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(3) Is guilty during his confinement or 250.00 over 300.00 3.75 3.75
illness of gross negligence with regard to
his health; SECTION 22. Collection of Employees and
Employers Contribution.
(4) Refuses to be examined by or fails to
comply with the advice of the medical (a) Within such time and manner as the
practitioner appointed for supervision SSS or GSIS may prescribe, the employer
purposes by the SSS or GSIS; and shall deduct and withhold from his
employees monthly compensation the
(5) Fails to comply with any provision of employees contribution; and
Program I of this Act or rules and
regulations of the SSS or GSIS required for (b) Within such time and manner as the
entitlement to the benefits provided in this SSS or GSIS may prescribe, but not
Act. beyond twenty days from the date due,
the employer shall remit directly to the
SECTION 20. Exclusion. The benefits GSIS or the SSS, as the case may be, his
granted under this Act shall not cover any corresponding contributions together with
expense for: the employees contribution. No employer
shall deduct, directly or indirectly, from
(a) Cosmetic surgery or treatment; the compensation of the covered
employees or otherwise recover from
(b) Dental Service, except major dental them his own contributions in behalf of
surgery or operation which needs such employees: provided, that failure of
hospitalization; the employer to remit to the GSIS or the
SSS the corresponding employees and
(c) Optometric service or surgery; employers contributions shall not be a
reason for depriving the employee of the
(d) Services related to the case of benefits of this Act.
psychiatric illness or of diseases traceable
to such illness; and SECTION 23. Health Insurance Fund.
The Health Insurance Funds of the SSS
(e) Services which are purely diagnostic. and the GSIS are hereby created which
shall consist of all contributions and all
SECTION 21. Rates of Contributions. For accruals thereto and shall be kept
employees covered by the GSIS and the separate and distinct from all other funds
SSS, the initial monthly contributions shall paid to and collected by said agencies to
be in accordance with the following be utilized for the purpose of meeting
schedule: claims for benefits under this Act.
SECTION 35. Terms Defined. For the (k) Service Beds. Beds reserved for
purposes of this Act, the following terms beneficiaries under Program II.
shall, unless the context indicate
otherwise, have the following meanings: (l) Community Mutual Health Funds.
Funds accruing from the contributions of
(a) SSS. The Social Security System residents in each chartered city or
created under Republic Act Numbered One municipality, plus the one hundred
thousand one hundred sixty-one, as percent (100%) government counterpart
amended. funds.
thousand pesos, nor more than five
(m) Administrator. Refers to the thousand pesos or by both such
Administrator of the Commission, unless imprisonment and fine, at the discretion of
specified otherwise. the court.
SECTION 36. Study and Research. SECTION 38. Separability Clause. In the
Immediately upon its organization, the event any provision of this Act or the
Commission shall undertake actuarial application of such provision to any person
studies for the purpose of determining the or circumstance is declared invalid, the
contributions necessary in order to insure remainder of the Act or the application of
adequate financing and disbursement of said provision to other persons or
funds to all participants of the plan and circumstances shall not be affected by
the extent and scope of benefits of the such declaration.
beneficiaries of the plan.
SECTION 39. Repealing Clause. All laws,
Immediately upon completion of such executive orders, and administrative rules
study, the Commission shall submit to and regulations or parts thereof which are
Congress a report with its inconsistent with the provisions of this Act
recommendations as to the amount to be are hereby repealed or modified
assessed from each resident or inhabitant accordingly: provided, however,
covered by the plan for purposes of thatnothing in this Act shall be construed
legislation by Congress. to remove or eliminate the present powers
and functions of existing agencies
SECTION 37. Penal Provisions. involved.
(a) Any person, who for the purpose of SECTION 40. Appropriation. The sum of
securing entitlement to any benefit or one million pesos is hereby appropriated
payment under this Act or the issuance of out of any funds in the National Treasury
any certificate or document for any not otherwise appropriated for the initial
purpose connected with this Act, whether organizational expenses of the
for him or for some other person, commits Commission and the Medical Care
fraud, collusion, falsification, Councils, as provided for in Sections 29,
misrepresentation of facts or any other 30 and 31. Thereafter, the necessary
kind of anomaly shall be punished with a funds for the yearly operation of the
fine of not exceeding one thousand pesos above-mentioned agencies shall be
or imprisonment not exceeding one year incorporated in the General Appropriations
or by both such fine and imprisonment, at Act.
the discretion of the court; and
SECTION 41. Effectivity. Program I shall
(b) Any contribution or other amount be implemented immediately and upon
collected by the treasurer, as provided for the effectivity of this Act.
under Section 28 of this Act, shall not be
used, appropriated or diverted for a Program II shall be implemented in the
purpose other than that authorized by this manner and time to be determined by
Act. Any person violating this provision Congress upon recommendation of the
shall be punished with imprisonment for Commission.
not less than one year nor more than five
years or with a fine of not less than one Approved: August 4, 1969