant communication with SSS to make sure that you are following the correct processes.

Remember Moms, Daig ng maagap ang masipag!

Source: http://sssphilippinesnotes.blogspot.com/2013/07/reasons-sss-maternity-benefit-denied.html

SSS Maternity.jpg

As a female SSS member, whether employed, self-employed, unemployed, or voluntary, you are entitled to Maternity Benefits. To help you in filing for your Maternity Benefit claim, here is a summary of procedures and requirements. These were lifted from the SSS website (www.sss.gov.ph) and other helpful websites; the links are provided at the bottom of the page:

  1. Notification Procedures:
    • For Employees:
      • As soon as a member has confirmed that she is pregnant, she needs to notify her employer.
      • Include in the notification the probable date of her childbirth which must be at least 60 days from the date of conception.
      • These information must be reflected on the SSS Maternity Notification Form; attach other supporting documents that will corroborate the pregnancy.
    • For Employers:
      • Upon receipt of employee’s Maternity Notification Form and other supporting documents, the employer must notify the SSS.
      • Submit the SSS Maternity Notification Form and other supporting documents submitted by the employee to SSS. This may be done over-the-counter at an SSS branch, or online through the SSS website.
      • To submit online, both employee and employer must be registered users of the SSS website.
    • For Unemployed, Self-employed, and Voluntary Members:
      • If your member category is any of the above, you must notify SSS directly.
    • If the employee fails to notify the employer, or the SSS, in the case of an unemployed, self-employed, or voluntarily paying member, the maternity benefit application may be denied.
  2. Application Requirements
    • For Notification
      • For Employees, Unemployed/Self-employed/Voluntary Members
        • Maternity Notification Form
        • UMID or SSS biometrics ID card or two (2) other valid IDs, both with signature and at least one (1) with photo and date of birth.
        • Proof of pregnancy (ultrasound report)
    • For Reimbursement
      • For Employed Members
        • Maternity Notification Form duly stamped and received by SSS
        • Maternity Reimbursement Form
        • UMID or SSS biometrics ID card or two (2) other valid IDs, both with signature and at least one (1) with photo and date of birth.
        • As an additional means to ensure that the member will receive the said benefits, the company’s representative who will be filing the claim must present the member’s SSS digitized ID or the E-6 acknowledgement stub with two valid IDs (at least one with photo). This is in addition to the presentation by the company representative’s own SSS digitized ID and blue card.
      • For Separated Members
        • Maternity Reimbursement Form
        • Certification from last employer showing the effective date of separation from employment or notice of company’s closure/strike or certification from the Department of Labor and Employment that the employee or employer has a pending labor case.
        • Certification that no advance payment was granted (if confinement days applied for are within or prior to separation).
        • UMID or SSS biometrics ID card or two (2) other valid IDs, both with signature and at least one (1) with photo and date of birth.
    • Additional Requirements
      • Normal delivery – certified true or authenticated copy of duly registered birth certificate. In case the child dies or is a stillborn, duly registered death or fetal death certificate.
      • Caesarean delivery – certified or authenticated copy of duly registered birth certificate and certified true copy of operating room record/surgical memorandum.
      • Miscarriage or abortion – obstetrical history stating the number of pregnancy certified by the attending physician an dilatation and curettage (D&C) report for incomplete abortion, pregnancy test before and after abortion with age of gestation and histopath report for complete abortion.
  3. Filing Procedure

Claims may be filed at the nearest SSS office; however, processing will be done at the branch where the employer and employee records are based.

For your reference, here are copies of the SSS Forms: Maternity Notification and SSSForms_Maternity_Reimbursement.

Sources:

https://www.sss.gov.ph/sss/appmanager/pages.jsp?page=maternityapplication

https://www.sss.gov.ph/sss/appmanager/pages.jsp?page=maternitycomputation

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