Guide To HMO Companies In The Philippines: Coverage, Benefits, And Affordable Options

A company that cares is one that rarely despairs. When translated to corporate-speak, there are minimal employee turnovers.

Companies can show their appreciation for employees through two things. The first is fair compensation, which includes above minimum wage and other monetary benefits like employee bonuses. In fact, the Decoding Global Talent report conducted by JobStreet together with the Boston Consulting Group and the Network, shares that financial compensation ranks #7 in the list of top employee preferences. 

Aside from remuneration, you can also count the non-monetary benefits. This includes leave allocations, work perks, and the Health Management Organization (HMO) plan. Having an HMO plan is also a factor of talent attraction, especially because of the pandemic. This will still stay relevant even after because people are now conscious of their health and safety. 

In this article, we give you an overview of HMO companies in the Philippines and the benefits that they provide. To stay up to date on current packages, we encourage you to get in touch with your HMO provider of choice to discuss your options in further detail.

An HMO plan refers to the medical and healthcare benefits that an employee is entitled to. Should they encounter an emergency, they can pull this out anytime to cover a percentage of the cost. Not only that, each member gets access to the plan’s network. This includes the list of accredited hospital partners and perks. 

What is also important to note is that HMO complements PhilHealth coverage. Most, if not all, employees already are members but the more help they can get, the better. A suggested way of going about the medical assistance is to couple PhilHealth with the HMO plans. That way, they can save on costs even more. 

Most companies have this on their line-up of perks. In order to avail of this benefit, companies can either pay for this wholesale or deduct a certain amount from their employees’ payroll. The deduction percentage is dependent on several factors, but the average ratio is 60% company, 40% employee. 

Coverage inclusions are usually financial assistance for a select number of surgeries and consultations. Some HMO plans also extend coverage for annual physical exams and dental. 

But in line with the pandemic, HMOs have adjusted accordingly to the needs and rising health demands. Most HMO companies have supplied medium to full financial coverage of hospital bills. They have also provided teleconsultation services in place of face-to-face appointments for safety purposes. 

Ultimately, the coverage will depend on the HMO company. Therefore, it is still best to consult with them directly on how they can help you out. 

Now you may be wondering, “How does this differ from just getting insurance?” Insurance plans are more comprehensive, but they may cost more. This is because they cover more than just regular medical expenses. Insurance plans cover critical illnesses as well. 

So what is better? The ideal answer is to get both. After all, the more coverage you have, the more secure you will be. But if your priority is to stay cost-efficient, providing HMO plans is already a good start. In any case, you can always encourage your employees to get their own insurance. 

As an employer, determining the best HMO company for you can be overwhelming. This is because plans differ per company, and you just want the best for your employees. The best way to go about it is to ask the following questions:

First of all, you should find out what package benefits are a priority for your employees. Are there more mothers on the team? Maybe they would need labor fund assistance. What about professionals with existing comorbidities? You can pick a plan that has COVID-19 benefits. 

Second, you can also check the accredited partner hospitals and see if they fit your liking. More importantly, will they be able to provide the most cost-efficient assistance for you and your company? 

Lastly, what are the types of health plans available? Will splurging on a plan be better for your company? Or will trying out a budget-friendly plan be enough for now? Picking the right one will be up to your discretion. What is more important is that you are willing to prioritize the health and safety of your employees. 

With all these in mind, let us take a look at five HMO companies and their offerings. Each plan comes with its own set of benefits and is applicable for a certain number of enrollees. Most of these also include perks not just for the principal holder, but for their dependents too. 

It is important to take note that HMO plans cover two categories. The first is the in-patient, which encapsulates procedures requiring hospital admission. Examples of such include major operations and critical illnesses. On the other hand, the out-patient category covers procedures that do not require a stay-in at the hospital. 

Maxicare Established in 1987, this company has three plans fit for SMEs to sign up for. 

Maxicare Business Essential Dubbed their most cost-efficient plan, this package only covers out-patient procedures. Should you want to upgrade to the full plan, you can do so from 3 employees up to 99 enrollees. 

Maxicare Starter Plan This plan includes a minimum of 3 principals up to 99 enrollees. Aside from the usual in-patient and out-patient coverage, they also have dental coverage and accidental dismemberment benefits. 

Vaccine shots for tetanus and animal bites are also covered, as well as health monitoring and tracking. 

MaxicarePLUS This comprehensive plan covers both in-patient and out-patient, but with more benefits. They include cancer case perks, dental coverage and wellness programs. For those who want to check their vitals, annual and executive check-ups are also covered. 

Howden Prime HMO This London-founded corporation started out from three people and branched out to corporations outside their home base. This includes a station right here in the Philippines. 

Unlike other HMO programs, they do not have a minimum number of enrollees for companies. So from solo entrepreneurs to as many as 200, you can take part in their program. 

What is also unique about their plans is the inclusion of common-law and LGBT spouses. Principal holders can sign their partners up at no extra cost. They also reimburse maternity and labor costs up to Php 7,000. 

AllCare This company specializes in packages for the modern working world. Their credo specifies that they are the response to traditional employee benefits. This means that they provide plans especially for freelancers, solo entrepreneurs, and SMEs. 

With a minimum enrollee number of 5 employees, they cover up to Php 30,000 in medical fees for those with pre-existing conditions. More than that, they also cover mental health, optical concerns, and do telemedicine consultations. 

Affinitas While originally an insurance broker, this company also has a plan specially made for SMEs. 

Their minimum requirements include 5 employees up to 99 employees. But for dependents to enjoy some of the perks in full, 75% of the company employees must sign up for their program. 

In this program, they cover pre-existing conditions and congenital illness. For exams, you can take the Annual Physical test and you are also entitled to dental benefits. Also, should you run into an emergency, you are covered wherever you are in the world. 

Intellicare This company has the SME Fit Plan, which is a customized group plan fit for small to medium enterprises. 

If HMO plans do not fit your company budget, do not fret. You can still show your employees that you care for their health and wellness. In fact, here are three suggestions you can refer to:

Offer reimbursement options for certain situations This is especially applicable to those who pose health risks at the office. For example, if one of your employees is symptomatic of COVID-19, they can have their test fees reimbursed. The same goes for non-pandemic related situations caused because of a circumstance that happened at work. These include accidents, food poisoning, and the like. 

Spread awareness on government benefits Though most employees already have this in the bag, there are still some that do not. You can inform your colleagues through an awareness drive of the different public perks we have. Ranging from SSS to PhilHealth, it is best to keep your employees informed about what rights they are entitled to. 

You can even zero in on PhilHealth and explain the medical benefits citizens are entitled to. Like for instance, you can share about the fixed costs you must deal with and the percentage of coverage available. 

Incorporate health and wellness programs This adage rings true: Prevention is better than cure. The way to incur costs from the pandemic or for any related sickness is to prevent it. How do you go about that? In addition to implementing workplace guidelines, focus on the different aspects of health. Whether that be physical, mental, emotional, or spiritual, there are solutions for each. It could be hosting a virtual exercise program, implementing mental health programs, or having health talks. 

Some companies even send wellness kits that include alcohol, vitamin C, and masks. You can also provide special benefits for your skeleton team. It could be higher remuneration and providing on-site testing. 

Increasing the inventory of your clinic is also good. You can purchase oxygen tanks, introduce new medicines to your cabinet and the like. 

Also read: 5 ways to care for employee mental health

Whatever effort you provide for the wellness of your employees is always appreciated. But the best way to quantify it is to look after their long-term health. An HMO plan is a great solution, but you can always divert to other ways if the cost is high. But more importantly, see to it that you provide the best for your company. 

It will not only be good for them, but also for you to gain a higher percentage of loyalty. 

Just like caring for your employees, provide opportunities for #JobsThatMatter and find the right candidates with Talent Search. Access one of the largest databases in Southeast Asia and use machine learning to find the right person for the right job. Download our Decoding Global Talent Report for the latest work trends and employee insights.