Post by messi05 on Jan 23, 2024 23:41:24 GMT -5
Details the regulatory agency. Regarding the plan administrator, ANS argued, in the justification for editing the standard, that “the proposal brings into regulation an agent that already operates in the collective plans market, ordering the activities that are private, permitted and express prohibitions that guarantee compliance with legislation”. The ANS also highlights that “the participation of benefit administrators in contracting collective plans is not mandatory, and it is possible for the contracting legal entity to formalize a contractual instrument directly with the operator”. Currently, 47 million people have health plans in Brazil. Of this total, 19.5% of beneficiaries are in an individual or family plan, 66.5% in corporate groups, 13.6% in group memberships, and 0.4% in various agreements. The absence of obligations, according to ANS, is partial and exists due to the very nature of these companies.
Benefits administrators do not need to send, for Buy Phone Number List example, information to the Beneficiary (SIB) and Product (SIP) information systems, because this data is already passed on by the health plans. “It should also be noted that, if necessary, ANS may request information at any time based on §1 of article 4 of Law 9,961/00, regardless of the existence of any regulations”, explains ANS. The agency also mentions that there is a classification of illicit acts in paragraph 2 of article 1 of RN 124/2006, which deals with penalties for violations of health plan legislation. “It should be noted that law 9,656/98 itself already allows the exercise of police power and the application of sanctions on benefit administrators, in accordance with its articles 25 and 27, independently of any infralegal normative act.
” The PSL also claimed that access to collective contracts is limited. “RN 195/2009 organizes and establishes guidelines for the regulation of the collective plans market, but it does not provide anything about the regulations and status of contracting legal entities”, counters the ANS. In relation to free initiative, the ANS states that it only regulates the relationship between a legal entity contracting party and the health plan, imposing minimum obligations on them to be complied with. “The ANS rules challenged in no way violate the constitutional principle of free enterprise, because they do not prevent contracts from being signed directly between health plan operators and legal entities”, he states.
Benefits administrators do not need to send, for Buy Phone Number List example, information to the Beneficiary (SIB) and Product (SIP) information systems, because this data is already passed on by the health plans. “It should also be noted that, if necessary, ANS may request information at any time based on §1 of article 4 of Law 9,961/00, regardless of the existence of any regulations”, explains ANS. The agency also mentions that there is a classification of illicit acts in paragraph 2 of article 1 of RN 124/2006, which deals with penalties for violations of health plan legislation. “It should be noted that law 9,656/98 itself already allows the exercise of police power and the application of sanctions on benefit administrators, in accordance with its articles 25 and 27, independently of any infralegal normative act.
” The PSL also claimed that access to collective contracts is limited. “RN 195/2009 organizes and establishes guidelines for the regulation of the collective plans market, but it does not provide anything about the regulations and status of contracting legal entities”, counters the ANS. In relation to free initiative, the ANS states that it only regulates the relationship between a legal entity contracting party and the health plan, imposing minimum obligations on them to be complied with. “The ANS rules challenged in no way violate the constitutional principle of free enterprise, because they do not prevent contracts from being signed directly between health plan operators and legal entities”, he states.