Claiming Your SSS and Philhealth Benefits: A Right and A Responsibility

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

How to Compute Your SSS Pension

As paying members of the Social Security System (SSS), we are all looking forward to that day when we can just sit back, relax, and wait for our monthly pension to arrive.  We count the years until we are prepared to retire from our jobs and finally be able to take that much needed vacation, spend quality time with our children, and no longer be bothered by “work”.  We look forward to that day when we can finally ask ourselves, “What do I do with all these free time on my hands?”

But the question we should all be asking at this point is, how much must I expect as monthly pension from the SSS and will that be enough to sustain my needs as I approach my senior years?

To help you determine your monthly pension, here is a guide lifted from the SSS website and a recent article from the Manila Bulletin.

WHAT IS YOUR SSS COVERAGE?

Are you under the Compulsory or Voluntary program of the SSS?

The Compulsory program covers employers and their employees, as well as self-employed individuals.  Their contributions are automatically deducted from their monthly salaries and remitted by their employers to SSS.

Voluntary members are OFWs, non-working spouses of SSS members, and members who have separated (resigned) from their jobs.  They pay their monthly contributions “voluntarily” by going to SSS offices or accredited payment centers.

Apart from the two programs, SSS also encourages its members to establish a separate savings account under the SSS Personal Equity and Savings Option (PESO) to add to their retirement funds.  This is a tax-free investment fund that can earn income based on interest rates of five-year Treasury yields.  At a minimum amount of Php 1,000 per month, a qualified SSS member is able to basically double his SSS savings.

HOW DO YOU COMPUTE FOR YOUR RETIREMENT PENSION?

A member’s pension is determined based on the number of credited years of service (CYS) and the number of dependent minor children.

There are three formulae that the SSS uses to compute for a member’s pension; the monthly pension will be the highest amount resulting from any of the three formulae.

1. The sum of = Php 300.00 + 20% of the Average Monthly Salary Credit (AMSC) + 2% of the AMSC for each Credited Year of Service (CYS) in excess of 10 years, OR
2. 40 % of the AMSC, OR
3. Php 1,200.00 if the CYS is at least 10 but less than 20.
4. Php 2,400 if the CYS is 20 or more.

Note: The AMSC is determined by the SSS based on your monthly compensation.  Salaries from Php 15,750 and above are assigned an AMSC of 16,000.

Example:

Using formula number 1, here is a sample computation for an individual who:

1. Is earning Php 30,000.00 monthly
2. Has worked and contributed to the SSS for 40 years

Monthly Pension (MP) = P300 + (20% of AMSC) + (2% of AMSC x 30 years (40 years – 10))

MP = Php 300.00 + (20% x 16,000.00) + (2% x 16,000 x 30 years)

MP = Php 300 + 3,200 + 9,600

MP = Php 13,100.00

ARE YOU QUALIFIED YET?

There are two ways to determine if you are qualified for SSS retirement benefits:

a. You are 60 years old and are no longer working or have ceased to be self-employed.  You have made at least 120 monthly contributions before the semester of retirement.

b. You are 65 years old – may be employed or not – and have made at least 120 monthly contributions before the semester of retirement.

HOW TO CLAIM YOUR SSS MONEY

There are also two ways to receive your retirement benefits:

a. Lifetime monthly pension – receive your pension monthly through the bank that you pick as your designated bank.

b. Lump sum – receive the first 18 months of your pension at a discounted rate determined by the SSS.  Your monthly pension will begin on the 19^th month.

WHAT ARE THE DOCUMENTS YOU NEED TO PREPARE?

Be ready with the following IDs and documents when filing for your retirement benefits:

1. Retirement claim application form (SSS Form DDR – 1);
2. DDR Saving Account form;
3. Certificate of Separation from last employer (for members less than 65 years old);
4. Passbook (if pension);
5. Certified true copies of birth or baptismal certificate of dependent children;
6. Certificate of cessation of business or practice of profession (for self-employed less than 65 years old);
7. Certified true copy of marriage certificate (if with dependent children);
8. Proofs of filiation for illegitimate dependent children; and
9. SSS digitized or E-6 (acknowledgment stub) with two valid IDs, one of which has a recent photo.

For a more thorough and accurate computation of your retirement benefit, visit the nearest SSS branch.

Source:

http://www.mb.com.ph/how-much-will-you-get-from-the-sss-when-you-retire/

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

Effects of Non-Reporting of SSS Remittances

A person’s SSS membership must be kept active at all times.  Keeping your information, contributions, and loan payments (if you have any) updated help you avoid inconveniences when claiming for your benefits later on.

But what if a member (whether employed or voluntary) or his employer fails to update the SSS contributions and payments?  What are the effects of non-reporting and non-remittance of contributions to the SSS?  Let us find out.

For Employed Members

The employees’ entitlement to his SSS benefits shall remain in spite of his employer’s failure to remit the necessary SSS contributions.

For Self-employed and Voluntary Members

It is important for self-employed individuals to know that they need to be registered members of the SSS, otherwise, they may be subjected to fines.  Voluntary and self-employed members may pay their monthly contributions on time or in advance, but not retroactively.  Meaning, if a member missed a contribution for a particular month, he cannot double his payment for the following month to cover for the month he missed.  The previous month will remain unpaid while his succeeding payments are credited to his SSS account.

For Non-working Spouses who gains employment later on (or declares himself to be self-employed or an OFW), his membership shall be re-classified but he will not be issued a new SSS number.  A member cannot have more than one SSS number; his membership may only be re-classified depending on the updates on his employment status.

For Employers

An employer is considered in violation of SSS laws if he fails to report temporary or provisional employees under his payroll.  In case he fails to remit the corresponding SSS contributions of his employees, he may be punishable by fine and / or imprisonment.  The employer is responsible to deliver the following in favor of the employee, even if he failed to remit the employee’s SSS contributions:

a. Pay the benefits of those who die, become disabled, get sick, or reach retirement age;

b. Pay all unpaid contributions plus a penalty of 3% per month.

As paying SSS members, we can regularly check the progress of our contributions and loan payments online.  You may create your online SSS account at www.sss.gov.ph

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