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STJ Decides that it is Right to Re-Adjust Collective Health Plans based on Age Group |  Policy

STJ Decides that it is Right to Re-Adjust 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, the other ministers accompanied the rapporteur on two issues. Syrians for Truth and Justice understood that Re-adjustment is possible provided that:

  • stipulated in the contract;
  • observance of 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 To judge 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 all this context of the increase in the population aged 60 and over, it can be concluded that the service rendered, especially in relation to group plans, is gaining increasing importance in that, in addition to providing a longer time It is essential to provide them with a healthy life,” Minister Nancy Andregue said.