Clipping of news on Brazilian Culture, Law and Citizenship
23/07/2013
This article was translated by an automatic translation system, and was therefore not reviewed by people.
Ceiling specified by ANS goes for individual and family plans hired from January 1999
Surge can be applied only from the anniversary date of each contract, from May of this year and April 2014
To Protest, increase will jeopardize the family budget
RIO - The National Health Agency (ANS) Limited 9.04% in the index adjustment for health plans hospital medical individual and family hired from January 1999 or adapted to Law 9.656/98, which regulates plans private health care. According to a survey by the Brazilian Institute for Consumer Defense (IDEC), this is the highest rate applied by the agency in the last eight years. The increase was also 2.55 percentage points above the official inflation index, the IPCA accumulated in the 12 months to April, which is 6.49%. The adjustment covers a universe of 17.6% of consumers plan in the country, about 8.4 million people. The percentage approved by the Ministry of Finance, the ceiling is valid for the period between May of this year and April 2014. Last year, the limit of the adjustment was 7.93%.
The methodology used by the NSA to define the maximum rate of increase for individual plans takes into account the average percentage adjustment applied by operators to group plans with more than 30 recipients. In this case, we considered the rates applied between May 2012 and April 2013. This formula is the same since 2001. In calculating this year was also considered the list of procedures required for plans in effect from 2012. The update Rol will occur from January 2014, currently in public consultation, will be assessed only one year after the term.
The formula is criticized by Idec, Protest - Consumers Association and the PhD in Human Rights from the University of São Paulo (USP) and researcher in the area of health plans Daniela Battle Trettel:
- The ANS uses as a basis adjustments charged by operators in group plans with more than 30 Beneficiaries, which are not under any rules. Although ANS understand that the market behaves well for larger contracts, regulates itself, in practice this does not happen. And the tradition of applying increases greater than inflation was maintained.
"This established ceiling does not apply to group plans, which cover approximately 77% of total consumers of health plans in Brazil, which are at the mercy of abusive adjustments applied by companies - Full Ione Amorim, economist Idec.
Maria Ines Dolci, institutional coordinator of Protest, suggests that the regulator adopts an indexer, as the IPCA. The General Manager Actuarial and Economic and Financial Products of the regulator, Rosana Neves argues that this methodology allows individual plans benefit negotiations between contractors already made plans and collective operators.
The regulator also argues that the rate of adjustment of the plans is not comparable to general price index or inflation indices, which measure changes in prices of inputs from various sectors such as food, housing, transportation and education.
"The adjustment index released by the ANS is not a price index. It is made by varying the frequency of use of services such as appointments and tests, new technologies available in the plans and changes in health costs. A comparison of the variation monthly income in the six metropolitan regions of Brazil, with the index adjustment, we find that the income has been growing over the roof of increase reported by ANS, "argues the regulatory manager, in an interview available on the website of the ANS.
Index will be retroactive to May
The rate increase authorized by the agency can be applied only from the anniversary date of each contract. The collection of retroactive value is allowed if the gap between the application and the anniversary date is no more than four months. And it should be done every month. For instance, under contract with the beneficiary birthday in May will receive the billet August with rejuste and more the difference of May, September and June will pay the difference in October July.
In the evaluation of Protest, the adjustment will compromise the Brazilian household budget, "they will have to make cuts to fit the new values." Maria Inês, said the impact will be greater for those who have time-adjusted basis in May, because for three months will have to pay the difference retroactively, "since the ANS delayed announcing the rate increase."
A regulator that is justified at the time of disclosure index, which goes from May to July. Last year, the increase was announced in late June. And argues, through counsel, that the collection of retroactive diluted month just to "not get heavy for consumers."
- Companies will have to attach to the first billet adjustment with a statement informing the recipient on the increase, and if they have to pay retroactive, it will be done every month - complements Maria Inês.
In a statement, the National Federation of Health Insurance (FenaSaúde) said that the rate of annual adjustment of monthly individual plans have different effects for each carrier, because the needs adjustment depend on the composition of the portfolio of customers of each operator and variables such as age profile of the beneficiaries, geographical distribution, network of medical providers, among others.
Beneficiaries should check base date
The agency also recommends that recipients stay tuned to their slips from next month. Should check, especially if the collection with index adjustment is being made from the anniversary month of the contract.
In case of doubt or complaint, consumers should contact through Dial ANS (0800 701 9656), the Central Customer Service at the address www.ans.gov.br, or in person at one of 12 Centers of agency in the country.
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Source: The Globe
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This article was translated by an automatic translation system, and was therefore not reviewed by people.