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publicado em 23/08/2013 às 04h16:00
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ANS limited readjustment of individual older than five operators

The standard reaches five operators that have signed statements of commitment (TC) on adjustment clauses

 
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The National Health Agency (ANS) announced on Thursday (22) the maximum annual adjustment to be applied to contracts for individual health plans made before the Law n. 9.656/98 enter into force. The standard reaches five operators that have signed statements of commitment (TC) on adjustment clauses.

The far reaches 425,105 beneficiaries of health plans old operators: Amil, Golden Cross, Bradesco Saúde, South America and Itauseg Health

The agency noted that chargeback will be allowed, up to three months in the case of discrepancy between the application and the readjustments anniversary month of the contract. For example: if the contract anniversary is in June and the adjustment is applied in September 2013, will be allowed to charge for the months of September, October and November of value that was not applied during the months of June, July and August.

In 2004, the NSA questioned the high adjustments made by operators Bradesco Saúde, South America, Itauseg Health, Amil and Golden Cross. Until 2003, the agency authorized indexes 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 adjustments to contracts before the validity of the law governing sector health plans.

Five operators had clauses in their contracts adjusted annually based on the change of medical and hospital costs, which, according to the regulator, not reflected clearly the criteria used for the definition of the indices. The NSA then proposed the signing of terms of engagement. Through these terms, five operators have pledged to correct the irregularities.

The contents were allowed:

- Amil: mode - group medicine, authorized limit 9.04%

- Golden Cross: mode - group medicine, authorized limit 9.47%

- Bradesco Saúde: mode - specialized health insurer, authorized limit 10.17%

- South America: mode - specialized health insurer, authorized limit 10.17%

- Itauseg Health: mode - specialized health insurer, authorized limit 10.17%

Source: AGÊNCIA BRASIL
   Palavras-chave:   Ring    Health plans    Health insurance increases    The National Health Insurance    Health   
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