FOPH lets small health insurer self rule

BAG Krankenkasse Aufsicht Regulator Prämien Reserven
The FOPH overseas the solidarity community in basic insurance. (Image. M. Hassan / pixabay)

The Federal Office of Public Health (FOPH) normally monitors very closely how health insurance companies calculate their rates. If necessary, officials intervene – but apparently, not with all.

The Federal Office of Public Health FOPH is known for closely controlling even the smallest details, such as the accounting of incontinence aids, at the supervised health insurance companies. But now the case of a small health insurer that can do whatever it wants has come to light.

“We are certainly not selling off our silverware on orders from Bern,” Felix Waldmeier, the managing director of the small Wädenswil health insurance company, was quoted as saying in Thursday’s “Tages-Anzeiger” newspaper in Zurich.

Reserves much too high

In August the FOPH demanded that the health insurer lower its premiums and reduce reserves, the report continued. The latter are already three times higher than required, it said in its explanation.

But for Waldmeier, high reserves are particularly important for such a small health insurance company. A single expensive case of illness among the approximately 11,000 insured could already bring the fund out of balance, the manager explained.

Investments in real estate

In addition, the reserves of KKW, as the Wädenswil health insurance is abbreviated, are partly invested in real estate in Wädenswil and he does not want to simply sell that.

He had also clearly told the FOPH all of this, the article continued. Since mid-September, however, he had heard nothing more from federal officials, which the head of the health insurance company KKW interpreted as an approval of their premiums.

Wrong signal

It is interesting to see, after all, what is possible in the Swiss health insurance market while interacting with the regulator. However, the statements, if true in all of this, absolutely send a completely wrong signal to the industry.

10/06/2022/kut./ena.

FOPH lets small health insurer self rule

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