Does your work environment prioritise employee wellbeing? If so, then employee healthcare benefits can become one of your strategic assets. This is certainly true for corporate leaders in the Philippines who are grappling with the talent war.

In fact, 80% of employers in the Philippines recognise the intense competition for talent as the foremost factor influencing their employee benefits strategy, according to Willis Towers Watson’s recent Benefits Trends Survey.

The figures align with other research materials, such as Aon’s 2025 Employee Sentiment Study, which found that 64% of Filipino employees are actively contemplating or pursuing new employment opportunities with better healthcare benefits.

This convergence of employee expectations and employer focus highlights the critical role of comprehensive benefits packages – particularly robust Health Maintenance Organisation (HMO) plans – in attracting and retaining a skilled and engaged workforce.

The financial implications of healthcare are also becoming increasingly pronounced in the Philippines.

The escalating cost of medical insurance places considerable pressure on both employees, who face the prospect of higher out-of-pocket medical expenses, and employers, who must navigate rising healthcare expenditures while striving to offer competitive benefits.

This is why selecting an HMO provider becomes paramount for businesses seeking to effectively manage healthcare costs and provide meaningful health coverage to their employees.

Also Read: Medical benefit for Philippine government workers under way

Understanding HMOs in the Philippines

In the Philippine healthcare system, an HMO operates as a healthcare delivery system that arranges or provides a wide array of healthcare services to its members for a fixed prepaid fee, known as a premium.

Functioning as an intermediary, an HMO contracts with a network of healthcare providers, including hospitals, clinics, and physicians, to offer medical services to its enrolled members. The system aims to manage healthcare costs and ensure that members have access to necessary medical care through the designated network.

For workers in the Philippines, having HMO coverage offers several significant advantages. Many employers extend benefits beyond the basic PhilHealth coverage by providing access to general practitioners, dental care, optical services, and maternity benefits through their HMO plans.

A key benefit is the emphasis on preventive care, with HMOs often facilitating and encouraging regular disease screenings, early detection measures, vaccinations, and health education campaigns.

Furthermore, HMOs provide access to a network of healthcare providers, offering employees a potentially wider choice of hospitals, clinics, and specialists, often in more convenient locations. This is usually coupled with financial security, as employees typically pay fixed premiums and experience lower out-of-pocket expenses for covered medical services within the HMO network.

The structured approach of HMOs, often involving referrals and coordinated care within the network, can also streamline the process of accessing necessary medical attention. Comprehensive health benefits through HMOs play a vital role in supporting the overall wellbeing and financial stability of the Filipino workforce, potentially leading to a healthier and more productive employee base.

Also Read: Filipino employees demand better benefits

Key factors to consider when choosing an HMO provider

When selecting an HMO for their workers, Philippine employers must carefully evaluate several critical factors to ensure the chosen plan effectively meets the diverse healthcare needs of their workforce while aligning with the company's budgetary constraints and strategic objectives.

Coverage and benefits

The scope of coverage and benefits offered by an HMO is the first thing to consider. Employers should meticulously review the coverage for various medical services, including in-patient care such as hospitalisation, room and board, surgeries, and medications during confinement. Out-patient coverage, which includes doctor consultations, laboratory tests, diagnostic procedures, and therapies, is equally important.

Network of healthcare providers

A wide and high-quality network of accredited hospitals, clinics, and doctors ensures that employees have sufficient options for accessing care. Accessibility across different geographical regions is particularly important for employers with a workforce distributed across urban and rural areas. A larger network with reputable healthcare facilities and professionals in convenient locations enhances the value and usability of the HMO plan for employees.

Cost and premium structures

Employers need to analyse the premium costs associated with different HMO plans in relation to the benefits they offer. A lower premium might come with limitations in coverage or network size, so a thorough cost-benefit analysis is essential. Exploring options for scaling the plan based on the size of the business is also crucial, as some HMO providers offer tailored packages designed for small, medium, and large enterprises.

Quality of service and customer support

Responsiveness to inquiries, efficiency in processing claims, and overall satisfaction levels are important aspects to evaluate. Seeking feedback from other companies that have utilised the HMO provider and reviewing online testimonials and ratings can offer valuable insights into their service quality.

Flexibility and customisation

With a significant majority of Filipino employees expressing a willingness to trade existing benefits for better options, the ability to tailor plans to suit the diverse needs of the workforce is a major advantage. Considering factors such as age demographics, different job roles, and individual preferences within the company can help employers identify HMO providers that offer customisable plans or a range of options that employees can choose from.

Reputation and reliability

Employers should conduct thorough research into the HMO's standing within the industry, review testimonials and feedback from other clients, and assess their financial stability and track record. Checking for accreditations and any history of complaints or issues can provide further assurance of the HMO's dependability.

Regulatory environment and legal considerations

Philippine employers must navigate a specific regulatory environment when selecting and implementing HMO plans for their employees. The Philippine Labour Code establishes the framework for employee benefits, aligning with government regulations.

The Department of Labor and Employment plays a crucial role in overseeing the enforcement of labour laws and monitoring compliance with mandatory employee benefits. Therefore, it is essential for employers to have a clear understanding of the relevant Philippine health insurance laws and mandates that may influence their choice of HMO.

This includes the National Health Insurance Act, which provides universal health coverage to all Filipinos, and any specific regulations pertaining to private health insurance or HMO operations within the country. Ensuring that the chosen HMO plan adheres to all applicable legal requirements is not only crucial for compliance but also for safeguarding the rights and wellbeing of employees.

Employers have an obligation to provide health benefits that meet the legal standards set forth by Philippine law, and employees, in turn, have the right to receive healthcare coverage that aligns with these standards.

Making an informed decision

Choosing the best HMO for your workers in the Philippines is a multifaceted decision that requires careful consideration of various factors. The significant employee interest in better benefits, coupled with the competitive talent market and rising healthcare costs, underscores the strategic importance of this choice.

Employers must prioritise plans that offer comprehensive coverage, a wide and accessible provider network, competitive cost structures, high-quality service, flexibility to meet diverse employee needs, and a strong reputation for reliability. Navigating the regulatory environment and understanding the legal obligations are also essential.

Ultimately, by taking a strategic and diligent approach to selecting an HMO, employers in the Philippines can make informed decisions that support the wellbeing of their workforce, contribute to a more engaged and productive work environment, and enhance their ability to attract and retain top talent in a competitive market.