Insurance Commission(IC)

October 17, 2023 Dear Mr. Doering, Greetings! Thank you for your request dated Oct 11, 2023 10:40:23 AM under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch. Your Request You asked for follow-up on information on HMOs losses. Response to Request In relation to your request, please be informed of the following as advised by our Health Maintenance Organizations (HMO) Division: HMO Division is mandated to examine the financial condition of HMOs and monitor their compliance with the following regulatory requirements set forth by the Insurance Commission: (1) Net Worth, (2) Acid-Test Ratio, and (3) Risk-based Capitalization. In case the losses incurred by the HMO will result to a deficiency or non-compliance in any of the regulatory requirements mentioned above, the Commission shall issue regulatory actions based on Circular Letter No. 2016-41 (attached herewith for reference) for the HMO to cover-up the deficiency and comply with the regulatory requirement. As regards the claims increases and financial losses, determining the reasons for these necessitates further research which is outside the purview of the division. For further inquiries, you may contact our Health Maintenance Organizations Division at 8523 8461 local 156. For your information and guidance. If you are unhappy with this response to your FOI request, you may ask us to carry out an internal review of the response by email at [email protected]. Your review request should explain why you are dissatisfied with this response, and should be made within 15 calendar days from the date when you received this letter. We will complete the review and tell you the result within 30 calendar days from the date when we receive your review request. If you are not satisfied with the result of the review, you then have the right to appeal to the Office of the President under Administrative Order No. 22 (s. 2011). The quality of services you deserve matter to us. To help the Insurance Commission monitor the progress in improving its services, we appreciate accomplishing the Customer Satisfaction Surveys (CSS) through the following link: https://bit.ly/ICCustomerSatisfactionSurvey Thank you. Respectfully, Atty. Albert Lawrence Vinzon FOI Decision Maker