Adjusted Operating Revenues corresponds to the sum of Healthcare Plan Premiums with the Revenues from Other Operations.
Healthcare plan premiums. This item refers to the monthly fees of healthcare plans charged to Amilpar’s individual, family and corporate clients, established at the beginning of the plan according to the risk profile, and then adjusted annually according to the terms of the agreement. Most of these monthly fees are charged on a prepayment basis, whereby the client pays the fees during the coverage period, and the rest are charged on a post payment basis, whereby the client pays the fees after the coverage period.
Revenues from other operations: Refers to the amount charged to other health plans when they use our own medical facilities.
Taxes on sales. Amilpar’s operations are subject to the following taxes and social contributions:
- PIS/COFINS. These contributions are levied on the healthcare plan premiums paid after the deduction of medical costs, at a rate of 0.65% for PIS and 3.0% for COFINS.
- ISS. ISS rates vary from 0.3% to 5%, according to the place and nature of the delivered medical care.
Cost of services
Cost os services are composed of Claims less recovered claim payments plus variation in the provision for incurred but not reported claims (IBNR).
Claims. Medical claims refer to all collection notices for healthcare services carried out by Amilpar’s third-party network of healthcare providers and costs related to healthcare services provided in its owned delivery network to members of its healthcare plans and of other healthcare plans. They also include reimbursements paid to our plan members for the use of healthcare services outside of its service provider network. Include costs incurred from healthcare services provided in hospitals, laboratories, therapeutic centers and specialized clinics.
Recovered claim payments. This item refers to amounts Amilpar recovers in respect of claims charged by healthcare providers but disputed by the Company, including: (i) amounts charged in violation of contractual terms and (ii) amounts charged more than once or which refer to medical procedures not covered under its healthcare plans, among other reasons. Amilpar also records in this account the co-payments exceeding contractual limits paid by the client.
Selling expenses. Under the ANS Accounting Plan, selling expenses refer exclusively to commissions paid to Amilpar’s network of independent healthcare plan brokers, as well as its own sales team.
Administrative expenses. Under the ANS Accounting Plan, administrative expenses include operating expenses, personnel expenses and expenses relating to services rendered by third parties, advertising and publicity, rent, taxes and depreciation and amortization, among others.
Other net operating expenses. According to the ANS, are considered other net operating expenses a variety of operational revenues and expenses which could not be categorized into any other line of our Income Statement.
Financial result. The sum of all financial revenues generated by availabilities and by penalties and interest charged to clients due to delays in payments, minus financial expenses generated by bank loan interests and interests from tax installment programs.
Income tax (IRPJ) and social contribution tax (CSLL). Amilpar pays (1) corporate income tax (Imposto de Renda Pessoa Jurídica), or IRPJ, on its taxable income at a rate of 15%; (2) a 10% surtax on annual adjusted taxable income in excess of R$240,000; and (3) social contribution tax (Contribuição Social sobre o Lucro Líquido), or CSLL, at a rate of 9% on its net profit. Pursuant to Brazilian tax legislation, income tax and social contribution may be offset against withholding taxes on gains from cash investments.