STJ mandates ANS adjustment indices for false collective health plans

The Superior Tribunal de Justiça (STJ) has issued rulings regarding ‘false collective’ corporate health insurance contracts. In decisions made in May and June 2026, the court maintained that adjustment indices set by the Agência Nacional de Saúde Suplementar (ANS) for individual and family plans must be applied to these contracts, rather than the higher percentages charged by operators.

These ‘false collective’ contracts are formally registered as corporate plans but lack effective business collectivity, often consisting of small groups or single family units. Data from the consultancy Arquitetos da Saúde indicates a significant rise in this segment, with corporate contracts involving up to five lives growing 81% between December 2019 and May 2026, reaching 4.9 million beneficiaries.

Recent rulings by ministers Raul Araújo and Isabel Gallotti emphasized that the characterization of these plans as ‘false collectives’ depends on the family composition of the insured group rather than just the number of participants. The STJ has selected specific appeals to serve as representative cases for this controversy, which may lead to a standardized legal precedent.