Wednesday, February 16, 2011

MAXICARE CORPORATE ENROLLMENT TEMPLATE.



The Template has 3 sheets:

Info Sheet – basic info about the company

Principals – masterlist of principals/employees that are enrolling

Dependents – masterlist of dependents that are enrolling


Principals Sheet

Philhealth – indicate “Required” (all employees were assumed Philhealth members and are required to file their Philhealth incases of confinement)

Rider – leave blank. I will fill this up myself


The plan of choice (Silver, Gold, Platinum)

  • could be uniform for all principals and dependents (eg. Everyone under Gold Plan)
  • according to the position of the company, let’s say Platinum for President/Owner, Gold for Managers, Silver for Staff
  • The dependents plan could either be uniform for all dependents of the company or consistent with the position of the principals. Let’s say, All dependents of the President/Owner are under Platinum, All dependents of Managers are under Gold and all dependents of the Staff are under Silver
  • The plans per employee should also be consistent. Let’s say a Male Manager has 3 dependents. It cannot be if his wife is under Gold Plan and the kids are under Silver. They should be the same.
  • Note: Company can choose from any of the plan types from any of the 6 options BUT all plan types must come from one (1) option only.

Example:

Executives - Platinum

Managers - Gold

Rank and File – Silver

But they should come from one (1) option only

Dependents Sheet:

The total number of dependents must be equal to at least 75% of the population of the principals/employees

For example: 5 employees x .75 = 4 dependents even if all 4 dependents came from 1 person only


Hierarchy of Enrollment and Age Limit

For married principals

1st - spouse (must be 65 & below)

2nd - eldest child (must be 21 & below)

3rd - up to the youngest child (must be 21 & below)

For single principals

1st - mother (must be 65 & below)

2nd - father (must be 65 & below)

3rd - eldest sibling (must be 21 & below)

4th - youngest sibling (must be 21 & below)


Thus, if a married principal would like to enroll 1 dependent, he MUST enroll his wife first. If he wants to enroll 2 dependents, he MUST enroll his spouse and his eldest child. The same principle is applied for the single applicants based on the hierarchy stated above.



Exemptions from the Hierarchy

A dependent can be exempted or excluded from the hierarchy. The principal applicant can then now skip and proceed to the next eligible dependent.

Examples:

  1. Wife is currently enrolled with another HMO
  2. Mother is already deceased
  3. Husband is working abroad
  4. Father is over aged


Should by any chance, you are only able to submit 4 principal names, your company’s application as a group account will not be processed unless the minimum number of 5 applications is submitted and approved by Maxicare’s underwriting



Thank you.

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