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Group Opt-in Proposal

Implementing EO 64 Medical Allowance (informal)

Even without Division Office Support

An Open Letter to Principals and Division Superintendents

Most available HMO options within ₱7,000 offer limited benefits, often excluding vital services for teachers such as annual physical exams, maternity care, and hospitalization.

To address this gap, we are pleased to present the National Healthcare Shield (NHS): a comprehensive, affordable health plan by Kaiser International HealthGroup, specifically designed to meet the needs of teachers and DepEd personnel.

Download Open Letter for Principals and SDS

See NHS Informal Groups.

Implementing EO 64 Medical Allowance (non-procurement)

With Division Office Support

1. Context
   Starting FY 2025, public school teaching and non-teaching personnel will receive a ₱7,000 annual medical allowance as directed under Executive Order No. 64 s. 2025, section 7, as subsidy to get HMO-type health coverage, with implementing guidelines by DBM Budget Circular No. 2024-6 and DepEd Order No. 16, s. 2025.
    
2. Simplified Implementation
   To ensure timely and inclusive implementation without undergoing formal procurement, we propose complementing the individual availment option allowed under Section 7.1.2 of DBM Budget Circular No. 2024-6 and Section 4.1 under DepEd Order 16 C. Availing of Medical Allowance.
   
   These provisions allow employees to avail their own HMO-type benefit.
   The Implementing Unit may then assist the employees by facilitating consolidated enrollment and payment remittance for the chosen HMO plan.
    
3. Legal and Administrative Basis
   This implementation is anchored on the following policies:
   • Section 7.1.2, DBM Budget Circular No. 2024-6: Allows cash release for employees who avail their own or renew their existing HMO-type benefit.
   • Section 15.1, DBM Budget Circular No. 2024-6: Empowers agencies to issue internal guidelines for release, use, and monitoring of the allowance.
   • Section 4 under Department of Education Order 2025-16 C. Availing of Medical Allowance: Individual Availment and allowing payroll disbursement for the availment of new/renewal of individual HMO
   • Item f, of Department of Education Order 16-2025 Policy Statement: demonstrates the Department’s proactive role in protecting and promoting the holistic well-being of its workforce.
   • COA GAM Vol. I, Section 19: Authorizes payroll deductions and remittances to third-party entities upon employee consent, with proper documentation.
   This is also compliant with the following policies prohibiting commercialization
   • Department of Education Order 28, s. 2001
   • Department of Education Order 39, s. 2009
   
    
4. Employee Choice / Group Opt-in
   Under this implementation, a list of HMO plans that meet the Department’s encouraged criteria shall be prepared:
   • Include benefits for high-risk cases such as pregnant women, senior citizens, or persons with disabilities (PWDs)
   • The HMO coverage shall be for a period of 12 months
   • The following shall be considered for HMO packages
     1. In-patient benefit
     2. Out-patient benefit
     3. Emergency care benefit
     4. Annual Physical Exam
     5. Dental Benefit
   After the list has been prepared:
   • Employees choose their HMO plan from a list of plans meeting the criteria
   • Employees submit the Medical Allowance Form (Annex A) and a signed Authorization to Deduct and a Group Opt-in form specifying group plan to enroll in.
   • The implementing unit
     • consolidates forms for enrollment
     • executes a Memorandum of Agreement as an Enrollment / Payment facilitator with the HMO provider
     • issues a one-time payment to the HMO provider.
   • The provider issues a collective receipt enumerating each individual member and confirms coverage.
   This is assisted enrollment, and not a government procurement, compliant with COA Government Accounting Manual guidelines for payroll deduction and remittance to third party entities upon employee consent and proper documentation.
    
5. Required Documentation
   1. From Employee (requirements for employee consent)
      1. Medical Allowance Registration Form (Annex A)
      2. Employee Authorization to Deduct
      3. Employee Group Opt-in
   2. From Implementing Unit (requirements for proper documentation)
      1. Summary List of Enrollees
      2. MOA or Letter of Agreement with HMO provider
      3. Transmittal Letter with one time remittance / payment
   3. From HMO provider ( requirements for Individual Availment under DepEd Order 16)
      1. Copy of HMO agreement
      2. Valid identification card reflecting name of employee
      3. Official Receipt detailing list of enrollees, acknowledging individual payment of the membership fee for the HMO product acquired
   
    
6. Benefits of This Implementation
   • Quick, proactive implementation consistent with the spirit of proactive role in protecting and promoting the holistic well-being of the workforce
   • Maintains full documentation and audit under Department Order 16 s. 2025
   • Encourages informed choice with list of validated plans
   • Respects employee choice of plan and provider
   • Non-procurement process, consistent with the DBM, COA and DepEd guidelines
   • Empowers employees who choose individual availment to get better benefits at lower group HMO rates, instead of lower quality plans at higher individual HMO rates.
   
    
7. Alignment with Department Order No. 16, s. 2025 This proposal is fully aligned with the intent and spirit of DepEd Order No. 16, s. 2025. Specifically, it supports item (f) of the Policy Statement: “To demonstrate the Department’s proactive role in protecting and promoting the holistic well-being of its workforce.”
   
   While Section 3.0 of the same order provides for procurement of group HMO plans by the Department, compliant with RA 12009 and RA 9184, the selected HMO limits the employee choice to one plan.
   
   This proposal does not conflict with that provision. Rather, it serves as an enhancement of the option provided under Section 4. Individual Availment, which allows employees to avail of the medical allowance through “4.1 Payroll disbursement for the availment of new/renewal of individual HMO.”
   
   This implementation enables support of individual availment through consolidated enrollment and one-time remittance, allowing individual employees to collectively access more affordable HMO plans through group-negotiated rates—without undergoing formal procurement.
   
   Moreover, this implementation empowers employees to exercise genuine choice among providers, rather than being limited to a single HMO selected through bulk procurement.
   
   It balances cost-efficiency, flexibility, and respect for DepEd’s non-commercialization policies.
    
8. Compliance with DepEd Order No. 39, s. 2011 The Department’s existing policy “Prohibiting Commercialization of the DECS Organization Through Endorsements of Goods and Services” embodied in DepEd Order Order 28, s. 2001 and reiterated in DepEd Order 39, s. 2011 state there is no need to give an institutional endorsement to any product or services to prevent distortion of market forces by giving impression of superior quality to a product. It further dissuades the department from favoring one commercial product or service against the other.
   
   Under this implementation, the Department will compile a list or matrix of compliant plans from various providers for the sole purpose of empowering employees to make informed, voluntary choices.
   
   The list or matrix will objectively summarize features of HMO plans including price, and criteria encouraged in Department Order 16, and disseminated purely for information of the organization.
   
   This ensures full transparency and respect for internal policies on provider engagement, ethical practices, and employee empowerment.
   
   It ensures that employees retain the freedom to choose, and that the Department maintains its neutral, non-commercial stance, while still enabling the quick and efficient rollout of the medical allowance for the individual purchase of HMO-type benefits.
    
9. Proposal
   It is proposed that NHS be included in a matrix of HMO plans and that it be considered for inclusion based on the following:
   • Competitive premium and benefit value
   • Compliance with encouraged criteria under DepEd 16
   • Healthcare services provided
   • Accessibility of network and services
     Our organization does not seek endorsement, exclusivity, or preferential promotion, but rather submit our health plan for evaluation alongside other available HMO plan options, for the purpose of empowering government employees to make informed, voluntary choices.
    
10. Summary
    It is recommended this one-time remittance group opt-in implementation under the Individual Availment provision. It ensures timely delivery, respect for employee choice, providing maximum healthcare values at the least possible cost to the employee, while remaining compliant with all pertinent DBM, COA, DepEd guidelines and regulations.

Kaiser International HealthGroup

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