Clipping of news on Brazilian Culture, Law and Citizenship
 


Consumer News

Readjustment old individual plans with commitment agreement

07/07/2016

This article was translated by an automatic translation system, and was therefore not reviewed by people.

 

 

transparent image

 

ANS

The National Health Agency (ANS) limited the maximum levels to be applied to the former individual health plan contracts (those concluded before the entry into force of Law 9,656 / 98) four operators signed Terms of Commitment (TC) on adjustment clauses. The measure is valid for approximately 316,920 beneficiaries of health plans for certain former plans of the following operators:. Amil, Bradesco Saúde, South America and Itauseg Health This universe corresponds to 0.65% of total health care plans to beneficiaries in Brazil .

Through these terms, the four operators started to submit adjustments to the regulation of ANS. These agreements prevented consumers were forced to pay for increases that reached 80% in 2004. It is worth noting that the commitment agreement aims the protection and defense of the interests of consumers. If operators exceed the defined percentage (see table below) are subject to fines and penalties.

adjustment limits authorized by the NSA to old plans with Commitment Terms - 2016

Table adjustment Term

chargeback will be allowed up to two months in the case of discrepancy between the rate increase and the month of the contract anniversary. For example, if the contract birthday is in June and the adjustment is applied in August 2016, will be allowed to own chargeback in August and in September of the values that have not been applied in June and July.

Historic

In 2004, the NSA questioned the high increases charged by operators Bradesco Saúde, South America, Itauseg Health, Amil and Golden Cross. By 2003, the Agency authorized the indices applied by these companies, but a direct action of unconstitutionality (ADIN) filed that year the Supreme Court withdrew the NSA's prerogative to pre-authorize the adjustments of prior agreements to the validity of the law that regulates the industry health plans.

All these operators have in their contracts annual rate adjustment clauses based on the variation of medical costs (VCMH), which does not translate clearly the criteria used for the definition of indexes. The NSA then proposed the signing of Terms of Commitment. Through these terms, the five operators are committed to correcting the irregularities. From 2014, after the sale of its portfolio of individual plans, the Golden Cross operator is no longer part of the group of operators that signed commitment agreement with the NSA.

Consumers can ask questions by contacting the regulatory agency for the Dial ANS (0800 701 9656), the electronic form available on the Agency's website in the Customer Service Center section (www.ans.gov.br), or in person at one of 12 ANS nuclei existing in all regions of the country. See addresses here.

- See more at: http://ans.gov.br/aans/noticias-ans/consumidor/3393-reajuste-dos-planos-individuais-antigos-2#sthash.9XqYtp8Q.dpuf

 

Source: ANS

To access the ANS site, click here.

Our news are taken in full of our partner sites. For this reason, we can not change their content even in cases of typographical errors.

 

This article was translated by an automatic translation system, and was therefore not reviewed by people.

Important:
The JurisWay site does not interfere in the work provided by doctrine, why only reflect the opinions, ideas and concepts of their authors.


  Subjects list
 
  Copyright (c) 2006-2009. JurisWay - All rights reserved.