Fa Insular Health Care Online Rate Calculator 06-20-2017 05:58:21 MEMBERS ELIGIBILITY A.INDIVIDUAL MEMBERS. [Atleast 15 daye to less than 60 years od for new members and up to lee than 65 years old for renewing member 8 PRINCIPAL MEMBERS. Atleast 18 years to less than 60 years old (new members) Aileast 18 years to less tan 85 years old (renewing members only) C, DEPENDENTS OF PRINCIPAL MEMBERS (FOLLOWING HIERARCHY GUIDELINES) For single Principal members: Parents) rst who islare less than 65 years old and not gainfully employed; fllawed by he eldest sibling down tothe youngest who Isao 15 daysto loss than 21 years old, unmarried and not gainfully employed For single parent Principal members: Eldest child down othe youngest, 15 days toless than 21 For marie Principal members: Spouse frst whois less than 65 years old followed by the ai unmarried and not gainfully employed. Parents) or spouse 60 years old to tess than 85 years old fr renewing members ond D, PRIMARY MEMBERS. Elgast child whose both parents are either working abroad or have existing health cae coverage, 15 days less han 18 years old SECONDARY MEMBERS For Primary members: Eldest sibling fst down fo the youngest, 15 days to less than 18 years old, unmaried and not gainfully employed. rs old, unmarried and net gainfully employed 3 child down tothe youngest, 15 days o eas than 21 years old DEPENDENT / SECONDARY MEMBER'S COVERAGE ‘Accommodation /Plan of Dependents /Secondaty Members should be equal tor lower than the Principal /Pimary Members accommodationolan. Individual Only © Principal And Dependents) Single Parents) Sibingts) © Maries spouse Cidren(s) (¥ Single Parent Chidren(s) | Primary Secondary Dependents 1 ¥ Proceed to Step 2Membership Age Room Aecommedation Hospital Program Dental Program Type PRINCIPAL 28 + SEMPRIVATE, PREFERRED HOSPITAL ¥ OPENDOOR . SPOUSE at ¥ SEMLPRIVATE, PREFERRED HOSPITAL (OPEN DOOR ‘A. Semi-Private Room - Some accredited Moto Marila and provincial hospitals no longer have somi-pvaa rooms orn longer admit HMO paiontsto = semi-private rooms, For members who select he semi-private room accommodation plan andlor use hospitals, without sem\-prvate rooms for in-patient benefits, please be advised that hese hospitals automatcally admitthe member to the nexthigher roam accommodation on a tp tadder bass. 2. Fees ar inclusive of 12% VAT Generate Computation Name Membership Age Room Hospital Semi Quarterly Type ‘Aecommodation Program Annual Fees Matty D. Lopez PRINCIPAL 28 -«SENPRIVATE PREFERRED OPEN Pup PHP PHP Hosprat DOOR g9c000 520470 2.697 30 Ralph Gerald F. Lopez SPOUSE = 3t LPRNATE PREFERRED OPEN Pup Pup PHP HOsPAL DOOR 10,700.00 5575.00 2,888.00 Dental ees (Annual PaymentOny) PHP 0.00 © PHPO0D © PHPO.OO (Free Dental Promo) Enrollment fees (One-ime Fee Only) PHP Pup PHP 3200033000 a30000 ‘Tolal Membership Fees (rounded to he nearest peso) Pup pup exe 202000 1129800 5916.00, PROMO RATE. PHP Pup PHP (wih S%siecount) 19,986.00 10,747.00 5,637.00 3% Discount on Membership Fees with FREE Open Door Dental plus a Healthy Summer Bundle itp:/wwwwinsularheat \care,com phinews/healthy-summer-bundlel Jontine-appicaion assistance