Individual health plans have a historic increase

(Photo: Archive/Agência Brasil)

The National Supplementary Health Agency (ANS) yesterday (26) approved the maximum annual readjustment index for individual and family health plans. The increase can be up to 15.5%. The decision was taken by the board by a vote of four to one.

This is the largest annual adjustment ever approved by the agency, created in 2000. Health plan operators will be able to apply the index in monthly fees charged between May 2022 and April 2023. But the update of the values ​​can only be carried out from the anniversary date of each contract. If the contract anniversary month is May, it is possible to charge the adjustment retroactively.

The decision does not apply to collective plans, whether corporate or by membership. It only applies to monthly fees for individual and family contracts signed from January 1999 onwards. There are approximately 8 million beneficiaries, which corresponds to 16.3% of the supplementary health market.

The historic increase occurs one year after the ANS first approved a negative adjustment. In 2021, operators were forced to reduce monthly fees by at least 8.19%, because there was a generalized drop in demand for health services amid the social isolation resulting from the covid-19 pandemic. In the period, the plans registered a cost reduction.

“In 2021, we had a gradual resumption of the use of these services. It is also a year influenced by strong inflation throughout the country”, said the Economic-Financial and Product Actuarial Manager at ANS, Daniele Rodrigues, when presenting the details of the index calculation.

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In a note released on its electronic portal, the ANS maintains that both the negative readjustment of 2021 and the historical readjustment of this year are related to the effects of the covid-19 pandemic. “One cannot analyze the percentage calculated for 2022 without considering the context and atypical movements in the health insurance sector in the last two years”, says the text.

The readjustment proposal was submitted to the Ministry of Economy at the beginning of the month. The ministry issued a technical note approving the application of the methodology on Monday (23). According to ANS, the current formula for calculating the annual readjustment was adopted in 2018. The calculation is mainly influenced by the variation in care expenses from the previous year. It also takes into account the Broad Consumer Price Index (IPCA), which measures the country’s inflation.

The variation in assistance expenses in 2021 was 20.35%. It is the highest percentage of the historical series presented at the meeting, with data since 2014. In 2020, this variation had been negative by 9.2%. The calculations are performed by the ANS Standards and Product Qualification Department.

Different directors evaluated that the pre-defined formula guarantees transparency and predictability for the readjustment. “It is a methodology that very clearly reflects the variation in care expenditure”, argued the director of Sectorial Development, Maurício Nunes.

For the director-president of ANS, Paulo Rebello, the application of the methodology protects the public interest. “The agency regulates and seeks to keep the sector afloat,” he said.

The only dissenting vote, the Director of Inspection, Eliane Medeiros, praised the team’s efforts to apply the methodology in force, but took a position against the proposed index.

Editing: Fernando Fraga

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