IMS – Government HMO Enrollment Form

IMS-ANEC Enrollment Form for Government Shield Package (GSP)

For agencies or organizations enrolling multiple government employees under a single application. Please provide the group details, coordinator information, and the full list of employees to ensure smooth and efficient processing of your group enrollment. Make sure all required fields are completed to secure coverage for all members of your group.

Bank Deposit Payment Notice

For deposit transactions, kindly request your official IMS Account Number by contacting:

📧 customer.service@ims.com.ph
📱 0906-0181090

Please ensure you use the correct account number before making any payment.

Government Group Enrollment Form

Complete the form below to enroll multiple government employees under one group application for the Government Shield Package (GSP).

This platform is exclusively for government agencies enrolling multiple employees. Individual enrollments should use the separate individual form.

Disclaimer: All members listed must be government teaching or non-teaching personnel. Enrollment may be declined for employees not recognized as part of a valid government agency or organization.

Coordinator Name *

Agency *

If your agency is not listed, please send an email to ims.dm@ims.com.ph with your agency details.

Government Agency Delivery Address (Where the Physical Card Will Be Sent) *

Contact Number *

Email *

Plan Availing *

Agent *

Upload Coordinator ID *

Group Members

Bulk Upload via Excel

Download the official template, complete all required fields, then upload the file below.

Upload Completed Template *

Preview

Please review the uploaded data before submitting.

Row	Last Name	First Name	Middle Name	Suffix	Birthdate	Employee ID	Email

Before proceeding to payment

I hereby agree to the terms and conditions set forth under this order.

Terms & Conditions for Government Shield Package

That as a bonafide government employee, I shall be provided with access to affordable healthcare under the program Government Shield Package (GSP).
That I understand the program is exclusive to government personnel only.
That I have been informed of the available plan options and have selected the one that suits me best.
That I am enrolling as a government employee and not on behalf of non-government personnel.
That I am not applying for my dependent(s) through this enrollment.
For group enrollments: That all members listed in this application are verified government employees and eligible for coverage.

I agree to the Terms & Conditions