Who is our HMO provider?

Our current HMO provider is Intellicare.

Who is covered under my HMO plan?

• Your HMO plan covers you as an employee and includes one (1) free immediate dependent.
• You may also request to enroll additional dependents, with the cost deducted from your salary.

Is there a required order (hierarchy) for enrolling dependents?

Yes. The order of enrolling dependents depends on your status:

If you are single:
You must enroll your parents first. If both parents already have an HMO card, you may then enroll your siblings as immediate dependent, provided they are 21 years old or younger.

If you are married:
You must enroll your spouse first, followed by your children. If your spouse already has an HMO account, is an OFW, or you are legally separated, you may proceed with enrolling your children. Once your spouse and children are enrolled, you may add your parents, provided they are 65 years old or younger. Please note that a different rate applies for parents of married employees.

If you are a single parent:
You must enroll your child first before you can add your parents.

Who is considered my immediate dependent?

If you are single:
Your immediate dependents are your parents.

If you are married:
Your immediate dependent is your spouse.

If you are a single parent:
Your immediate dependent is your child, followed by your parents.

How do I enroll an additional dependent?

To enroll an additional dependent, please follow these steps:

1. Go to HRMS and create a ticket.
2. Select HMO as the ticket category.
3. Choose Enrollment of Additional Beneficiary.
4. Wait for the link that will be provided for your additional dependent request.
5. Complete the form and attach the required documents.

What documents do I need to submit?

If you are single:
Submit your birth certificate.

If you are married:
Submit your marriage certificate.

If you are single with a sibling as a dependent:
Submit your parents’ HMO details and your sibling’s birth certificate.

If you are a single parent:
Submit your child’s birth certificate.

For partners / cohabitation:
Submit a CENOMAR for both parties and a Certificate of Cohabitation.

How much will it cost me to add another dependent?

The current rates (as of September 2025) are as follows:

Immediate dependent: ₱6,248.48 per quarter
Enrolled parents of a married principal: ₱12,496.96 per quarter
Overage immediate dependent (ages 66–70): ₱12,496.96 per quarter
Overage immediate dependent (ages 70–75): ₱18,744.32 per quarter

What if the cost of my immediate dependent is higher than the free dependent rate?

If the cost of your immediate dependent exceeds the free dependent rate, the excess will be processed through payroll deduction.

When will the HMO deduction take effect?

The HMO deduction will begin on your next payroll. Adjustments will be applied once the billing statement from Intellicare is received. You may also request a customized deduction schedule if needed.

What is the coverage of my Intellicare plan?

Your Intellicare plan provides a maximum benefit limit (MBL) of ₱190,000 per year for both the principal member and enrolled dependents.

Do we have pre-existing limit for the current HMO contract?

Yes. Coverage for pre-existing conditions depends on the type of dependent:

For immediate dependents:
Pre-existing conditions are covered up to the maximum benefit limit (₱190,000).

For existing extended dependents:
Up to 25% of the maximum benefit limit can be used.

For newly added extended dependents:
Coverage is up to ₱20,000 only during the first year of membership.

Where can I access my Intellicare account?

You can download the Intellicare Avega app to access your HMO benefits and track your utilization anytime.

What services are usually covered by the HMO?

Your HMO typically covers the following services:

1. Emergency treatment
2. Inpatient care and confinement
3. Outpatient consultations
4. Teleconsultations / telemedicine

When can I start using my HMO account?

For employees, your HMO account is available starting on your first day of work. For dependents, activation usually takes 10–14 days.
Note: Delays may occur if required documents are incomplete, which can affect the activation period for dependents.

How long will it take to receive my HMO card?

The processing time for HMO card delivery is approximately 3 to 4 weeks.

How do I use my HMO if my account is still inactive?

You may email hr@staffdomain.com to request a manual endorsement, or contact your CSP directly for urgent availment.