Corrections in health insurance premiums

As in previous years, premium credits in 2017 will be awarded to insureds whose place of residence on 1 January is a canton where excessive premiums were charged in the past. The relevant cantons are specified by the Federal Office of Public Health.

Persons entitled to a premium credit will receive a separate statement which, where possible, will be sent in one envelope along with the premium invoice.

• It will be sent at the end of May.
• If the customer has provided us with details of a bank/postal account, the amount will be credited automatically at the beginning of June.
• If no bank details are available and the credit is less than CHF 25.65, it will be offset against the premium.
• If no bank details are available and the credit is higher than or equal to CHF 25.65, it will be paid out by cheque.

Overview by canton

Insureds have already paid the maximum amount specified for premium corrections through the surcharges collected in 2015 and 2016 (max. CHF 266 million in accordance with Art. 106 para 1 KVG/LAMal).

However, the Swiss government will contribute over CHF 88 million to this initiative in 2017 and health insurance companies will pay a surcharge of CHF 33 per insured.

What’s it all about?

The Swiss parliament has decided to remedy disparities between the premiums charged for mandatory basic insurance in different cantons in the past. The corrective scheme will run from 2015 to 2017.

The Federal Office of Public Health (FOPH/BAG) fixes the amount of these surcharges and credits which will be recalculated each year. Health insurance companies are responsible for implementing these corrections. Your place of residence with effect 1 January of the respective year determines whether you will have to pay a surcharge or are due a refund.

How will Sanitas handle these premium corrections?

Premium surcharge

If you are obliged to pay a surcharge, you will receive a one-off invoice which, where possible, will be sent in one envelope along with the premium invoice.

• Monthly premium payment:
  With the June invoice (sent end of April).
• Bimonthly, quarterly, semiannual and annual premium payment:
  With the July invoice (sent end of May).
• Premium deduction through employer:
  Invoice to insured (sent end of May).
  

Premium credit

Persons entitled to a premium credit will receive a separate statement which, where possible, will be sent in one envelope along with the premium invoice.

• It will be sent at the end of May.   
  
• If you have given us details of a bank/postal account, you will be credited the amount automatically at the beginning of June.   
  
• If no bank details are available, and the credit is less than CHF 36.95, it will be paid out with the next invoice.   
  
• If no bank details are available, and the credit is more than CHF 36.95, it will be paid out by cheque.
  

One-off surcharge in 2016

In March 2014, the Swiss parliament made an amendment to the Swiss Federal Health Insurance Act (KVG/LAMal) which stipulates that all health insurers are legally bound to levy a one-off surcharge of CHF 33 per insured (CHF 2.75 per month), irrespective of their place of residence. This surcharge will be offset against the basic insurance premium and is listed separately on your policy document.

This amount is being financed either as a surcharge on top of the regular premiums or by drawing off reserves, and will be paid directly to the Gemeinsame Einrichtung (KVG).

The Sanitas Group is committed to offering basic insurance at an affordable price which is why its premiums are calculated so as to build up sufficient reserves in order to comply with regulatory requirements and any unexpected increase in healthcare costs. At the same time, premiums are calculated so that reserves aren’t excessively high in the long term and thus don’t unnecessarily burden premium payers.

If reserves develop better than expected, the Sanitas Group passes on these savings to their customers. This is the case for Compact Grundversicherungen AG customers. Here the one-off surcharge is being financed by drawing off reserves.