Helsana has agreed on a tariff structure with doctors as well as the clinics La Colline, des Grangettes, Bois-Cerf and Cecil and the private hospital de La Tour. This now meets the supervisory requirements of FINMA. Helsana already developed a legally compliant solution with the clinics of the SMN Group at an earlier stage. Helsana will therefore once again cover the benefit costs of its insured persons for semi-private and private treatment in the aforementioned clinics and private hospital.
23.06.2025
The negotiations that led to an agreement with the hospitals and doctors in Geneva and Vaud were long and intense. With this agreement, restrictions for Helsana customers regarding semi-private and private hospital treatment will also be lifted in the last two cantons. “I am pleased that we were able to reach an agreement on a tariff structure that serves the interests of our insured persons while respecting regulatory requirements. But sometimes it takes time to make progress and find viable solutions,” says Helsana CEO Roman Sonderegger.
In response to the FINMA requirements published in 2020, the Swiss Insurance Association (SIA) developed the “VVG additional benefits” guideline in 2021. On this basis, the aim was to ensure transparency and traceability when billing supplementary insurance benefits and their differentiation from compulsory basic insurance. Helsana subsequently cancelled and renegotiated all contracts that did not comply with the SIA principles. On 1 January 2025, FINMA’s transitional period ended. Unfortunately, Helsana was not able to reach contractual agreements with all service providers. This was particularly the case in the cantons of Geneva and Vaud.
To ensure that premiums remain affordable, health insurers regularly negotiate with hospitals. During this process, Helsana always advocates for fair prices and transparent billing. If a health insurer and a hospital cannot reach an agreement – for example, because their tariffs are inexplicably high in a cross-comparison or otherwise do not comply with the SIA principles – no contract is concluded. Without a contract, no costs can be covered under supplementary hospital insurance.
Helsana is committed to the health and quality of life of its customers and has been providing them with financial security in relation to prevention, illness and accidents for over 125 years. So that they stay healthy, recover quickly or can live a better life when affected by illness. We provide advice with the objective of offering the best quality of care in every health situation. With innovative services and products, we offer people individual support for a healthy life. As a shaper of the Swiss healthcare system, we work to ensure a sustainable, high-quality, competitively organised and accessible healthcare system. With a premium volume of about CHF 8.2 billion and a workforce of around 3,400 employees throughout Switzerland, Helsana is one of the leading providers in the Swiss insurance market. Helsana offers a wide range of products and services in the areas of basic, supplementary and accident insurance, as well as daily sickness benefits, protecting over 2 million people against the financial consequences of illness, accidents, maternity and long-term care in old age. We develop insurance solutions to mitigate the economic consequences of illness or accident-related occupational absences for some 60,000 companies and associations.
We're here to help.