Social Legislation 1st exam | Windows User

SSS (RA 8282) GSIS (RA 8291)

“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
orders as regards the employment, except the
Government and any of its political subdivisions,
branches or instrumentalities, including corporations
owned or controlled by the Government: Provided,
That a self-employed person shall be both employee
and employer at the same time.
“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.
“Dependents” The dependents shall be the following:
"(1) The legal spouse entitled by law to receive
support from the member;
"(2) The legitimate, legitimated or legally adopted,
and illegitimate child who is unmarried, not gainfully
employed, and has not reached twenty-one (21)
years of age, or if over twenty-one (21) years of age,
he is congenitally or while still a minor has been
permanently incapacitated and incapable of self-
support, physically or mentally; and
"(3) The parent who is receiving regular support from
the member.
“Compensation” All actual remuneration for employment, including
the mandated cost-of-living allowance, as well as the
cash value of any remuneration paid in any medium
other than cash except that part of the remuneration
in excess of the maximum salary credit as Provided
under Section Eighteen of this Act.
Beneficiaries Primary beneficiaries
1. The dependent spouse until he or she
remarries,
2. the dependent legitimate, legitimated or
legally adopted, and illegitimate children,
Provided, That the dependent illegitimate
children shall be entitled to fifty percent
(50%) of the share of the legitimate,
legitimated or legally adopted children:
Provided, further, That in the absence of the
dependent legitimate, legitimated children
of the member, his/her dependent
illegitimate children shall be entitled to one
hundred percent (100%) of the benefits.
The national government, its political subdivisions,
branches, agencies or instrumentalities, including
government-owned or controlled corporations, and
financial institutions with original charters, the
constitutional commissions and the judiciary.
Any person receiving compensation while in the
service of an employer as defined herein, whether
by election or appointment, irrespective of status
of appointment, including barangay and
Sanggunian officials;
Dependents shall be the following: (a) the
legitimate spouse dependent for support upon the
member or pensioner;
(b) the legitimate, legitimated, legally adopted
child, including the illegitimate child, who is
unmarried, not gainfully employed, not over the
age of majority, or is over the age of majority but
incapacitated and incapable of self-support due to
a mental or physical defect acquired prior to age of
majority; and
(c) the parents dependent upon the member for
support;
The basic pay or salary received by an employee,
pursuant to his election/appointment, excluding
per diems, bonuses, overtime pay, honoraria,
allowances and any other emoluments received in
addition to the basic pay which are not integrated
into the basic pay under existing laws;
Primary beneficiaries- The legal dependent spouse
until he/she remarries and the dependent children;
Secondary beneficiaries- The dependent parents
and, subject to the restrictions on dependentq
children, the legitimate descendants;

Secondary Beneficiaries
1. the dependent parents of the member.
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In the absence of all the foregoing, any other person

designated by the member as his/her secondary
beneficiary.
1q Compulsory: Membership in the GSIS shall be compulsory for all
a. upon all employees not over sixty (60) years employees receiving compensation who have not
of age and their employers reached the compulsory retirement age (65),
b. household helpers with at least 1,000 irrespective of employment status,
monthly pay
c. Self- employed including but not limited to
the following:

1. All self-employed professionals;

"2. Partners and single proprietors of

businesses;

"3. Actors and actresses, directors,

scriptwriters and news correspondents who
do not fall within the definition of the term
"employee”

"4. Professional athletes, coaches, trainers

and jockeys; and

"5. Individual farmers and fishermen.

Voluntary:
a. Spouses who devote full time to managing
the household and family affairs, unless they
are also engaged in other vocation or
employment which is subject to mandatory
coverage, may be covered by the SSS on a
voluntary basis.
b. Filipinos recruited by foreign-based
employers for employment abroad.
c. Employees already separated from
employment or those self-employed with no
realized income for a given month, who
chose to continue with contributions to
maintain right to full benefit.

Exclusion from a. Employment purely casual and not for the a. members of the Armed Forces of the
Coverage purpose of occupation or business of the Philippines and the Philippine
employer National Police,
b. contractuals who have no employer
b. Service performed on or in connection with and employee relationship with the
an alien vessel by an employee if he is agencies they serve.
employed when such vessel is outside Ph c. members of the judiciary and
constitutional commissions who shall
c. Service performed in the employ of the have life insurance only.
Philippine Government or instrumentality or
agency thereof;

d. Service performed in the employ of a foreign

government or international organization, or
 Social Legislation 1st exam | Windows User

their wholly-owned instrumentality:

Provided, however, That 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:
Provided, further, That the terms of such
agreement shall conform with the provisions
of this Act on coverage and amount of
payment of contributions and benefits:
Provided, finally, That the provisions of this
Act shall be supplementary to any such
agreement; and

e. Such other services performed by temporary

and other employees which may be
excluded by regulation of the Commission.
Employees of bona fide independent
contractors shall not be deemed employees
of the employer engaging the service of said
contractors.
Effective date of Employer: 1st day of operation
coverage Employee: 1st day at work
Self-employed: Upon registration
Effect of When an employee under compulsory coverage is A member separated from the service shall
Separation from separated from employment, his employer's continue to be a member, and shall be entitled to
Employment/Servi contribution on his account and his obligation to pay whatever benefits he has qualified to in the event
ce contributions arising from that employment shall of any contingency compensable under this Act.
cease at the end of the month of separation, but said
employee shall be credited with all contributions paid
on his behalf and entitled to benefits according to the
provisions of this Act. He may, however, continue to
pay the total contributions to maintain his right to
full benefit.
Dispute SSC CA [Rule 43; question of law and fact] SC GSIS CA[Rule 43]SC [Rule 45]; appeal does not
Settlement [Rule 45; question of law only] stay execution
Prescriptive period 20 yrs 4 yrs

BENEFITS
MONTHLY Shall be the highest of the following amounts: The amount shall be:
PENSION
1. 300 + [20% x [Ave monthly salary credit]] + a. 37.5% x [revalued ave. monthly compensation],
[2% x [Ave monthly salary credit ] x [# of plus
cash credited years of service in excess of 10 b. 2.5 x [revalued ave. monthly compensation] x
years]]or [years in service in excess of 15 years]

2. 40% x (ave monthly salary credit)or
3. 1,000; provided, that the monthly pension
shall in no case be paid for an aggregate
amount of less than sixty (60) months.
The monthly pension shall not exceed 90% of the
average monthly compensation.
It shall not be less than P2,400 for those with 20
years of service and not less than P1,300 for
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everyone else.
Note: Notwithstanding the abovementioned, the
minimum pension shall be 1,200 for members with at
least 10 credited years of service and 2,400 for those
with 20 credited years of service.

Dependents' Pension. - Where monthly pension is

payable on account of death, permanent total
disability or retirement, dependents' pension
equivalent to: 10% of the monthly pension or P250,
whichever is higher, shall also be paid for each
dependent child conceived on or before the date of
the contingency but not exceeding five (5), beginning
with the youngest and without substitution:
Provided, That where there are legitimate or
illegitimate children, the former shall be preferred.
RETIREMENT Eligibility requirements:
BENEFITS 1. 120 monthly contributions;
2. Age: 65 years old OR a member who has
reached 60 years may also avail if he is
already separated from employment or has
ceased to be self-employed.
Benefit- entitlement to monthly pension from
retirement until death.
The monthly pension shall be suspended upon the
reemployment or resumption of self-employment of
a retired member who is less than 65 years old.
In case of death of member
1. Primary beneficiaries (PB) as of the date of
retirement shall be entitled to receive the
monthly pension; OR
2. If no PB and died within 60 months from the
start of pension, Secondary Beneficiaries
(SB) shall be entitled to a lump sum benefit
equivalent to the total monthly pensions
corresponding to the balance of the 5 year
guaranteed period, excluding the
dependent’s pension.
Eligibility requirements:
1. 15 years service
2. 60 years of age; and
3. Not receiving pension benefit from
permanent total disability.
Note: Retirement is compulsory for employees 65
years of age who have rendered at least 15 years of
service; if employee has less than 15 years of
service, he may be allowed to continue in
accordance with Civil Service laws.
Benefit- Choice between:
a. 60 x [basic monthly pension] lump sum
payment at the time of retirement PLUS
basic monthly pension payable monthly
for life after expiry of the 5-yr guaranteed
period which is already covered by the
lump sum; OR
b. Cash payment equivalent to 18 x [basic
monthly pension] PLUS monthly pension
for life immediately but with no 5-yr
guarantee.
Note: subject to periodic adjustment

Lump Sum Alternative- Member may opt to receive

his first 18 monthly pensions in lump sum BUT such is
discounted at a preferential rate of interest

*A member who is sixty (60) years old at retirement

and who does not qualify for pension benefits under
paragraph (a) above, shall be entitled to a lump sum
benefit equal to the total contributions paid by him
and on his behalf: Provided, That he is separated
from employment and is not continuing payment of
contributions to the SSS on his own.
PERMANENT Eligibility requirement: Eligibility requirement:
DISABILITY  Member who has paid at least 36 monthly  A member who suffers permanent
BENEFITS contributions PRIOR to the semester of disability for reasons not due to his grave

disability shall be entitled to the monthly
pension.
 In case the member dies, it would be given
the same treatment as a retiree dying.
 For PERMANENT PARTIAL DISABILITY, the
pension is not lifetime. Also, the monthly
pension benefit shall be given in lump sum if
it is payable for less than 12 months.
 For MULTIPLE PARTIAL DISABILITIES, they
shall be additive when related or
deteriorating-the percentage shall be equal
to the number of months the partial
disability is entitled to, divided by 75
months. (e.g. loss of sight in 1 eye> 25/75;
loss of arm> 50/75; if both occur due to
same cause, then 25/75 + 50/75= 100% so
treated as if it were permanent total
disability.
Lump Sum Alternative- monthly pension X the
number of monthly contributions paid to the SSS OR
12x monthly pension, whichever is higher. (for
members who have not paid at least 36 monthly
contributions)
Note: A member who 1. Has received a lump sum
benefit; and 2. Is reemployed not earlier than one
year from date of disability shall again be subject to
compulsory coverage and shall be considered a new
member.
The following disabilities shall be deemed
permanent total:
"1. Complete loss of sight of both eyes;
"2. Loss of two limbs at or above the ankle or wrists;
"3. Permanent complete paralysis of two limbs;
"4. Brain injury resulting to incurable imbecility or
insanity; and
"5. Such cases as determined and approved by the
SSS.
Permanent Partial Cases
Complete and permanent Number of
loss of use of Months
One thumb 10
One index finger 8 "(2) such other cases as my be determined by the
One middle finger 6 GSIS
One right finger 5
Social Legislation 1st exam | Windows User
misconduct, notorious negligence,
habitual intoxication, or willful intention to
kill himself or another, shall be entitled to
the benefits provided
Employee is:
1. In service at the time of disability; or
2. Even if separated, he has paid at least 36
monthly contributions within the 5year
period immediately prior to disability OR
has paid a total of at least 180 monthly
contributions prior to disability; and
3. Member is not enjoying old-age
retirement benefit.
Benefit for Permanent Total Disability
 Monthly income benefit for life equal to
basic monthly pension- This is effective
from date of disability;
 If member is in service at the time of
disability and he has paid at least 180
monthly contributions, in addition to the
monthly income benefit, he shall receive
an additional cash payment of 18 times
basic monthly pension.
To the ineligible- If member has rendered at least 3
years of service, then he shall receive cash payment
equal to 100% of ave. monthly compensation for
each year of service [essentially total amount of
contributions made] or 12,000, whichever is higher.
Permanent Partial Disability
He shall receive a cash payment in accordance with
a scheduled of disabilities to be prescribed by the
GSIS provided that he also satisfies the conditions
above.
Permanent total cases- same sa SSS
Permanent Partial cases:
(1) complete and permanent loss of the use of:
(i) any finger
(ii) any toe
(iii) one arm
(iv) one hand
(v) one foot
(vi) one leg
(vii) one or both ears
(viii) hearing of one or both ears
(ix) sight of both eyes
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One little finger 3

One big toe 6
One hand 39
One arm 50
One foot 31
One leg 46
One ear 10
Both ears 20
Hearing of one ear 10
Hearing of both ears 50
Sight of one eye 25

TEMPORARY Similar to sickness

DISABILITY
BENEFITS
SICKNESS BENEFIT Eligibility requirements and other conditions:
1. Inability to work due to sickness or injury
2. Confined for at least 4 days either in a
hospital or elsewhere with SSS approval;
3. At least 3 months of contributions in the
12month period immediately before the
semester of sickness or injury has been paid;
4. All company sick leaves with pay for the
current year have been used up;
5. Maximum of 120 days per 1 calendar
year[maximum permissible for the same
sickness confinements is 240 days for 2
consecutive years]
6. Employer has been notified, or, if separated,
voluntary or self-employed member, the SSS
directly notified within 5 days of
confinement;
7. Notice to employer or SSS not needed when
confinement is in a hospital; notice to
employer not required as well when
employee became sick or injured while
working or within premises of thee
employer.
Eligibility requirements
1. Employee must be:
 In service at the time of disability;
or
 If separated, he has rendered at
least 3 years of service and paid
at least 6 monthly contributions
in the 12 month period
immediately prior to disability;
2. All sick leave credits including CBA sick
leaves for the current year has been used
up; and
3. Maximum of 120 days per 1 calendar year[
so maximum permissible for the same
sickness confinements is 240 days for 2
consecutive years]
Benefit- 75% of the current daily compensation for
everyday or fraction thereof of disability or P70,
whichever is higher.

Benefit- daily cash allowance paid for the number of

days a member is unable to workdue to sickness or
injury equivalent to 90% x [ave daily salary credit]

Note: 100% of the daily benefits provided shall be

reimbursed by the SSS to said employer upon receipt
of satisfactory proof of such payment and legality
thereof if the ff conditions are met:
1. Er notified SSS of the confinement within 5
calendar days after receipt of the
notification from the Ee
2. If notification is made beyond 5 days, he
shall be reimbursed only for each day of
 Social Legislation 1st exam | Windows User

confinement starting from the tenth

calendar day immediately preceding the
date of notification to the SSS
3. SSS shall reimburse the employer or pay the
unemployed member only for confinement
within the 1-year period immediately
preceding the date the claim for benefit or
reimbursement is received by the SSS,
except confinement in a hospital in which
case the claim for benefit or reimbursement
must be filed within 1 year from the last day
of confinement.
DEATH BENEFITS Eligibility requirement When member dies, the primary beneficiaries are
36 monthly contributions prior to the semester of entitled to ONLY ONE of the ff:
death 1. Survivorship pension
a. If he was in the service when he died;
Benefit- monthly pension to PB; OR a lump sum or
benefit equivalent to 36 x the monthly pension to SB. b. Even if separated from the service, he
has at least 3 years of service and has
To those ineligible- lump sum benefit which shall be paid 36 monthly contributions within
higher between the two: the 5 years immediately preceding
 Monthly pension x 12; OR death; or
 Monthly pension x # of monthly c. Even if separated from the service, he
contributions has paid 180 monthly contributions
prior to death.

2. Survivorship pension plus cash payment of

100% ave. monthly compensation for
every year of service [essentially, pension
plus total contributions made]
a. If he was in the service when he died;
and
b. With 3 yrs of service

3. Cash payment equivalent to 100% ave

monthly compensation for each year of
service he paid contributions or 12,000,
whichever is higher
a. With 3 yrs of service; and
b. He has failed to qualify in the prior 2
schemes.
FUNERAL 12,000 in cash or in kind, to help defray the cost of The amount of funeral benefits shall be determined
BENEFITS funeral expenses upon the death of a member, and specified by GSIS but shall not be less than
including a permanenetly totally disabled member or 12,000: provided, that it shall be increased to at
retiree. least 18,000 after 5 years and shall be paid upon
the death of:
a. An active member;
b. Member separated from service but still
entitled to funeral benefit;
c. Pensioner
d. Retiree who at the time of retirement was
of pensionable age but opted to retire
under RA 1616
MATERNITY LEAVE Eligibility requirements:
BENEFITS 1. A female member
2. Paid at least 3 monthly contributions in the
 Social Legislation 1st exam | Windows User

12th month period immediately preceding

the semester of her childbirth or
miscarriage-

Shall be paid a daily maternity benefit

equivalent to 100% of her ave. daily salary
credit for 60 days or 78 days in case of
caesarian delivery, subject to the following
conditions:

(a)Ee shall have NOTIFIED her Er of her

pregnancy and the probable date of her
childbirth, which notice shall be
transmitted to the SSS;

"(b) The FULL PAYMENT shall be

advanced by the employer within thirty
(30) days from the filing of the
maternity leave application;

"(c) That payment of daily maternity

benefits shall be a BAR to the recovery
of sickness benefits for the same period;

"(d) shall be paid only for the first four

(4) deliveries or miscarriages;

"(e) That the SSS shall immediately

reimburse the employer of 100% of the
amount of maternity benefits advanced
to the employee by the employer upon
receipt of satisfactory proof of such
payment and legality thereof; and

"(f) That if an employee member should

give birth or suffer miscarriage without
the required contributions having been
remitted for her by her employer to the
SSS, or without the latter having been
previously notified by the employer of
the time of the pregnancy, the
employer shall pay to the SSS damages
equivalent to the benefits which said
employee member would otherwise
have been entitled to.
LOAN SSC Resolution No. 669. Moreover, certain circulars GSIS website provides for this
provide for treatment of salary loans and more
flexible payment terms or condonation for
delinquent payers. SSS website also shows loans.
SEPARATION Eligibility requirement:
BENEFITS 1. 60 years of age, or separated from service
with at least 3 years but not over 15 years
served;
2. Below 60 yrs of age, but at least 15 yrs of
service rendered.
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Benefit
1. For 60 years of age or separated from
service with 3-15 years of service: cash
payment of 100% of ave. monthly
compensation for each year of service
[essentially, total amount of
contributions], or 12,000, whichever is
higher
2. Below 60 yrs of age and at least 15 yrs of
service: cash payment equivalent to 18x
monthly pension at the time of resignation
or separation plus an old-age pension
benefit equal to basic monthly pension.
UNEMPLOYMENT Eligibility requirements
BENEFITS 1. Employee separated from service due to
abolition of office or position; and
2. Employee has been paying integrated
contributions for at least 1 year prior to
separation.

Benefit
Monthly cash payments of 50% of ave. monthly
compensation for a duration which is proportional
to years rendered, ranging from 2 months to 6
months.
SURVIVIORSHIP Beneficiaries are entitled to the ff:
BENEFITS 1. Basic survivorship pension which is 50% of
basic monthly pension; and
2. Dependent children’s pension not
exceeding 50% of the basic monthly
pension.
LIFE INSURANCE COMPULSORY LIFE INSURANCE
BENEFITS All employees except for members of the AFP and
PNP. It shall automatically take effect as follows:
1. For those employed after the effectivity of
this act, their insurance shall take effect on
the date of their employment;
2. for those whose insurance will mature
after the effectivity of this Act, their
insurance shall be deemed renewed on
the day following the maturity or expiry
date of their insurance;
3. for those without any life insurance as of
the effectivity of this Act, their insurance
shall take effect following said effectivity.

DIVIDENDS
An annual dividend may be granted to all members
of the GSIS whose life insurance is in force for at
least 1 yr in accordance with a dividends allocation
formula to be determined by the GSIS.

OPTIONAL INSURANCE
a member may apply for insurance and/or pre-
need coverage embracing life, health,
hospitalization, education, memorial plans, and
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such other plans as may be designed by the GSIS,

for himself and/or his dependents. Any employer
may likewise apply for group insurance coverage
for its employees. The payment of the
premiums/installments for optional insurance and
pre-need products may be made by the insured or
his employer and/or any person acceptable to the
GSIS.

REINSURANCE
GSIS may reinsure any of its interests or part
thereof with any private company or reinsurer
whether domestic of foreign: Provided, That the
GSIS shall submit an annual report on its
reinsurance operations to the Insurance
Commission.

Note: Judiciary and Constitutional Commissions are

entitled to life insurance only.