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

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.

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.

This case has been brought to court for several consumer complaints against abusive increases after age 59 in the HMOs.

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.