The National Council of Social Security (CNSS) announces that in May, the implementation of the per capita differentiated in the Health Insurance (SFS) of the Contributory Regime will start. This model adjusts payments by age and sex, promoting equity and sustainability in the Dominican Social Security System (SDSS).
Exact date and legal basis
The Dominican Association of Health Risk Administrators (Adars) specifies that the per capita differentiated will come into effect on May 1, 2026, from the corresponding distribution. The measure is based on Resolution CNSS No. 634-02, of October 31, 2025, supported by Article 169 of Law 87-01, which allows risk-based tariffs with technical evidence.
Benefits of the per capita differentiated for the health system
This scheme corrects distortions of the previous per capita unique, assigning resources according to real needs. Factors such as age and sex determine the values, notified by the Social Security Treasury (TSS) to the ARS. Experts highlight its role in the financial balance of the SDSS in the medium term.
Historical context and preparation
The CNSS worked for months on technical adjustments for an orderly transition. Historically, the uniform model generated inequalities, with high-risk groups underfinanced. Now, the per capita differentiated aligns funds with demands, directly benefiting vulnerable affiliates such as older adults and women in reproductive stages.
- Strengthens the response capacity of the ARS.
- Improves the sustainability of the SFS.
- Distributes resources objectively and solidarily.
Authorities emphasize that the operational conditions are ready, after the approved schedule. This reform modernizes the financing, ensuring the viability of the SDSS in the face of growing health demands in the Dominican Republic.
The per capita differentiated represents a key advance. Observers of the health sector expect it to boost quality in services provided under the Contributory Regime, with an impact on millions of affiliates to the SFS.
