Health insurance: Supervisory measures

As a supervisory authority, the FOPH has extensive supervisory powers and, under the Health Insurance Supervision Act (KVAG), it can take a variety of measures to protect the insured and to ensure the solvency of health insurers. In particular, it can order protective measures vis-à-vis an insurer’s controlling body (Board) and executive management if the insurer fails to comply with the relevant legal requirements or to act as instructed by the FOPH, or if the interests of the insured appear to be jeopardised. 

FOPH issues instructions and conducts inspections.

The FOPH can issue instructions to insurers and conduct on-site inspections. Such inspections may also be conducted without advance notice. Insurers must grant the FOPH unrestricted access to all information relevant for the purposes of the inspection.

Protective measures and termination of operations.

The FOPH can order a variety of protective measures.
Options for intervention by the FOPH include restricting an insurer’s control of its assets, transferring powers held by the insurer’s officers or ordering their dismissal, and ordering increases in premiums or the adoption of a financing or rescue plan.
The supervisory authority can assign responsibility for the implementation of such measures to an independent third-party expert.
It can transfer an insurer’s policyholders to another insurer and take various measures in the event of liquidity shortages or insolvency on the part of an insurer.
Lastly, the FOPH can revoke a health insurer’s licence to operate social health insurance if the insurer so requests or if the legal requirements are no longer met.
A licence can also be revoked merely for certain parts of an insurer’s operations.

Information on supervisory measures and sanctions.

The FOPH can inform the public about supervisory measures which it has taken and about associated criminal-law sanctions.

Under this heading, the FOPH publishes legal decisions concerning.

Legislation

The documents are available in German, French or Italian.

Last modification 20.09.2018

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Contact

Federal Office of Public Health FOPH
Health and Accident Insurance Directorate
Section Legal Supervision of Health Insurance
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/Aufsichtsrechtliche-Massnahmen.html