vinta systems, inc[1][1] '07 sa fin

SERVICE AGREEMENT

BY AND BETWEEN

MAXICARE HEALTHCARE CORPORATION(MAXICARE)

AND

VINTA SYSTEMS, INC.

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SERVICE AGREEMENT NO. C7411

KNOW ALL MEN BY THESE PRESENTS:

This Agreement made and entered into this 30th day of December, 2007 at Makati City, by and between:

MAXICARE HEALTHCARE CORPORATION, a corporation duly organized and existing under and by virtue of the laws of the Republic of the Philippines, with principal office at the 19th Floor, Medical Plaza Building, Amorsolo corner Dela Rosa Streets, Legaspi Village, Makati City and represented in this act by its PRESIDENT AND CHIEF EXECUTIVE OFFICER, Mr. JOSE PASTOR Z. PUNO and its VICE PRESIDENT AND CHIEF ACTUARY - UNDERWRITING AND ACTUARIAL, Mr. VICTOR R. TANJUAKIO, hereinafter referred to as “Maxicare”;

- and -

VINTA SYSTEMS, INC., a corporation duly organized and existing under and by virtue of the laws of the Republic of the Philippines, with its principal office at Unit 27-C Rufino Pacific Tower, 6784 Ayala Avenue, Makati City and represented in this act by its CHAIRMAN AND CHIEF EXECUTIVE OFFICER, Mr. AUGUSTO LAGMAN, hereinafter referred to as “Client”.

WITNESSETH: That

WHEREAS, Maxicare is engaged in the business of providing healthcare and maintenance services and programs to all qualified and bona fide Members;

WHEREAS, Maxicare has offered to extend the aforesaid services and programs to the employees of the Client subject to the payment of the appropriate fees;

WHEREAS, the Client has agreed to engage the services of Maxicare to provide medical coverage for its employees who would qualify to become bona fide Members of Maxicare;

NOW THEREFORE, for and in consideration of the foregoing premises and the mutual terms, conditions and covenants herein below set forth, the parties have hereunto agreed as follows:

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ARTICLE I - DEFINITION OF TERMS

A. AGREEMENT: This Service Agreement executed by and between Maxicare and the Client contains the effective date, benefits, coverage, claims and member satisfaction provisions, limitations and exclusions of benefits, mode of payment of membership fees, termination of coverage and other matters relevant to the relationship between the member and Maxicare. The application for membership duly submitted by the accepted Member, and the Maxicare Identification Card, form part of this Service Agreement, together with any and all endorsements which may be incorporated thereto.

B. MEMBER: A Member is any person who is eligible for membership, as defined in the Membership Eligibility provision hereunder (Art. III [E]), and enrolled under the Agreement.

C. AFFILIATED HOSPITAL: A hospital with which Maxicare has an existing and valid accreditation contract wherein a Member can seek medical services. It shall also mean any of the hospitals named in such list as Maxicare may from time to time prepare and distribute to Members, and with which Maxicare’s Medical Coordinator has made arrangements for the provision of medical services to Members pursuant to this Agreement.

D. AFFILIATED MEDICAL CLINIC: Such duly licensed out-patient medical and health care facility as Maxicare may establish or designate for the purpose of providing out-patient care to Members. It shall also mean a private medical facility which is capable of providing complete medical, diagnostic and therapeutic facilities, and which Maxicare has an existing service agreement with.

E. AFFILIATED MEDICAL STAFF: A group of medical practitioners and other allied health professionals who are affiliated by Maxicare and duly authorized to carry out the delivery of the required medical services to all Members.

F. MAXICARE MEDICAL COORDINATOR: A duly licensed medical practitioner as Maxicare may designate in an Affiliated Hospital to direct and supervise the provision of Medical Services to Members in that particular hospital with whom Member may also seek medical consultation, and from whom the Member may request for prescription, referrals to specialist, request for laboratory examination and hospitalization arrangement.

G. AFFILIATED PHYSICIAN OR SPECIALIST: A duly licensed physician or specialist affiliated by Maxicare and named in the list of Maxicare affiliated doctors with whom Maxicare has made arrangements to provide the required services under this Agreement.

H. IDENTIFICATION (ID) CARD: The card issued by Maxicare to a Member containing the latter’s name and signature, ID reference number, and other matters relevant to Membership.

I. IN-PATIENT MEDICAL SERVICES: The hospitalization which includes accommodations, medicines and supplies and surgery whenever medically necessary, furnished to a registered bed patient and provided by a duly licensed hospital and are regularly included in its service and procedures.

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J. MEDICALLY NECESSARY: A medical service which is (a) consistent with the diagnosis and customary medical treatment of the condition, (b) in accordance with the standards of good medical practice, (c) not for the convenience of the Member or the Affiliated Physician, and (d) performed in the least costly manner required by the medical condition.

K. EMERGENCY CONDITION: A life threatening or accidental injury or a sudden and unexpected onset of a condition which at the time of the occurrence reasonably appears to have the potential of causing immediate disability or death, or which requires the immediate alleviation of pain or discomfort. These illnesses or injuries require urgent medical or surgical care which the Member secures immediately after the onset or as soon as the care may be made available but in any case not later than 24 hours after the onset. Heart attacks, cardiovascular accidents, poisonings, loss of consciousness or respiration and convulsions are examples of emergency conditions.

L. CONVALESCENT OR REHABILITATION CARE: The restoration of person’s ability to function as normally as possible after a disabling illness or injury.

M. CUSTODIAL OR MAINTENANCE CARE: Care furnished primarily to provide room and board (which may or may not include nursing care, training, personal hygiene, and other forms of self or supervisory care); or care furnished to a person who is physically or mentally disabled or both; and

1. Who is not under any specific medical, surgical or psychiatric treatment to reduce the existing disability to the extent medically necessary to enable the patient to live outside an institution providing such care; or

2. When despite such treatment, there is no reasonable possibility that the disability will be reduced or diminished.

N. DOMICILIARY CARE: Care provided in the patient’s home when in-patient care is not medically necessary.

O. ROOM AND BOARD ACCOMMODATION: The pre-assigned type of hospital room and board by Maxicare to the Member based on the plan enrolled in.

P. REASONABLE CHARGES: Professional fees of non-Affiliated physicians for services rendered to Maxicare Members which do not exceed the standardized professional fees/terms of the Maxicare Affiliated Physicians/Specialists where the services were rendered. In cases where Maxicare does not have a standard professional fee for the professional service rendered, Maxicare reserves the right to determine the amount of reasonable charges for the service.

Q. CONFINEMENT/HOSPITALIZATION: A person is said to be confined or hospitalized if he is admitted in a hospital as a registered bed patient for at least twelve (12) hours.

R. PRE-EXISTING CONDITION: An illness or injury shall be considered pre-existing if prior to effective date of the Member’s coverage (1) any professional advice or treatment has been obtained for such illness or injury prior to the said effective date as certified in writing by the attending physician; or (2) such illness or injury was evident upon medical

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examination in connection with the Member’s application; or (3) the natural history of such illness or injury can be clinically determined to have started prior to the effective date of coverage whether or not the Member is aware of such illness or injury.

S. BALANCE BILLING: It is the act by some physicians and other health professionals duly affiliated by Maxicare to charge members for the difference between their desired higher rate and the agreed Maxicare standard professional fees for specific medical services.

T. MAXIMUM BENEFIT LIMIT (MBL): The maximum liability that Maxicare shall assume per illness/injury per year on a certain Member, except ACU’s, consultations and routine procedures. In other words, the In-patient Benefits (PF, HB, ER charges) and Out-patient Diagnostic and Therapeutic procedures done within the one-year term of the Agreement with respect to any particular illness/injury shall be charged against the MBL. MBL is replenished upon renewal of the Client but not during extension.

ARTICLE II - MEMBERSHIP FEE

A. AMOUNT OF MEMBERSHIP FEES: For the services covered in this Agreement, the Client shall pay to Maxicare a membership fee per Member as per schedule below:

Member’s Description PlanMembership Fees

Per MemberPer Quarter

EXECUTIVES AND HIS SPOUSE Platinum Php21,377

MANAGERS AND SUPERVISORSAND THEIR SPOUSE /

PARENTS AND CHILDREN OF EXECUTIVES / ACCOUNTING SUPERVISOR AND

GENERAL MANAGER OF PROTEMPSAND THEIR DEPENDENTS

Gold 1 4,976

RANK & FILE EMPLOYEES (1 year) AND SPOUSE /

PARENTS AND CHILDREN OFMANAGERS AND SUPERVISORS /

PROTEMPS RANK & FILE

Gold 2 4,374

RANK & FILE EMPLOYEES (6 months)AND THEIR DEPENDENTS /

PARENTS and CHILDREN OF RANK & FILE EMPLOYEES (1 year) /

ACCOUNTING SUPERVISOR AND ALL DEPENDENTS OF VINTA

Silver 3,047

Above Maxicare rates are inclusive of the twenty percent (20%) service fee which is subject to the applicable VAT rate. In accordance with industry practice, the remaining eighty percent (80%) is allocated for all medical services consistent with Client’s benefit

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program. Any difference between the actual and assumed cost for medical services, shall be for the account of Maxicare.

B. PAYMENT OF MEMBERSHIP FEES: (Modified: Refer to Special Endorsement on Suspension of Membership)

The membership fees are due on the effective date of this Agreement and every month thereafter for monthly mode of payment, every quarter thereafter for quarterly mode of payment and every semester thereafter for semi-annual mode of payment. The membership fees due on any due date shall be the aggregate of the membership fees for all the persons enrolled under this Agreement.

The membership fees of Members added after any due date and any adjustments in the statement of account such as addition or deletion of Members, upgrading or downgrading of plan, errors and changes still under process shall be reflected in another statement of account to be given within thirty (30) days from the date the advice from the Client is received by Maxicare.

Should there be any dispute, contest or conflict as regards the statement of account (SOA) on any substantial matter appertaining thereto, the Client shall pay ninety percent (90%) of the sum demanded on or before the due date, notwithstanding such dispute, contest or conflict, unless the Client shows proof of significant error on any substantial matter stated in the statement of account. For purposes of this, significant error means an error that would affect at least 25% of the total amount due. Upon resolution of the dispute, contest or conflict, the adjustments, if any, shall be reflected in another statement of account to be given within thirty (30) days from the date the dispute, contest or conflict was settled by the Client and Maxicare. In this regard, a FULL payment of such adjusted SOA shall be made 15 days from the time of receipt of such adjusted SOA.

The absence of any written notice to Maxicare regarding dispute, contest or disagreement in the details contained in the SOA 15 days from the receipt thereof shall constitute Client’s absolute agreement thereof.

In all cases herein, the number of days shall be on a calendar-day basis.

C. LATE PAYMENT OF MEMBERSHIP FEES: (Modified: Refer to Special Endorsement on Suspension of Membership)

If membership fees are not paid after the due date, Maxicare reserves the right to suspend all service under this Agreement or services to Members whose membership fees have not yet been received until full payment of all membership fees due including penalties as stated below. Maxicare also reserves the right to terminate this Agreement if the membership fees due remain unpaid 31 days after the due date or statement of account date, whichever is later.

If the membership fees due remain unpaid 31 days after the due date or statement of account date, whichever is later, the Client shall pay Maxicare penalty charges equivalent to three percent (3%) a month or a fraction thereof on the unpaid membership fees due, computed from the due date or statement of account date, whichever is later.

D. REFUND/CREDIT OF MEMBERSHIP FEE: In the event a Member dies or a Member’s coverage for any reason is otherwise terminated, the unused pro rata membership fee

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paid shall be refunded to the Client. However, if the termination contemplated in the preceding sentence is caused by the pre-termination of the Client then, a pre-termination fee of Php250 per member shall be deducted from such refunded membership fees to cover for administrative and other costs.

E. MEMBERSHIP FEE OF MEMBERS ADDED AFTER THE EFFECTIVE DATE OF THE AGREEMENT: The membership fee of Members added after the effective date of the agreement shall be computed on a pro rata basis equivalent to the ratio between the number of months from the effective date of the Member’s coverage until the end of the contract year and 12 months. A fraction of a month is considered as 1 month.

ARTICLE III – GENERAL PROVISIONS

A. ENTIRE CONTRACT: This Agreement, the application form submitted by the accepted Member, the master list of enrollment, the Maxicare Identification Card, and/or any stipulation or endorsement attached or posted to this Agreement, shall constitute the entire contract between Maxicare and the accepted Member. All statements and information contained in the Membership application form shall be deemed representations and warranties made by the Member himself/herself for purposes of applying the provisions of this Agreement.

B. EFFECTIVE DATE AND TERMINATION OF THIS AGREEMENT: This Agreement is effective for a term of one (1) year, beginning December 30, 2007 up to midnight of December 29, 2008. It may be renewed from year to year subject to mutually agreed upon terms and conditions.

Upon termination and/or expiry of this Agreement, the Client shall cause the return and surrender of the Maxicare ID Cards of all Members. All medical services and coverage under this Agreement shall terminate on the termination date, without prejudice to any claim for covered medical services rendered to a Member prior to the termination date.

C. SERVICE AREA: This Agreement and the benefits appurtenant thereto shall apply only within the territorial jurisdiction of the Philippines, except for conditions stated in Article IV, Section F (3).

D. NON-TRANSFERABILITY: All benefits of the Agreement are purely personal to the duly accepted Member and are not transferable or assignable.

E. MEMBERSHIP ELIGIBILITY: The persons described in Schedule A herein and forming an integral part of this Agreement, when accepted by Maxicare, are eligible to be enrolled under this Agreement subject to the following provisions:

a) For Principal Membership: All employees of the Client who, on effective date or commencement date of membership, are at least eighteen (18) up to sixty-five (65) years old and actively at work. “Actively at work” shall mean that the employee, on the commencement date of membership, is performing work that is usual and necessary to the business of the Client.

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Any employee more than sixty-five (65) years old shall be accepted for Maxicare membership but his availment shall be on a fee-per-service based on Maxicare standard rates for Professional Fees and Hospital Bills. The Member shall still pass through the same availment system but the cost shall be borne by the Client. The Client shall settle the amount availed within fifteen (15) days from receipt of the billing statement from Maxicare.

b) For Dependent Membership: That only children with full term births, meaning those born at least 37 weeks from conception shall be given coverage. Children born prior to such period shall have to wait for that 37th week which marks the period from which their minimum eligibility age shall be counted from, in order to gain coverage. Provided lastly, That the children and the brothers and sisters are not gainfully employed and have no children of their own.

Parents above sixty-five (65) years old shall be accommodated for membership but shall be on fee-per-service arrangement, as described herein under item (a) on Principal Membership.

The Client shall certify in writing as to the accuracy of the information provided by its employees.

c) For non-contributory coverage, those eligible for membership shall be enrolled immediately at the Effective Date and for contributory coverage, enrollment of those eligible shall be within thirty (30) days from the Effective Date.

F. EFFECTIVE DATE OF A MEMBER’S COVERAGE: The coverage of a Member shall become effective on the applicable date set forth below:

1. If no membership fee contributions from Members are required, on whichever is the latest of:

a. The effective date of this Agreement,

b. The date on which a Member first meets the eligibility requirements stated in the Membership Eligibility provisions.

2. If membership fee contributions from Members are required, on whichever is the latest of:

a. The effective date of this Agreement,

b. The date of enrollment, provided that the enrollment date is not more than one calendar month after the effective date of this Agreement, or the date on which the person first becomes eligible, if later. When the date of enrollment is not within said calendar month, or whenever a person has voluntarily terminated his coverage but has remained eligible and subsequently reapplies for coverage, then the coverage shall not become effective until the date Maxicare, at its option, approves the application subject to the submission by such person of satisfactory evidence of good health.

G. INVALIDATION OF MEMBERSHIP: Failure to disclose or concealment/misrepresentation of any material information on a Member in the application form or medical examination,

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whether intentional or unintentional shall automatically invalidate the coverage of the Member from the very beginning, and the liability of Maxicare shall be limited to the return of all membership fees paid pertaining to the Member less any cost of previous medical services rendered or amount already refunded to the Member. An information is deemed material if its disclosure would have resulted in the declination of the application for membership of the applicant or the assessment of a higher membership fee or the inclusion of additional restrictions to the benefits of the Member under this Agreement.

H. TERMINATION OF MEMBERSHIP: The rights of Member shall be extinguished for any of the following reasons:

1. In case membership fee contributions from Members are required, non-payment of membership fee contributions by a Member.

2. Non-payment of personal accounts within a period of fifteen (15) days from receipt of the statement of account from Maxicare, unless extended by Maxicare in writing. “Personal accounts” refer to the cost of the medical services not covered by this Agreement but for some reason was advanced by Maxicare.

3. When a Member permits the use of his ID Card by any other person.

4. When the Member enters military, naval or air service.

5. When the Member ceases to be eligible for coverage as defined in the Membership Eligibility provision.

6. When the Member is a dependent, the date when the coverage of the Principal Member is terminated.

In case of a Member’s resignation, termination, separation or retirement, the Client shall notify Maxicare thereof in writing within thirty (30) days prior to the effective date of the termination of membership. The Client shall also cause the return and surrender of the ID card prior to the effective date of the termination of membership. However, in case of immediate termination, the Client shall notify Maxicare in writing 2 days prior to effective date.

In case the Client failed to notify Maxicare within thirty (30) days prior to termination of a Member’s coverage or to cause the return and surrender of the ID Card, the cost of all medical services arising out of an unauthorized use of the ID Card shall be for the account of the Member and shall be paid by the Client.

I. REINSTATEMENT: If a Member’s coverage is terminated due to items (1) or (2) of the Termination of Membership Provision, he may reapply for coverage. The reinstatement however shall not become effective until the date Maxicare, at its option, approves the application subject to the submission by such Member of satisfactory evidence of good health.

ARTICLE IV – BENEFITS AND COVERAGE

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MEDICAL SERVICES

Maxicare undertakes to arrange and provide for preventive, diagnostic and treatment service for Members by Maxicare Affiliated Hospitals, Clinics and Staff, subject to the exclusions, limitations and conditions specified in this Agreement.

The different Maximum Benefit Limit (MBL) per member per illness per year shall be as follows:

Member’s Description PlanMaximum Benefit

Limit

EXECUTIVES AND HIS SPOUSE Platinum Php150,000

MANAGERS AND SUPERVISORSAND THEIR SPOUSE /

PARENTS AND CHILDREN OF EXECUTIVES /

ACCOUNTING SUPERVISOR AND GENERAL MANAGER OF PROTEMPS

AND THEIR DEPENDENTS

Gold 1 150,000

RAND & FILE EMPLOYEES (1 year) AND SPOUSE /

PARENTS AND CHILDREN OFMANAGERS AND SUPERVISORS /

PROTEMPS RANK & FILE

Gold 2 100,000




Silver 60,000

A. OUT-PATIENT BENEFITS

The following no charge services shall be provided to all Members of good standing when medically necessary.

1. Medically necessary consultations, including pre and post natal consultations during regular clinic hours, except prescribed medicines.

2. Eye, ear, nose and throat (EENT) treatment prescribed by an Affiliated Physician/Specialist.

3. Treatment for minor injuries such as lacerations, mild burns, sprains and the like.

4. X-Ray, laboratory examinations, routine, diagnostic and therapeutic procedures prescribed by an affiliated physician/specialist, provided however that the cost of diagnostic and therapeutic procedures covered shall be limited to the amount set forth under pertinent sections below.

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The routine, diagnostic and therapeutic procedures done on an out-patient basis shall consist of the following:

4.1. Routine Procedures done on an out-patient basis to be covered at 100% of actual cost:

a. Complete Blood Countb. Blood Chemistriesc. Urinalysisd. Diagnostic Radiographs

i. Face (including sinuses), Head and Neckii. X-ray of the spine (cervical, thoracic, lumbo-sacral)iii. Chest, ribs, sternum and clavicleiv. Biliary tract: Cholecystogram and Cholangiogram v. Digestive: Plain film of the abdomen, Barium enema

Upper GI Series, Small Bowel series, Lower GI seriesvi. Urinary: Kidney, Ureter and Bladder, Pyelograms and

Cystogramsvii. X-ray of the extremities and pelvis

e. Lead Electrocardiogramf. Treadmill Stress Testg. Electroencephalogramh. Pap Smear

4.2. Diagnostic Procedures to be covered at 100% of actual cost and to be computed against maximum benefit limit.

a. Computed Tomography Scansb. Magnetic Resonance Imagingc. Magnetic Resonance Angiographyd. Fluorescein Angiographye. Impedance Plethysmographyf. Diagnostic Ultrasounds:

i. 2D-Echo, ii. Doppleriii. Ultrasound of the Lungs, iv. Digestive and Urinary Systems,v. Abdomen vi. Deep vein thrombosis ultrasonic scanning.

g. Bone Mineral Density Studiesh. Polysomnograms (Sleep Recording)i. Cardiac Stress Tests

(Thallium and Dipyridamole Stress Tests)j. Ambulatory Cardiac Monitoring (Holter)k. Arterial Blood Gasl. Lung Function Studiesm. Microscopic Examinations:n. Radioisotope Scans And Function Studies

i. Thyroid Scansii. Liver

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iii. Renaliv. Gastrointestinalv. Cardiacvi. Parathyroid, Bone, Pulmonary

(Perfusion, Ventilation Lung Scans) Total Body Scanso. Audiograms And Tympanogramsp. Electromyelography & Nerve Conduction Studiesq. Mammography and Sonomammogramr. Radionuclide Ventriculographys. Nuclear Radioactive Isotope Scant. Neuroscanu. Thallium Scintigraphyv. Perfusion Scanw. Myelogramx. Bone Densitometry Scan (Dexascan)y. Adrecortical Functionz. Plasma Urinary Cortisol, Plasma Aldosteroneaa. Anti-Nuclear Antibody, C-Reactive Protein, Lupus Cell Exam

4.3. Therapeutic Procedures done on an out-patient basis to be covered at 100% of actual cost up to ten (10) treatments or sessions subject to the provision on maximum benefit limit.

a. Therapeutic Radiologyi. Cobaltii. Iodineiii. Radioactive Cesiumiv. Linear Accelerator Therapyv. Brachytherapy

b. Chemotherapyc. Dialysis

5. Minor surgery not requiring confinement prescribed by an Affiliated Physician / Specialist.

6. Eye laser therapy for retinal detachment and glaucoma, excluding eye correction such as Lasik, PRK and the like, prescribed by an Affiliated Physician/Specialist up to Php1,200 per member per year.

7. Physical therapy / Occupational therapy excluding subspecialties such as cardiac rehabilitation, pulmonary rehabilitation and the like prescribed by an Affiliated Physician/Specialist up to six (6) sessions per member per year.

8. Cauterization of warts, except genital warts and condyloma acuminata, prescribed by an Affiliated Physician/Specialist up to Php1,000 per member per year.

9. Allergy testing / allergy screening and other related examinations prescribed by an Affiliated Physician up to Php2,500 per member per year.

10. Tuberculin test prescribed by an Affiliated Physician up to Php600 per member per year if availed at Maxicare Primary Care Centers. Availment from providers

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other than the Maxicare Primary Care Centers shall also be pegged at Php600 per member per year but coverage shall be on reimbursement basis.

11. Sclerotherapy for varicose veins as prescribed by an Affiliated Physician up to Php5,000 per leg per member per year to be availed through Maxicare Primary Care Centers and through affiliated vascular surgeons.

12. Consultations for speech therapy (for stroke patients only) shall be covered as charged but on reimbursement basis.

B. PREVENTIVE CARE BENEFITS

The following no-charge services shall also be provided to Members of good standing by Affiliated Physicians and Affiliated Hospitals:

1. Passive and active vaccines for treatment of animal bites, snake bites and tetanus up to Php18,000 per member per year.

2. Periodic monitoring of health problems.3. Health-education and counselling on diets or exercise.4. Health habits and family planning counselling.5. Wellness programs: up to two (2) lectures per year.

C. ANNUAL CHECK-UP

The annual check-up entitlement of a Member shall be as set forth in Schedule B, likewise forming an integral part of this Agreement.

The terms and conditions for the availment of the annual check-up shall be provided under the ACU Endorsement attached herein and forms part of this contract.

D. IN-PATIENT BENEFITS

Confinement or hospitalization, and the related services enumerated hereunder when medically necessary, shall be available at no charge for Members of good standing, in any Affiliated Hospital when prescribed or authorized by the attending Affiliated Physician.

1. Room and Board according to the Member’s Room and Board Accommodation and subject to the maximum rate of Daily Room and Board, if any, of the plan under which the Member is enrolled.

Member’s Description PlanRoom & Board

Type/Limit

EXECUTIVES AND HIS SPOUSE Platinum Large Private

MANAGERS AND SUPERVISORS Gold 1 Regular Private

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AND THEIR SPOUSE / PARENTS AND CHILDREN OF EXECUTIVES /

ACCOUNTING SUPERVISOR AND GENERAL MANAGER OF PROTEMPS

AND THEIR DEPENDENTSRAND & FILE EMPLOYEES (1 year)

AND SPOUSE / PARENTS AND CHILDREN OF

MANAGERS AND SUPERVISORS / PROTEMPS RANK & FILE

Gold 2 Regular Private




Silver Semi - Private

2. Use of operating and recovery rooms.

3. Professional fees in accordance with Maxicare Schedule of Rates.

a. Attending Physiciansb. Surgeonsc. Anesthesiologists d. Cardio-pulmonary clearance before surgery and cardiac

monitoring during surgery.

4. Drugs and medicines for use in the hospital.

5. Whole blood and human blood products transfusions and intravenous fluids, including blood screening and cross matching.

6. X-Ray, laboratory examinations, and diagnostic tests.

7. Dressings, conventional casts (plaster of Paris) and sutures.

8. Anesthesia and its administration.

9. Standard nursing services.

10. Standard admission kit.

11. Use of Intensive Care Unit (ICU).

12. All other items directly related in the medical management of the patient, as deemed medically necessary by the attending Affiliated Physician.

Notwithstanding all the above, Maxicare does not cover the bills for the following extra-services:

a. Use of extra bed, TV, electric fan, DVD/ VCD, and other similar items unless such appliances and items are necessarily and ordinarily included in the Member’s

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Room & Board Accommodation.b. Extra food.c. Toilet articles like face towel, soap, toothbrush and the like.d. Charges of room and board beyond the limits of the Member’s Room and Board

Accommodation, the incremental rate differences for professional fees, diagnostic and laboratory examinations, and other ancillary medial services brought about by said Member’s voluntary availment of a room other than his Room and Board Accommodation.

e. Services of a private or a special nurse.f. All other items not medically necessary in the medical management of the patient.

Except for Emergency Conditions wherein the Emergency Provisions of this Agreement will apply, the provision of the in-patient services or benefits mentioned above shall be subject to the following general conditions:

a. The hospital confinement must be recommended by an Affiliated Physician and approved by a duly authorized representative of Maxicare in that Affiliated Hospital prior to confinement.

b. The confinement shall be in an Affiliated Hospital and the room accommodation shall be in accordance with the Member’s Room and Board Accommodation.

c. Professional services shall be provided only by Affiliated Physicians.d. If a patient for whom discharge order has been issued by the attending physician

refuses to be discharged, Maxicare shall no longer be responsible for all hospital expenses and professional fees incurred subsequent to the day the patient should have been discharged. Such expenses shall be to the “personal account” of the patient.

e. As a proof of items a, b, and c above Maxicare shall issue the requisite Letter of Authorization (LOA).

E. OTHER PROCEDURES & MODALITIES

1. The following procedures shall be covered at one hundred percent (100%) of their actual cost up to MBL per procedure per year.

a. Lithotripsyb. Laparoscopyc. Hysterescopic Myoma Resectiond. Hysterescopically-guided Dilation & Curettagee. Cryosurgeryf. Percutaneous Ultrasonic Nephrolithomyg. Video Gastroscopyh. Arthrocospic Procedures, Orthopedic Arthroscopyi. Stereotactic Brain Biopsy j. Gamma Knife Surgery

2. The following modalities shall be covered based on the following limits:

a. Transurethral Microwave Therapy of Prostate, up to Php25,000 per member per year.

b. Angiogram, up to Php30,000 per member per year.

Note :

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Angioplasty/Coronary Artery Bypass Graft shall be covered provided medically necessary and shall have with Angiogram, one shared limit up to the MBL.

3. Other medically necessary modalities not mentioned above and those for which there are no comparable, conventional or traditional counterparts (such as but not limited to Stapled Hemorrhoidectomy, Scalpel Hemorrhoidectomy, Mammotone, 4D Ultrasound, 24 Hour EEG Monitoring, Esophageal Manometry, Intensified Modulated Radiotheraphy and Botox) shall be covered up to Php5,000 per procedure per member per year.

Note:

Fees of the assistant surgeons / resident doctors employed or hired by the attending Physician in the process of rendering the abovementioned services shall not be chargeable to the patient and/or Maxicare.

F. EMERGENCY CARE (Modified: Refer to Special Endorsement on Incremental Rate Difference)

In case of Emergency Conditions, as defined under Article I hereof, the following services shall be provided:

1. In any Affiliated Hospital: NO CHARGE emergency care treatment will be provided to Members as enumerated below. Prior authorization shall not be required for initial treatment of medical emergencies as herein defined, or in the case of accidental injuries, where the covered Member’s life would be jeopardized.

a. Doctor’s servicesb. Emergency room feesc. Medicines used for immediate relief and during treatmentd. Oxygen, Intravenous fluids and whole blood and human blood products.e. Dressings, casts and sutures.f. X-Rays, laboratory and diagnostic examinations, and other medical services

related to the emergency treatment of the patient.

If after the emergency treatment has been administered and the Member still requires confinement, Maxicare will provide the in-patient benefits of this Agreement subject to the In-patient Benefits provision of this Agreement.

If at the time of the emergency, the Affiliated Hospital has no available room in accordance with the Member’s Room and Board Accommodation, Maxicare reserves the right to assign the Member to another Affiliated Hospital where the Member’s Room and Board Accommodation is available. However, the Member may opt to avail of a room accommodation in the Affiliated Hospital which is higher than his Room and Board Accommodation but Maxicare will cover the charges of room and board beyond the limits of the Member’s Room and Board Accommodation, the incremental rate differences for professional fees, diagnostic and laboratory examinations, and other ancillary medical services only in the first 24 hours of confinement. The said charges and expenses covered by Maxicare shall be subject, as always, to the Member’s Maximum Benefit Limit.

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2. In Non- Affiliated Hospitals: If the healthcare was administered in a Non- Affiliated Hospital, whether as in-patient or out-patient and the illness or condition is covered under this agreement, the member shall pay the cost of his medical care and Maxicare shall thereafter reimburse the Member up to 80% of the actual hospital bills and 80% of the actual professional fees based on Maxicare rates incurred during the first twenty-four (24) hours of treatment up to Php15,000 per case per member per year.

NOTIFICATION:

If after emergency treatment has been administered and the Member still requires confinement, he or his representative, as a pre-requisite for in-patient coverage, must notify Maxicare head office in writing within a period of twenty-four (24) hours from admission. No in-patient coverage will be provided without the 24-hour notification. However, in case the patient, due to his medical condition, is unable to communicate directly or through a representative, the 24-hour notification period shall be extended until twenty-four (24) hours from the time he is clinically able to do so.

3. Outside of the Philippines: When a Member of good standing requires immediate medical attention outside of the Philippines, Maxicare shall reimburse the Member 80% of the actual hospital bills and 80% of the actual professional fees incurred during the first twenty-four (24) hours of treatment up to 100% of what Maxicare would have paid had0 the Member been confined in an Affiliated Hospital according to his Room & Board Accommodation and the services of Affiliated Physicians been utilized or up to Php15,000 per case per member per year.

In all these circumstances, Maxicare reserves the right to validate whether treatment received is emergency in nature and/or illness or condition is covered under the provisions of this Agreement.

G. PROCEDURE ON AVAILMENT

The benefits and/or services conferred under the titles: Out-patient, In-Patient, and Emergency Care must be claimed in accordance with the procedure set forth below.

A. Out-Patient / Non-Emergency Services

1. Any out-patient or non-emergency services are accommodated by the Maxicare Primary Care Physician at any Maxicare Primary Care Center located at:

A) MAXICARE CENTER – MAKATI (Makati Medical Center) In-Patient Services only, Rm. 131 New Wing, #2 Amorsolo St. Makati City

B) MAXICARE CENTER – (Medical Plaza Makati) – Out-patient services only, Rm. 1805 18/F Medical Plaza Makati, Amorsolo St., Legaspi Village, Makati City

C) MAXICARE CENTER – QUEZON CITY (St. Luke’s Medical Center) Rm. 1501 15/F North Tower, Cathedral Heights Bldg.,

Quezon City

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D) MAXICARE CENTER – ORTIGAS (The New Medical City)Rm. MGR04 Ground Floor, Medical Arts Tower, Inc., Meralco Compound, Ortigas Center,

Pasig City

E) MAXICARE CENTER – QUEZON CITY (De Los Santos Medical Center) Unit 302, 3/F De Los Santos Building, 201 E. Rodriguez Avenue, Quezon City

F) MAXICARE PRIMARY CARE CENTER - Cebu City Rm. 308, 3/F Dr. Jose Cecilio Borromeo Bldg. Kamuning St. (across ER unit of Cebu Doctors’ Hospital) Cebu City

2. Should the Member be inaccessible to any one of the above listed centers, he may proceed to any Maxicare-affiliated hospital through the Maxicare Coordinator.

(a) Prior to availment, Member shall be required to present his Maxicare Membership ID Card, supported by any valid ID card (e.g., company ID, SSS ID, other ID cards bearing photo and signature) for verification. For cases when the Maxicare membership ID card is not available, the Maxicare Certification can be honored.

(b) The Maxicare Coordinator shall diagnose the Member for any ailment. Appropriate medical treatment will then be given or confinement may be recommended, if necessary. If medical case requires treatment or consultation with another specialist, the Maxicare Primary Care Physician or Coordinator may refer accordingly.

(c) Necessary laboratory exams or diagnostic procedures may be requested by the Maxicare Primary Care Physician or Coordinator using the Maxicare Laboratory Request Form. Member may then proceed to the medical department where the tests can be availed from (i.e., Laboratory, X-ray, Heart stations, etc). Result of the tests may be followed up with the Maxicare Primary Care Physician or Coordinator.

B. In-Patient Services

1. Upon recommendation of the Maxicare Primary Care Physician or Coordinator, Member may be admitted to the hospital either on emergency or elective confinement.

2. For proper monitoring of confinement by Maxicare, Maxicare Membership ID Card must be presented to the hospital’s Admitting Section immediately upon admission. Likewise, said section must be notified of room-and-board entitlement for proper room accommodation.

(a) Room upgrading during an elective confinement is allowed. However, the difference in the room-and-board, doctor’s professional fees and incremental costs incurred shall be charged to and settled by the member upon discharge.

(b) In an emergency confinement where room entitlement may not be available,

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room upgrading is likewise allowed. However, upgrading is applied only to the next higher room accommodation. In this case, member shall not shoulder the excess charges (i.e., difference in the room-and-board, doctors’ professional fees and incremental costs) on the first 24 hours of confinement.

3. Once confinement is monitored, the Maxicare Customer Care Department prepares the Letter of Authorization (LOA), which signifies Maxicare’s extent of coverage on availment. This is issued by the Maxicare Customer Care Representative (CCR) to the hospital where admitted.

4. All provisions indicated in the LOA shall be discussed by the Maxicare CCR with the Member on the first or second day of confinement. This allows Member to be aware of any uncoverable charges may incur during confinement, as well as other requirements pertinent to availment.

5. If Service Agreement specifies integration of Member’s PhilHealth (Medicare) Sickness Benefit into Maxicare health benefits, prompt filing of PhilHealth Sickness Benefit Claim is necessary. This should be forwarded to the hospital’s Phil. Health Section prior to discharge. Should the Member fail to do so, he would be required to pay the Phil. Health cost equivalent upon discharge.

C. Emergency Care Services

For emergency conditions as defined under Article I [K], the Member may proceed to the emergency room of the nearest hospital/clinic whether affiliated or non-affiliated.

1. Maxicare-Affiliated Hospitals

a. Once confinement is determined, the MAXICARE HEAD OFFICE, thru the Customer Care Department, must be notified WITHIN 24 HOURS so that proper assistance is promptly rendered.

2. Non-Maxicare-Affiliated Hospitals

a. After treatment at the Emergency Room, all necessary receipts and clinical records must be secured for processing of claim for reimbursement.

b. The Maxicare Claim for Reimbursement and Medical Certificate forms must be promptly accomplished and submitted to Maxicare Head Office within thirty (30) days upon date of discharge.

D. Procedure on Balance Billing

Maxicare shall maintain a list of preferred affiliated providers and specialists. Upon availment, the member shall be directed by Maxicare’s Customer Care Representatives (CCR) to the appropriate provider on the list. If the member insists on availing from an affiliated provider not referred by Maxicare’s CCR and balance billing results, the member shall be responsible for the additional charges, if any.

In no case shall the Member demand reimbursement from Maxicare for the excess charge paid by the member to the provider.

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ARTICLE V - PRE-EXISTING CONDITIONS

The Member shall be entitled to receive full benefits on all pre-existing non-dreaded and dreaded conditions up to 100% of the MBL except for illnesses or conditions specifically excluded by an endorsement which is made part of the Agreement.

For purposes herein, a dreaded disease is any condition that is considered to be chronic, progressive, and may be life-threatening that does not ensure complete cure and may entail lifelong therapy. The following list shall non-exclusively be considered a dreaded disease:

1. Complicated hypertension – includes renal failure, stroke, heart failure, and coronary artery disease and others.

2. Neurosurgical conditions – brain tumors, arteriovenous fistula, aneurysm and others.3. Neurological conditions – seizure disorder (secondary to space occupying lesions).4. Valvular heart diseases – includes rheumatic heart disease except Mitral Valve Prolapse.5. Cancer and blood dyscrasias – includes leukemia, lymphoma.6. Chronic pulmonary diseases – Chronic and Organic Pulmonary Disease

(emphysema/chronic bronchitis), sleep apnea.7. Collagen/immunologic diseases – Systemic Lupus Erythematosus, scleroderma,

rheumatoid arthritis.8. Cirrhosis of the liver – all causes except alcoholic liver cirrhosis 9. Poliomyelitis.

ARTICLE VI - MOTOR VEHICLE LIABILITY

In case of injuries sustained by a Member in a motor vehicle accident, the Member’s emergency care treatment, medical services and hospitalization expenses as defined herein shall be covered by Maxicare.

ARTICLE VII - CLAIMS AND MEMBERSHIP SATISFACTION PROVISIONS

IMPORTANT: NO CLAIM FOR REIMBURSEMENT SHALL BE HONORED OR ENTERTAINED BY MAXICARE UNLESS DUE NOTICE TO MAXICARE IN ACCORDANCE WITH THE PROVISIONS OF THIS AGREEMENT HAD BEEN COMPLIED WITH.

A. LIMITATION: These claims for reimbursement apply only in emergency treatment from non-Affiliated Hospitals.

B. FORM: All claims for reimbursement must be in writing and submitted to the Maxicare head office within thirty (30) working days from the completion of the required medical

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services for which the claims expenses were incurred unless extended for good cause by Maxicare. The claim must be accompanied by the following:

1. Original receipts of all hospital bills, including a clinical abstract of the case/ treatment duly signed by the attending physician.

2. If surgical intervention was performed, the claim must be accompanied by the operative record of the case, and its histopathological report.

3. Such other documents or proofs which are necessary to support the reimbursement.

C. RESERVATION: During the pendency of the claim, Maxicare reserves the right and opportunity to physically examine the Member whose injury or illness is the basis of the claim.

D. PAYMENT OF CLAIMS: Upon processing and approval of the claim, payment of the same shall be made directly to the Member unless otherwise specified. In case of death of the Member, payment shall be made to the Client in trust for the person entitled thereto. In the latter case, the Plan Administrator of the Client shall be required to sign or execute an affidavit of satisfaction of claim, which shall discharge Maxicare from any and all obligations arising out of the same.

E. REQUEST FOR RECONSIDERATION: If claim for reimbursement is denied, or the Member is not satisfied/agreeable to the reimbursement paid by Maxicare, a written request for reconsideration must be filed at Maxicare Head Office not later that ten (10) working days from receipt of such denial or questioned reimbursement. Otherwise, the claim shall be deemed satisfied or terminated. The request for reconsideration shall contain all the reasons upon which reconsideration is sought and shall be decided upon by upper management of the company, whose decision shall be final.

ARTICLE VIII - EXCLUSIONS AND LIMITATIONS PROVISIONS

Notwithstanding any provisions to the contrary, the following shall fall under the exclusions and limitations of medical and health-care services:

1. Services obtained from Physicians and Hospitals in any of the following circumstances: (a) non- Affiliated Physicians and non- Affiliated Hospitals, (b) non-Affiliated Physicians and Affiliated Hospitals, (c) Affiliated Physicians and non-Affiliated Hospitals or other non affiliated healthcare facility, except as provided under emergency care at non- Affiliated Hospitals, including adverse medical conditions arising from the treatment by non-Affiliated Physicians.

2. Except as otherwise provided in the Emergency Care Provisions, additional hospital charges resulting from obtaining a room accommodation different from the Member’s Room and Board Accommodation, or additional personal comfort items such as additional telephone and TV, etc., not ordinarily included in the Member’s Room and Board Accommodation.

3. Custodial, domiciliary, convalescent and intermediate care.

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4. Long-term rehabilitation and Psychiatric care.

5. Treatment resulting from self-inflicted injuries (including infections or complications as a result of tattoos, piercing of the ear or in any body part, whether self-inflicted or done by a third party) or attempted suicide or self-destruction, whether sane or insane.

6. Developmental disorders including functional disorders of the mind, alcoholism and drug addiction or abuse.

7. Treatment of any injury received which is proved to be attributable to the Members own misconduct such as gross negligence, intemperate use of drugs or alcoholic liquor, vicious or immoral habits, direct or indirect participation in the commission of a crime whether consummated or not, violation of a law or ordinance, and unnecessary exposure to imminent danger or hazard to health.

8. Aesthetic, cosmetic and reconstructive surgery or any consultation or treatment for any beautification purposes except if necessary to treat a functional defect due to accidental injury within the initial confinement.

9. Oral surgery following accidental injury to teeth for purposes of beautification.

10. Dental examinations, extractions, fillings and other dental treatment except as provided under the Dental Benefits Endorsement and to the extent that are medically necessary for repair or alleviation of damage to the Member caused solely by an accident.

11. Maternity care and all other conditions, except pre and post natal consultations related to and/or resulting from pregnancy, which affect the conditions of the principal member and the dependent child.

12. Circumcision, sex transformation, diagnosis and treatment of fertility or infertility, artificial insemination, sterilization or reversal of such.

13. Experimental medical procedures.

14. Acupuncture, chirotherapy and other forms of rehabilitation therapies.

15. Routine, diagnostic, therapeutic and other procedure whether or not of the same or similar nature not otherwise specified under Article IV [A][4].

16. All expenses incurred in the process of organ donation and transplantation, unless the Member thereof is the recipient of such donation or transplantation.

17. Routine physical examinations required for obtaining or continuing employment, requirement in school, insurance or government licensing.

18. Purchase or lease of durable medical equipment, oxygen dispensing equipment, and oxygen except during covered in-patient care.

19. Corrective appliances, artificial aids, prosthetic appliances.

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20. Take-home medicine; Out-patient medicine except intravenous chemotherapy medicine and medicine administered during an emergency treatment.

21. Congenital deformities and abnormalities affecting functions of individuals, except for hernias, in excess of Php20,000 per member per year.

22. All physical deformities prior to enrollment except for pre-existing scoliosis as provided for under Article X [J].

23. Treatment of injuries/illnesses caused directly or indirectly by engaging in any hazardous sport or activity i.e. scuba diving, mountain climbing, parachuting et.al. and injuries resulting from riots, strikes, and other civil disturbances.

24. Sexually transmitted diseases, AIDS and AIDS related diseases.

25. Chronic Dermatoses, Valvular heart disease (congenital and/or acquired) including Cardiomyopathies, Chronic Glomerulonephritis and Pyelonephritis, previous craniotomy sequelae/hearing impairment/ Neurologic disease and Spinal Stenosis (if pre-existing)/Poliomyelitis/Slipped disc (if pre-existing) and Guillain-Barre Syndrome, Diabetes and its complications (if pre-existing), Complicated Hypertension (e.g. those with history of stroke, myocardial ischemia or infarction and poor kidney function), and all malignant tumors (if pre-existing). (Modified: Refer to Special Benefits Endorsement)

26. Infectious diseases (according to the local epidemiologic patterns) that may arise in times of an epidemic, (i.e. Avian Flu, Meningococcemia, etc..)

27. Pre-existing Hepatitis B and Hepatitis B Screening.

28. Any disease, condition, or complication, the proximate cause of which is dog bite, except as provided for under Article IV, section B, paragraph 1.

29. Treatment of injuries or illnesses resulting from war or any combat-related activities while in military service.

30. Financial responsibility for medical care covered by Philhealth and Employee’s Compensation Act Benefits already enjoyed by the Member by reason of compulsory coverage therein.

31. All other government funded health-care entitlements as provided for by law.

32. Laser therapy and speech therapy except for the coverage as provided for under Article IV [A][6] and Article IV [A][12].

ARTICLE IX - LIMITATIONS IN SERVICES PROVISIONS

The rights of the Member and obligations of Maxicare are subject to the following

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limitations:

1. If a major disaster or epidemic causes unavailability of facilities or personnel, or if circumstances are not within the control of Maxicare such as complete or partial destruction of facilities, war, riot, civil insurrection, labor disputes, or similar causes occur, Maxicare shall not be liable for any delay or failure to provide services to the member. Maxicare shall, however, exert its best effort to provide services to the Member, as the circumstances permit.

2. Maxicare’s aggregate liability for Out-patient, In-patient and Emergency Care Benefits during the one year term of this Agreement with respect to any particular disease/condition and their complications shall be limited to the Member’s Maximum Benefit Limit (MBL).

3. If the Member refuses to follow the recommended treatment or procedures and Maxicare physician believes that no professionally acceptable alternative exists, then Maxicare shall no longer be responsible to provide care for the condition under treatment while such refusal exists. However, if the earlier refusal resulted in the aggravation of the medical condition, then Maxicare shall no longer be responsible for the treatment thereof.

4. If a Member refuses to comply with established rules, regulations and procedures of the chosen hospitals or clinics and by reason of which services are denied, Maxicare is not liable for any claims, charges or damages caused to the member.

5. Maxicare is not liable for any claims, charges or damages caused to the Member by the acts of the doctors or physicians in the course of the delivery of the medical services whether in-patient or out-patient as it is hereby understood that the liability of Maxicare is limited to the payment of hospital bills, professional fees and all medical expenses directly related to the medical management of the Member.

ARTICLE X - OTHER PROVISIONS

A. PHILHEALTH COVERAGE: It is hereby declared and agreed that this Agreement is integrated with PHILHEALTH. For this purpose, the Member is deemed to be a PHILHEALTH member. PHILHEALTH proceeds shall be primarily liable for the satisfaction of any claim, medical, surgical or otherwise, payable under the provisions of NATIONAL HEALTH INSURANCE ACT of 1995 and its Implementing Rules and Regulations and subsidiarily by the benefits payable under this Agreement. Should PHILHEALTH proceed be not applied in the manner so indicated, the same shall be considered as a personal account of the Member and shall be paid by him unless otherwise expressly provided in this Agreement. Philhealth Benefits shall be on top of the MBL.

B. RELEASE WAIVER: Maxicare holds the Client free and harmless of any and all claims, liabilities and causes of action for all medical charges/expenses and services covered by the benefits of this Agreement except as herein stated.

C. DOWNGRADING OF COVERAGE: Availment of a room accommodation lower than the

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Member’s Room and Board Accommodation can be done at the option of the Member in which case, there shall be no refund for the cost difference in room accommodation and other related medical benefits.

D. AREAS WITHOUT AFFILIATED HOSPITALS: In areas without affiliated hospitals, MAXICARE will reimburse the following:

1. 100% on room and board charges if according to the Member’s Room and Board accommodation.

2. 100% on medicines and laboratory examinations while confined.

3. Professional fees based on what it would have cost Maxicare if an Affiliated Physician render the service in an Affiliated Hospital.

E. AMBULANCE SERVICE: Subject to availability and when medically necessary, Maxicare will on reimbursement basis, cover road ambulance service for transfers from an affiliated hospital to another affiliated hospital up to MBL and up to Php2,500 per conduction if it is from a non-affiliated hospital to an affiliated hospital. All of which could be availed regardless of location.

F. PROCESSING FEE: For lost ID Card, an affidavit of loss and a processing fee of P100 pesos per card shall be submitted to Maxicare within thirty (30) days from the date of loss.

G. UPGRADING/DOWNGRADING OF PLAN: Any changes in that type of plan by the Client is not applicable. However, should there be a need to upgrade or downgrade a Member’s plan as a result of promotion or demotion of the Member in the company, such shall be approved subject to the conditions relevant to the said change:

1. Client notifies Maxicare in writing.

2. The effective date of the upgrading/downgrading of the plan shall be the first day of the month following the date the Client notifies Maxicare in writing or the first day of the month following the date of promotion/demotion, whichever is later.

3. In case of an upgrade in plan, the Client shall pay the additional membership fee pertaining to the period that the upgraded plan is in effect. In case of a downgrade in plan, Maxicare shall reimburse the Client the reduction in the membership fee pertaining to the period that the downgraded plan is in effect.

H. FUTURE TAXES, LEVIES AND GOVERNMENT IMPOSITION: If during the effectivity of

this Agreement, the fees and benefits are made subject to new taxes, levies or fees, or such law, regulation or its equivalent resulted to changes in the formula or manner of computing taxes thereby resulting in additional obligations on the part of Maxicare, any additional amount due shall automatically be charged to the Client/Member in addition to the fees stated herein. Future taxes, levies or fees referred herein are only those that affect the quoting of Membership Fees (Ex. 12% VAT), other future taxes, levies or government impositions that do not affect the quoting of Membership fees are therefore excluded.

I. WORK RELATED CASES: Sickness and injuries arising from and during the course of

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employment or health services compensable under the ECC Program are covered up to Php20,000 per member per year when provided within the Maxicare network.

J. Scoliosis including necessary procedures shall be covered up to the MBL if acquired, up to Php2,000 if pre-existing and up shall be subject to congenital provision if congenital.

K. ASSAULT: All cases of assault whether provoked or unprovoked, whether initiated by the Member or by a known or unknown third party, shall be covered up to MBL.

IN WITNESS WHEREOF, the parties have hereunto affixed their signatures on the date and at the place first above written.

MAXICARE HEALTHCARE VINTA SYSTEMS, INC.CORPORATION

By: By:

_________________________________ _______________________________ Jose Pastor Z. Puno Augusto Lagman President and Chief Executive Officer Chairman and Chief Executive Officer

_________________________________ _______________________________ Victor R. Tanjuakio Vice President and Chief Actuary Underwriting and Actuarial

SIGNED IN THE PRESENCE OF:

_________________________________ ________________________________ Yvonne Marie A. Santos Assistant Vice President Sales and Marketing - Intermediaries

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ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)MAKATI CITY )SS

BEFORE ME, a Notary Public for and in Makati, Metro Manila, Philippines, this ___ day of _________________________, personally appeared:

Name CTC No. Date/Place Issued

Jose Pastor Z. Puno 04695918 1-17-07 / Makati City

Victor R. Tanjuakio 04695989 1-29-07 / Makati City

Augusto Lagman 19475052_________ 1-11-08 / Makati City ______________________

All known to me to be the same persons who executed the foregoing instrument and they acknowledged to me that the same is their free and voluntary act and deed and those of that corporation herein represented.

This instrument refers to a Service Agreement and consists of 44 pages including this page where the acknowledgement is written and has been signed by the parties and their instrumental witnesses on each and every page hereof.

WITNESS MY HAND AND SEAL, on the date and at the place first above written.

Doc. No. _____;Page No. _____;Book No. _____;Series of 200_.

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SCHEDULE A

PERSONS ELIGIBLE FOR MEMBERSHIP

1. All regular and full-time employees of the Client who are eighteen (18) years old and actively working in the company, are qualified to apply subject to the following:

a. For employees enrolled under Gold 1, Gold 2 , Silver and Bronze plans: up to 60 years old

b. For employees enrolled under Platinum plan: up to 65 years old.

2. For married employees, eligible dependents qualified to apply are:a) Legal spouse (where age eligibility is the same as that of the employees above);

andb) Legitimate, legitimated, legally adopted children, 15 days to 21 years old in order

of age (eldest to youngest in that order).

3. For single employees, eligible dependents qualified to apply are: a) Parents (where age eligibility is the same as that of the employees above); andb) Brothers and / or sisters 15 days to 21 years old, in order of age (eldest to

youngest in that order).

4. For single parent employees, eligible dependents qualified to apply are:a) Children or legally adopted children, 15 days to 21 years old in order of age

(eldest to youngest in that order); and/orb) Parents (where age eligibility is the same as that of the employees above) and

brothers and sisters 15 days to 21 years old, in order of age (eldest to youngest in that order).

IMPORTANT CONSIDERATIONS

(1) For purposes of this Agreement, the ages heretofore set forth shall refer to the age of the Member on the last birthday. The Member may therefore maintain membership in the healthcare program up to said age;

(2) The hierarchy or order of dependents set forth under paragraph 2, 3 & 4 must strictly be observed and followed. Non-compliance therewith without justifiable reasons shall cause disapproval of the application for membership.

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SCHEDULE B

ANNUAL CHECK-UP BENEFITS

The following annual check-up program/s (based on member classification) shall be conducted at a Maxicare designated Affiliated Medical Hospital or Mobile Clinic once a year:

Member Classification Program

Platinum Multi - B (MMC)Gold 1 Routine (Mobile)Gold 2 Routine (Mobile)Silver Routine (Mobile)Bronze Routine (Mobile)

MULTI-B : (Makati Medical Center)

1. Complete Blood Count2. Blood Chemistry

>FBS >Potassium >Total Cholesterol >HDL >LDL >VLDL >Cholesterol >Triglycerides >BUN >Creatinine >SGOT >SGPT >Albumin >Globulin >Total Protein >Uric Acid >Calcium Phosphatase >Total Bilirubin

>Alkaline Phosphatase >Urea

3. Thyroid Function: TSH-IRMA 4. Hepatitis Screening:

>HbsAg, Anti-HBs, Anti-HBc

5. Routine Urinalysis 6. Routine Fecalysis including stool for occult blood 7. Cardiac Work-up >12 lead ECG >Treadmill Stress Test 8. Chest X-ray 9. Abdominal work-up >Upper Gastrointestinal series >Ultrasound of liver, gallbladder & Pancreas >Barium Enema >Proctosigmoidoscopy

Consultations: 1. Gastroenterologist 2. Cardiologist 3. Gynecologist/Urologist

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Consultations without additional cost if deemed necessary by the attending physician (Choose 3):

Dentistry Hematology Otorhinolaryngology Surgery Cardiology Rheumatology Psychiatry Pulmonology Infectious/Tropical Neurology Nephrology Orthopedics

ROUTINE PROGRAM:

1. Physical Examination2. Urinalysis3. Fecalysis4. Chest X-Ray5. Complete Blood Count (CBC)

Hemoglobin Hematocrit Differential RBC WBC

6. ECG (Optional for Members 40 years old and above)7. Pap Smear (Optional for female Members 40 years old and above)

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MEMBERSHIP GUIDELINES ENDORSEMENT

This endorsement is attached to and made part of the Service Agreement No. C7411 (“the Agreement“) between Maxicare Healthcare Corporation (“Maxicare”) and VINTA SYSTEMS, INC. (“Client’).

Notwithstanding provisions of the Agreement to the contrary, it is hereby understood and agreed that the guidelines stated below shall be part of the Agreement.

I. Enrollment of New, Additional Members and /or Membership Updates

1. Client shall fill-out the Data Change Form (formerly R002 form, now DCF) and submit to the assigned Maxicare representative, servicing agent or broker or submit directly to Maxicare Head Office or Maxicare Centers on or before the enrollment cut-off dates. From the DCF, Maxicare’s Underwriting Section will secure information needed to enroll additional members or change in membership data.

In cases wherein the volume of additional enrollees is substantial, please attach a list, following Maxicare’s required format, of new members to be enrolled on a formatted diskette signed and endorsed by the Client’s authorized representative/s in the DCF.

Maxicare shall only honor membership listings coming directly from the Client’s authorized personnel. This is to ensure accuracy and security of data to be submitted and processed.

The Client authorizes the following personnel:

Name: ___________________________________Juliet D. PerezPosition: _________________________________Executive Secretary

Name: ___________________________________Position: _________________________________

Data Change Forms and/or member lists that are clearly faxed may be accepted to meet the cut-off dates. However, submission of the original copy of documents is required to avoid discrepancy in member data.

2. The effective date of coverage or the assignment of effective date for new / additional applications shall be as follows: (Modified: Refer to Special Benefits Endorsement)

a. For application forms received by Maxicare between the first (1st) and fifteenth (15th) day of the month, effective date shall be set on the first day (1st) day of the following month.

b. For application forms received by Maxicare between the sixteenth (16th) and the 30th / 31st day of the month, effective date shall be set on the sixteenth (16th) day of the following month.

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2.1. Change of effective date within the coverage period shall not be allowed.

2.2. Request for late enrollment shall no longer be accommodated even on a retroactive effective date.

2.3. Effective dates of enrollees whose coverage are being held due to needed additional requirements/verifications shall be based on the completion of the said requirements/verifications and receipt of Maxicare, applying the two standard cut-off mentioned above.

Pending requirements shall be completed within 30 calendar days from date of advice of Maxicare, non-compliance would mean automatic forfeiture to enroll with Maxicare.

2.4. Should the effective date of applicants/enrollees be considered as date of regularization of the employee, the Client shall ensure the endorsement of DCF prior to the date of regularization or thirty (30) days thereafter. The effective date of the newly regularized employees shall then follow the date of regularization. Failure to submit the abovementioned requirements within thirty (30) days after the date of regularization would result to the disapproval of the application.

Effective date of approved upgrading due to promotion shall follow certain member classification/grade and the standard cut-off for the effective date.

Certain considerations on late submission of within 60 days only from the date of regularization may be given on a case-to-case basis due to reasons deemed acceptable and approved by the Vice President and Chief Actuary of Maxicare.

2.5. All additional enrollees/dependents from the first batch of enrollment and/or during the renewal period must be endorsed within the first month or within 30 days of the coverage period and shall follow the original /renewal effective date for the assignment of effective date. Thus, additional enrollees beyond this date shall be considered in the next renewal period already except for newly regularized employees whose endorsement must be prior to the date of regularization or within 30 days thereafter and also for the first month or within 30 days after the date of eligibility for newly wed spouse and newly born dependents.

2.6. For new enrollees to be enrolled within the last quarter of the coverage period, list of enrollees should be endorsed to Maxicare within two (2) months prior to the maturity date of the account and shall follow the standard cut-off dates or date of regularization (whichever is applicable), otherwise, they will be considered and accepted as additional enrollees during renewal.

Certificate of coverage shall be issued in lieu of the Maxicare ID cards.

2.7 If the cut-off falls on a weekend or holiday, the last working day prior to the cut-off date shall be the cut-off date.

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II. Cancellation and/or Termination of Members

1. The effective date of Cancellation of members should be based on the date specified in the cancellation notice or the Data Change Form (DCF), provided that it was received by Maxicare prior to the effective date of the said cancellation and/or termination. Otherwise, the cancellation of members shall be based on Maxicare’s receipt of the cancellation notice or DCF.

2. Membership ID cards of cancelled, resigned/ separated members must be submitted together with the DCF. If cards are not returned, any availment or possible access of such members after the cancellation date shall be charged accordingly to the Client’s account and will form part of the Client’s total utilization.

All other terms and conditions in the Agreement not affected by this Endorsement shall remain the same.

The effective date of this endorsement is the effective date of the Agreement.

At Makati City, Philippines this 30th day of December, 2007.


By: By:

_________________________________ _______________________________ Jose Pastor Z. Puno Augusto Lagman President and Chief Executive Officer President and Chief Executive Officer




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ANNUAL CHECK-UP (ACU) ENDORSEMENT


Notwithstanding any provision of the Agreement and its Annexes to the contrary, it is hereby agreed and understood that Maxicare shall provide coverage for Annual Check-Up (ACU) subject to the following terms and conditions:

1. The ACU shall be extended to all Members covered under the “Agreement”.

2. The ACU shall be rendered at following affiliated ACU provider/s:

_________________________________________________________

_________________________________________________________

_________________________________________________________

However, if the number of Members to undergo the ACU is at least one hundred (100) in one day, arrangements may be made for a mobile laboratory to conduct the ACU at the Client’s worksite. In case the number of actual mobile ACU availers falls below the minimum required number, the Client shall shoulder the additional cost attributable to such shortfall.

3. The Members may avail of the ACU at anytime upon full settlement of the initial Modal Membership Fees. Provided, however, that in case of a monthly mode of payment of membership fees, the Members may avail of the ACU after payment of the membership fee for the sixth (6th) month of the Agreement.

4. The Members may avail of the ACU only during the effectivity of this Agreement. The ACU coverage shall terminate on the expiry or termination date of this Agreement, without prejudice to any claim for covered medical services rendered to a Member prior to the expiry or termination date. Moreover, if a member fails to avail of the ACU Benefit within the period for its provision, the same shall be forfeited in Maxicare’s favor.

5. Additional Members with less than two (2) months remaining coverage within this Agreement period shall not be entitled to ACU.

6. Covered tests and services included are those provided for under Schedule B of this Agreement. Other tests and services are excluded and shall be for the Member’s and/or the Client’s account if rendered.

7. In case of pre-termination of contract of membership, and the Annual Check-Up had been rendered, the additional premium for this Special Endorsement shall be paid in full by the Client.

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8. Client may notify Maxicare’s Customer Care Department (CCD) at least one (1) month prior to preferred schedule. This is to ensure enough time for the ACU coordination with all concerned parties.

The request can be e-mailed to [email protected] or through postal mail addressed to:

Cecille F. Rudica Assistant Manager 19th floor, Medical Plaza Makati Building

Amorsolo cor Dela Rosa Streets,Legaspi Village, Makati City 1229

or: Ritchelle B. Cruz.Customer Care Associate

Maxicare’s CCD-ACU Team shall acknowledge receipt of Client’s written request within two (2) working days.

9. Any request for rescheduling or change of venue other than hereinabove indicated as per provision no.2 must be in writing and should be forwarded to CCD one (1) week prior to the original ACU schedule. Maxicare reserves the right to disapprove such requests.

All other terms and conditions of the Agreement not otherwise modified or amended in this Endorsement shall continue to be in full force and effect.

This Special Endorsement shall be effective and co-terminus with the Agreement.

Signed this 30th day of December, 2007 at Makati City, Philippines.


By: By:



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SPECIAL ENDORSEMENT ON SUSPENSION OF MEMBERSHIP


1. Grace Period for Payment of Membership FeesThe guidelines prescribed under Article II [B] regarding payment of membership fees shall remain in force except that disputed/ contested Statements of Accounts or SOA shall suspend the full payment by the Client of the Membership Fees due. It shall be necessary however that there must be proof of significant error on any substantial matter stated in the SOA and that the same is not merely a scheme to delay payment, otherwise the SOA would be deemed binding and effective in all respects. In such case, the 30-day Grace Period within which the Client is required to pay shall commence from the receipt by the Client of said SOA.

Upon the resolution of the dispute, contest or conflict, a new SOA bearing all the necessary adjustments shall be furnished to the Client. The receipt of the Client of such adjusted SOA, the date of which being indicated in the Acknowledgement Receipt, shall signal the commencement of the 30 day grace period within which the Client is required to pay its financial obligations.

2. Late Payment or Non-Payment of Membership Fees, Effect OfIf the Client refuses or fails to pay the amount billed after reconciliation, within the Grace Period provided, it shall be considered in default upon the expiration thereof and coverage shall be suspended automatically.

3. Lifting of SuspensionThe suspension shall be in force until the Client shall have paid the Membership Fees due plus the three percent (3%) per month penalty charge, as provided under Article II, [C]. In no case shall the suspension exceed two (2) months otherwise Maxicare shall automatically cancel the membership without prior notice to the account. In case the coverage of the account is canceled for failure to remit payment, Maxicare shall be entitled to a fee of P150.00 per head to cover administrative and other costs.

4. ReactivationWhen payment had been satisfied, Maxicare shall initiate the re-activation of the Client’s membership to the effect that members can access Maxicare’s network of medical providers. The reactivation shall take effect five (5) calendar days following the date of payment subject to clearing of checks, whichever is later. This period shall be referred to as the Waiting Period. Claims incurred during the Suspension and Waiting Period will not be reimbursed.

Notwithstanding provisions of the Agreement to the contrary, it is hereby understood and agreed that the guidelines stated below shall be part of the Agreement.


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By: By:





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SPECIAL ENDORSEMENT ON INCREMENTAL RATE DIFFERENCE


GUIDELINES ON INCREMENTAL RATE DIFFERENCES AND EXCESS CHARGES

If a Maxicare member is confined in a hospital room of higher category than his allowable benefit within the Maxicare network for whatever reasons, including but not limited to, lack of semi private rooms in a particular hospital or hospital policy to allow private paying patients only to use its semi-private rooms, the member shall be liable for incremental rate difference and excess charges as follows:

1. For covered Hospital Charges or Ancillaries other than Room & Board expenses and Professional Fees, the Member shall pay:

a. The amount equivalent to thirty percent (30%) of covered hospital charges or ancillaries, if the Member is confined in a hospital room next higher or one (1) category higher than his allowable benefit. (e.g., from Semi-Private to Private)

b. The amount equivalent to forty percent (40%) of covered hospital charges or ancillaries if the Member is confined in a hospital room two (2) categories higher than his allowable benefit. (e.g., from Semi-Private to Suite)

c. The amount equivalent to fifty percent (50%) of covered hospital charges and ancillaries if the Member is confined in a hospital room three (3) categories higher than his allowable benefit. (e.g., from Ward to Suite)

Subject to the condition that if the hospital in which the Member was confined does not charge incremental rate difference on particular hospital charges or ancillaries, Maxicare shall likewise not levy incremental charges on said covered hospital charges or ancillaries.

2. For Professional Fees, the member shall pay the difference between the allowable Professional Fees (PF) based on Maxicare’s Schedule of Fees and the actual Professional Fees charged by the doctor.

3. For Room and Board charges, the Member shall pay the difference between the actual rate of the room occupied and the allowable room rate. In case no Semi-Private rooms are available in the Hospital, Maxicare shall use the following average Room and Board charges in computing for the allowable room rates which are as follows:

3.1. For Metro Manila, Metro Cebu and Metro Davao : Php850 per day 3.2 For Outside Metro Manila and Metro Cities : Php700 per day

Philhealth portion for which the Member is eligible shall be applied to or deducted from allowable charges.

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4. For purposes of the above, the valid and official Room and Board Categories shall be:

Notwithstanding provisions of the Agreement to the contrary, it is hereby understood and agreed that the guidelines aforementioned shall be part of the Agreement.



By: By:





Category 1 Suite

Category 2 Private

Category 3 Semi-Private

Category 4 Ward

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DENTAL BENEFITS ENDORSEMENT

This endorsement is attached to and made as an integral part of the Service Agreement No. C7411 (“the Agreement“) between Maxicare Healthcare Corporation (“Maxicare”) and VINTA SYSTEMS, INC. (“Client”).

Notwithstanding the provisions of the said Agreement to the contrary, it is hereby understood and agreed that Members shall be covered under the above-mentioned Agreement and are entitled to the following dental services listed below:

STANDARD BENEFIT PACKAGE:

1. Annual Oral/Dental Examination and Consultation2. Emergency Dental Treatment3. Oral Prophylaxis – once a year4. Simple Tooth Extractions5. Restorative & Prosthodontic Treatment Planning6. Permanent Fillings – 2 fillings/year7. Temporary Fillings – unlimited, as needed8. Desensitization of Hypersensitive Teeth – up to 2 teeth9. Simple Adjustment of Dentures10. Recementation of loose crowns, inlays and onlays11. Dental Nutrition and Dietary Counseling12. Dental Health Education

These dental services shall be provided by Dental Channels Company.


The effective date of this Endorsement is the effective date of the Agreement.

At Makati City, Philippines this 30th day of December, 2007.


By: By:

_________________________________ _______________________________ Jose Pastor Z. Puno Augusto Lagman President and Chief Executive Officer President Chairman and Chief Executive Officer

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SPECIAL BENEFITS ENDORSEMENT


Notwithstanding the provisions of the Agreement to the contrary, it is hereby understood and agreed that all Members covered under the above-mentioned Agreement are entitled to the following additional benefits:

1. Congenital illnesses shall be covered up to Php20,000 per member per year. Congenital hernia shall however be covered up to MBL.

2. Article VIII (25) is hereby modified to the extent that the diseases enumerated therein (except for Chronic Dermatoses) shall be covered up to the MBL whether acquired or pre-existing.

3. Other Arrangements/Benefits:

a. (1) Effective/eligibility date for new and additional principal enrollees shall be as follows:

For Vinta Systems:

The date of regularization for Platinum Plan Holders (Principal only).

All Dependents will be enrolled under Silver Plan regardless of the movements of the Principals.

All Rank & File will be enrolled under Silver Plan after regularization.

Managers & Supervisors will be enrolled under Silver Plan after regularization. They shall be enrolled under Gold Plan after two (2) years of continuous service with the Client.

Employees may enroll their dependents after one (1) year of continuous service with the Client.

For Protemps:

Date of employment for Principals.

Principals will be enrolled under the same plan unless requested by the Client for amendment.

For CPL, STI, SSI and Logic

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Date of regularization for Platinum Plan Holders (Principals only).

Newly regularized employees may be enrolled after six (6) months of employment under the following plans:

Rank & File – Silver Plan Managers and Supervisors – Gold Plan

Plan Type of Rank & File employees are automatically upgraded from Silver to Gold 2 Plan after one (1) year of continuous service with the Client.

Employees may enroll their dependents after one (1) year of continuous service with the Client.

For Spouse – same plan with that of the employee. For Parents, Siblings and Children – one plan lower than the

employee.



By: By:





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