Health insurance: Comparison of premiums
Health insurance premiums are calculated by the insurers. They are approved and published by the FOPH.
An overview and premium calculator for compulsory health insurance are available at www.priminfo.ch.
Premiumapproval
Insurers calculate the premiums for compulsory health insurance (basic insurance) and optional daily allowance insurance. They are required to submit the premiums to the supervisory authority, i.e. the Federal Office of Public Health (FOPH), for approval.
The FOPH checks that the premiums ensure the insurer’s solvency and safeguard the interests of policyholders. Premiums are only approved if they comply with the statutory requirements and cover costs. However, premiums must not exceed costs by a disproportionate amount or lead to excessive reserves.
Premium approvalprocess
The premium approval process can basically be divided into four phases, as shown in the following table:
Phase 1
The preparatory phase involves preparing the systems for data exchange between the FOPH and insurers, obtaining an independent cost forecast and reminding of the legal framework.
Phase 2
In the second phase, insurers calculate the premiums. Besides the estimated benefits, they also need to consider various other influencing factors. These include potential policyholder churn, risk adjustment, solvency and administrative costs. The insurers then submit their calculated premiums and the associated calculations to the FOPH.
Phase 3
The supervisory authority analyses the submitted premiums and reviews whether they meet the statutory requirements. In particular it checks whether future premium income will cover future costs (cost coverage). This cost coverage must be complied with for each insurer and each canton (equal treatment of cantons). If the submitted premiums meet the statutory requirements, they are approved by the FOPH.
Involvement of the cantons
The cantons are also involved in the premium approval process. The FOPH consults them on the cost projections and sends them the initial premium submissions from insurers. The cantons can then submit their input, particularly regarding the costs in their area. This feedback helps the FOPH assess the submissions from insurers.
Phase 4
After being approved, health insurance premiums are published by FOPH: an overview and premium calculator for compulsory health insurance are available at www.priminfo.ch. Premiums for optional daily allowance insurance are published on the FOPH website.
These tools can be used by policyholders to compare premiums.
In addition to details of new premiums, the FOPH provides factsheets and further information for policyholders.
Further information
Federal Office of Public Health FOPH
Insurance Supervision Division
Schwarzenburgstrasse 157
Switzerland - 3003 Bern