May 17, 2022

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STJ decides that it is right to readjust collective health plans based on age group |  Policy

STJ decides that it is right to readjust collective health plans based on age group | Policy

The second section of Supreme Court of Justice On Wednesday (23rd), (Syrians for Truth and Justice) acknowledged the validity of the items in the collective health plans that stipulate the amendment based on the age group of the beneficiary.

The trial began in November last year when the rapporteur, Minister Paolo di Tarso Sanseverino, voted in favor of the amendment’s validity.

STJ has already recognized the possibility of adjusting according to the age group of individual and family plans. The Rapporteur considered that the same understanding should be applied to collective plans.

The analysis was interrupted by a request for proposal (more time to analyze the case) from two ministers, Ricardo Villas Boas Cueva and Nancy Andregue.

On the resumption of the trial, he accompanied the other ministers to the rapporteur on two issues. Syrians for Truth and Justice understood that Re-adjustment is possible provided that:

  • stipulated in the contract;
  • Observe the rules issued by the regulatory bodies of the bodies;
  • Unreasonable or random percentages that, tangibly and without an appropriate actuarial basis, excessively burden the consumer or discriminate against the elderly are not applied.

The value of health plans is expected to increase by more than 15% in 2022

During the deliberations the department decided Judging at another time whether it is up to operators, and not plan users, to provide actuarial calculations That would justify the readjustment indication.

Minister Vilas Boas Koiva highlighted that the jurisprudence of the STJ has already applied the same guidelines outlined for individual plans in cases involving group plans. “I completely agree with the thesis proposed by the rapporteur in terms of applying theses to collective plans,” he said.

“Our appearance must be special and humane. In every context of the increase in the population of 60 years or over, it may be concluded that the service rendered, especially in relation to group plans, acquires an increasing importance in so far as, in addition to the provision of a longer time of existence, necessary to give them a healthy life,” said Minister Nancy Andregue.