Other Benefits

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Theres more to the GSIS than life insurance, retirement, and loans. GSIS takes care of its members and pensioners
with added benefits, providing financial security amidst various life events.

Separation
Benefit package for members with more than three (3) but less than 15 years in service.

Disability
Program intended for members who lost their earning capacity due to non-work related disability.

Employee Compensation
The GSIS administers Employees Compensation Fund for government employees who suffered work-related
illnesses, disability, or death.

Unemployment
Monthly cash payment for permanent employees who are involuntarily separated from the service due to abolition of
office or position due to reorganization.

Funeral
Assistance extended to spouse or children of a deceased member or pensioner.

Survivorship
Pension benefit for qualified dependents of GSIS pensioners who passed away.

Separation
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The Separation benefit is given to employees who have not reached the retirement age (60) but have been separated
from the service. It is provided under RA 8291, which took effect on June 24, 1997.
The
benefit
can
be
in
the
form
of
ash
payment
or
cash
payment
and
pension.
Here are the conditions under which a member may be qualified for cash payment and pension, and the
corresponding benefits:

If the member has been in the service for at least 3 years but less than 15 years, and he is below 60 years of
age, benefit is:
Cash payment equivalent to 100% of the Average Monthly Compensation (AMC) for every year of service payable
upon reaching age 60.

If the member has been in the service for at least 15 years and is below 60 years of age, benefit is:
Cash payment equivalent to 18 times the Basic Monthly Pension, payable upon separation and Monthly pension for
life starting at age 60.

Disability benefits are benefits granted to a member due to the loss or reduction in earning capacity caused by a loss
or impairment of the normal functions of the employee's physical and/or mental faculties as a result of an injury or
disease.
The
1.
2.

loss in earning capacity shall be determined on the basis of the

The
employee's
actual
loss
of
income
from
the
usual
The
capacity
to
engage
in
any
other
gainful
occupation
because
of

disability

may

following:
occupation
impairment

either

be:
Total
Partial
Total

Permanent
Permanent
Temporary
Injuries resulting in any of the following are deemed Permanent
a.
Complete
loss
of
sight
of
b.
Loss
of
two
limbs
at
one
or
above
the
c.
Permanent
complete
paralysis
of
d. Brain injury resulting in incurable imbecility, insanity or other irreversible conditions

Total

Disability
both
ankle
or
two

(PTD)
eyes
wrist
limbs

The
benefits
for
Partial
Total
Disability
are
as
follows.
1. If the member is in the service with less than 15 years of service, benefit can be either:
a.
Basic
Monthly
Pension
2. If the member is in the service with at least 15 years of service, benefit can be either:
a.
Basic
Monthly
Pension
b.
Cash
payment
of
18
times
the
Basic
Monthly
Pension
3. If the member is separated from service with 36 monthly contributions within the 5-year period immediately
preceding
PTD,
benefit
can
be
either:
a.
Basic
Monthly
Pension
4. If the member is separated from service with 180 monthly contributions prior to PTD, benefit can be either:
a.
Basic
Monthly
Pension
5. If the member has at least 3 years service with contributions, but PTD occurs 5 years after separation from the
service,
benefit
is:
Cash payment equal to 100% of AMC X Service (but not less than P12,000) payable immediately. No more
separation
benefit
shall
be
paid
in
the
future.
Injuries resulting in any of the following are deemed Permanent Partial Disability (PPD)
Complete and permanent loss of the use of: any one finger, any toe, one arm, one hand, one foot, one leg, one or
both ears, sight of one eye or such other cases as may be determined by the System
The

benefits
for
Permanent
Partial
Disability
are
as
1.
If
member
is
in
the
service,
benefit
Cash payment CP = BMP X nos. of PTD months as recommended by the GSIS medical evaluator

follows:
is:

2. If the member is separated from the service but has paid 36 monthly contributions within the last 5 years
immediately preceding the disability or has paid at least 180 monthly contributions, benefit is:
Cash payment CP = BMP X nos. of PTD months as recommended by the GSIS medical evaluator

Employee Compensation and State Insurance Fund

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While one could only hope for the best, it is a fact that life has full of uncertainties. This is why we always try to secure
our future and our familys as well. We try to be ready to what may happen, in case we get sick or be in an accident
while we are at work.
We, however, do not have to carry the entire burden. The Employees Compensation and State Insurance Fund, as
provided under Presidential Decree No. 626, is another security blanket for the working class. The EC Fund for
government employees is administered by the GSIS.
The employees' compensation benefits or disability benefits is a compensation package for public and private sector
employees and their dependents in the event of work-related injury, sickness, disability or death.
The EC is a purely employer-based contribution benefit. Thus, the employee does not contribute any amount to the
program.
Benefits under the EC are in the form of income or services, and consist of the following:
1.

Medical services, appliances and supplies;

2.

Rehabilitation services;

3.

Temporary total disability benefit;

4.

Permanent total disability benefit;

5.

Permanent partial disability benefit;

6.

Death benefit; and

7.

Funeral Benefit

In case of death and funeral benefits, the beneficiaries may either be one of the following:
1.

2.

Primary
1.

Your legitimate spouse until he or she remarries

2.

Your dependent children (legitimate, legitimated or adopted, and illegitimate):

1.

Below 18 years old, unmarried, not gainfully employed; or

2.

More than 18 years old but incapacitated and incapable of self-support due to mental or
physical defect acquired prior to age of majority.

Secondary
1.

Your dependent parents

2.

Your legitimate descendants

To be more specific, the benefits given to the employee or his beneficiaries are in the form of:

1.

Daily cash income benefit for temporary total disability (TTD);

2.

Monthly cash income benefit for permanent total disability (PTD) on a lifetime basis;

3.

Monthly cash income benefit for permanent partial disability (PPD);

4.

Monthly cash income benefit for death, also on a lifetime basis, except for benefit paid to secondary
beneficiaries, which is a monthly pension not to exceed 60 months but not less than fifteen thousand pesos;

5.

Medical services, appliances and supplies for injury or sickness;

6.

Rehabilitation services for permanent disability; and

7.

Carer's allowance for permanent disability.

8.

Funeral benefit of P3,000 to be paid upon the death of a covered employee or permanently totally disabled
pensioner to one of the following:
1.

A surviving spouse;

2.

The legitimate child who spent for the funeral services; or

3.

Any other person who can show unquestionable proof or proof of his having borne the funeral
expenses (ECC Resolution No. 3682, July 21, 1987.

The Compensability Conditions are as follows:

1.

Injury must be the result of accident arising out of and in the course of employment

2.

Sickness must be listed /considered an "occupational disease"; or even if not listed as one, it must be shown
that the risk of contracting the sickness is increased by the working conditions

3.

Disability/Death is caused by work-connected injury or sickness

Exceptions to Compensability or injury, sickness, disability or death

When any of these is due to the employee's:
1.

Intoxication or drunkenness

2.

Willful intention to injure or kill himself or another

3.

Notorious negligence

4.

Not work-related

List of Occupational Diseases (under PD626)

1.

Papilloma of the bladder

2.

Cancer,
epithellomatous
corneal surface of the eye

or

ulceration

of

the

skin

or

of

the

3.

Cataract

4.

Deafness

5.

Decompression
Caisson
Aeroembolism

6.

Dermatitis due to irritants and sensitizers

7.

Infections: Anthrax, Brucellosis, Glanders, Rabies, Tuberculosis, Tularemia, Weill's disease, Q Fever or
equine encephalomyelitis, Mite dermatitis

8.

Ionizing radiation disease, inflammation, ulceration or malignant disease of the skin or subcutaneous tissues
of the bones or leukemia or anemia of the aplastic type due to X-rays, ionizing particles, radium or other
radioactive substances Acute radiation syndrome: Chronic radiation syndrome and Glass blower's cataract.

9.

Poisoning

sickness
disease

10. Pneumoconiosis
11. Diseases caused by abnormalities in temperature and humidity
12. Vascular disturbance in the upper extremities due to continuous vibration from pneumatic tools or power
drills, riveting machines or hammers
13. Viral hepatitis
14. Poisoning by cadmium
15. Leukemia and lymphoma
16. Cancer of the stomach and other lymphatic and blood forming vessels, nasal cavities and sinuses
17. Cancer of the lungs, liver and brain
18. Cardio-vascular diseases
19. Cerebro-vascular accidents
20. Malaria and schistosomiasis
21. Pneumonia
22. Hernia
23. Bronchial asthma
24. Osteoarthritis
25. Viral encephalitis
26. Peptic ulcer

27. Pulmonary tuberculosis

28. Viral hepatitis
29. Essential hypertension
30. Asbestosis

Unemployment
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The unemployment benefit is paid when a permanent government employee who has paid the required 12 months
integrated contributions under RA 8291 is involuntarily separated from the service as a result of the abolition of his
office or position usually resulting from reorganization. The benefit is in the form of monthly cash payments equivalent
to 50% of the average monthly compensation (AMC). The duration of the benefit depends on the length of service
and
ranges
from
2
months
to
a
maximum
of
6
months.
The unemployment benefit shall be paid in accordance with the following schedule.
1.

If the contributions have been made for a period of 1 year but less than 3 years, the benefit duration is for 2
months.

2.

If the contributions have been made for a period of 3 or more years but less than 6 years, the benefit
duration is for 3 months.

3.

If the contributions have been made for a period of 6 years or more but less than 9 years, the benefit
duration is for 4 months.

4.

If the contributions have been made for a period of 9 years or more but less than 11 years, the benefit
duration is for 5 months.

5.

If the contributions have been made for a period of 11 years or more but less than 15 years, the benefit
duration is for 6 months.

Burial Benefits
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Death, although inevitable, is always an unpleasant incident in every one's life. It

can also be costly to those who we leave behind. But with GSIS's funeral benefit, our
survivors will have less to worry about.

Schedule of Availability of Service

Monday to Friday, 8:00 a.m. to 5:00 p.m. with no noon break

Eligible to Avail of the Service

1.

Surviving Spouse

2.

Any of the following persons who can present receipt/s of expenses, provided that the surviving spouse, if
still living, has acknowledged that this person shouldered the funeral expenses

* Children of the deceased member or pensioner

* For single deceased member or pensioner, relatives up to second degree of consanguinity; and

* Any claimant other than children

Documentary Requirements
1.

If claimant is the spouse

* Death Certificate issued by the Local Civil Registrar (LCR) or NSO

* Marriage Contract of member issued by NSO

* Birth Certificate of spouse issued by the NSO or LCR or two (2) valid government issued IDs with
date of birth and picture if claimant is not a GSIS member

2.

* Certification of Last Day of Actual Service (LDAS), if member died in active service

If claimant is other than the spouse

* Affidavit of Funeral Expenses;

* Death Certificate of member issued by the Local Civil Registrar (LCR) or NSO

* Death Certificate of spouse issued by the Local Civil Registrar (LCR) or NSO

* If legal spouse is living, duly notarized waiver of the legal spouse in favor of the claimant

* Two (2) valid IDs of the legal spouse with signature

* If claimant is not a GSIS member, Birth Certificate of claimant issued by the NSO/LCR or two (2)

valid government issued IDs with date of birth and signature

* Official Receipt issued to the claimant

*Certification of Last Day of Actual Service (LDAS), if member died in active service

Note
1.

Additional documents may be required by the Operating Unit Concerned (OUC) if documents submitted
have discrepancies (e.g. name, appellation)

2.

Original documents should be submitted by the claimant. If photocopy, original should be presented to the
Frontline Staff for authentication

3.

Additional documents may be required by the OUC if with adverse claim

Survivorship
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When a member or pensioner dies, his or her beneficiaries are entitled to cash and/or pension benefits, subject to the
existing rules and regulations on survivorship and policies on the maximum amount of survivorship pension.

Coverage
All primary and secondary beneficiaries residing in the Philippines or abroad who are existing survivorship
pensioners or claiming for survivorship benefit;
Those who were receiving survivorship benefits but were suspended when the policy on the same was amended
and implemented in August 2009; and
Those who applied for survivorship benefits but were disapproved due to the issuance/approval of Management
Implementing Guidelines (MIG) 01-2009 dated October 22, 2009 that took effect as early as August 2009, and MIG
04-2010 dated April 26, 2010.

Eligibility Requirements
1.

When a member or pensioner dies, the primary beneficiaries (surviving legal spouse and dependent
children) or secondary beneficiaries, as the case may be, shall be entitled to the applicable survivorship
benefits.

2.

The primary beneficiaries[1] shall be the following:

* The legitimate spouse, until s/he re-marries, or co-habits/engages in common-law relationship;

o
and

* The dependent legitimate, legally adopted or legitimated children, including illegitimate children,
who have not reached the age of majority, or, have reached the age of majority but incapacitated and
incapable of self-support due to a mental or physical defect acquired prior to age of majority

3.

The secondary beneficiaries shall be the dependent parents and, subject to the restrictions on dependent
children, the legitimate descendants[2].

The secondary beneficiaries shall only be entitled to survivorship benefits if there are no primary beneficiaries[3].
Maximum Amount of Survivorship Pension
1.

The surviving spouse shall be entitled to basic survivorship pension which is fifty percent (50%) of the Basic
Monthly Pension (BMP) but not to exceed fifty percent (50%) of the current Step 8[4] salary of an
Undersecretary,
pursuant
to
the
Salary
Standardization
Law
and
its
amendments.
For example, if the salary of an Undersecretary is equal to P63,380.00 and the BMP of the deceased
member/pensioner is equal to P70,000.00, the maximum amount of survivorship pension is P31,690.00
(50% of P63,380.00) for the surviving spouse, not P35,000.00 (50% of P70,000.00).
However, the existing survivorship pensioners (surviving spouse) who are receiving more than the said limit
shall
not
be
subjected
to
this
policy.
For survivorship pensioners whose survivorship pensions were suspended as a result of the previous policy,
the amounts accruing for the period they were suspended shall be restored by the GSIS, subject to the
maximum amount of survivorship pension provided under this policy.On the other hand, for surviving spouse
whose applications for survivorship benefits were denied as a result of the previous policy, their applications
may be submitted to GSIS, and if found to be qualified, their benefits shall be granted and computed
retroactively, subject to the maximum amount of survivorship pension provided under this policy.

2.

The dependent children shall be entitled to dependent childrens pension for a maximum of five (5)
children, equivalent to 10% of the BMP for each child but not to exceed fifty percent (50%) of the BMP,
counted from the youngest and without substitution.

3.

The maximum amount of basic survivorship pension prevailing at the time of death of the member or
pensioner shall apply. Any subsequent increase/s in the Step 8 salary of an Undersecretary will not result
in any adjustment to the survivorship pension already being received by the surviving spouse.

Disqualification / Discontinuance to Entitlement to Survivorship Pension of Dependent

Spouse and/or Children
1.

The payment of survivorship pension to the surviving spouse shall be discontinued when s/he re-marries,
cohabits/engages in common-law relationship.

2.

In the case of the dependent children, survivorship pension shall be discontinued upon reaching the age of
majority.

3.

When the dependent spouse and dependent children are already receiving the basic survivorship pension
and dependent childrens pension, respectively, any subsequent death, emancipation or disqualification
of any one of them shall not result in the accrual of that portion of benefits to the other beneficiaries.

Documentary Requirements
Basic Documents
1.

Application Form

2.

Ombudsman Clearance

3.

Death certificate of member/pensioner issued by the National Statistics Office (NSO)

4.

Last Day of Actual Service; and

5.

Two (2) valid IDs of payees

If Married
1.

Marriage certificate between the deceased and his/her spouse issued by NSO

2.

Affidavit of Surviving spouse

3.

If spouse is not a GSIS member, Birth Certificate issued by NSO

4.

Birth Certificate/s of minor/incapacitated children issued by NSO

5.

If with minor/incapacitated children, Affidavit of Guardianship

6.

If the legal guardian is not the natural parent, the affidavit should be supported by a Certification from the
Barangay and DSWD

If Single
1.

If with minor/incapacitated children, Affidavit of Guardianship

2.

If the legal guardian is not the natural parent, the affidavit should be supported by a Certification from the
Barangay and DSWD; and

3.

If guardian is not a GSIS member, Birth Certificate issued by NSO

If without primary beneficiary (with Parents)

1.

Birth Certificate of member issued by NSO

2.

Marriage Contract of members parents issued by NSO

3.

Birth Certificate of members parents issued by NSO if parents are not GSIS members/pensioners.

If without primary beneficiary (without Parents; with Siblings)

1.

Birth Certificate of member issued by NSO

2.

Marriage Contract of member's parents issued by NSO

3.

Death Certificates of member's parents issued by NSO

4.

Birth Certificate of member's parents issued by NSO

5.

Affidavit of Surviving Legal Heirs stating among others that affiants are the only surviving legal heirs of the
deceased member, their date of birth and relationship to the deceased member and that they are executing
the document for the purpose of claiming the benefit from GSIS

6.

Birth Certificate of all the siblings of the deceased member issued by NSO

7.

Marriage Contract of all the female siblings of the deceased member issued by NSO

8.

If with deceased brother or sister, extra judicial settlement among the legal heirs of the deceased brother /
sister of the member designating one payee

Additional Requirements for Muslim Members

1.

Proof of Surviving legal heirs indicating all the wives and children

2.

If only one (1) spouse is claiming: submit duly notarized affidavit that her husband has no other
marriages/wife

3.

Court Order for Guardianship should be issued in the absence of parent for minor children

4.

Application for survivorship must be duly endorsed by the office and a certification indicating the legal
spouse/s and children/s of the deceased

Effectivity
The above policies on survivorship benefits shall be implemented retroactively from the time the existing policies on
eligibility requirements of a surviving spouse to survivorship benefits were adopted.
[1] Sections 2 (f) and (g), Republic Act No. 8291
[2] Sections 2 (h)
[3] Section 21 (c)
[4] Step 8 is equivalent to P63,380.00.

Frequently Asked Questions on Survivorship Benefits

Why

did

the

GSIS

revise

the

existing

policy

on

the

grant

of

survivorship

benefits?

The existing policies on the grant of survivorship benefits were revised by Management with the goal of granting
equitable benefits to survivorship pensioners, taking into consideration the specific provisions under the Family Code,
such that dependency for support of the surviving spouse to the deceased GSIS member shall not be dictated by the
surviving
spouses
financial
status
or
capability.
Given the said revisions, members and pensioners are secured of their future benefits in GSIS without compromising
the
financial
viability
of
the
Social
Insurance
Fund.
Who

will

be

covered

The following shall be covered by this new policy:

by

this

new

policy?

1.

All primary and secondary beneficiaries residing in the Philippines or abroad who are existing survivorship
pensioners or claiming for survivorship benefit;

2.

Those who were receiving survivorship benefits but were suspended when the policy on the same was
amended and implemented in August 2009; and

3.

Those who applied for survivorship benefits but were disapproved due to the issuance/approval of
Management Implementing Guidelines (MIG) 01-2009 dated October 22, 2009 that took effect as early as
August 2009, and MIG 04-2010 dated April 26, 2010.

Who

are

the

primary

and

secondary

beneficiaries?

The primary beneficiaries shall be the following:

1.

The legitimate spouse, until he/she re-marries, or co-habits/engages in common-law relationship; and

2.

The dependent legitimate, legally adopted or legitimated children, including illegitimate children, who have
not reached the age of majority, or, have reached the age of majority but incapacitated and incapable of selfsupport due to a mental or physical defect acquired prior to age of majority.

The secondary beneficiaries shall be the dependent parents and, subject to the restrictions on dependent children,
the
legitimate
descendants.
When will a surviving legal spouse or dependent children be disqualified from receiving the survivorship
pension?
The payment of survivorship pension to the surviving dependent spouse shall be discontinued when he/she remarries
or
cohabits/engages
in
common-law
relationship.
On the other hand, the dependent children shall be disqualified from receiving the survivorship pension once he/she
reaches
the
age
of
majority.
What will happen to the survivorship pension being received by the surviving spouse and dependent
children when any of them dies or becomes disqualified from receiving the survivorship pension?
When the surviving spouse and dependent children are already receiving the basic survivorship pension and
dependent childrens pension, respectively, any subsequent death, emancipation or disqualification of any one of
them shall not result in the accrual of that portion of benefits to the other beneficiaries.
How

will

the

beneficiaries

claim

for

survivorship

benefits?

The application for survivorship benefits should be filed together with the documentary requirements, including the
following affidavits:
1.

Affidavit of Surviving Spouse;

2.

Affidavit of Guardianship of Incapacitated Dependent Child. The Affidavit shall be supported by a court
order. In the absence of a court order, the Affidavit shall be supported by a Certification of Guardianship
from the Barangay Captain and the City/Municipal Social Welfare Head where the incapacitated dependent
child is residing; and

3.

Affidavit of Guardianship of Minor Dependent Child. The Affidavit shall be supported by a court order. In
the absence of a court order, the Affidavit shall be supported by a Certification of Guardianship from the
Barangay Captain and the City/Municipal Social Welfare Head where the minor dependent child is residing.

Will the secondary beneficiaries and legal heirs be required to comply with the submission of the Affidavits?
The secondary beneficiaries and legal heirs, since they are not entitled to pension, shall not be required to comply
with
the
submission
of
the
said
affidavits.
How can a child of minor age or with physical or mental incapacity claim for survivorship benefits?
The guardian of the minor child or child with physical or mental incapacity should secure a court order. In the
absence of a court order, the Affidavit shall be supported by a Certification of Guardianship from the Barangay
Captain and the City/Municipal Social Welfare Head where the dependent child is residing. This should be
submitted to the GSIS as a supporting document to the application for survivorship benefits and to the Affidavit of
Guardianship
of
Minor
Dependent
Child
or
Incapacitated
Dependent
Child.
What will happen if the survivorship pensioners fail to execute the Affidavit of Surviving Spouse/Children for
that
year?
Failure on the part of the survivorship pensioner/s to submit the required affidavit shall be a ground for the
suspension
of
the
survivorship
pension.
When

will

the

secondary

beneficiaries

be

entitled

to

survivorship

benefits?

The secondary beneficiaries shall be entitled to survivorship benefits only if there are no primary beneficiaries and
shall
be
subject
to
limitations
defined
by
GSIS.
Who will be entitled to receive the survivorship benefits if there are no primary and secondary beneficiaries?
In the absence of primary and secondary beneficiaries, the legal heirs, as defined under the Rules on Succession,
New Civil Code of the Philippines, shall receive the applicable cash benefit depending on the eligibility of the
deceased
member
or
pensioner.
The cap on the amount of basic survivorship pension is fifty percent (50%) of the current Step 8 salary of
an Undersecretary, pursuant to the Salary Standardization Law and its amendments. What is the basis for
this?
The position of an Undersecretary is the highest career position in the government, hence, the most appropriate basis
when putting a cap on the basic survivorship pension. As of December 2010, there is only 0.24% of the general
membership who is receiving more than the current Step 8 salary of an Undersecretary, and, consequently, will be
affected
by
this
policy.
Why

did

the

GSIS

put

cap

on

the

amount

of

basic

survivorship

pension?

RA 8291 mandates the periodic review of its rules and regulations to ensure their responsiveness to its members as
well
as
to
safeguard
the
financial
viability
of
the
System.
Applying a ceiling on the basic survivorship pension, particularly for those who have received salaries more than that
of an Undersecretary, is a measure to guarantee the actuarial soundness of the System. More importantly, it is a
mechanism to bring about equity and fairness among members and their survivors, regardless of whether they come
from
an
agency
within
or
exempt
from
the
Salary
Standardization
Law
(SSL).

The pension is derived from the basic monthly pension (BMP) of a member. The BMP is based on the average
monthly compensation (AMC) which is determined from the aggregate compensation received by the member during
his/her last 36 months. Generally, the last 36 months of service of a government employee corresponds to higher
compensation as compared to his service prior to the said period. Hence, the premium contributions that were
collected during the prior services are lower than those for the last 36 months. This results to a disproportionate
relation between the aggregate contributions with the last compensation and, consequently, any pension, including
survivorship
pension.
To put a cap on the amount that certain income groups in SSL-exempt agencies at the level of the highest career
position of SSL agencies is intended to avert an unfair situation where members or their survivors in regular SSL
agencies, who are already receiving less, will eventually be subsidizing the pensions of members or their survivors,
who
are
already
receiving
more.
How will the survivorship pension of the dependent children be computed, 10% of the BMP or 10% of the
cap?
The

survivorship

pension

of

the

dependent

children

shall

be

computed

at

10%

of

the

BMP.

When will the survivors of a retiree who availed and was paid the 5-year lumpsum benefit receive the
survivorship
pension?
When the old age pensioner dies within the 5-year period after receiving the five-year lump sum, the survivorship
pension shall be paid only after the end of the said five-year period. However, the claim for survivorship benefits
should be filed together with the claim for funeral benefit, and this should be done within four (4) years from the date
of
death
of
the
retiree.
How will GSIS determine if the survivorship pensioners are still qualified to receive the survivorship
pension?
The GSIS eServices Department (for Central Office) / Frontline Services Unit (for Regional and Branch Offices) shall
schedule and conduct home visitation as part of the investigation process to determine if the primary or secondary
beneficiaries
should
continue
to
receive
the
survivorship
pension.

Who will be responsible

for cleansing and tagging the records

of survivorship pensioners?

The Membership Group shall undertake data cleansing and tagging every six (6) months to ensure that the pension
records
of
all
disqualified
or
suspended
primary
beneficiaries
are
tagged
accordingly.
Who
The
When

will

be

Membership
is

responsible
Group

shall
the

for
be

updating

responsible
effectivity

for

the

cap

updating
of

in
the

the

cap
this

in

computerized
the

system?

computerized

system.

new

policy?

This new policy shall be implemented retroactively from the time the existing policies on eligibility requirements of a
surviving spouse to survivorship benefits (disqualifying a surviving spouse who is gainfully employed or engaged in
any gainful activity or receiving pension from GSIS or any other local or foreign institutions from receiving the
survivorship
pension)
were
adopted.
What is the effect of this new policy to the survivors who were disapproved/stopped from receiving their
survivorship pension due to the issuance/approval of MIG 01-2009 dated October 22, 2009 that took effect as
early
as
August
2009
and
MIG
04-2010
dated
April
26,
2010?

For survivorship pensioners whose survivorship pensions were suspended as a result of the previous policy, the
amounts accruing for the period they were suspended shall be restored by the GSIS, subject to the maximum amount
of
survivorship
pension
provided
under
PPG
No.
207-11
dated
February
16,
2011.
On the other hand, for surviving spouse whose applications for survivorship benefits were denied as a result of the
previous policy (disqualifying a surviving spouse who is gainfully employed or engaged in any gainful activity or
receiving pension from GSIS or any other local or foreign institutions from receiving the survivorship pension), their
applications may be submitted to GSIS. If found to be qualified, their benefits shall be granted and computed
retroactively, subject to the maximum amount of survivorship pension provided under PPG No. 207-11 dated
February
16,
2011.

Will the existing survivorship pensioners be subjected to the maximum limit of basic survivorship pension?
No, the existing survivorship pensioners (surviving spouse) who are receiving more than the said limit shall not be
subjected
to
this
policy.
If a claim was filed prior to the end of the prescription period, but was denied due to the previous policy, can
the surviving spouse still file the survivorship benefit claim under this new policy?
The claim is not considered prescribed since it was filed prior to the end of the prescription period. Hence, the claim
may be submitted to the GSIS, and if found to be qualified, the benefit shall be granted and computed retroactively,
subject to the maximum amount of survivorship pension provided under PPG No. 207-11.
If the survivorship benefit claim has prescribed, under what condition can the claim for survivorship benefit
be
allowed
to
be
filed
to
the
GSIS?
If a survivorship benefit claim has prescribed, the said benefit may still be claimed from the GSIS provided that there
was a claim for funeral benefit which was previously filed within the 4-year prescription period. The claim for funeral
benefit shall be considered as a constructive notice for the survivorship benefit claim. If found to be qualified, the
benefit shall be granted and computed retroactively, subject to the maximum amount of survivorship pension
provided
under
PPG
No.
207-11.
Will

the

other

existing

policies

on

survivorship

benefits

be

affected

by

this

PPG?

All other policies which are not affected by the approved PPG, including the Restructured Survivorship Benefits under
RA 8291, as approved by the Board through Board Resolution No. 188 dated August 13, 2003, shall still apply.
However, the policy on the maximum amount of basic survivorship pension payable to the surviving spouse, as
provided under the approved PPG, shall apply to the Restructured Survivorship Benefits under RA 8291.

Inpatient Benefits

These benefits are paid to the accredited Health Care Institution (HCI) through All Case
Rates

The case rate amount shall be deducted by the HCI from the members total bill, which shall
include professional fees of attending physicians, prior to discharge

The case rate amount is inclusive of hospital charges and professional fees of attending
physician

Availment condition: Member must have at least three (3) months premium contributions
within the immediate six (6) months prior to the month of availment

Documents needed: copy of Member Data Record or PhilHealth Benefit Eligibility Form
(PBEF) and duly accomplished PhilHealth Claim Form 1

Where available: all accredited HCIs*

*Different case rate amounts for selected medical conditions are being implemented when done in
Primary Care facilities (PhilHealth Circular 14, s-2013)

Only admissible cases shall be reimbursed

Outpatient Benefits
1. Day Surgeries (Ambulatory Or Outpatient
Surgeries) Are Services That Include Elective (NonEmergency)Surgical Procedures Ranging From
Minor To Major Operations, Where Patients Are
Safely Sent Home Within The Same Day For PostOperative Care

Payments for these procedures are made to the accredited facility through All Case Rates
The case rate amount shall be deducted by the HCI from the members total bill, which shall
include professional fees of attending physicians, prior to discharge

The case rate amount is inclusive of hospital charges and professional fees of attending
physician

Availment condition: Member must have at least three (3) months premium contributions
within the immediate six (6) months prior to the month of availment

Documents needed: copy of Member Data Record and duly accomplished PhilHealth Claim
Form 1

Where available: Accredited Ambulatory Surgical Clinics (ASCs)

2. Radiotherapy

The case rate for radiotherapy using cobalt is P2,000 per session and P3,000 per session for
linear accelerator

Includes radiation treatment delivery using cobalt and linear accelator

Claims for multiple sessions may be filed using one (1) claim form for both inpatient and
outpatient radiation therapy

May be availed of even as second case rate (full case rate amount)
45 days benefit limit: One session is equivalent to one day deduction from the 45 allowable
days per year

If procedure is done during confinement, only the total number of confinement days shall be
deducted

Exempted from Single Period of Confinement (SPC) rule (admissions and re-admissions due
to same illness or procedure within 90-calendar day period)

Availment condition: Member must have at least three (3) months premium contributions
within the immediate six (6) months prior to the month of availment

Where available: Accredited HCIs including Primary Care Facilities that are accredited for
the said service

3. Hemodialysis

The Case Rate for hemodialysis is P4,000 per session

Covers both inpatient and outpatient procedures including emergency dialysis procedures for
acute renal failure

Claims for multiple sessions may be filed using one (1) claim form for both inpatient and
outpatient hemodialysis

May be availed of even as second case rate (full case rate amount)
45 days benefit limit: One session is equivalent to one day deduction from the 45 allowable
days per year

If procedure is done during confinement, only the total number of confinement days shall be
deducted

The procedure is exempted from Single Period of Confinement rule (admissions and readmissions due to same illness or procedure within 90-calendar day period)

Availment condition: Member must have at least three (3) months premium contributions
within the immediate six (6) months prior to the month of availment

Where available: All Accredited HCIs this benefit is no longer restricted to hospitals and
free standing dialysis centers provided that the service is within their capability as provided for in the
DOH license

4. Outpatient Blood Transfusion

The case rate for outpatient blood transfusion is P3,640 (one or more units)

Includes Drugs & Medicine, X-ray, Lab & Others, Operating Room

Covers outpatient blood transfusion only

One day of transfusion of any blood or blood product, regardless of the number of bags, is
equivalent to one session
May be availed of as second case rate (full case rate amount)
45 days benefit limit: One session for each procedure is equivalent to one day deduction
from the 45 allowable days per year Exempted from the SPC rule
Where to avail: All Accredited HCIs

5. Tamang Serbisyo Para Sa Kalusugan Ng Pamilya

(TSeKaP)
i. Preventive Services
1. 1. Consultation
2. 2. Visual inspection with acetic acid
3. 3. Regular BP measurements
4. 4. Breastfeeding program education
5. 5. Periodic clinical breast examinations
6. 6. Counseling for lifestyle modification
7. 7. Counseling for smoking cessation
8. 8. Body measurements
9. 9. Digital rectal examination

ii. Diagnostic Examinations (as recommended by the

doctor)
1. 1. Complete blood count
2. 2. Urinalysis
3. 3. Fecalysis
4. 4. Sputum microscopy
5. 5. Fasting blood sugar
6. 6. Lipid Profile
7. 7. Chest x-ray

iii. Drugs and Medicines

1. 1. Asthma including nebulisation services
2. 2. Acute Gastroenteritis (AGE) with no or mild dehydration
3. 3. Upper Respiratory Tract Infection (URTI)/Pneumonia (minimal and low risk)
4. 4. Urinary Tract Infection (UTI)

Payments for these services are made to the primary care provider through Per Family
Payment Rate (PFPR)

Availment condition: Indigent and Sponsored Members, as well as migrant workers and their
legal dependents should avail of these benefits within the effectivity of their coverage as indicated in
their PhilHealth ID cards or Member Data Records. iGroup (Gold) members may avail themselves of
these benefits within the validity of their group policy contracts, while DepEd personnel may avail
themselves of the benefits as long as they are still active members of PhilHealth

Documents needed: Copy of Member Data Record or PhilHealth ID

Where available: accredited rural health units, health centers or outpatient departments of
selected government hospitals where members are enlisted