ANS studies new rules for collective health insurance adjustments

The Brazilian National Supplementary Health Agency (ANS) is studying new regulations for collective health insurance plans. The proposed changes aim to increase transparency, improve the clarity of price adjustment calculations, and refine contract termination rules.

Unlike individual or family plans, which have an annual price ceiling set by the ANS, collective plans with 30 or more beneficiaries have adjustments negotiated directly between the operator and the contracting company. The agency is considering expanding the risk pool by grouping more contracts together, which could help distribute the financial impact of high-cost medical events and provide more predictability for small businesses.

Other measures under review include creating a standardized clause to explain how adjustment percentages are calculated and addressing rules related to co-participation. These proposals are currently in the study and discussion phase and do not represent new rules already in effect.