Of the 70 health plans that had their marketing suspended this Monday by the National Supplementary Health Agency (ANS), 42 are from Amil and 12 from Unimed-Rio. The two operators are at the top of the list of eight companies in the sector that had contacts with the sale interrupted due to complaints related to assistance coverage in the first quarter of this year.
From January to March, the ANS analyzed 37,512 assistance complaints against health plans. The sale ban starts on the 30th of this month.
In all, the 70 plans that had their sale suspended add up to 1,453,044 beneficiaries. Users of these plans will not have their service affected. On the contrary, the purpose of the ANS with the interruption of the sale is to protect them. Operators can only re-market these contracts if they show improvement in care data.
In addition to the suspensions, the ANS also discloses the list of plans that may be marketed again. In this cycle, four plans from three operators will be released for sale.
See the complete list of suspended and resumed plans by clicking on this link.
The measure is part of the monitoring of the guarantee of service carried out by the regulatory agency, which regularly monitors the performance of the sector and acts in the protection of consumers.
Sought, Amil claims that the temporary suspension “of some of its products by the National Supplementary Health Agency (ANS) was impacted by the increase in notifications resulting from the reorganization of diagnostic medicine providers, extended to most of its individual and business customers, occurred in the last quarter of 2021. Although the replacements took place entirely within the agency’s parameters, the change required a period of stabilization in the use of services by the beneficiaries, impacting the notifications.”
Another relevant factor, according to the operator, was the transfer of its portfolio of individual and family plans to the operator APS, effective in early 2022. This transfer was suspended on April 4 and definitively rejected on May 2, when the Amil resumed the aforementioned portfolio. The process generated noise and doubts for the beneficiaries, reflected in the increase in notifications in the period.
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Amil also highlights that “it has already implemented initiatives to improve the experience of its beneficiaries and that all notifications were duly handled by the company, in accordance with the action plan from which it instituted a reception cell for cases that refer to the accredited network ; new flow for network search, scheduling and directing in call centers; expansion of free home collection; among other initiatives whose objective was to reassure its beneficiaries.”
According to the regulation, the suspension is temporary and is reassessed by the agency in quarterly cycles. The service to current customers linked to these products remains fully assured, as well as the sale of other non-suspended products already offered by the company. Amil reiterates its commitment to the continuous improvement of the experience of its beneficiaries, ensures that the actions taken and new ones in progress will be reflected in the monitoring of the current quarter and remains available through its service channels.
Unimed-Rio points out that the suspension of products does not have any impact on customer service and states that there are initiatives in progress to normalize the points that generated an increase in customer complaints. According to the operator, in addition to the impacts of the pandemic, the cooperative’s result in monitoring the ANS has the operational effects caused by a technological incident that affected the company’s service provision.