Supervisory measures

The FOPH has extensive supervisory powers. In particular, we can order protective measures vis-à-vis an insurer’s controlling body (Board) and executive management.

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

Documents
Legislation

Newsbeitrag vom 26.06.2024: Unterjährige Prämienerhöhung bei der KLuG Krankenversicherung (in German, French and Italian) (PDF, 82 kB, 26.06.2024)

Increased premiums from KLuG Krankenversicherung (in German) (XLSX, 33 kB, 26.06.2024)

Die Prämien der KLuG Krankenversicherung in den Kantonen Aargau, Luzern, Nidwalden und Zürich werden ab dem 01.09.2024 erhöht. Das BAG ordnet diese Massnahme aufgrund der schlechten finanziellen Lage der Krankenkasse an. Die betroffenen Versicherten können den Versicherer wechseln.

Mutationen Krankenversicherer 1.1.2024 (in German and French) (PDF, 41 kB, 26.09.2023)

Weisung vom 15. Februar 2024 gegen einen Krankenversicherer betreffend Berechnung der versicherungstechnischen Rückstellungen und Meldepflichten (in German) (PDF, 119 kB, 03.04.2024)Im vergangenen Jahr ist das BAG bei einem Versicherer auf mutmassliche Unregelmässigkeiten im Bereich der Rückstellungen gestossen. Deshalb wurde eine aufsichtsrechtliche Untersuchung durchgeführt.

The documents are available in German, French or Italian.