Hapvida

A

ANS
National Supplementary Health Agency. It is the regulatory agency linked to the Ministry of Health responsible for the health sector in Brazil.

B

C

CADE
Conselho Administrativo de Defesa Econômica, Brazil’s antitrust agency.

Cash Medical Accounts
Corresponds to medical care expenses adjusted by (i) the provision for reimbursement of SUS, (ii) IBNR, and (iii) depreciation and amortization.

CBR
Risk-based capital

Coparticipation
Percentage paid for each medical service in addition to the monthly payment.

D

Disallowance
Refers to the nonpayment by health plans of amounts related to the services, medications, materials or fees charged by providers (hospitals, clinics, laboratories and others) and autonomous healthcare professionals.

E

F

G

H

HMO
Health Maintenance Organization, which offers employers or groups a solution for all the healthcare needs of their employees or members at lower costs negotiated with specific doctors, hospitals and clinics. These specific providers must be used by the employee at the lower rates to be offered to the health insurance plan.

I

IGR
General complaints index. Its purpose is to present a behavior thermometer of the sector’s operators in attending to the problems pointed out by the members. It includes the average number of complaints from members received in the previous three months and classified up to the data’s date of extraction. The index is based presented per 10,000 members.

IBNR
Provision of events occurred but not reported. Provision for payment of events that have already occurred and were not informed to the company before the end of the period, which was constituted based on actuarial methodology.

IPO
Initial Public Offering.

J

K

L


M

MAE
Minimum adjusted equity. In order to operate in the healthcare market regulated by the ANS, the health plan operator must keep the adjusted shareholders' equity for economic purposes as established by the ANS. Minimum adjusted equity is calculated as equity less non-current intangible assets, tax credits arising from fiscal losses, deferred sales expenses and prepaid

Medical care ratio
Index that shows the relationship between healthcare expenses and total revenues from healthcare operations (effective payments).

N

National Accreditation Organization
It is a non-governmental and non-profit entity that certifies health services quality in Brazil, focusing on patient safety.

N

O

OCR
Outstanding claims reserve. Provision for the collateral of events that have already occurred, recorded in the accounts and not yet paid. The accounting record is made at the full amount informed by the supplier or member when the charge is presented to the entity, and is subsequently adjusted for glosses and discounts after company’s evaluation (medical auditors).

P

PDA
Provision for doubtful accounts – Provisions recorded as expenses even though they have yet to be incurred. A provision is accrued when a company creates a reserve representing the expected loss of an asset or an estimated expense.

PPO
Preferred Provider Organization, which offers lower costs to billed members in their health insurance plans. Similar to an HMO, except that employees or members may choose the physician of their preference instead of being limited to HMO providers. A member may choose between a member and a provider that is not a member.

Provision for SUS
Charges for the use of SUS by the members of the operator.

Q

R

Restricted Cash
Refers to the Company’s cash balance held with the ANS to cover technical provisions.

Risk-Based Capital
It is the capital rule that defines a variable amount to be observed by the operator according to factors predetermined by a standard model established by the ANS, comprising the main risks involved in the activities related to the operation of private healthcare plans, namely: subscription risk, credit risk, market risk, legal risk and operational risk.

S

SUS
Sistema Único de Saúde, Brazil’s public healthcare system, which was inspired by the British National Health Service.

T

U

UPR
Unearned premiums reserve. It is characterized by the accounting record of the charged by the operators to hedge contractual risk proportional to the days not yet elapsed within the monthly coverage period, to be appropriated as revenue only in the subsequent period when the term is actually incurred.

V

W

X

Y

Z

Last updated at January 8, 2024.
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