Premium invoice

Correction of premium imbalances pursuant to 106 of the Swiss Health Insurance Act (KVG)

On 21 March 2014, the Federal Parliament voted to address the problem of cantonal imbalances in basic health insurance premiums that had emerged in the period between 1996 and 2013.

  1. Premium structure
  2. Basis of calculation
  3. What does this mean for you (Art. 106 KVG) ?
  4. Information on premium calculation for insured persons belonging to canton group 1 (AI, FR, GE, GR, TG, TI, VD, ZG, ZH)
  5. Information on premium calculation for insured persons belonging to canton group 2 (AR, BE, BL, GL, JU, LU, NW, OW, SH, SO, UR)
  6. Information on premium calculation for insured persons belonging to canton group 3 (AG, BS, NE, SG, SZ, VS)
  7. What happens if there is a change of residence in 2017?
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Premium structure

The imbalances came about because, in some cantons, insured persons were paying more towards the cost of basic insurance – relative to the cost of the benefits – than in others, even though the premiums had been approved by the relevant authorities. Over the years, health insurers have always abided by the laws governing premiums and their structure.

The process of adjusting historic premium payments will take place between 2015 and 2017 and the decision will be final.

Totalling some CHF 800 million, the compensation amount will be funded as follows:

• ⅓ via redistribution of premiums among insured persons in the cantons

• ⅓ from federal tax revenues

• ⅓ from the free reserves of health insurers

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Basis of calculation

The Federal Office of Public Health (FOPH) is responsible for calculating the premium adjustments. The FOPH figures are identical for all health insurers and are binding. For their part, the health insurers are responsible for implementing the changes passed by parliament.

The premium adjustment is determined by your official place of residence on 1 January 2017. Where you lived before that date is irrelevant in terms of the redistribution of premiums.

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What does this mean for you (Art. 106 KVG) ?

Depending on where you live on 1 January 2017, you fall into one of the following groups of cantons.

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Information on premium calculation for insured persons belonging to canton group 1 (AI, FR, GE, GR, TG, TI, VD, ZG, ZH)

If your official place of residence is in one of the above cantons on 1 January 2017, you will receive a one-off premium credit in June 2017 (consisting of a premium rebate and a premium refund). You will not receive a credit if you relocate to a canton in canton group 2 or 3 before the above qualifying date. The amount of the credit will be offset or paid out.

Table of premium credit vouchers per canton

Canton Credit voucher per person in CHF 2016 Credit voucher per person in CHF 2017
ZH 37.00 *
ZG 13.35 *
FR 16.25 *
AI 20.75 *
GR 0.45 *
TG 48.10 *
TI 60.75 *
VD 86.05 *
GE 57.30 *

*Sum will be set by the FOPH in February 2017

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Information on premium calculation for insured persons belonging to canton group 2 (AR, BE, BL, GL, JU, LU, NW, OW, SH, SO, UR)

For the year 2017, the previous monthly surcharge will be waived.

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Information on premium calculation for insured persons belonging to canton group 3 (AG, BS, NE, SG, SZ, VS)

If your official place of residence is in one of these cantons on 1 January 2016 or 1 January 2017, you will not be affected at all by the premium adjustment. You will receive the standard refund from the environmental levies. The standard refund is stated in your KVG policy documents.

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What happens if there is a change of residence in 2017?

Your premium adjustment is determined by your official place of residence on 1 January 2017. Where you lived previously or live subsequently will not be taken into account in the redistribution.