Name: Annieska Maceda Alde

Congratulations! In line with your successful application as CSR Position in Carelon Global Solutions, we are happy to
inform you that we are pushing forward with the Pre‐Hire Stage of the process.

CHECKLIST OF PRE‐EMPLOYMENT REQUIREMENTS

Statutory Numbers
Please submit the following within 3 days after the Job offer: .

□ Photocopy of any proof of your SSS Number

 SSS ID
 SSS E1 New Member Form
 SSS E4 Member Data Change Request (If applicable)

□ Photocopy of any proof of your TIN Number

 TIN ID
 BIR Form 1905
 BIR Form 2316
 BIR Form 1902

□ Photocopy of any proof of your Philhealth Number

 Member Data Record

□ Photocopy of any proof of your PAG‐IBIG Number

 Member Data Form
 Pagibig loan statement with contributions

□ NBI Clearance or proof of request

Other Documents needed:

□ Professional Regulatory Commission (PRC) License and/or USRN License (If applicable)

□ Stamped BIR Form 1905

□ Updated BIR Form 2316 (Previous Employment within the year)

□ Existing Government Loans

 Latest SSS Statement of Account
 Latest PAGIBIG Statement of Account

□ Educational Requirement
  CHED Certified Transcript of Records
 College Diploma
 Any proof of Highest Educational Attainment

□ Work History Requirement

 Certificate of Employment
 Employee Clearance
 Signed Resignation Letter – should be acknowledged by TL or HR (If COE and Clearance are not yet available)
 Notarized Affidavit of Undertaking

Maxicare Requirements
□ Photocopy of PSA Birth Certificate

□ Photocopy of PSA Birth Certificate of Dependent(s)

□ Photocopy of PSA Marriage Certificate (If applicable)

BDO – Payroll Requirements
□ Please fill out the online BAO Form
 ✓ Manila - https://forms.office.com/r/H73Cg56AbG
 ILOILO - https://forms.office.com/r/1PsTJCRn2b
□ Once the online forms has been filled out, kindly submit the hard copies of your BDO Application form to the nearest
branch for Manila and to One Fintech Office for Iloilo.

Background Check ✓
Please complete the online application form and Data Privacy and Consent Form within 3 days after the job offer:

Manila - https://forms.office.com/r/tmPvisra69

Iloilo - https://forms.office.com/r/D0KdZtft5w

Medical Exam

□ This should be completed within 3 days upon receipt of Medical Referral Slip. (LOA)

□ Physical exam will only be taken at accredited clinics.

□ Please use this link to get the information of the candidate for us to be able request for their LOA -
https://forms.office.com/r/8gn3egyLAB

Please make sure to submit and accomplish your pre‐employment requirements on or before the deadline. Failure to
submit on time will cause forfeiture of your employment at Carelon Global Solutions Philippines.

Kindly be advised that failure to comply with the BDO process before the deadline will also cause a delay in your payroll as
this is part of the pre‐employment requirements.

Please also ensure that your declared statutory numbers (SSS, Philhealth, Pagibig, TIN) are correct. Incorrect statutory
numbers provided will cause a delay in the remittance. The mandatory contributions shall only be remitted when you have
submitted a valid number and thus the associated penalties will be shouldered by you and shall be deducted from your
payroll.

I acknowledge the above statement and it is my responsibility to comply with Carelon Global Solutions Philippines’ pre‐
employment requirements.

Signature: Annieska M. Alde

Date: November 4, 2023

 CANDIDATE APPLICATION FORM

I hereby authorize Carelon Global Solutions to verify the information and/or documents mentioned in my application form, either from an outside
background screening agency and/or directly, which includes my current/previous employment history, educational/ professional credentials and my
criminal/address background check at any time. I understand and acknowledge that any possible employment with Carelon is conditional
upon the satisfactory background checks conducted on me at any time.

I understand, agree and consent that Carelon and/or the outside background screening agency may contact and obtain appropriate information
from different sources as per the details mentioned in my application form submitted to Legato, which includes employment history from my
current/previous employer, educational / professional credentials to be checked from school / college / university / autonomous institute
and my criminal/address background check from civil/credit violations records in compliance with applicable law.

I understand and agree that the outside background screening agency respectively reserve the rights to obtain appropriate information / documents from
any individual, corporation or any confidential information deemed necessary to check my credentials and furnish the same to Carelon hereunder and I
expressly consent to the same.

I unconditionally release Carelon and all concerned parties hereunder from all liabilities that might arise as a result of my background
verification check and also do not hold responsible, any individual, corporation or private and public entity as a consequence of this check.

I also authorize release of this information to Carelon / the outside background screening agency in original, fax or photocopy form as deemed necessary
and authenticate the validity of the same.

Annieska M. Alde
Signature over Printed Name

Date : November 4, 2023

 Carelon Global Solutions
Data Privacy Notice and Consent Form

Article III of the 1987 Constitution protects the right of privacy. Section 2 states, “The right of the
people to be secure in their persons, houses, papers, and effects against unreasonable searches and
seizures of whatever nature and for any purpose shall be inviolable, and no search warrant or warrant
of arrest shall issue except upon probable cause to be determined personally by the judge after
examination under oath or affirmation of the complainant and the witnesses he may produce, and
particularly describing the place to be searched and the persons or things to be seized.” Section 3
states, “(1) The privacy of communication and correspondence shall be inviolable except upon lawful
order of the court, or when public safety or order requires otherwise as prescribed by law. (2) Any
evidence obtained in violation of this or the preceding section shall be inadmissible for any purpose in
any proceeding.” Section 7 states, “The right of the people to information on matters of public concern
shall be recognized. Access to official records, and to documents and papers pertaining to official acts,
transactions, or decisions, as well as to government research data used as basis for notice
development, shall be afforded the citizen, subject to such limitations as may be provided by law.”

The Civil Code also states that “every person shall respect the dignity, personality, privacy, and peace
of mind of his neighbors and other persons,” and punishes acts that violate privacy by private citizens,
public officers, or employees of private companies.

Republic Act No. 10173 or the Data Privacy Act of 2012 provides safeguards meant to ensure that
personal and other sensitive data in information technology and communications systems in the
government and private sector remain protected and secure.

Carelon's Commitment to Data Privacy Protection

Protecting the security and privacy of your personal data is important to Carelon therefore, we conduct
our business in compliance with applicable laws on data privacy protection and data security. We hope
the notice outlined below will help you understand what data Carelon may collect, how Carelon uses
and safeguards that data and with whom we may share it.

Carelon will not collect, process or disclose any personal data about you unless you voluntarily choose
to provide us with it and give your consent thereto, or unless such disclosure is required or permitted
by applicable laws and regulations.

Purpose

Carelon uses personal data to process transactions with you for purposes, such as: 1) recruitment and
placements; 2) administration of compensation and benefits; 3) performance management and
training; 4) advancement planning; 5) performance of our master vendor relationships, on-site
management services and outsourcing arrangements 6) workplace management; 7) workforce and risk
management; 8) client and government reporting; and 9) other legal and expected business-related
purposes.

Sensitive Information

Carelon collects and uses sensitive information, for which we provide additional and appropriate
privacy protection and confidentiality, only if required to meet its
legal obligation and always with your consent. Sensitive personal information means information
revealing racial or ethnic origin, religious beliefs, political affiliations, education, health, information
provided by government agencies which are peculiar to an individual like social security numbers,
licenses, tax returns and such other data declared by law to be sensitive.

Disclosure

In general, we may disclose or share your job-related personal information with our Carelon affiliates,
to subcontractors who perform services on our behalf, clients and, only where we are otherwise
required to do so, to a court of law. Personal information pertaining to you may be transferred outside
Philippines to locations of Carelon entities worldwide. Carelon has taken steps to ensure that all
information transferred receives an adequate legal data protection.

Children

Carelon will not knowingly collect personal data from children without insisting that they seek prior
parental consent if required by applicable law. We will only use or disclose personal data about a child
to the extent permitted by law, to seek parental consent pursuant to local law and regulations or to
protect a child. The definition of "child" or "children" under Philippine law is one who is below eighteen
years old or, even if above eighteen, is unable to take care of himself/herself due to certain
circumstances.

Security

To protect your personal data against accidental or unlawful destruction, loss or alteration and against
unauthorized disclosure or access, Carelon uses technical and organizational security measures.

Questions, Inquiry/Requests and Comments

Carelon will respond to reasonable requests to review your personal data and to correct, amend or
delete any inaccuracies. If you have any questions or comments about the Carelon Data Privacy
Notice and Consent Form (e.g. to review and update your personal data), or if you want some data,
which you provided to us, not to be disclosed to anyone, please contact your Carelon Human
Resources Department, or write to us at dpa_inquiry@legatohealth.com, or visit us at the 25th Floor,
Alliance Global Tower, 36th St., corner 11th Ave., Bonifacio Global City, Taguig.

Acknowledged by and signature over name:

Annieska M. Alde
November 4, 2023
Date:
 Maxicare Enrollment Form

Employee's Full Name: ALDE, Annieska Maceda

(Last Name, First Name and Middle
Name) A L D E , A NNI E SKA M A CE D A

Birth Date
(mm/dd/yyyy): September 28, 1998 Date Hired:
Civil Status: Single Position Title: CSR Position

INSTRUCTIONS: Please fill out indicating COMPLETE details. This form must be submitted to HR Department within 30 days from your joining date

FULL NAME Birthday Relationship to the

Gender Civil Status
(Last Name, First Name and Middle Name) (mm/dd/yyyy) Principal Member
April 15 1976 Father Married
1 ALDE,
Allan Ocana Male
July 6 1977 Mother Married
2 MACEDA, Elvira Reyes Female
3
4
5

2 dependents shall be covered by the company

Employee may enroll additional one dependent only - at employee's cost

Annieska M. Alde
Signature

Please note of the hierarchy of dependents that must be followed:

Minimum Age Maximum Age
Married Spouse - 1st 18 yrs old 65 yrs old
Children - 2nd day 1 21 yrs old

Single Parents - 1st 18 yrs old 65 yrs old

Siblings - 2nd day 1 21 yrs old

*Single (with common-law or same sex partner) Common Law - 1st 18 yrs old 65 yrs old
Children - 2nd day 1 21 yrs old

Single Parent Children - 1st day 1 21 yrs old

Parents - 2nd 18 yrs old 65 yrs old
Siblings - 3rd day 1 21 yrs old

Attach the following:

Deceased parent/s Copy of Death Certificate

Single Parent Copy of Solo Parent ID

Copy of CENOMAR (Principal and Dependent)

Barangay Certificate of Cohabiting (Principal and Dependent)
Affidavit of Co-habitation
Supporting Documents for Non-enrollment of Parents and
*Common-law or same sex Siblings
partner

Dependent With Existing HMO provider Copy of Maxicare Card

Copy of Certificate of Coverage (if other HMO Provider)

 HQP-PFF-093
(V04, 01/2019)

REQUEST FOR CONSOLIDATION/

MERGING OF MEMBER’S
RECORDS
November 4, 2023

Date

Dear Sir/Madam:

I would like to request for the consolidation/merging of my membership records with the following
information:

Pag-IBIG MID Number : 121216723455

Member’s Name : ALDE ANNIESKA MACEDA
Last Name First Name Name Extension Middle Name
Present Home Address : 189 I RODRIQUEZ ST. SANGANDAAN CALOOCAN CITY

Marital Status : ✓ Single/Unmarried  Widow/er  Annulled

 Married  Legally Separated
Contact Number : 09814405550
Employer/Business Name : Carelon Global Solutions

Employer/Business Address : 24th - 29th Floors, Alliance Global Tower, 36th St., cor. 11th Ave., Bonifacio Global City, Taguig City

Employer/Business Contact No. :

Purpose of Consolidation/Merging :  Short-Term Loan (STL)Application
 Application for Provident Benefits Claim
 Others, please specify

Previous Employer/Business Name Previous Employer/Business Address Inclusive Date(s)

1. Adventuristas Travel and Tours Novaliches Quezon city Nov 2021 – Jan 2023
2.
3.
4.
5.

Requesting Pag-IBIG Fund Branch: Bagong Barrio PAGIBIG branch

Requested by:
Processed by:
Annieska M. Alde
Member’s Name and Signature Name and Designation of Authorized Signatory

Approved by:

Name and Designation of Authorized Signatory

 MUTUAL NON-DISCLOSURE AGREEMENT

THIS MUTUAL NON-DISCLOSURE AGREEMENT ("Agreement"), shall be effective as of (insert

date) and is made by and between Elevance Health on behalf of itself and its Affiliates (defined herein)
(collectively “ElevanceHealth”) and (“Supplier”).

RECITALS

WHEREAS, the parties believe that they would mutually benefit by sharing with each other certain
Confidential Information (as defined herein) and believe it is in their mutual interest to ensure that all
Confidential Information shared by one party (the “Discloser”)will be safeguarded and carefully protected by the
recipient (the “Recipient”).

NOW THEREFORE, in consideration of the recitals and respective promises of the parties contained herein,
the adequacy of which is hereby acknowledged, the parties, intending to be legally bound, hereby agree as set
forth below.

AGREEMENT

1. “Affiliate” Defined. The term“Affiliate” in this Agreement shall mean any entity that controls, is contro
led by or is under common control with a party, where control is defined as direct or indirect ownership of
greater than fifty percent (50%) of equity or other voting interest therein.

2. “Confidential Information” Defined. The term “Confidential Information” in this Agreement

shall mean any information not generally known by the public that relates to the existing or reasonably
foreseeable businessof the Discloser and/or its Affiliates, and which specifically includes, but is not
limited to:

a) technical information, including functional and technical specifications, analysis, research, processes,
computer programs, source code, patent applications and files, methods, ideas, "know how" and the
like;

b) business information, including financial information, internal market analyses and forecasts, sales
and marketing research, proposed products or services, design samples, research and development plans, test
data or other data, commercial or strategic planning, pricing, materials, plans, provider and beneficiary
demographics, provider-specific information, customer lists, customer demographics, and customer-
specific information (references to “customers” herein includes customers’ employees), business methods
personnel information, unannounced business relationships (that Discloser is negotiating or has entered
into) , and the like; and

c) Trade secrets.

3. Covenant Not to Disclose; Protection of Confidential Information. The Recipient hereby agrees that
it shall not use, commercialize or disclose the Confidential Information to any person or entity, except to its
own employees, contractor personnel, and to its attorneys, accountants, consultants and other professional advisors
having a “need to know”, and who are themselves bound by similar nondisclosure restrictions (collectively,
“Representatives”). If Recipient becomes aware of any disclosure or use not in compliance with this
agreement, Recipient shall notify Discloser in writing within three (3) days. The Recipient shall use at least the
same degree of care in safeguarding the Confidential Information as it uses in safeguarding its own confidential
information. Each party’s Representatives shall be bound to comply with all terms of this Section 3. Upon the
request of a party, the other party shall provide a written acknowledgement fromeach of its Representatives that
said Representative isbound by the terms of this Section 3.

4. Scope of Obligation. Except for Protected Health Information as defined in the Health Insurance
Portability and Accountability Act of 1996 and the regulations promulgated thereunder, Recipient’s obligation not to
use or disclose Confidential Information under this Agreement shall not apply to information that: (a) becomes
generally available to the public other than as the result of unauthorized disclosure by the Recipient or a third
party; (b) is independently developed by the Recipient without the aid, application or use of Confidential
Information; or (c) was received by the Recipient on a non-confidential basis prior to receipt from the Discloser or
from a third-party lawfully possessing and lawfully entitled to disclose such information. The burden of establishing
that information was known, received, acquired or independently developed by Recipient as provided above shall
be on the Recipient.
Signature:
Disclosure of Confidential Information shall not be precluded if such disclosure is (a) required pursuant to a
valid court order; or (b) in the opinion of legal counsel for the Recipient, is otherwise required by law, provided that
in either circumstance: (i) the Recipient shall furnish the Discloser with a copy of the demand, summons, subpoena
or other legal process to compel such disclosure; (ii) the Recipient shall give the Discloser reasonable prior notice
of its intention to disclose the Confidential Information in order to allow the Discloser an opportunity to seek
appropriate protection; and
(iii) the Recipient shall take all reasonable steps to restrict the disclosure of the Confidential Information to the
greatest extent possible.

5. Proprietary Rights Legend. The Recipient shall not alter or remove from any Confidential
Information, any proprietary rights legend, copyright notice, trademark or trade secret legend, or any other
legend or notice identifying the material as Confidential Information.

6. Return or Destruction of Information. Upon termination of this Agreement, the Recipient shall return
or destroy the Confidential Information, and upon request, shall provide the Discloser with a certification of such
return or destruction; provided, however, that Recipient may retain copies of the Discloser’s Confidential
Information for archival and evidentiary purposes only, subject to the confidentiality obligations set forth
herein.

7. Remedies for Breach of Confidentiality. The Recipient hereby acknowledges that its violation of
the restrictions imposed hereunder would cause irreparable harm to the Discloser and that remedies at law
would be inadequate to redress any actual or threatened violation of this Agreement. Each party agrees that, in
addition to other relief, the other party may seek to enforce the foregoing restrictions by temporary and
permanent injunctive relief. Any award of relief to the Discloser in an action in which the Discloser substantially
prevails shall include recovery of the Discloser’s costs and expenses of enforcement (including reasonable
attorneys' fees).

8. Third Party information. Neither party shall disclose to the other any confidential information of a
third party in violation of an obligation of confidence to, or other proprietary right of, the third party. The
Discloser shall defend, indemnify and hold harmless the Recipient and the Recipient’s officers, directors,
employees, contractor personnel, and Representatives fromand against any claims, losses, liabilities, damages,
judgments, costs, and expenses (including reasonable attorney’s fees) arising out of or in connection with any
claimby a third party that the Discloser’s disclosure to the Recipient constituted a breach of a duty owed by the
Discloser to the third party.

9. Term and Termination. This Agreement shall become effective on the date first written above and
shal terminate upon the happening of the earlier of (a) the written notice of either party to the other of its election,
with or without cause, to terminate this Agreement; or (b) the expiration of twelve (12) months from the date
first written above; or (c) the mutual execution of an agreement between the parties for the provision of services
by one party to the other. Each party agrees that its obligations undertaken herein as Recipient with respect to
Confidential Information disclosed to it, as well as any provisions of this Agreement, that by their terms, require
performance after the termination or expiration of the Agreement or have application to events that may occur
after such terminationor expiration, shall survive and continue after any termination or expiration of this
Agreement.

10. Freedom of Action. Nothing in this Agreement is to be construed to preclude Recipient from using,
marketing, licensing, and/or selling any designs, work product, processes, methodologies software, data processing
or other information or material (collectively, “Material”) that is similar or related to those of Discloser, provided
that the same are independently developed without reference to Confidential Information disclosed by the
Discloser under this Agreement. Fromtime to time, Recipient may have explored, and in the future is free to
explore, similar business opportunities with other companies, and/or to pursue similar business opportunities on
its own, including without limitation developing and/or marketing and distributing Material in competition with
the other party. Subject to the specific obligations in this Agreement, such activities will not be considered a
breach of this Agreement.

11. Relationshipof the Parties. With respect to all performance of this Agreement, each party, including
its employees, officers and agents, shall be considered an independent contractor, and not an employee, agent,
partner, or joint venturer of the other party. Except as expressly provided in this Agreement, neither party
shall have any right to act for, obligate or make commitments, express or implied, on behalf of the other.

12. Assignment. Unless it has first obtained the written consent of an officer of the other party,
neither party may assign this Agreement to any other person. Notwithstanding the foregoing, either party
may, with advance written notice to the other, assign or otherwise transfer its rights and obligations
hereunder, in whole or in part, to: (i) any of its Affiliates; or (ii) any entity surviving a transaction
involving the merger,
acquisition, consolidation, or reorganization of the party, in which all or substantially all of the party’s assets
2
Signature:
are sold, provided that the surviving entity is not a competitor of the non-assigning party. Either
party is required to provide advance written notice under this provision only to the extent
permissible under applicable law and the reasonable terms of the agreement(s) governing such
merger, acquisition,
consolidation, reorganization, or asset sale. If advance written notice is not allowed, notice shall be
provided as soon as practicable. Upon receipt of notice of an assignment of this Agreement, the other
party may terminate this Agreement by providing the assigning party with thirty (30) days advance
written notice of termination. Any assignee of rights or benefits under this Agreement shall be subject to
all of the terms and provisions of this Agreement. Either party may subcontract any of its duties under
this Agreement without the prior written consent of other party; however, the party subcontracting the
services shall remain
responsible for fulfilling its obligations under this Agreement.

13. Choice of Law, Forum. This Agreement shall be governed by Indiana law, without reference to or
use of any conflicts of laws provisions. The parties hereto agree that with respect to any disputes, actions, suits
or proceedings arising in connection with this Agreement, venue will be in the State of Indiana and in such
event, the parties hereby consent to the exclusive jurisdiction of the federal and state courts located in Marion
County, Indiana.

14. Waiver. No failure or delay by either party to exercise any right or to enforce any obligation herein,
and, no course of dealing between the parties, shall operate as a waiver of such right or obligation or be
construed as or constitute a waiver of the right to enforce or insist upon compliance with such right or
obligationin the
future. Waiver of any provision herein must be in writing.

15. Notices. All notices, requests, claims, demands, and other communications specifically required pursuant
to this Agreement.(each a “Notice”) shall be in writing, signed by an authorized representative of the party
providing the Notice, and shall be given or made by delivery in person, by a nationally recognized courier
service (with proof of delivery), by certified mail (postage prepaid, return receipt requested) or by
electronic mail containing a signed copy of the Notice in a separate attachment (with proof of delivery) to the
respective party at the following address set forth below or at such other address as such party may hereafter
notify the other party in accordance with this Section 15.

For ElevanceHealth:
Elevance Health.

Attention:

with a copy to
Elevance Health
120 Monument Circle
Indianapolis, IN 46204
Attention: General Counsel

For Supplier:

Attention:
with a copy to

Attention:

Each such Notice will be effective when actually received by the respective party if delivered in person, by
courier, or by electronic mail, with proof of delivery in each instance, or otherwise five (5) days after
mailing. Notice to Elevance Health at the address indicated shall constitute notice to Elevance Health and its
Affiliates and notice by Elevance Health shall be deemed to be on behalf of Elevance Health and its Affiliates
unless otherwise specifically indicated in the notice.
3 Signature:
16. Use of Name. Elevance Health reserves all rights to and control over its and its Affiliates’ names,
symbols, service marks or trademarks now existing or hereafter established. Supplier shall not use any such
names, symbols or marks for any purpose without Elevance Health's prior written consent. Supplier reserves
all rights to and control over its name, symbols, service marks or trademarks now existing or hereafter
established. Elevance Health shall not use any such names, symbols or marks for any purpose without the prior
written consent of Supplier.

17. General Provisions. This document constitutes the entire agreement between the parties with
respect to the subject matter hereof and supersedes all other communications, whether written or oral. This
Agreement is expressly limited to its terms and may be modified or amended only by a writing signed by an
authorized representative of the party against whom enforcement is sought. If any provision of this
Agreement is deemed invalid or unenforceable, such provision shall be ineffective only to the extent of
such prohibition or invalidity without invalidating the remainder of such provision or the remaining
provisions of this Agreement. Headings are for reference purposes only and have no substantive effect.

18. Execution; Counterparts. This Agreement may be executed and delivered in separate counterparts,
each of which will constitute an original, but all of which together will constitute one and the same instrument.
Any counterpart may comprise one or more duplicates, any of which may be executed by less than all of the
parties provided that each party whose execution is required executes at least one such duplicate. A copy of
this Agreement, executed on behalf of a party and transmitted to theother party by FAX, or in graphical-image
formby email or other electronic transmission, is to be deemed for all purposes to have been executed and
delivered by that party to the other party. A photocopy of a fully- or partially-executed original of this
Agreement, including for example a FAX- or graphical-image copy, will be admissible in evidence for all
purposes in any proceeding as between the parties to the same extent (if any) as the original.

IN WITNESS WHEREOF, and intending to be legally bound, the parties hereto have caused this Agreement to
be executed by their duly authorized representatives.

Annieska Maceda Alde Elevance Health Elevance Health

Supplier Elevance Health Procurement Department
(required)

By: By: By:

Signature Signature Signature

Annieska Alde
Printed Name Printed Name Printed Name

CSR
Title Title Title

November 4, 2023
Date Date Date

4
 Renaming Sample

Kindly rename each file according to their classifications.

[SURNAME] Name of Document
Ex. [DELA CRUZ] TIN ID

Please indicate the location (MNL or ILOILO) with your Surname on the subject line when
sending your responses so we can process your documents accordingly.

[MNL] [SURNAME] POSITION – FOLLOW-UP REQUIREMENTS

Ex. [MNL] [DELA CRUZ] MMS I – FOLLOW-UP
REQUIREMENTS