Supplementary Health Plans
Market
Brazilian Federation for Private Health Insurance and Plans FenaSaúde is an entity that represents twenty-three health plans and specialized health insurance companies, being one of the associative federations that compose the Brazilian Insurance Confederation – CNseg.
18
large groups
23
associated companies
9
specialized health insurers
10
medical groups
4
dental groups only
29
millions of beneficiaries
Insurance Market Premiuns by segments 17% 5%
41% 37%
General Insurance
Surety bonds
“The Supplementary Health plans and insurance participates with 41% of the Insurance Market Share”. Source: ANS/Susep/FenaSaúde - 2016
Life and Pension Coverage
Insurance Market
Supplementary Healthcare
Revenue in Reais (R$ Billions)
General Insurance
69,6
Surety bonds
21,1
Life and Pension Coverage
148,7
Supplementary Health Plans and Insurance
165,6
Total
405,0
FenaSaúde’s Associates data for March / 2017
14,4 %
Premiuns increase in 12 months
16,8
(R$) Billions in technical provisions
72 % 234 %
Growth in the number of medical plans beneficiaries in the last 10 years Growth in the number of dental-only plans beneficiaries in the last 10 years
70,4
(R$) Billions in premiuns
69,0
(R$) Billions in expenses | 19,5% growth
58,8
(R$) Billions in medical expenses | 15,9% growth
84,6 %
Medical Assistance claim rate
Regulatory framework of the sector The Supplementary Healthcare Sector in Brazil is regulated by Law n. 9,656/98, which established the main requirements to the sector. The Regulatory Framework established rigid parameters and rules for the Healthcare Operators in Brazil. Among the rules brought by legislation, the following ones stand out:
Readjustments Control | Individual plans Prohibition of unilateral rescission of contracts | Individual plans Imposition of maximum waiting periods Rigidty on assistance segmentation
Premiuns according to age brackets Prohibition of price readjustment over the age of 59 Forbidden the risk selection based on age and health criteria Rules for retired people and laid-off workers
The National Regulatory Health Agency Role The National Regulatory Agency for Private Health Insurance and Plans (ANS) is the Agency established by the Brazilian Government under the Ministry of Health that operates nationwide to regulate, standardize, control and inspect the private health insurance and plans sector in Brazil. It was established by Law 9,961 in 2000, which defines its spheres of competence. Its institutional purpose is to protect the public interest in terms of supplementary health insurance, regulating health operators in this sector - including their relationships with providers and consumers.
supplementary healthcare participation in the brazilian GDP
70 millions of brazilians enrollees in health insurance and health plans to medical and dental services
168,5 billions in expenses
137,2 billions in medical and dental assistance expenses
169,9 billions in revenue
84,3% The Supplementary Health Plans Market in Brazil 54 %
claim rate in medical assistance segment
The Brazilian market is among the biggest supplementary healthcare markets of the world.
of health expenditures in Brasil is private
Source of data: ANS and FenaSaĂşde / last 12 months ended in 1Q17
2,6 % is the
Operators in Activity with Beneficiaries according to Category Category
Numbers of Operators with beneficiaries
Self-insured Plans
160
Medical Cooperative
297
Nonprofit Health Operators
45
Medical Group
262
Health-specialized Insurer
9
Dental Cooperative
107
Dental Group
188
TOTAL
1.068 Source: ANS / Period: May / 2017
70 million beneficiaries | 80% collective plans and 20% individual plans
47,4
millions
healthcare plans beneficiaries
22,6
millions
healthcare plans beneficiaries of dental-only plans
Proportions of Beneficiaries by contract type Source: Situation Room /ANS / July/2017
Medical assistance
Dental-only
18,2%
19,5%
8,3% 13,6%
Affinity group
66,5%
73,3%
Employer-based group
Individual or family
Return to Society: the Supplementary Healthcare assistance performance The healthcare plans operators are responsible for the organization of the mutual system on which the functioning of the Supplementary Health Sector is based. It is this solidary scheme that allows people to access treatments and therapies, that only a few could afford on its own. Supplementary Health Plans improvies people’s life quality and contributes to the increase in the population life expectancy. Besides that, it stimulates the generation of new markets and jobs.
DATA FROM 2016
29,4% 1,5
of the eldery in Brazil has private healthcare plans
billion
of medical and dental procedures per year
273
million
of medical appointments per year
543
thousands
of childbirths per year
797
million
of lab tests per year
7,8
million
of hospitalizations per year
34
millions
of radiographic test per year
3,4 7,6%
millions
of jobs
78,4% or
of Brazil’s labour force Source: IESS - April/2017
311
thousand
Doctors working in the private sector
data from 2015’s Medical Demography
131
thousand
134
thousand
of outpatient clinics
of hospital beds
Source: CNES/MS/May/2017
Source: CNES/MS/May/2017
Mission Our mission is to contribute to the strengthening of the healthcare private market through the exchange of experiences and analysis of topics of common interest, and through the making of proposals for the growth and development of the market and our empowerment as an institutional representative of private healthcare plans operators.
FenaSaúde
Board of Directors The Federation is headed by Solange Beatriz Palheiro Mendes. The current board, elected in February 2016 for a 3-year term, is composed of 14 representatives from FenaSaúde’s associates: fenasaúde board of directors
VOCÊ SEMPRE B E M.
others members
www.fenasaude.org.br w w w.fe na s a ud e .o rg .b r
Version: October 2017
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