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SINDOB
Aposentados e demitidos
Aposentados e demitidos
Aposentados e demitidos
O aposentado ou o ex-empregado exonerado ou demitido sem justa causa,que contribuía para o custeio do seu plano privado de saúde, tem o direito de manter as mesmas condições de cobertura assistencial de que gozava quando da vigência do contrato de trabalho, sem prejuízo de eventuais vantagens obtidas em negociações coletivas.
A empresa empregadora é obrigada a manter o aposentado ou o ex-empregado demitido ou exonerado sem justa causa no plano enquanto o benefício for ofertado para os empregados ativos, desde que o aposentado ou o ex-empregado demitido ou exonerado sem justa causa, tenha contribuído para o custeio do seu plano privado de saúde e que o mesmo não seja admitido em novo emprego.
A decisão do aposentado ou o ex-empregado demitido sem justa causa de se manter no plano deve ser informada à empresa empregadora no prazo máximo de 30 dias contados a partir da comunicação do empregador sobre o direito de manutenção do gozo do benefício.
Condições
Para que o aposentado ou ex-empregado demitido ou exonerado sem justa causa seja mantido no plano devem ser observadas as seguintes condições
1 - Ter sido beneficiário de plano coletivo decorrente de vínculo empregatício.
2 - Ter contribuído com pelo menos parte do pagamento do seu plano de saúde.
3 - Assumir o pagamento integral do benefício.
4 - Não ser admitido em novo emprego que possibilite o acesso a plano privado de assistência à saúde.
5 - Formalizar a opção de manutenção no plano no prazo máximo de 30 dias, contados a partir da comunicação do empregador sobre o direito de manutenção do gozo do benefício.
Confira a cartilha com as orientações para aposentados e demitidos.
Dependentes do aposentado ou ex-empregado
O direito ao uso do plano é extensivo obrigatoriamente ao grupo familiar que estava inscrito quando da vigência do contrato de trabalho, se assim desejar o aposentado ou o ex-empregado demitido ou aposentado.
No caso de morte do aposentado ou do ex-empregado demitido ou exonerado, seus dependentes continuam no plano pelo restante do tempo a que o beneficiário titular tinha direito.
Quem paga o plano e por quanto tempo posso ser mantido no plano?
Atenção: O aposentado ou ex-empregado demitido ou exonerado deve assumir o pagamento integral da mensalidade do plano.
Aposentado que contribuiu para o plano de saúde por 10 anos ou mais - tem o direito de se manter no plano enquanto a empresa empregadora oferecer esse benefício aos seus empregados ativos e desde que não seja admitido em novo emprego.
Aposentado que contribuiu para o plano de saúde por período inferior a 10 anos - poderá permanecer no plano por um ano para cada ano de contribuição, desde que a empresa empregadora continue a oferecer esse benefício aos seus empregados ativos e que não seja admitido em novo emprego.
Ex-empregado demitido ou exonerado sem justa causa - a manutenção no plano será correspondente a 1/3 (um terço) do tempo de permanência em que tenha contribuído para o plano, com um mínimo assegurado de seis e um máximo de 24 meses.
Quando o plano de saúde deixa de ser oferecido pelo empregador, o aposentado ou o ex-empregado demitido sem justa causa tem o direito de contratar um plano individual com aproveitamento das carências já cumpridas, caso a operadora comercialize plano de contratação individual e familiar.
Direitos do aposentado que continua trabalhando na mesma empresa ou grupo empresarial
O aposentado que permanece trabalhando pode continuar a gozar do benefício no plano de ativos até que se desligue completamente da empresa (pedido de demissão ou demissão com ou sem justa causa) quando deverá passar a gozar dos benefícios garantidos aos aposentados.
