Unimed Ferj will adjust individual and family health plans by 20%

The individual and family plans linked to Unimed Ferj will be modified by 20%. The increase is almost three times the maximum of 6.91% that the National Agency for Complementary Health (ANS) has set for these contracts between May of this year and April 2025, reports Miriam Leitao's column in O Globo. The actuarial technical rebalancing of all the plans of this modality transferred from Unimed-Rio to Ferj has been carried out, with the aim of matching the accounts of this portfolio of contracts, which is in deficit.

This measure is included in the terms of commitment provided for in the transfer of ministerial portfolios between cooperatives and approved by the National Security Agency, which was also signed by the Federal and State Public Ministries (MP) and the Public Defender's Office of Rio de Janeiro.

The increase may be retroactive.

But only now, with the adjustment percentage set by the ANS, is the news being announced. The Unimed Ferj website explains to consumers that the adjustment percentage is valid from May 2024 to April 2025 and will be applied on the anniversary date of the contract. In other words, it could be retroactive until May.

Since 2017, Unimed-Rio has requested a technical adjustment from the Air Navigation Agency, claiming that the maximum rate set by the agency was not sufficient to meet the operator's calculations. Behind the scenes, what is being said is that the 20% rate is still not enough to rebalance the portfolio, which will still be in deficit, but with a smaller gap.

The ANS says the technical review topic is included in the preliminary studies for the regulatory agenda from 2023 to 2025, but it has been included in a broader discussion on adjustment and pricing policy, including improving the regulation of adjustment of group plans.

The agency also stated that it is not considering granting technical amendments to other operators’ wallets. This regulation on this subject has been suspended by the NSA since 2003, when the initial decision of the Federal Supreme Court (STF) on the direct action of unconstitutionality (Adin) 1,931 suspended the effectiveness of the rule.