Purple Cow SME Healthcare – Frequently Asked Questions / FAQs
1. About Purple Cow
Q: What is Purple Cow? Purple Cow is a healthcare program built specifically for SMEs (small and medium enterprises), positioned around the tagline “FIGHTING for Better SME Healthcare.” It packages a health plan underwritten by ETIQA with a set of added protections, tools, and terms designed to be more favorable to smaller companies than a standard group HMO/insurance plan.
Q: Who underwrites or powers Purple Cow’s coverage? Purple Cow’s plans are powered by Etiqa, which provides the underlying insurance backing and network access for the coverage. Purple Cow layers its own “unfair advantages” and optional terms on top of the standard ETIQA plan.
Q: Who is Findshare, and how are they related to Purple Cow? Findshare is the platform/broker through which Purple Cow plans are presented and sold, including managing lead generation, advisor consultations, and a referral rewards program.
Q: Is Purple Cow only for large corporations? No — it’s specifically positioned as an SME (small and medium enterprise) healthcare solution, though the minimum company size or headcount requirement is 5. You’d confirm eligibility thresholds directly with a Purple Cow advisor.
Q: Is Purple Cow only for large corporations? Yes. Purple Cow SME Healthcare is specifically aggregates to SMEs, startups, and with no less than five (5) employees.
Q: Is Purple Cow available nationwide in the Philippines? Purple Cow is trusted by organizations across the Philippines and lists partner networks (Big 9 hospitals and Healthway clinics).
2. Plans & Pricing
Q: What plans does Purple Cow offer? Two main tiers: Essential Care and Premium Coverage.
Q: What does Essential Care cost? Essential Care starts at ₱6,797 per year per employee.
Q: What does Premium Coverage cost? Premium Coverage starts at ₱26,673 per year.
Q: What’s included in the Essential Care plan?
- Medical (MED) coverage included
- Standard coverage benefits
- Coverage for 3 principals + dependents
- Room & Board coverage from ₱10,000 to ₱50,000
- Room options: Ward, Semi-Private, and Small Private
- Flexible payment terms (Annual, Semi-Annual, or Quarterly)
Q: What’s included in the Premium Coverage plan?
- Room & Board coverage from ₱20,000 to ₱200,000
- Wider room options, from Ward up to Large Private
- MED coverage included
- Outpatient benefits available
- Optional add-ons: Dental, Annual Physical Exam (APE), Life Insurance
- 1–2x Life & Accident coverage
- Additional add-ons available: BRO, ABL, IPH, CCO
- Flexible payment terms (Annual, Semi-Annual, or Quarterly)
Q: What’s the difference between Essential Care and Premium Coverage? Premium Coverage offers a significantly higher Room & Board limit (up to ₱200,000 vs. ₱50,000), more room type flexibility (including Large Private), outpatient benefits, and optional add-ons like Dental, Life Insurance, and Life & Accident coverage — at a higher starting price point.
Q: How many people does a plan cover? The Essential Care plan is described as covering 3 principals + dependents. The Premium Coverage listing doesn’t restate a specific principal count on the page, so it’s worth confirming per-plan headcount details with an advisor.
Q: What are their payment options/Can I pay monthly? Purple Cow lists Annual, Semi-Annual (Semi), and Quarterly as the flexible payment options.
Q: Do prices vary by company size, age of employees, or industry? The page shows “starting at” prices, implying these are entry-level rates that could scale based on factors like group size, age, or benefit selections. Exact pricing details would come from a personalized quote.
3. Purple Cow’s “Unfair Advantages” (vs. Standard Plans)
Q: What are Purple Cow’s 4 “unfair advantages”? These are the areas where Purple Cow’s plan goes beyond a typical HMO/insurance package, each covered up to 100% of MBL: Pre-Existing Conditions, Congenital Conditions, Special Procedures, and No-Fault Coverages.
Q: How does Purple Cow SME Healthcare cover Pre-Existing Conditions — 100% coverage for conditions that existed before enrollment (e.g., chronic asthma, cancer, hypertension, diabetes).
Q: How does Purple Cow SME Healthcare cover Congenital Conditions — 100% coverage for conditions present from birth (e.g., developmental disabilities, congenital hernia, cleft lip, club foot).
Q: How does Purple Cow SME Healthcare cover Special Procedures / New Modalities — 100% coverage for alternatives to conventional treatment (e.g., laparoscopic/arthroscopic procedures, laser therapy — excluding Lasik unless legally blind — prosthetics, MRI, dialysis, chemotherapy).
Q: How does Purple Cow SME Healthcare cover No-Fault Coverage — 100% coverage despite circumstances that are normally excluded elsewhere. Full coverage (up to MBL) for cases without needing to establish fault — commonly relevant to accident-related claims. Specific terms would be defined in the policy contract.
Q: What is “No-Fault Coverage” covering, specifically? It removes 7 conditions that are typically excluded by fault-based clauses:
- Mental-nervous disorders, alcohol/drug-related conditions (including mental health)
- Participation in brawls, riots, or crime
- War or combat-related activities
- Hazardous activities or dangerous sports
- Own misconduct, gross negligence, or immoral habits
- Self-inflicted injuries
- STD/AIDS
Notably, no police report is required to claim under this provision.
Q: What is “MBL”? MBL stands for Maximum Benefit Limit — the ceiling amount the plan will pay out for covered benefits. Several of Purple Cow’s headline features are described as coverage “up to MBL.”
Q: Does Purple Cow cover Inpatient, Outpatient, and Emergency care? Yes — Purple Cow explicitly lists Inpatient, Outpatient, and Emergency medical benefits as part of the coverage.
Q: Is outpatient care included in both plans? Outpatient benefits are explicitly listed under Premium Coverage. It’s not explicitly listed as a standard Essential Care feature on the page, so you’d want to confirm this distinction with an advisor.
4. ETIQA’s Competitive Advantages
Q: What makes ETIQA’s plan more than a “usual” health plan? Four things the site highlights.
- Access to the Big 9 hospitals + Healthway for no-cash-out care.
- Reimbursement for non-emergency treatment received outside the network.
- Benefits that sit on top of PhilHealth rather than being folded into it.
- Digital/mobile access to healthcare services.
Q: How exactly does Purple Cow SME Healthcare’s “on top of PhilHealth” work?
- Benefits are on top of PhilHealth: Total Benefits = MBL + PhilHealth (NOT MBL – PhilHealth) meaning PhilHealth pays its share separately, in addition to your MBL, rather than PhilHealth’s payout being deducted from your MBL.
Q: What digital tools come with the plan / How can I access their online services?
- Members Portal – request an LOG online (Go2.purplecow.com.ph/MEMBERSPortal)
- Smile App – A mobile app to request an LOG of Letter of Guarantee. Downloadable via Google Play Store and Apple Store.
- Doctor Anywhere App – A mobile app for 24/7 telemedicine consultations, no LOG required.
5. Optional Benefits / Add-Ons
Q: What optional add-ons are available? The page lists two groups of add-ons:
- DEN • APE • L&A — Dental, Annual Physical Exam, Life & Accident
- BRO • ABL • IPH — Reimbursement, Annual Benefit Limit, PhilHealth Independence
Q: What’s included in the Dental HMO benefit? Ten benefits: 1 permanent filling (whole tooth/light-cure), 2 oral prophylaxis (cleanings), oral examination as needed, gum problem consultation/treatment, simple tooth extraction (excluding impaction), temporary fillings when indicated, re-cementation of loose jacket crowns, denture adjustment/repair, oral hygiene instruction, and dental health education. No reimbursement is allowed — it must be used at Dental HMO clinics, and participation is 100% by rank (i.e., applied uniformly across an employee rank/level).
Q: What’s included in the Annual Physical Exam? A complete physical exam (oral exam, visual acuity, medical history), chest X-ray, CBC (complete blood count), routine urinalysis, routine fecalysis, ECG (for members 35 and up), and Pap smear (for members 35 and up, where applicable).
Q: How do we schedule an APE for our company? You will have to send an email to your advisor or someone from Purple Cow, 2–4 weeks before your preferred date. A minimum of 50 employees is required to schedule a mobile/on-site APE.
Q: What does the Life & Accident Insurance add-on cover?
- Life: Death by any cause (1–5x MBL, except suicide in the first year), Provoked Murder (in lieu of Life), Total & Permanent Disability (in lieu of Life).
- Personal Accident: Death from accident (double indemnity), Provoked Assault (in lieu of Accident), and a disablement schedule (1–100% of MBL).
Example given: if MBL = ₱100,000, then 1x MBL = ₱100,000 in Life & Accident coverage. Participation is 100% by rank.
Q: Can I add Dental and Life Insurance to any plan? Dental, APE, and Life Insurance are listed as optional benefits under Premium Coverage specifically. Availability for Essential Care isn’t stated on the page.
Q: What is BRO (Benefits for Reimbursement Only)? It’s reimbursement — not a Letter of Guarantee — for 7 items normally excluded because they’re considered elective/lifestyle rather than medically necessary:
- Screening-only procedures
- Dental/Vision
- Annual Physical Exam / Executive Check-Up
- Take-home or prescribed medicines/vaccines
- Maternity/sex-related procedures
- Cosmetic/aesthetic procedures
- Complementary & Alternative Medicine (CAM)
Reimbursement under BRO is capped at a combined 1/10th of MBL. No LOG is needed — the member just signs a claim form and submits the provider’s official receipt. BRO is only available to members with REGPVT (Regular Private Room) or higher Room & Board, and participation is 100% by rank.
Q: What is ABL (Annual Benefit Limit)? It changes the benefit structure from an MBL per illness, per year, to a single Annual Benefit Limit shared across all illnesses/accidents combined for the year. This is an all-or-none election for the company (not selectable per employee).
Q: What is IPH (Independent of PhilHealth)? Normally, Total Benefits = MBL + PhilHealth, and the member must file a PhilHealth claim. Under IPH, the member has no PhilHealth involvement at all — Total Benefits = MBL only, and the member doesn’t need to file PhilHealth or cover PhilHealth’s share of the bill. This can be elected individually.
6. Eligibility & Enrollment Rules
Q: What is the Hierarchy Rule (Rule A)? It governs who counts as a Principal vs. a Dependent, and in what order Dependents must be enrolled:
- Principals (18–65 y/o) can be Single, Married, or Single Parents.
- Senior Dependents (18–65 y/o) are Spouses or Parents.
- Junior Dependents (0–25 y/o) are Children (legitimate/legitimized/recognized natural children, step-children, or legally adopted/foster children) or Siblings (full/half).
- Single Principals must enroll Parents first, then Siblings (oldest to youngest).
- Married Principals must enroll Spouse first, then Children (oldest to youngest).
- Single Parents must enroll Children first, then Parents, then Siblings (oldest to youngest).
Q: Can single parents, unmarried or same-sex partners be enrolled as dependents? Yes — Single Principals or Single Parents can enroll a single Domestic Partner, Common-Law partner, or LGBTQ partner in lieu of their Parents/Siblings slot. This requires HR certification of Dependent coverage and a notarized affidavit of cohabitation. A beneficiary designation form is also required if the optional Life & Accident (L&A) benefit is included.
Q: What is the 100% Rule? Either 100% of Principals enroll their eligible Dependents, or none can be enrolled — it’s all-or-nothing at the group level. This can also cascade by rank: if a higher rank doesn’t cover 100% of its own Dependents, then no lower rank is allowed to cover its Dependents either.
Q: What is the Same Combo Rule? Dependents must be enrolled in the same R&B/MBL combination as their own Principal, or in the same lower R&B/MBL combination as all other Dependents in the group — i.e., Dependents can’t be mixed across different arbitrary benefit combos.
Q: What is the Overage Rule (Rule D)? Principals/Dependents who age out or otherwise become ineligible can stay enrolled until the end of the current policy year (though without the optional Life & Accident benefit). At renewal, older members are re-rated at a multiple of the base MED rate:
- 66–70 years old: 2.5x MED
- 71–75 years old: 3x MED
- 76–80 years old: 5x MED
Q: Who can join the “Purple Cow Premium” pool? Corporate or Non-Corporate Clients with 10 Principals (or 10 Dependents without Principals) can insure MED and join the Purple Cow Premium pool. Groups with fewer than 10 are subject to approval on a case-by-case basis.
Q: Do smaller clients need to file individual applications or usage reports? No — the Purple Cow contract states there’s no franchising, no individual application forms, and no utilization reports required for Premium Clients.
Q: Do Principals and Dependents get different benefit levels? Room & Board (R&B), Maximum Benefit Limit (MBL), and Mode of Payment (MOP) choices vary depending on group size, but Principals and Dependents always get the same Costs & Benefits as each other within a group.
Q: Is there a deadline to enroll a new dependent (e.g., a newborn or new spouse)? Yes — Dependents must be enrolled within 30 days from the day they first become eligible for coverage.
Q: What documents does a company need to submit to sign up as a Premium Client?
Four signup documents:
- Master List (of Principals/Dependents)
- Contract
- SEC/DTI Registration
- BIR Form 2303 (Certificate of Registration)
Q: Does a new client’s past claims history affect their starting rate? No — all new Premium Clients start at the same designated pool, regardless of past claims history with a previous provider.
7. Renewal & Premium Pooling (“Renewal Math”)
Q: What is “Renewal Math” at Purple Cow? It’s Purple Cow’s term for how a client’s premium is adjusted at each policy renewal, based on that company’s own health claims experience over the past year — rather than a flat, across-the-board rate hike applied to every client.
Q: What is a “Pool” in this Purple Cow system? A Pool is a pricing tier/step. The Pool is described as a staircase (Pool 1 through Pool 5+), a client’s position on that staircase goes up or down and it determines their premium for the next policy year. What are the most common renewal scenarios? Three scenarios:
- +1 Pool — premium increases by +15%
- = Pool (no change) — premium stays the same, +0%
- -1 Pool — premium decreases by -15%
Q: What decides whether a Purple Cow client moves up, stays, or moves down a pool? Their own health claims experience — essentially, how much the company’s employees used the plan relative to the premiums paid. Better-than-expected (lower) claims can move a client down a pool (cheaper renewal); worse-than-expected (higher) claims can move a client up a pool (costlier renewal).
Q: Is there a cap on how far a client can move in one renewal? Under normal circumstances, movement is limited to one pool step at a time symbolizing the controlled, predictable +/-15% adjustment per renewal rather than a sudden spike or drop.
Q: What’s the exception to the “one pool at a time” rule? Accounts whose claims exceed 100% of the premiums paid can move up more than +1 pool at a time — meaning unusually high claims usage can trigger a bigger jump than the standard +15% increase.
Q: How many pools are there in total? Purple Cow illustrates at least 5 pools (Pool 1 through Pool 5), shown as ascending stair steps, with the client depicted climbing (or descending) them over time.
Q: Why does Purple Cow describe this as “self-reward” or “punishment”? Because the outcome is driven by the client’s own claims behavior rather than an arbitrary insurer decision — favorable claims experience effectively rewards the client with a lower renewal rate, while high claims usage effectively “penalizes” the client with a higher one.
Q: How is this different from how other insurers handle renewals? This frames as Purple Cow’s offering of “a kinder, gentler client experience at renewal time” — implying the pooling system is more transparent and predictable (capped, step-based, percentage-based adjustments tied to the client’s own data) compared to less transparent or steeper renewal rate hikes elsewhere in the market.
Q: If my premium goes down one year, will it keep going down every year after? Not necessarily. Each renewal is reassessed independently based on that year’s claims experience, so a client could move down a pool one year and up the next, depending on utilization in each period.
Q: Does a company get warned before a pool change takes effect? Nothing specify a notice process for how far in advance renewal terms/pool movement are communicated, it’s best to confirm directly with you Purple Cow auditor or your account handler. Purple Cow illustrates at least 5 pools (Pool 1 through Pool 5), shown as ascending stair steps, with the client depicted climbing (or descending) them over time.
8. Network, Claims & Access
Q: What does “no cash out” mean? It means that for accredited hospitals and clinics, you don’t need to pay out of pocket at the point of care — Purple Cow SME Healthcare settles directly with the provider via a Letter of Guarantee (LOG).
Q: Where can I use No-Cash-Out? At ETIQA’s Accredited Doctors, Accredited Hospitals, Accredited Clinics, Dental Clinics, and APE (Annual Physical Exam) Clinics — each has its own directory linked from the homepage and your auditor will provide the list included in your contract and documents.
Q: Which hospitals are in the Purple Cow network? The page references the “Big 9 Hospitals” and Healthway Clinics as the no-cash-out network.
- Makati Medical Center
- St. Luke’s Medical Center – Quezon City
- St. Luke’s Medical Center – Global City
- Cardinal Santos Medical Center
- Asian Hospital and Medical Center
- The Medical City
- Chong Hua Hospital – Cebu City
- Cebu Doctors’ University Hospital – Cebu City
- Davao Doctors Hospital – Davao City
- Healthway Clinics (network-wide)
Q: How many total partner does Purple Cow have? Purple Cow SME Healthcare current has 800+ partners which is around 25,000 individuals.
Q: What happens if I go to a hospital outside the network? Non-emergency treatment outside the network is handled via reimbursement rather than no-cash-out access. Turnaround time is usually 15 days.
Q: How does the claims process work? Two pathways are described:
- No-Cash-Out (via Letter of Guarantee) — for Inpatient, Outpatient, and Emergency care within the network: use your ETIQA health card/ID to get a Letter of Guarantee (LOG) at an accredited doctor, hospital, or clinic — you don’t pay out of pocket.
- Reimbursement — as-charged, up to MBL, covering all services (e.g., for out-of-network non-emergency care).
Q: Is there a deadline to file a reimbursement claim? Yes — claims must be submitted within 30 days of the date of treatment (consult or discharge). Turnaround time (TAT) is 15 days from receipt of complete documents.
Q: Does Purple Cow coordinate with PhilHealth? Yes — the plan is positioned as providing benefits on top of PhilHealth, described on the page as “MBL = P/H, not MBL – P/H,” meaning PhilHealth-eligible amounts aren’t deducted from your Purple Cow benefit limit.
Q: Can I access healthcare digitally or via mobile? Yes — digital access to healthcare via online/mobile platforms is listed as one of Etiqa’s four competitive advantages.
Q: Is there 24/7 access to care or telemedicine? The page references “digital access to healthcare from online/mobile platforms” but doesn’t specify telemedicine hours or features in detail.
Q: How do I file an Inpatient (IP) claim for Purple Cow?
Requirements:
- Completed and signed IP claim form
- Hospital Statement of Account (photocopy accepted)\
- BIR-approved invoices for professional fees and hospital bills
- Prescription (Rx) for any medicines bought outside due to non-availability
- All documents in original copies, except the Statement of Account
- Any erasures must be countersigned by the authorized signatory
- Original receipts are required if the claim exceeds ₱10,000
Submit the completed form and documents via go2.purplecow.ph/SubmitClaims. ETIQA reserves the right to request additional documentation case by case.
You can also coordinate these steps with Purple Cow’s Team via Facebook Messenger Group Chat.
Q: How do I file an Outpatient (OP) claim for Purple Cow?
Requirements:
- Completed and signed OP claim form
- Medical certificate in lieu of a doctor’s diagnosis on the claim form
- BIR-approved invoices for professional fees and hospital bills
- For lab expenses, a lab request signed by the doctor (photocopy accepted)
- All documents in original copies, except lab requests
- Erasures must be countersigned by the authorized signatory
- Original receipts required if the claim exceeds ₱10,000
Same submission channel: go2.purplecow.ph/SubmitClaims.
Q: Where do I get the claim forms? Both Inpatient and Outpatient claim forms are downloadable directly from the site (linked as “Download Inpatient/Outpatient Claim Form”) You can also coordinate with your advisor via Facebook Messenger Group Chat.
Q: How long does reimbursement take? 15 business days turnaround time (TAT) from receipt of complete documentation, per the site’s stated policy for non-emergency/emergency reimbursement.
9. Getting Started / Sign-Up
Q: How do I sign up for Purple Cow? You can request a consultation/schedule a meeting through the “Get Started” button on the FindShare page, which leads to a form to schedule a meeting with the Purple Cow healthcare team. Or you can learn more about Purple Cow SME Healthcare and schedule a meeting through here: https://www.findshare.com/purple-cow-referee/
Q: What’s the onboarding sequence once I’m interested about the Purple Cow SME Healthcare plan? Here are the step-by-step path:
- Brochure – view the plans details via https://www.findshare.com/purple-cow-referee/
- Book the online consultation via Google Meet or Zoom – discuss details live
- Proposal – view/download a formal proposal, masterlist, list of accredited doctors, hospitals, and clinics
- Masterlist – submit your employee masterlist to “Join the Herd”
- Contract – execute and submit the contract coordinated with the FindShare and Purple Cow team
- Orientation – employee onboarding session
- Newsletter – ongoing updates after enrollment
Q: What information do I need to provide to get a quote? The sign-up form asks for: Full Name, Mobile Number, Email, Company Name (SEC/DTI registered), Position (HR, Finance, CEO, etc.), Number of employees and dependents, preferred GoogleMeet/Zoom meeting time and date, and who referred you to Purple Cow.
Q: Can I schedule a consultation before committing? Yes — the page offers to schedule a GoogleMeet/Zoom meeting with the FindShare/Purple Cow team to discuss the right plan for your company.
Q: How does the Zoom consultation work? Meetings are scheduled from 10:00 AM to 2:00 PM, but this is subject to change upon request of a different time availability. You must request a session at least 2 days in advance, and to allow up to 24 hours for email confirmation.
Q: Do I need to be the final decision-maker to inquire? No — the form has a Yes/No field asking whether you’re the decision-maker for HMOs, implying non-decision-makers can still submit inquiries (likely to be routed appropriately).
10. Referral Program
Q: Is there a referral program for Purple Cow? Yes — Findshare runs a referral rewards program. Upon successful completion and partnership between Purple Cow and the referred company, referrer is entitled to Php 15,000 reward.
Q: How do referral rewards work? Rewards are given for every unique, valid, and approved company referral.
Q: When is a referral considered “valid”? A referral is valid once the referred company is verified and meets internal qualification criteria.
Q: When are referral rewards paid out? Rewards are released after referred company/business signed up, and participants must provide accurate details for payout to proceed.
Q: What disqualifies a referral? Fraudulent, duplicate, or misleading referrals will be disqualified.
Q: Can the referral program terms change? Yes — the organizer reserves the right to review approvals and to modify or end the program at any time.
Q: What does submitting the form mean in terms of the referral program? Participation in the form/process is treated as acceptance of the program’s terms and conditions.
11. General / Trust & Credibility
Q: Does Purple Cow have testimonials or proof of trust? Yes — the page features video testimonials from representatives of organizations including Kooapps Philippines, Ideawell & FindShare, Bridges-PH, RAROCO Insurance Brokers, and REAL LIFE Foundation.
Q: Who owns/operates Purple Cow SME Healthcare? Tom Gotuaco is the founder and owner of Purple Cow SME Healthcare. He established the company on August 8, 2008, with distribution through Findshare and underwriting support from Etiqa.
Q: Where can I get the full list of covered benefits, exclusions, and fine print? The landing page presents highlights rather than a full policy document — for complete terms, exclusions, and benefit schedules, you’d request the official plan brochure or contract from a Purple Cow/Findshare advisor.