International Coordination Health Insurance

Assignments

In the Agreement on the Free Movement of Persons the Gemeinsame Einrichtung KVG (Common Institution under the Fed. Health Insurance Act) is defined as liaison office as well as the assistant institution for disease and maternity. As Beneficiaries of Swiss pensions who live in any country of the European Community (EC), Iceland or Norway are not the responsibility of Swiss Canton Governments anymore the Gemeinsame Einrichtung KVG has been assigned to additional tasks by parliament (exemption from compulsory insurance, assignment of non-insured persons to compulsory health insurance, premium reduction).

Assignments in Detail

1. Liaison office

1.1. Collection Benefits

The Gemeinsame Einrichtung KVG estimates about 100’000 cases per year on each of these tasks.

1.2 Lump Sums

There are two categories which concern persons with constant residence in another country (pensioners, family members of a person resident and gainfully employed abroad). In these two categories the right of coordination of the EC arranges a calculation of a monthly lump sum instead of the effective costs. These lump sums are calculated annually per state and category and have to be approved of by an EC commission before they can be charged. Experience shows the procedure might take up to 3 or 4 years.

The Gemeinsame Einrichtung KVG (Common Institution under the Fed. Health Insurance Act) is in charge of the following tasks concerning lump sums:

2. Assistant institution

The main task is the Mutual Benefits Assistance in Switzerland. There are three reasons why the number of cases will increase dramatically compared to when there was only the Agreement on Social Security between Switzerland and Germany:

The Gemeinsame Einrichtung KVG (Common Institution under the Fed. Health Insurance Act) compiles an annual statistic on Swiss mutual benefits assistance for the Federal Office of Social Security (Art. 19 Abs. 2 Bst. c KVV).

3. Tasks taken over from Cantons

Beneficiaries of a Swiss pension are, due to the Agreement on the Free Movement of Persons, obliged to register under compulsory Health Insurance in Switzerland even if they live in an EC country, Iceland or Norway. Pensioners who are resident in the afore-mentioned countries are, therefore, not under the responsibility of the Swiss Cantons anymore. In a so called “Federal Solution”, the Swiss Parliament decided to assign these tasks, formerly dealt with by the Cantons, to the Gemeinsame Einrichtung KVG (Common Institution under the Fed. Health Insurance Act):

In addition, the Gemeinsame Einrichtung KVG (Common Institution under the Fed. Health Insurance Act) has the one-time task to inform all pensioners who already live in an EC country, Iceland or Norway by the time the Agreement on the Free Movement of Persons comes into force.

The “Federal Solution” has the effect that there is one office in particular which has profound knowledge of the right of coordination, adaptation of territorial law and the circumstances in EC and EFTA countries. The Parliament has therefore engaged the Gemeinsame Einrichtung KVG (Common Institution under the Fed. Health Insurance Act) to assist the Cantons in respect of the enforcement of premium reductions for insured people abroad who are still the Cantons’ responsibility.

4. Additional Tasks

Another international task of Switzerland concerning Health Insurance is the agreement on bilateral mutual benefits assistance between Germany and Switzerland which has been valid since 1st April, 1990 (2. supplementary agreement of 2nd March 1989 to the agreement on Social Security) as well as the Rheinschifferabkommen (agreement concerning Social Security for Rhine boatmen). Now that the Agreement on the Free Movement of Persons has been ratified, the bilateral agreement with Germany has lost its meaning. It now mainly applies to third-country nationals.

Financing

The financing of the tasks of the Gemeinsame Einrichtung KVG (Common Institution under the Fed. Health Insurance Act) is regulated under the Health Insurance Act KVG ( change of 6th October 2000) respectively in the Health Insurance Regulations KVV (change of 3.July 2001). Administrative costs for Mutual Benefits Assistance in Switzerland are financed by Swiss Health Insurers. This complies with the European doctrine and is seen as a contribution of insurers to international understanding. The Swiss Confederation, however, takes over the cost of capital of the Mutual Benefits Assistance. In addition, the Gemeinsame Einrichtung KVG (Common Institution under the Fed. Health Insurance Act) has concluded a credit agreement with a bank, which is covered by the Swiss Federation to up to 200 million Swiss Francs due to a parliamentary agreement.

Organisation

Due to the ratification of the Agreement on the Free Movement of Persons, the office of the Gemeinsame Einrichtung KVG (Common Institution under the Fed. Health Insurance Act) was considerably extended. Medium-term, a further expansion to 60 employees is expected. This represents a considerable increase in the number of jobs available compared to a few years ago. The board of supervisors and the staff look forward to this challenge and will approach the new tasks diligently and pragmatically.