Skip to main content

PhilHealth Contribution Remittance Form (Philippines)

PhilHealth Contribution Remittance Form (Philippines)

PHILHEALTH CONTRIBUTION REMITTANCE WORKSHEET

Republic Act 11223 (Universal Health Care Act of 2019) | PhilHealth Circular No. 2023-0009

Employer: [Company Name]

PhilHealth Employer Number (PEN): [Employer PEN]

Address: [Company Address]

Contribution Period: [Contribution Period]

Payment Deadline: [Payment Deadline]

PREMIUM COMPUTATION SUMMARY

Total Covered Employees: [Number of Employees]

REMITTANCE COMPUTATION (2024 Rate — 5% of Basic Monthly Salary)

Premium Rate: 5% total | Employee: 2.5% | Employer: 2.5%

Monthly Premium Floor: PHP 500 combined (for salary at or below PHP 10,000)

Monthly Premium Ceiling: PHP 5,000 combined (for salary at or above PHP 100,000)

Total Employee Premium Share: [Total Employee Share]

Total Employer Counterpart: [Total Employer Share]

TOTAL PHILHEALTH REMITTANCE: [Total Remittance]

PAYMENT DETAILS

Payment Date: [Payment Date]

EPRS Reference / RF-1 Serial No.: [EPRS Reference]

Note: Under Section 7(c) of RA 7875 as amended by RA 11223, late remittance incurs 3% monthly interest on unpaid premiums plus 25% damages on total liability. Employees of delinquent employers retain PhilHealth benefit coverage — PhilHealth recovers benefits from the delinquent employer.

CERTIFICATION

HR / Payroll Officer: ___________________________ Date: _______________

Authorized Signatory: __________________________ Date: _______________

HR / Payroll Officer

________________

Signature

Authorized Signatory

________________

Signature

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a PhilHealth Contribution Remittance Form (Philippines)?

A PhilHealth Contribution Remittance Form in the Philippines captures the information the relevant authority needs for the matter it concerns and creates a dated written record of what was submitted.

RA 11223 (Universal Health Care Act) mandates universal PhilHealth coverage for all Filipinos and significantly revised the premium contribution structure. Under PhilHealth Circular No. 2023-0009 (effective January 2023), the premium contribution rate is 5% of the basic monthly salary, equally shared between the employee and employer at 2.5% each, with a monthly premium floor of PHP 500 (for members earning PHP 10,000 or below) and a monthly premium ceiling of PHP 5,000 (for members earning PHP 100,000 or above, contributing PHP 2,500 each). The premium rate is scheduled to increase incrementally to 5% of monthly basic salary as of 2023, with the PhilHealth Board of Directors authorized to adjust the rate annually up to a ceiling of 5% by 2025 under RA 11223.

All private-sector employers are required to deduct the employee's PhilHealth premium share from the monthly salary and remit the combined employee and employer shares to PhilHealth through the Electronic Premium Remittance System (EPRS) or through PhilHealth-accredited collecting banks using the RF-1 form. Remittance deadlines are based on the last two digits of the employer's PhilHealth Employer Number (PEN), with deadlines ranging from the 10th to the last day of the following month.

PhilHealth premiums are used to fund the National Health Insurance Program (NHIP) benefits package — including inpatient and outpatient coverage, maternity care, dialysis, cancer treatment, and catastrophic illness benefits — available to members and their qualified dependents at PhilHealth-accredited hospitals nationwide. Employers who fail to remit PhilHealth contributions are liable to pay the unremitted premiums with a 3% monthly interest, plus damages of 25% of the total liability, under Section 7(c) of RA 7875 as amended by RA 11223.

The legal framework governing the PhilHealth Contribution Remittance Form (Philippines) in Philippines draws on several key statutes and regulatory bodies. Under Philippine law, the Civil Code of the Philippines (Republic Act No. 386) governs contractual obligations. The Revised Corporation Code (Republic Act No. 11232) regulates corporate entities through the Securities and Exchange Commission (SEC). The Labor Code of the Philippines (Presidential Decree No. 442) and Department of Labor and Employment (DOLE) govern employment matters. The Data Privacy Act of 2012 (Republic Act No. 10173) and the National Privacy Commission (NPC) protect personal data. The Bureau of Internal Revenue (BIR) administers tax obligations under the National Internal Revenue Code. Parties executing a PhilHealth Contribution Remittance Form (Philippines) in Philippines should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Local Government Code (RA 7160) sets the foundational requirements.

When Do You Need a PhilHealth Contribution Remittance Form (Philippines)?

A PhilHealth Contribution Remittance Form is needed in the Philippines in the following situations.

A PhilHealth Contribution Remittance Form is required each month when the employer prepares PhilHealth premium deductions from employee salaries and the employer's matching contribution, prior to uploading data through the EPRS or submitting the RF-1 to a PhilHealth-accredited collecting bank.

A PhilHealth Contribution Remittance Form is needed when a new employee is hired and the employer must register the employee with PhilHealth using the Employer Remittance Report or the electronic registration through the PhilHealth Member Portal, and begin remitting premiums from the first month.

A PhilHealth Contribution Remittance Form is required when an employee files a PhilHealth benefit claim for hospitalization, outpatient care, maternity, or other covered services, and PhilHealth verifies the employer's premium payment records to confirm the employee's eligibility for the specific benefit.

A PhilHealth Contribution Remittance Form is needed for DOLE compliance inspections under Department Order No. 183-17, which includes PhilHealth remittance compliance as a mandatory benefits check item alongside SSS and Pag-IBIG.

A PhilHealth Contribution Remittance Form is required at year-end for reconciliation of payroll deductions against PhilHealth's Employer's Statement of Account (ESOA) to identify any discrepancies, shortfalls, or overpayments before the January deadline for year-end compliance reporting.

Parties in Philippines should prepare a PhilHealth Contribution Remittance Form (Philippines) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under Philippine law, the Civil Code of the Philippines (Republic Act No. 386) governs contractual obligations. The Revised Corporation Code (Republic Act No. 11232) regulates corporate entities through the Securities and Exchange Commission (SEC). The Labor Code of the Philippines (Presidential Decree No. 442) and Department of Labor and Employment (DOLE) govern employment matters. The Data Privacy Act of 2012 (Republic Act No. 10173) and the National Privacy Commission (NPC) protect personal data. The Bureau of Internal Revenue (BIR) administers tax obligations under the National Internal Revenue Code. Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.

What to Include in Your PhilHealth Contribution Remittance Form (Philippines)

A valid Philippines PhilHealth Contribution Remittance Form contains the following essential elements under Republic Act 11223 (Universal Health Care Act) and PhilHealth Circular No. 2023-0009.

Employer Information: PhilHealth Employer Number (PEN) — the unique 12-digit employer identifier issued upon PhilHealth employer registration — company name, and business address as registered with PhilHealth. For corporations, this must match the name on file with the Securities and Exchange Commission (SEC) under the Revised Corporation Code (RA 11232).

Contribution Period: The specific month and year for which premiums are being computed and remitted. Remittance must be made on time based on the PEN deadline schedule; late remittance attracts 3% monthly interest plus 25% damages under Section 7(c) of RA 7875 as amended by RA 11223.

Employee Premium Schedule: For each covered employee — full legal name as registered with PhilHealth, PhilHealth Identification Number (PIN), monthly basic salary, applicable premium rate (5% for 2023 onwards under PhilHealth Circular No. 2023-0009), employee share (2.5% of monthly basic salary), and employer share (2.5% of monthly basic salary). The Labor Code of the Philippines (Presidential Decree No. 442) and Department of Labor and Employment (DOLE) Department Order No. 183-17 require that employers maintain accurate payroll records for all mandatory benefit deductions.

Premium Ceiling and Floor Application: Identification of employees at or above the PHP 100,000 monthly basic salary cap — maximum combined premium PHP 5,000 (PHP 2,500 each) — and employees at or below the PHP 10,000 monthly basic salary floor — minimum combined premium PHP 500 (PHP 250 each). These thresholds are set under PhilHealth Circular No. 2023-0009 implementing RA 11223.

Total Remittance: The aggregate sum of all employee shares and all employer shares for all covered employees for the contribution period, which is the amount to be remitted through the Electronic Premium Remittance System (EPRS) or paid to a PhilHealth-accredited collecting bank.

Payment Deadline: The applicable PhilHealth remittance deadline based on the last two digits of the employer's PEN, as published in the PhilHealth Contribution Payment Schedule. Deadlines range from the 10th to the last day of the month following the contribution period.

EPRS Reference and Documentation: Electronic Premium Remittance System (EPRS) transaction reference number, or RF-1 Premium Remittance Form serial number and bank payment receipt number, for audit and reconciliation purposes. The Bureau of Internal Revenue (BIR) requires that SSS, PhilHealth, and Pag-IBIG deductions be reflected in BIR Form 2316 (Certificate of Compensation Payment/Tax Withheld) as allowable deductions.

New Employee Registration: For newly hired employees, reference to the PhilHealth membership registration completed within 30 days of hiring through the PhilHealth Member Portal, consistent with Section 5 of RA 11223 mandating universal coverage. The Data Privacy Act of 2012 (RA 10173) administered by the National Privacy Commission (NPC) requires a lawful basis for processing employees' personal data including name, PIN, and salary information.

Year-End Reconciliation: At year-end, the employer's cumulative PhilHealth remittance records must be reconciled against PhilHealth's Employer's Statement of Account (ESOA) to identify discrepancies, shortfalls, or overpayments before the January deadline. The Bureau of Internal Revenue (BIR) requires PhilHealth contribution deductions to be accurately reflected in BIR Form 2316 (Certificate of Compensation Payment/Tax Withheld) issued to each employee annually. DOLE Department Order No. 183-17 compliance inspections verify PhilHealth, SSS, and Pag-IBIG remittance records together as part of the mandatory benefits compliance check. Forms-legal.com provides this PhilHealth Contribution Remittance Form (Philippines) template as a starting point for Philippine employer compliance documentation.

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). PhilHealth Contribution Remittance Form (Philippines) (Philippines) [Legal document template]. Forms Legal. https://forms-legal.com/philippines/government/social-security/philhealth-remittance-form-philippines

MLA

"PhilHealth Contribution Remittance Form (Philippines) (Philippines)." Forms Legal, 2026, https://forms-legal.com/philippines/government/social-security/philhealth-remittance-form-philippines.

BibTeX
@misc{formslegal-philhealth-remittance-form-philippines,
  author       = {{Forms Legal}},
  title        = {PhilHealth Contribution Remittance Form (Philippines) (Philippines)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/philippines/government/social-security/philhealth-remittance-form-philippines}},
  note         = {Free legal document template. Based on Local Government Code (RA 7160)}
}

Frequently Asked Questions

Based on Local Government Code (RA 7160) — Template last modified June 2026

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

Found an error? Let us know