Responsibility for supervising health insurance is divided between the Federal Office of Public Health (FOPH) and FINMA. Under the Federal Law on Health Insurance (KVG), the FOPH is responsible for compulsory health insurance. FINMA is responsible for supplementary insurance under the Insurance Contract Act (ICA
Anyone who intends to offer health insurance in Switzerland must obtain a licence from FINMA (insurance sectors: B2 illness in non-life insurance, and A5 health insurance in life insurance).
FINMA issues licences only if insured persons are guaranteed protection against misuse and insolvency by the insurance company. The licensing requirements which must be met include capital requirements, providing detailed information about business activities (business plan
) and proper business conduct requirements.
Insurance companies under ISA and general health insurance companies
When issuing licences and with a view to subsequent supervision, FINMA distinguishes between insurance companies under the Insurance Supervision Act (ISA) and general health insurance companies. The former provide basic and supplementary insurance in separate legal entities. Smaller insurance companies frequently offer both forms of insurance in a single legal entity. In these cases, as well as for general health insurance companies, the FOPH is responsible for supervision. FINMA's supervision applies only to areas covered by ISA.
Preventive product control
One special feature of supplementary health insurance is preventive product control under which insurance contracts can be concluded only after FINMA has approved the premiums and conditions. This ensures that insured persons are protected against excessive premiums and that the insurance company remains solvent (Art. 38 ISA).