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Agra 2CONVERTED PDF RA 8787 AND OTHERS PDF
Agra 2CONVERTED PDF RA 8787 AND OTHERS PDF
Agra 2CONVERTED PDF RA 8787 AND OTHERS PDF
WINTER
ANTI – SEXUAL HARASSMENT
Template
ACT OF 1995
-having-
- Demands
- Requests
EDUCATION/TRAINING
or
rejected
06
WINTER
If rejected, the effects are:
TemplateTRAINING
EDUCATION/
H – Hostile
O – Offensive
I - Intimidating
08
WINTER
DOMINGO VS. RAYALA
G.R. No.Template
155831; 155840
7. Others
NATURE OF SSS LAW
12
WINTER
POLICE POWER Template
MEASURE
....It does not violate the separation of
church and State, non – impairment
clause. The State can compel workers to
part with a portion of their income earned
during their productive years to cover
future contingencies...
NATURE OF SSS funds
13
PRIVATE FUNDS
HELD IN TRUST.
....They are private funds held in trust for its
members. The Church cannot justify non-
reporting and non – payment of contributions
with the use of the Constitutional prohibition
against the use public funds for religion...
MECHANICS FOR
BENEFITS
MECHANICS OF BENEFITS
15
1.Both covered employer and covered
employee contribute to the fund;
benefits
a. Sickness benefit 23
SB = ADS X 90% X No. of Days
Where:
SB - Sickness Benefit
ADS - Average Daily Salary
Number of Days - Number of days
member cannot work due to
sickness or injury
Period of entitlement 24
Period is 120 days
Maternity benefits
Maternity benefits 28
Maternity Benefits = ADS X 100% X (60/78 DAYS)
DISABILITY benefits
DISABILITY BENEFITS 32
Disability Benefits = lump sum
amount or monthy pension
CONDITIONS FOR ENTITLEMENT:
1. 1 monthly contribution;
DEATH benefits
DEATH BENEFITS 35
The death of an SSS member who
has paid at least 36 monthly
contributions entitles his primary
beneficiaries to a monthly pension.
retirement benefits
38
QUESTION
GAMOGAMO vs PNOC
NOTE:
R - Retiree – members
I - Individually – paying members
P - Privately-sponsored members;
E - Enrolled indigents
REPUBLIC ACT NO. 7875 54
If COVERED, they are entitled to: (HOI ETO)
H - Health Education Packages
O - Out – patient care
I - In – patient hospital care
E - Emergency Services
T - Transfer Services; and
0 - Other Health care services
REPUBLIC ACT NO. 7875 55
PHILHEALTH is not answerable for: (CosCosAlcoNon5thOpto)
Cos - Cosmetic surgery
Cos - Cost – inefficient procedures
Alco - Alcohol abuse
Non - Non-prescriptive drug and devices
5th - 5th & subsequent normal
obstetrical deliver ; and
Opto - Optometric Services
REPUBLIC ACT NO. 7875 56
ENTITLEMENT is conditioned on:
a. Payment of 3 monthly contribution except:
i) R - Retired SSS and GSIS members
(ii) E - Enrolled indigents
(iii) M - Members of PHILHEALTH who
are retired
b. Proof of regularity of payments; and
c. Non – liability under Section 44, RA 7875
57
SECTION 44, RA 7875 –
PENAL PROVISIONS
REPUBLIC ACT NO. 7875 58
MODE OF PAYMENT for PHILHEALTH services are:
(O Cap FEE)
a. Capitation
b. Fee for services; or
c. Other modes
REPUBLIC ACT NO. 7875 59
CAPITATION...
A payment mechanism where a fixed rate, whether per
person, family, household, or group, is negotiated with a health
care provider who shall be responsible for delivering or
arranging for the delivery of health care services required by
the covered person under the conditions of a health care
provider contract.
REPUBLIC ACT NO. 7875 60
FEE FOR SERVICES...
S - Social solidarity
U - Universality
R - Responsiveness
E - Equity
REPUBLIC ACT NO. 7875 62
PHILHEALTH PRINCIPLES ARE:
(SURE DIE IF)
D - Devolution
I - Informed choice
E - Effectiveness
REPUBLIC ACT NO. 7875 63
PHILHEALTH PRINCIPLES ARE:
(SURE DIE IF)
I - Innovation
F - Fiduciary Responsibility
81
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