COOP HEALTH
Consistent with our vision statement of being responsive to the members varying needs, COOPHEALTH, SLEMCOOP’s health care program was established. It provides cash benefit to members who are confined to accredited hospitals as a result of their illness. The program merely compliments the benefits derived from main health care providers such as PhilHealth and others.
What is the benefit of the program?
It gives daily cash allowance, as listed in the Table of Benefits for every day of confinement for a maximum period of thirty one days within the year. In serious, emergency and catastrophic cases as defined in the program, the first day allowance would be double.
| SHARE CAPITAL | BENEFIT AMOUNT |
| P15,000 and above | P500.00/day |
| P4,000.01 - P14,999.99 | P400.00/day |
| P4,000.00 and below | P375.00/day |
Who can participate in the program?
The program is compulsory to all members; regular & associate alike, except in the branches where the program is optional to its associate members.How can one participate?
Upon membership, by paying the required annual premium of P600.00 for the first year and P300.00 for the succeeding years for the whole period of five years.
What will happen after five years of paying the annual premiums?
The member is no longer required to pay the annual premiums while enjoying the full benefits of the program.
Can the annual premiums be paid in installments?
Annual premiums may be paid in monthly installments.
How does payment of premium in installments affect the benefits?
The benefit amount will be computed pro rata. The amount paid in installment within the year divided by 600 for the first year or 300 for the succeeding years.
Can a beneficiary of members be allowed to participate in the program?
A member at his option may enlist his/her qualified beneficiary.
Are there conditions imposed for enlisted beneficiaries?
Unlike the members, the payment for the annual premiums of beneficiaries will be required even after the five year period.
Who are the qualified beneficiaries of a member?
For married members - the husband/wife; children regardless of age and civil status;
parents of members.
For single members - parents; single brothers and sisters.
What are accredited hospitals?
All government hospitals in the province of So. Leyte are the accredited hospitals for purposes of the program. Confinement in accredited hospitals will receive 100% of the benefit amount. Confinement in non-accredited hospitals will only receive 80% of the benefit amount. However, if confinement to a non-accredited hospital was endorsed by the accredited hospital, then the benefit will be 100%.
Is there a period of contestability?
There is a six (6) months contestability period. Claims within the six months period after enlistment to the program will receive the benefits computed pro rata. i.e. no of months after enlistment divided by 6.
How can benefits be claimed?
For claims, a certificate of confinement from the hospital will be asked from the claimant.
