Health insurance: Supervision of insurers

Insurers offering compulsory health insurance are supervised by the Federal Office of Public Health, while responsibility for the supervision of supplementary insurance (covered by private insurance law) rests with the Financial Market Supervisory Authority (FINMA). 

The practice of social health insurance is subject to authorisation by the FOPH. To obtain this authorisation, insurers must have drawn up a business plan. Social health insurance is offered by numerous insurers that satisfy the legal requirements, including in particular the ability to meet their financial obligations at all times. As part of their activities, insurers process policyholders’ health data, and they must be able to ensure the protection of this sensitive data.

Supervision is designed to protect the interests of policyholders by ensuring, in particular, the transparency of social health insurance and the solvency of insurers. The FOPH ensures that the Federal Act on Health Insurance (KVG) is consistently applied by insurers. It also supervises insurers’ financial situation; for this purpose, insurers are required to submit their annual reports, budgets and financial statements to the FOPH, as well as the premiums for the following year, which are subject to approval by the FOPH.

The FOPH can take protective measures if the solvency of an insurer is compromised and policyholders’ interests are thus at risk. If an insurer becomes insolvent, the costs of statutory benefits are assumed by an insolvency fund managed by the Common Institution under the KVG. For this purpose, contributions are levied by insurers on social health insurance premiums.

The role of insurers is not restricted to reimbursing the costs of services provided to policyholders. They also, together with the cantons, support health promotion. The insurers and cantons jointly operate Health Promotion Switzerland, a foundation whose aim is to encourage, coordinate and evaluate the effects of health promotion and disease prevention measures.

Documents


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Press releases

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Legislation

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Further information

Activity reports on supervision of the social health and accident insurance systems

Activity reports on supervision of the social health and accident insurance systems from 2016.

Last modification 23.04.2020

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Contact

Federal Office of Public Health FOPH
Health and Accident Insurance Directorate
Governance Supervision Section
Schwarzenburgstrasse 157
3003 Berne
Switzerland
Tel. +41 58 462 21 11
E-mail

Print contact

https://www.bag.admin.ch/content/bag/en/home/versicherungen/krankenversicherung/krankenversicherung-versicherer-aufsicht.html