Did you know that a dismissed employee is entitled to remain in the health plan?

After being fired or exonerated without cause, the beneficiary has the right to remain in the health plan offered by the company for a specified period of time, under the same conditions of assistance coverage that he/she enjoyed during the term of the employment contract, provided that he/she starts to assume your payment in full. Retirees follow the same rule. However, these conditions do not apply to beneficiaries whose companies paid 100% of the plan’s monthly fee.

According to Article 30 of Law No. 9656/98 of the ANS (National Supplementary Health Agency), those dismissed or exonerated without just cause are entitled to the plan for a period equivalent to one third of the time they remained in employment and contributed to the collective health plan. After termination, the beneficiary can use the plan for a minimum period of six months and cannot exceed two years.

About the rights

There are some issues that beneficiaries should be aware of during a termination process, such as:

  1. For the beneficiary to remain in the plan, he must have contributed with the monthly fee during the time he was at the company (employment relationship).
  3. The beneficiary who continues to enjoy the benefit must be responsible for paying 100% of the health plan during the period. This corresponds to part of the monthly fee paid by the company and the beneficiary.
  5. The beneficiary who is admitted to a new job will lose the right to use the plan by the company from which he/she was terminated.
  7. Suppose the company was responsible for paying the full amount of the health plan. In that case, the former employee will not be entitled to maintain the plan, as only those considered contributors have the right to maintain it.
  9. If there is interest in remaining with the health plan, the beneficiary must formalize the request to the Company within a maximum period of 30 days in response to the employer’s communication, formalized in the act of communicating the prior notice, to be complied with or indemnified.
  10. The right to remain in the health insurance after a job plan after termination is exclusive to post-law contract products, that is, those that the company acquired from 01/02/1999 or plans that were adapted to Law No. 9,656/98.

about dependents

If the holder chooses, dependents who were already enrolled during the employment contract term may remain in the health plan. Only the inclusion of a new spouse and a new child is allowed.

How long can I stay on the plan after resignation?

The law ensures that the beneficiary has the right to remain in the plan for the equivalent of one third of the time he remained in the company contributing with the monthly fee (but limited to a minimum period of six months or a maximum period of two years).

Suppose the company cancels the health plan of all employees. In that case, the beneficiary will lose the right to the health plan and will be able to contract a new individual and family plan privately (if the operator offers it), taking advantage of the plan’s deficiencies already fulfilled.

Who will pay for maintaining the plan?

The beneficiary will be responsible for fully paying his health plan and dependents.

Is voluntary and consensual resignation (agreement) entitled to maintenance of the health plan?

No. The beneficiary will only be entitled to maintenance – to remain in the health plan for a specified period – if they have been terminated without cause.

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