STELLA ZIPAGAN-BANAWIS

Executive Director, ECC

Financial Management Practitioners: Rising to the Challenge of Change

Association of Government Accountants of the Philippines, Inc.
21 October 2016, Bohol, Philippines
OUTLINE OF PRESENTATION

I. THE ECC AND THE ECP

II. THE STATE INSURANCE FUND (SIF)
III. CHALLENGES AND REFORMS
IV. GOVERNANCE
V. WAY TO GO
 SOCIAL PROTECTION –
SOCIAL INSURANCE

• 9 major branches of social security

Maternity Sickness / Medical Care Unemployment Work injury

Family benefits Invalidity Death of the

breadwinner

Old age

Source: International Labour Organization

ASEAN D ECLARATION ON
S TRENGTHENING S OCIAL P ROTECTION
• Adopted at the 23rd ASEAN Summit in Brunei
Darussalam, on 9 October 2013

• “Everyone, especially those who are poor, at

risk, persons with disabilities, older people, out-
of-school youth, children, migrant workers, and
other vulnerable groups, are entitled to have
equitable access to social protection that is a
basic human right and based on a rights-
based/needs-based, life-cycle approach and
covering essential services as needed”
P HILIPPINE WORK-C ONTINGENCY
P REVENTION AND C OMPENSATION SYSTEM

ECC ECC

DOLE ECP
OSHC BWC
GSIS SSS
EMPLOYMENT INJURY OCCURRENCE

• 2.3 Million workers die from occupational

accidents or diseases every year
– 6, 400 people everyday
• 473 Million workers involved in non-fatal
occupational injuries and diseases annually
– 1, 295, 890 people everyday

• In the Philippines, around 49,118 workers suffered

from occupational injuries; 171,787 suffered from
occupational diseases in 2015
Source: International Labour Organization
2015 BLES Integrated Survey (BITS)
THE ECC AND THE ECP
 THE ECC
• Created in 1975 under P.D. 626

• A policy-making and quasi-judicial entity, classified as

a GOCC
• Attached to DOLE for policy and program
coordination
• Members of the Board composed of heads of DOLE,
GSIS, SSS, PhilHealth, OSHC, representatives of
employers’ and employees’ sector, ECC Secretariat
• The GSIS and SSS are the implementing agencies of
the employees’ compensation program (ECP)
 THE ECP

• The Employees’ Compensation Program

(ECP) provides a package of benefits for
public and private sector employees and their
dependents in the event of work-connected
contingencies such as sickness, injury,
disability or death.
EC BENEFITS

Principal Benefits Accessory Benefits

Temporary Total Disability Medical Benefits
(Sickness Benefit) Rehabilitation Services
Medical Benefits
Permanent Partial
Carer’s Allowance
Disability
Rehabilitation Services
Medical Benefits
Permanent Total Disability Carer’s Allowance
Rehabilitation Services
Death/Survivorship
Funeral Benefits
Pension
COVERAGE

• All compulsory members of SSS, including

seafarers
• All GSIS members
• Uniformed Personnel: AFP, PNP, BFP and
BJMP
EC M EMBERSHIP, 2015

Membership Number Percent

GSIS 1,702,101 7%

SSS 24,320,878 93%

Total 26,022,979 100%

Source: SSS and GSIS, 2015

STATE INSURANCE FUND
(SIF)
THE STATE INSURANCE FUND (SIF)

 Employers’ contributions
Government
and Private  Php10.00-30.00/worker
Employers’ /month for private sector
Contributions  Php100.00/worker/month
for public sector

STATE
Public Sector
Employers’
INSURANCE
Contributions
FUND

EC BENEFITS OPERATING EXPENSES

Government Employees ECC, OSHC, GSIS & SSS
Private Employees
TOTAL A SSETS - P53.98B (J UNE 2016)
Asset is increased by 6% or P3.22B from December 31, 2015

GSIS - P19.98B
(37%)
SSS - P33.99B
(63%)
REVENUES, 2014 AND 2015
SSS GSIS
% Inc % Inc
2014 2015 2014 2015
(Dec) (Dec)

Members
1,711,204,185 1,828,701,491 6.9 2,060,609,591 1,924,670,706 (6.6)
Contribution

Investment
754,089,45 1,026,998,283 36.2 443,276,809 428,158,250 (3.4)
Income

TOTAL 2,465,293,640 2,855,699,774 15.8 2,503,636,231 2,103,229,881 (16.0)

Total Revenues 2014 : P4,968,929,871; 2015: P4,958,929,655

TOTAL R EVENUES
Total – P4.46B
Revenues, Ph4.46M, January (J
to June
AN -J30,
UNE20162016)
4,500,000,000.00

4,000,000,000.00

3,500,000,000.00

3,000,000,000.00
in billion pesos

2,500,000,000.00

2,000,000,000.00

1,500,000,000.00

1,000,000,000.00

500,000,000.00

-
SSS GSIS TOTAL

SSS GSIS Total

Members Contribution 957,565,259.00 1,677,295,441.00 2,634,860,700.00
Investment and Other Income 990,540,663.00 832,400,914.00 1,822,941,577.00
Total 1,948,105,922.00 2,509,696,355.00 4,457,802,277.00

Members Contribution Investment and Other Income Total

 Revenues, GSIS - SIF
Contribution Investment Income
2.50

BILLIONS
2.00

1.50

1.00

0.50

0.00
2010 2011 2012 2013 2014 2015
Contribution 1,951,876,705. 1,969,684,985 2,022,875,274 2,243,644,080 2,060,609,591 1,924,670,706.
Investment Income 63,733,513.38 164,613,657.8 270,763,423.4 357,375,472.9 445,999,144.0 428,158,250.00
N UMBER & A MOUNT OF EC C LAIMS PAID , SSS & GSIS
2014 AND 2015

2014 2015

Number of EC Claims
Paid
SSS 268,923 248,295
GSIS 16,170 31,029
Total 285, 093 279, 324
Amount of EC Claims
Paid
SSSSource: SSS Php 1,096.90M Php1,071.66M
GSIS Php 160.22M Php 177.29M
Total Php 1,257.12M Php 1, 248.95M
 NUMBER OF BENEFITS CLAIMS
Public Sector, 2010 - 2015
35
THOUSANDS

30
NO. OF CLAIMS

25

20

15

10

-
2010 2011 2012 2013 2014 2015
TOTAL 4,946 7,925 5,603 7,165 16,170 31,029
YEAR
 AMOUNT OF BENEFIT PAYMENT
Public Sector
200
Millions

180

160

140
Amount Paid

120

100

80

60

40

20

-
2010 2011 2012 2013 2014 2015
TOTAL 30,710, 67,812, 38,245, 57,199, 160,219 177,289
Year
 26 Million Investment &
Other Income

Members ₱ 1.8 Billion

as of 2015

Jan. to Jun. 2016

₱ 53.98 B
Total Assets
₱ 658.4 M
Benefits Payment
Members
Contribution

as of June 2016 January to June 2016

₱ 2.6 Billion

13
Regional Extension Units EC Fund Life
Nationwide
CHALLENGES AND
REFORMS
MAJOR CHALLENGES

• LOW BENEFITS

• SLOW PROCESSING OF CLAIMS

• LOW AWARENESS
K EY R EFORM STRATEGY F RAMEWORK

Equalize ADEQUACY/

BENEFITS
ACCESSIBILITY
Enhance

Expand COVERAGE

SUSTAINABILITY
 LOW
BENEFITS
EC EQUALIZED AND ENHANCED BENEFITS
EC BENEFIT EQUALIZED
Sickness Benefit Public : Max P90/day since 1987 Equalized at P200/day in 2013
Private: Max P200/day since 1996 Increased the minimum to P110.00
and maximum to P480.00 in 2015
(for OP approval)
Funeral Benefit Public : P 3,000 since 1987 Equalized at P10,000 in 2013
Private : P10,000 since 1997 Enhanced to P 20,000 for both sector in
2013
Enhanced to P 30,000 for private and
public sector in 2016
Carer’s Allowance Public : None Equalized at P575 in 2013
Private : P575 since 1991
EC Survivorship Public: Payment suspended in 2004 Lifted suspension in 2012
Pension Private: No suspension (prospective applies)
Enhanced with a 10% across-the-board
increase for private sector in 2014
Enhanced with a 10% across-
the-board increase for public
sector in 2015
EC EQUALIZED AND ENHANCED BENEFITS
EC BENEFIT EQUALIZED
EC Medical Public: Payment suspended in 2004 Lifted suspension in 2013
Reimbursement for Private: No suspension (prospective application)
Retirees and Workers
Separated from the Lifted suspension 2016
Service (retroactive application)
Uniform schedule of Disparity in schedule of Equalized the schedule of
Reimbursement Rates reimbursement with SSS schedule reimbursement rates in 2015
for Laboratory, X-ray, generally higher in amount compared
and other Diagnostic to GSIS since 1984 (for approval by OP)
Examinations
Doctor’s Professional Public : P50- P60 since 1984 Equalized at private sector rate
Fees Private : P100- P150 since 1987 in 2013
Meals and P1,800.00 since 2000 P2,500 since 2010
Transportation
Allowance for PWRDs
during Rehabilitation
 SLOW
PROCESSING OF
CLAIMS
Average PCT (working days) Per Type of EC Claim

SERVICE LEVEL AGREEMENT,

TYPE OF CLAIM 2015

GSIS

EC Med 60

TTD 60

PTD 60

PPD 60

Death 60
Disposition Rate on EC Appealed Cases at ECC

DISPOSITION
YEAR DISPOSITION RATE PER PCT
RATE
40
100% 80%
2013 working
(171/171) (136/171)
days
40
99% 100%
2014 working
(139/141) (139/139)
days
20
96% 100%
2015 working
(131/136) (131/131)
days
LOW AWARENESS
Modes of ECP Information Dissemination

1. Seminars
• In-house
• On-site
• Other seminars
— OSHC (BOSH, CST and Seminars on Work-Related Diseases)
— DOLE ( Labor Law Compliance Officers (LLCO) Training
— Single entry Approach Desk Officers (SEnA DO) Training
— Tripartite Industrial Peace Council (TIPC)
— Orientation Seminars for Newly- Hired Employees
— Continuing Labor Education Seminar (CLES)
— Labor Education for Graduating Students (LEGS)
2. Press Conferences and Media Briefing (Advocacy Seminars)
• Press Interviews
 Modes of ECP Information Dissemination

3. Placement of Print Ads

4. Maintenance of ECC Website
5. Promotion of ECP through Social Media Accounts
(Facebook, Twitter)
6. Outdoor Advertising
• ECC Posters
• Tarpaulins at MRT, LRT (Line 1 & 2)
— Line 1 Stations: Baclaran, EDSA, Gil Puyat, Monumento and Balintawak
— Line 2 Stations: Santolan, Cubao, Betty Go, V. Mapa and Recto
— MRT Stations: North to Taft Stations
7. Collaboration
• MOA with
— Philippine National Police (PNP
— Department of Education (Thru DepED Circular No. 29 dated
26 February 2016
GOVERNANCE
GOVERNANCE

• TUV Rheinland Certification that ECC is ISO 9001:2008

Compliant (transitioning to 2015 version ongoing)

• DOLE Special Citation for Sustaining Record of 100% Disposition

Rate of Cases w/in PCT (2015, 2014)

• CSC Level II Certificate of Accreditation PRIME-HRM, 2013

• DOLE OPCR Rating: 2015 - 3.89; 3.88 - 2014

• GCG Performance Agreement Rating: 2015 – 97.79 ; 2014 -
94.03;

• Unqualified status per COA Annual Audit Report, 2010 to 2015

GOVERNANCE

• DOLE Special Citation for full settlement of Cash Advances of

officers and employees as of December 31, 2014
• DOLE Special Citation for successfully convincing GSIS to
compute its management fee not on the basis of 10% of its EC
premium collection but on the basis of the amount of benefits
they paid to the clients
• DOLE Special Citation for achieving highest compliance rate with
COA, 2014 – 2015
• ECC Services and Programs were Rated Satisfactory by the
Respondents in the Third Party Survey on Customer Satisfaction
Measurement conducted by TUV Rheinland
• GCG Governance Scorecard rating of 65% vs. Average Rating of
56.28% for all GOCCs
WAY TO GO
WAY TO GO

Continue primacy of prevention of work related

accidents and diseases
Study on facilitating EC claims through:
• adoption of a hospital billing scheme
• case rate system
• pharmacy billing system
Ongoing Actuarial Studies:
• Increase in monthly pension from 80% to 100% for
primary beneficiaries of a deceased EC pensioner
• Increase in carer’s allowance
• Coverage of self-employed workers under the ECP
WAY TO GO

Establishment of an Industrial Rehabilitation Center for

PWRDs

Strengthened information dissemination to expand

actual coverage

On-line/proactive application for EC claims

For more information, please contact us

Visit our website: http://www.ecc.gov.ph

Email us at:

http://www.facebook.com/ecc.official

@ecc_dole

Public Assistance
Center (PAC) 899-4251 local 239 & 896-7837
Thank you