Health plans reject agreement with ANS to comply with defaulters



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Refusing to maintain contracts with delinquent clients until June 30, during the covid-19 pandemic, the main health insurance operators in Brazil did not sign a commitment term proposed by the National Complementary Health Agency (ANS). The agreement with the agency revealed movements of R $ 15 billion from a fund that retains R $ 54 billion from the operators themselves.

The refusal was announced on Friday the 24th by the National Federation of Complementary Health (FenaSaúde), which represents an important part of the sector. The newspaper The state of S. Paulo He anticipated that the companies sought, behind the scenes, to remove the requirement to serve customers with late fees during the crisis. At the same time, the sector also wants to cancel the fines it has with ANS, under the argument of using resources to expand services.

The release of the R $ 15 billion was announced in March by the former Minister of Health, Luiz Henrique Mandetta (DEM), as the main government measure to strengthen complementary health. The private sector serves some 50 million people. The public network receives 150 million.

The State found that some operators agreed to sign the term. The names have not yet been released by ANS. The deadline to accept the conditions or does not end on Friday 24.

The regulatory agency’s proposal is to condition the fund’s movements to keep clients in breach of collective business plans with less than 30 lives. The same rule would apply to all group membership plans or individual plans. The commitment also requires guarantees of payment to service providers, such as hospitals, laboratories and clinics.

In a note, FenaSaúde reported that its associates “will not be able to assume the commitment to maintain coverage or to stop canceling the breached contracts without distinction until June 30, as proposed by ANS.” “The increase in the levels of delinquencies and delinquencies would have a double and undesirable effect: it would not only oppress the cash flow of the companies but it would also require an additional financial effort from the operators to expand the amounts constituted as a provision for doubtful debts, in strict compliance with the prudential, accounting and actuarial standards established by the ANS itself, ”said the federation.

FenaSaúde represents the following operators: Amil, Allianz Saúde, Bradesco Saúde, Care Plus Medicina, Gama Saúde, Golden Cross Saúde, Grupo NotreDame Intermédica, ITAUSEG Saúde, Mediservice, Metlife Odontológico, Odontoprev, Omint Saúde, Porto Seguro Saúde, Sompo Saúde, SulAmérica, Unimed Seguros Saúde.

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