Brazil’s New Communication Rules for Health Plans

Brazil's new ANS rules cover both individual and group plans with updated criteria for cancellation due to default and the inclusion of electronic means such as text messages and emails to facilitate contact.Brazil’s new communication rules for health plans went into effect on December 1, 2024, and concern notifying beneficiaries who have defaulted on their health plan payments. Brazil’s National Supplementary Health Agency (ANS) made these changes to help modernize communication between operators and consumers, guarantee greater transparency, and ensure beneficiaries have the opportunity to settle disputes before experiencing any interruption in service.

The new rules cover individual and group plans with updated criteria for cancellation due to default and approve the use of electronic communication, such as text messages and emails, to facilitate contact.

Here are the main points and how these changes impact health insurance contracts.

Default criteria

  • New contracts (signed from December 1, 2024) – The plan can be canceled if the beneficiary fails to pay at least two monthly payments, consecutive or not.
  • Old contracts (signed up to November 30, 2024) – The current rule is maintained. The contract can be canceled for non-payment for more than 60 days, consecutive or not, in the last 12 months of validity. A single invoice that has been unpaid for more than 60 days can be canceled.

Forms of communication with the beneficiary

  • Adding electronic means of communication is new and includes e-mail (with confirmation), text messages (SMS or WhatsApp, with a reply from the beneficiary), a recorded telephone call (with confirmation), or via letter with an acknowledgment of receipt.
  • For old contracts, the form of communication must follow the rules in the contract, which may include a registered letter, personal notification, or previously regulated electronic means.

The ANS emphasizes that it is essential for beneficiaries to keep their registration details up to date with the health insurance company so that they receive communications and are well informed.

 

This information about Brazil’s new communication rules for health plans is provided by Sciath, Asinta’s employee benefits consulting partner in the country. If you need support with your employee benefits in Brazil, please contact Asinta, and we will put you in touch with the local experts at Sciath.