2024-09-06 02:49:39
Starting this Sunday, Isapres will adjust all their health plans that have a value lower than the legal contribution of 7% of the remuneration of their users, by applying the Single Factor Table (TUF).
This Sunday, September 1, the Short Law of Isapres will officially begin to govern, initiative dispatched by Congress to make viable the ruling of the Supreme Court that ordered companies to apply the Single Table of Factors (TUF) to their affiliates and to return excess charges to them.
In this way, from this Sunday Isapres will adjust all their health plans that have a value lower than the legal contribution of 7% of their users’ remuneration.
Adjusting plans This will not mean that customers who had accumulated surpluses will lose them, but in fact, they will be able to continue using them, Those whose plan is modified upwards will see a series of benefits to compensate for the absence of these new surpluses. These improvements include an increase in coverage for care, preventive benefits and medicines, for example.
The Isapre must explain to each user the change to the Single Factor Table, the amount that will be charged from September 2024, together with a Single Notification Form (FUN) Type 3 for “Special situations” and Type 8 for “Modification of the agreed quote”, depending on each case.
If the person will not see a change in their plan with the entry into force of the TUF, they will be given a FUN Type 3 “Special Situations,” the Health Superintendency explained.
Short Law on Isapres: how will the refund of excessive charges be?
The Supreme Court’s ruling to apply the TUF brought with it that The industry will have to return USD 1.255 million to its 678,256 userswho are the ones who will see a drop in the value of their plans with the new short law.
The return method is not yet established, since Each Isapre must present its payment plan to the Health Superintendency, which will be reviewed by the Advisory Councilan organization created for this purpose and chaired by Paula Benavides.
The Isapres Consalud, Cruz Blanca, Banmédica, Vida Tres and Nueva Masvida are the first five institutions whose proposals were analyzed. Following its review, the Council forwards its recommendations to the Superintendency, which has 10 days to decide on them, approving or instructing the changes necessary for their approval.
If the Health Superintendency approves an Isapre’s payment plan, it will be ready for implementation and execution. If, on the other hand, “the corresponding Isapre will have a period of 30 days to present a new plan with the corresponding modifications.”