q
HEWSPECS-PIDS Baseline
could Norte,
avail 10%
Stud_, on private
of cash percent
contribution availed of.
for In
loan up of the
Health
]nsurance
to PI,000.00 net income
which cash loans Misamis Oriental,
, Page Z6
per from
ranging members
illness. IGP was from of
diocesan organization paid a monthly contribution in exchange for which their children below supplemental food if they became malnourished. p_eventive health services such as out-patient
Similarly, set aside
P200 - P300 a mothers' 5
in Surigao as health
per illness association
of P5 and PI0.00, years of age They were also consultation.
del fund
may and
be a
respectively may be given provided with In another
community-based scheme, the employer agreed to pay P5.00 per month per factory worker while the employees paid P5.00 per month through salary deduction to cover their dependents. The premium is remitted monthly to the affiliated nongovernment organization which rendered preventive health services plus limited outpatient medical and dental care. Should any enrollee avail of outpatient medical/dental services, a corresponding cost is deducted from the employer's premium failure
dues for the month. The deductions were treated as penalties of the preventive health measures which was the main program of
for the the NGO.
Most organizations conditions mentioned
companies with employer-provided health plans and community-based with health insurance did not have explicit policiesregarding the that were excluded from benefit-coverage. Most of them, however, that conditions arising from substance abuse and suicide were
definitely
not
covered
excluded suicide help himself.
2.
by
since
Profile
All of the of their members firms/organizations enrollees by the or organizations
their
such
of
health
condition
Insured
plans.
One
implied
that
community-based the
By the end of 1991, enrollees, 70 per cent of _hould be pointed out,
nine commercial indemnity firms whom were enrollees of two foreign however, that not all of the
_91,
Nine Of
the the
covered only as
by an
enrollees individual
in
a health optional who opted policies.
sample HMOs had the said total,
@_ two.investor-based _ยง_ctive branch
willing
to
sample companies/organizations had no ready data on the profile and had to process them for this study. Thirty-four (34) sample were able to give data on the total number of their members/ end of 1991. The details are shown in Table 4. Fifteen firms could not give any data on the total number of their members. firm
d@termine _0vlewlng
not
Members/Enrollees
One commercial indemnity of them to date.
necessarily Qffered this
organization
personwas
HMOs offices,
Bohol
plan rider. for
offered
health
plans
but
a total of 133,900 about 43 per cent
rider
health
one
availed
altogether had 8,669 non-life firms. It said enrollees were
since most commercial It was difficult for the
no
plan
indemnity firms several firms to since
it
entailed
enrollees in the fourth quarter of were members of the three branches
in NCR, Cebu and the NCR branches
Misamis Oriental. Among of both investor-based
their HMOs
E_ยง_@red the most number of enrollees, followed by the Cebu branch office. _._While, the hospital-basedand employer-initiated HMOs had 26,000 and ii,000 QmJ, respectively, all over the country. The company did not have a ยง_Own of their enrollees by region or province. Being an area-based __ve, the community-based HMO had the least number of coverage with 865 _@@S in the fourth quarter of 1991