The Quality Assurance Agency for Private Healthcare Services (ACESS) has issued the technical standard for obtaining the certificate of compliance with health terms in contracts, plans/programs offered by private health insurance companies[1]. The standard establishes the requirements and procedure for plans, programs and contracts offered by private health insurance companies to obtain a certification of compliance with health terms. It states:
- ACESS is responsible for issuing the certificate of compliance with health terms to private health insurance companies who meet the requirements in the technical standard and those issued by the National Health Authority.
- The certificate will be valid for two years.
- The certificate can be obtained by filing an application and meeting all the requirements, which include submitting the contracts and plans/programs on offer. To renew the certificate, the application must be filed with the requirements at least 90 days before the date of expiration.
- ACESS will evaluate each application and will either require completion if necessary, reject the application if the requirements are not met, or issue the certificate.
- ACESS must keep an up-to-date database on its website of the private health insurance companies that have this certificate.
- ACESS can cancel or suspend the certificate in the event of violations.
- All contracts, plans, programs and annexes which have been registered with ACESS for the approval of health terms before this standard came into effect will be reviewed and analyzed. Those which were subject to observations before the technical standard was issued can submit the corrections in accordance with the new resolution.
[1] Resolution No. ACESS-2019-0027, published in Official Register No. 145 on January 18, 2020.
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