Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

Seventeenth Congress
First Regular Session

HOUSE OF REPRESENTATIVES
HB. No.

Introduced by Representative H. Harry L. Roque Jr.

AN ACT
‘TO ENHANCE CITIZEN AWARENESS OF INSURANCE INFORMATION AND
SERVICES BY ESTABLISHING STANDARDS IN THE LANGUAGE
EMPLOYED IN INSURANCE DOCUMENTS

EXPLANATORY NOTE

‘The Constitution, Article 2, Section 15 provides that
The State shall protect and promote the right to health of the
people and instill health consciousness among them.

A good health care system is anchored on a sound insurance system.
Reasonable insurance coverage means less cost for the government in terms of disease
prevention and treatment. There are many insurers who afford reasonable coverage at
affordable cost to most of our countrymen, However, our country has yet to establish a
meaningful insurance system as most expenditures are still paid out of pocket or paid
for by the government. In 2007, expenditures on health services were paid for by the
government (33%) and out-of-pocket payments (57.00%) and total health expenditure
per capita was US$68. Government funding is a share from general taxation. Several

earmarked taxes are also directed to PhilHealth; these include: value added tax, sin


tax, stamp tax and excise tax. A small proportion of funding comes from private
insurance, HMOs, employment-based plans and private schools. Foreign assisted
Projects comprise only 1.7% of health finances. '

The lack of faith in the insurance sector can be attributed to several factors,
One is the public’s insufficient understanding of the health insurance industry. It can
be attributed to the legalese and technical terms employed by the insurance companies
in marketing and crafting the health insurance polices leading to failure to
communicate the benefits of having health insurance. As a result, the insurance system
is generally treated with distrust.

This bill seeks to mandate health insurance providers to use plain language in
Preparing insurance documents. By doing so, we will be able to democratize the
understanding of such documents and thereby establish faith in the health insurance

Nwm/

H. HARRY L. ROQUE JR

system?

' WHO and DOH: ae i het ag URL
‘http://www wpro.who int/health_services/service_delivery_profile philippines pdf>

* This bill was originally filed by Senator Miriam Defensor Santiago during the Sixteenth Congress,
Third Regular Session.

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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

Seventeenth Congress
First Regular Session

HOUSE OF REPR] TIVES
WB.No DBDd

Introduced by Representative H. Harry L. Roque Jr.

AN ACT
TO ENHANCE CITIZEN AWARENESS OF INSURANCE INFORMATION AND
SERVICES BY ESTABLISHING STANDARDS IN THE LANGUAGE
EMPLOYED IN INSURANCE DOCUMENTS

Be it enacted by the Senate and the House of Representatives of the Philippines
in Congress assembled:
SECTION |. Short Title. — This Act shall be known as the “Plain Language in

Health Insurance Act.”

SECTION 2. Purpose. — The purpose of this Act is to improve the
effectiveness and accountability of health insurance issuers, health plans, and
government health care programs by promoting clear communication that the public

can understand and use.

SECTION 3. Definition of Terms. — For purposes of this Act the term —
A. “Covered document” means any publicly distributed document issued
by a health insurance issuer, health plan, or government health care

program;


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B. “Plain language” means language that the intended audience can readily
understand and use because that language is clear, concise, well
organized, and follows other best practices of plain language writing:
and

C. “Secretary” means the Secretary of Health, unless otherwise indicated.

SECTION 4. Requirement to Use Plain Language in New Documents. — Not
later than one year after the date of effectivity of this Act, all health insurance issuer,
health plan provider, and government agencies implementing health care programs
shall use plain language in any covered document of the plan issued or substantially

revised.

SECTION S. Guidelines. — The Secretary of Health, not later than six months
after date of effectivity of this Act, shall develop guidelines on implementing the
requirements of Section 4 of this Act. The Secretary shall issue such guidelines to
health insurance issuers, health plans providers, and government agencies

implementing health care programs.

SECTION 6. Corrective Action Plan. — If the Secretary finds that a health
insurance issuer or health plan provider is in violation of Section 4 of this Act, the
Secretary shall issue an order requiring the issuer or plan to submit a corrective action

plan within 90 days for review and approval by the Secretary.

SECTION 7. Penalties. - Any health insurance issuer or health plan provider
that violates an order under Section 6 or any provision of a corrective action plan
approved by the Secretary pursuant to the same shall be liable for a penalty in an

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amount not to exceed One Hundred Thousand Pesos (P 100,000.00) for each such

violation.

SECTION 8. Government Health Care Programs. — The Secretary, in
consultation with other appropriate departments and agencies, shall establish
mechanisms to ensure that government health care programs meet the requirements of
Section 4.

SECTION 9. Initial Report to Congress. — Not later than six months after the
effectivity date of this Act, the Secretary shall submit to the appropriate committees in
the Senate and the House of Representatives a report that describes how the agency
intends to meet the following objectives:

A. Communicating the requirements of this Act to health insurance issuers,

health plans, and government health care programs,

B. Training government health care program employees to write in plain

language;
C. Meeting the requirement under Section 4;
D. Ensuring ongoing compliance with the requirements of this Act,
E. Enforcing the requirements of this Act pursuant to Section 6; and

F. Designating a senior official to be responsible for implementing the

requirements of this Act.


SECTION 10. Annual Reports. — The Secretary shall submit reports on
compliance with this Act to the appropriate committees in the Senate and the House of
Representatives annually for the first two years after the date of effectivity of this Act;

and once every three years thereafter.

SECTION 11. Appropriations. — The amount necessary for the initial
implementation of this Act shall be charged against the appropriations of the
Department of Health under the current General Appropriations Act. Thereafter, such
sum as may be necessary for its full implementation shall be included in the annual

General Appropriations Act as a distinct and separate item.

SECTION 12. Separability Clause. —f any provision of this Act is held invalid
or unconstitutional, the same shall not affect the validity and effectivity of the other

provisions hereof.

SECTION 13. Repealing Clause. — Any law, presidential decree or issuance,
executive order, letter of instruction, administrative order, rule or regulation contrary
to or is inconsistent with the provision of this Act is hereby repealed, modified, or
amended accordingly.

SECTION 14. Effectivity Clause. — This Act shall take effect fifteen (15) days
after its publication in the Official Gazette or in two (2) newspapers of general

circulation.

Approved,