Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION

Citystate Centre Building, 709 Shaw Boulevard, Pasig City
Healthline: 441-7444 Website: www.philhealth.gov.ph

STATEMENT OF PREMIUM ACCOUNT (SPA)

PEN :
EMPLOYER TYPE :
Business/Agency Name :
Attention :

019000020523
Private
GOOD SHEPHERD ACADEMY INCORPORATED

SPA NO : SPA100004003302
DATE : 10/05/2015

PhilHealth Employer Engagement Representative (PEER)

Remittance Due Date:

Please Pay Immediately

CURRENT SPA CHARGES

Applicable Month : September 2015
No. of Employees : 11
Amount of Premium:
Employee Share

1,087.50

Employer Share

1,087.50
_____________

Amount Due :
Interest Incurred :

2,175.00
0.00
_____________

TOTAL DUE FOR CURRENT SPA :

2,175.00
_____________
_____________

TOTAL AMOUNT DUE :

2,175.00
EPRS 6 EASY STEPS IN PREMIUM PAYMENTS

Steps (Employer Activity)

(Timelines)

1) Membership updating in EPRS

Within 30 days of the applicable month

(Requirement)
Mandatory

2) Generation of Preliminary Employees Premium List

1st-5th day after the applicable month

Optional

3) Generation of Statement of Premium Account

6th day after the applicable month

Mandatory

4) Preparation of voucher and check

7th-9th day after the applicable month

Mandatory

5) Remittance of PhilHealth Premium Contribution

On or before the 10th after the applicable month

Mandatory

6) Posting of Payment to EPRS

11th-15th day after the applicable month

Mandatory

Note :
1. This Statement of Premium Account reflects the total amount due based on membership records as of the last day of the applicable month
2. The total amount due in this SPA shall only pertain and apply to the total amount of premium remittance for the applicable month for which this SPA
was generated. Any arrearages, interest incurred from unpaid remittances, penalty and surcharges that may be due from the employer shall not be
deemed included hereof, unless it is otherwise specifically stated in the SPA.
3. PhilHealth Circular No. 057, s.2012 states that the premium contributions for the Employed Sector, starting January to December 2013 only, shall be in
accordance with the following premium contribution schedule using the following baselines:
a. Premium rate at 2.5% of the basic monthly salary
b. Use of salary bracket
c. Salary bracket floor shall start at P7,000.00
d. Salary bracket ceilling shall be at P35,000.00
4. Please Print the SPA as your supporting document to the disbursement voucher. To remit your contribution, please detach and bring the PPPS to
your nearest PhilHealth LHIO or Business Center or to our Accredited Collecting Agents (ACAs).
................................................................. Cut-off Here .....................................................................

PHILHEALTH EPRS PREMIUM PAYMENT SLIP

Remittance Due Date : Please Pay Immediately
PEN :
Business/Agency Name :
Applicable Month :

SPA No. : SPA100004003302

Date Generated : 10/05/2015
Employer Type : Private

019000020523
GOOD SHEPHERD ACADEMY INCORPORATED
September 2015
No. of Employees :

Amount of Premium:
Employee Share
Employer Share

1,087.50
1,087.50
_____________

Amount Due :
Interest Incurred :

2,175.00
0.00
_____________

TOTAL DUE FOR CURRENT SPA :

2,175.00
_____________
_____________

11