The suggestions will be analyzed by the legal area before being voted at the Agency
Brasilia- a Additional National Agency (ANS) A series of regulatory measures that can, among other points, discusses further adjustments on the individual plans, exceeding the fixed roof by the agency itself.
A new proposal was presented at the end of April, after the first suggestions for change in the standard, published last year, subjected to a consultation public.
For consumer protection experts, the changes made in the initial proposal for the benefit of the private sector compared to users.
“These punctual changes suggested by the agency are much more aligned with the interest of the market and the statements that operators have presented over the years compared to the rules of Consumer protection code“, Criticizes Marina Paullelli, lawyer of the health program of Consumer Protection Institute (idec).
Representative of the largest health insurance operators of the country, the National Federation of additional health (Fenasúde) He ranked the changes such as “Mini -Harvest regulatory” and defended a greater debate (read below).
ANS presented the proposal to the legal area and later analyzed the text on the Board of Directors. TO EstadãoThe agency has declared that the proposal is following the flow of processes and that there is no determined deadline to conform to the passages.
Wednesday (7), the Senate’s social affairs Commission will hold a public audition to discuss the agency’s recent decisions and discuss any impacts on health insurance users.
Individual plans
The possibility of applying extra adjustments to individual plans is one of the main objectives of the regulatory change under discussion. Currently, the increase in lessons is limited to a fixed ANS index. There is an old question from companies in order to re -read prices above this roof.
The most recent proposal, presented in a meeting at the end of April, flexes the criteria and counterparties for the technical review, since the application of the incoming in the plans of this mode is called. If it is approved, the measures would be valid in 2026.
Marina claims that the re -adaptation of the technical review is against what the consumer protection code says. “It should not be authorized because it allows unilateral change in the contract,” he says. In addition, the change can put the consumer in a disadvantage and in a worrying financial situation.
One of the most criticized points is the reduction of deadlines for companies to warn consumers who will apply the income. In the initial project, the forecast was that this would have been done in 90 days. Now, ANS has dropped the period to 60 days.
The criteria for companies that can apply increase have also been modified. Rather, they should present the following characteristics:
- Economic and financial imbalance of the total portfolio for three years;
- Imbalance in the individual portfolio in the same period;
- Active sale of individual plans.
In the updated version, the agency removed the first requirement, leaving only the last two.
The most recent proposal also included measures that had not been addressed by the agency, such as the periodicity of the re -adaptation and the maximum percentage:
- Adaptation limited to 20% per year, considering the impact of the percentage already set by ANS and the extra increase;
- The technical review can only be applied every five years;
- Customers with plan for less than five years from the date of concession of the revision will not be presented to the income.
According to Marina, the dilution of the income value does not reduce the problem. “Similar measure of dilution of values has already occurred during the pandemic And the research IDC showed how harmful to the consumer it was, “he says. The study of the Institute has shown that, in individual plans, the income dilution has caused an average annual increase up to 34.99%.
Collective plans
Initially, ANS has worked with the possibility of expanding the scope of collective health plans up to 29 lives at 1,000 screws. The increase in this number could generate a dilution of the risk by taking a plan, causing the most balanced raises.
But after the public consultation, the agency lowered the coverage limit to 400 screws and justified that the idea is to gradually reach the level of 1,000 screws.
“The reason for this change is not very clear or as it is destined to gradually reach the level of a thousand lives,” says Marina.
What does the sector say
About 52 million Brazilians use health plans. The regulation of the sector is a wrestling arm between companies and consumer protection agencies.
Currently, a bill that significantly alters the regulation of additional health is interrupted in Congress. For almost 20 years, the legislative proposals have tried to modify the rules of the market without success. In this context, the changes promoted by ANS obtain even more relevant outlines.
In a declaration sent to the report, Fenasúde said that the agency promotes a “regulatory mini -harvest” with proposed changes. The entity cites the breadth, scope and depth of suggested changes and states that “a more detained debate is necessary” on the subject, considering its impacts on operators and beneficiaries.
“In particular, we believe that it is still necessary for the proposals presented so far based on actor, legal and economic, with the aim of guaranteeing the sustainability of the sector and the guarantee of health care,” says Fenasaúde.
The Association of Brazilian health plans (Abramge) also reiterated the need to have “adequate and adequate technical analyzes of each of the proposals commented by ANS, considering their impacts individually and focused on the sustainability of the sector”.
Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
