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STJ to establish thesis to define conditions of funding and coverage for inactive beneficiaries of collective health plan

  • Sem Autor
  • 10 de February de 2020
  • Informatives
  • English
  • Portuguese (Brazil)

Tatiane Bagagí Faria
Lawyer at Marcos Martins Advogados

At the end of 2019, the Superior Court of Justice (STJ) assigned Special Appeals No. 1.818.487/SP, No. 1.816.482/SP and No. 1.829.862/SP to eliminate repetitive controversy described in Theme 1.034, in order to establish a thesis on the discussion related to the assistance and costing conditions of the health plan that must be maintained for inactive beneficiaries, in accordance with article 31 of Law No. 9.656/1998.

In his vote, Justice Antonio Carlos Ferreira justified the points necessary for discussion, in order for the thesis to be established, namely (i) whether a fixed or indefinite period of permanence in the plan will be considered; (ii) establishing the assistance rights of the inactive beneficiary and their dependents, (iii) determining which financial charges will be borne by the former employee.

According to the law, only employees who have contributed to the health plan for at least 10 (ten) years will be entitled to remain as inactive beneficiaries for an indefinite period. The STJ’s decision will define whether the former employee’s right to remain a beneficiary for an indefinite period of time and the conditions under which he or she will be covered by the health insurance plan.

Another aspect that will be analyzed by the STJ concerns the funding of the plan, which should only confirm the Court’s case law to the effect that it is necessary for the employee to contribute during the employment relationship in order to be entitled to the benefits after dismissal.

This is the way to establish a binding thesis and consequently standardize the jurisprudence of the lower courts, bringing security and stability to legal relations. Marcos Martins Advogados will be following the judgment, which is expected to take place in 2020.

Any questions? Talk to our lawyers.


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