Posted workers are subject to the social security legislation of their home country. As regards health insurance, various categories are to be distinguished, depending on the country from which workers are posted.
Postings from an EU/EFTA country
Swiss nationals or nationals of an EU/EFTA member state who are posted to Switzerland for a period of up to 2 years by a company based in the EU or EFTA remain subject to the legislation of the home country. Upon presentation of the appropriate certificate (attestation A1, issued by the social security institution of the home country), they are exempted from liability to Swiss social security contributions, including health insurance.
The Agreement on the Free Movement of Persons and the EFTA Convention are not applicable for third-country nationals. In most cases, such postings can proceed on the basis of bilateral agreements.
Postings from a contracting state
If a worker posted to Switzerland from a contracting state (outside the EU/EFTA, Croatia, India, Japan and Macedonia) wishes to be exempted from insurance obligations in Switzerland, the employer concerned must undertake to ensure that, for the entire duration of the exemption, at least the benefits specified in the Health Insurance Act are covered for treatments in Switzerland (for a list of international social security agreements concluded by Switzerland, see below).
Postings from Croatia, India, Japan and Macedonia
In order to be exempted from Swiss health insurance obligations, workers posted to Switzerland from Croatia, India, Japan and Macedonia need only submit a copy of their certificate of posting or extended posting (special agreement) to the cantonal body responsible for exemption from health insurance in their canton of residence.
Postings from a non-contracting state
Essentially, workers posted from a state with which Switzerland has not concluded a social security agreement (non-contracting state) are required to obtain insurance in Switzerland. In fact, as soon as workers pay contributions to Swiss social insurance schemes (e.g. AHV/IV), they are no longer deemed to be posted workers. Workers who are subject to compulsory health insurance abroad can apply for exemption from insurance obligations in Switzerland if they would otherwise face a double burden and if their existing insurance provides equivalent cover for treatments in Switzerland.
An overview of the relevant agreements is provided by the following document: “Overview of international social security agreements concluded by Switzerland/implications for health insurance and posted workers’ liability” (available in French/German). Additional information is available on the website of the Federal Social Insurance Office, and in the FSIO brochures on social security for posted workers.
Last modification 17.08.2018