Retirees and laid off: Keep your health plan!

If there's one benefit every employee enjoys (or at least should enjoy), it's health insurance. There's nothing like working for a company that cares about your health and helps pay for this increasingly expensive service.

But what if I end up getting fired? Or, when I retire, what will happen to my health insurance? Will I be able to keep it?

Can retired and fired people keep the company's health plan?

If there's one benefit every employee enjoys (or at least should enjoy), it's health insurance. There's nothing like working for a company that cares about your health and helps pay for this increasingly expensive service.

But what if I end up getting fired? Or, when I retire, what will happen to my health insurance? Will I be able to keep it?

Do you pay part of the monthly fee?

According to the 1998 Health Insurance Law, retirees and those dismissed without cause are entitled to continue with their company's health insurance plan. However, this can only occur under certain conditions.

The first question is whether the employee paid any portion of the health plan premium. Those who had it deducted from their paycheck have the right to remain on the plan. Conversely, if the company paid the entire premium, the employee is not eligible.

But be careful, we're not talking about co-payment. It's no use for an employee to have paid the co-payment and not contributed part of the monthly fee. After all, co-payment isn't considered a monthly fee.

How to stay on the health plan when retiring or after being fired?

As soon as you are notified of the dismissal, prior notice or retirement, request the amount to be paid for the health plan from your employer, along with the company-paid portion. Also, ask for the plan's adjustment table for age group changes.

Within 30 days, inform the company that you wish to continue with the health plan and are responsible for paying the full monthly fee.

However, there is a time limit for staying on the plan, which works as follows:

• Dismissed employees: may remain in the plan for a minimum of 6 months and a maximum of 24 months, counting from the termination of the employment contract.
• Retirees: Those with more than 10 years of contributions may remain in the plan indefinitely. However, for those with less than 10 years of contributions, the length of stay in the plan is equivalent to one year for each year contributed.

However, if you want to change plans during your stay, simply request special portability, as this will eliminate the need to comply with new waiting periods.

What is the monthly fee from now on?

As part of it is subsidized by the company, the amount becomes even lower. From the moment you retire or are fired and have the right to remain with the company plan, the monthly payment starts to be the full amount.

All beneficiaries continue to be part of the plan, but now payment and obligations are directly with the operator.

However, business plans generally have lower monthly fees than market plans, given the much higher customer volume. And, although the monthly fee is now full, it's still lower than the market price for individual or family plans.

If you retire due to disability, the Superior Labor Court (TST) understands that there is no actual termination of employment. Therefore, some judges rule that the employer must continue to pay part of the monthly premiums, as if the retiree were still working for the company.

Change or cancellation of the benefit by the company

It's possible that the company you worked for changed service providers. In these cases, all employees, including inactive ones, are transferred to the new contract, and you retain the right to remain on the corporate plan.

It's also possible to change categories, such as changing the accommodation type (from an apartment to a ward, or vice versa). However, this is only possible if the contract specifies these different options.

It may also happen that the company cancels the benefit, leaving the retiree or laid-off employee without the plan. If this happens, experts recommend seeking legal action to continue paying the plan directly to the provider.

See the rules for continuing with the company plan:

Fired

• Those dismissed without just cause have the right to continue in the plan;
• Part of the monthly fee deducted from payroll;
• You will now be responsible for the full amount of the monthly fee;
• Minimum stay of six months;
• Maximum length of stay equivalent to one third of the period during which you contributed to the monthly payments, with a limit of 2 years;
• Those dismissed for just cause or people who resign have no right to continue receiving the benefit.

Retirees

• Anyone who has paid for the health plan for ten years or more has the right to keep the plan for life;
• For a period of less than ten years, you can keep the plan in proportion to the time you contributed;
• You will now bear the full cost of the monthly fee;
• If you get a new job that offers health insurance, you lose your right to it.

Disability retirees

• They do not lose the right to health insurance;
• It is necessary to maintain the conditions from when the employee was active, that is, if he paid part of the plan, he will have to continue paying that part;
• There are some decisions stating that, if the disability retirement was generated by a work accident, the company would have to cover the full costs of the health plan.