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Insurances | publié par Loyco | 17.10.2024

Health insurance premiums: levers for reduction

It’s no secret that health insurance premiums are set to rise significantly again in 2025, by an average of over 6%. What can individuals do to cope? And what levers can companies pull to help their employees keep costs as low as possible, while maintaining good coverage? Our Head of Healthcare, Marcos Cosi, tells you all about it here.

By 2025, the average monthly health insurance premium in Switzerland will have risen by 6% to CHF 378.70. According to a press release from the Federal Office of Public Health, this increase is due to the continuing rise in healthcare costs, particularly as a result of the introduction of new treatments, the aging of the population and inflation. The current system, in which outpatient treatment is financed solely by insurers, exacerbates this burden.

So what can individuals do to reduce their premiums, and what levers can employers use to contain costs?

It’s important to remember that the premiums for compulsory basic insurance (KVG/LAMal) announced by the health insurance companies in October of each year are approved by the Swiss authorities. By law, no commercial discounts may be granted on basic insurance. However, premiums vary widely depending on the health insurer chosen, the place of residence, the deductible selected and the insurance model chosen (traditional or alternative). That’s why, when we talk to each policyholder, we validate their needs and advise them on the following points:

  • Suspension of basic coverage if the insured performs civil service, civil defence or military service.
  • Remove accident coverage for employees working more than 8 hours a week from the basic insurance contract. Accident risk (occupational and non-occupational) is compulsorily insured through the employer.
  • Adjust the optional deductible for basic coverage, depending on the anticipated health costs for the following year. For children, we advise against changing the ordinary deductible of CHF 0.-.
  • Choose an alternative model(family doctor, pre-call medical services, health network, etc.) which can reduce premiums by up to 12%, depending on the company. The Confederation’s 2025 premium calculation tool enables you to compare premiums quickly according to the models selected.
  • Competition between health insurers. Premiums can vary considerably, although basic coverage remains identical between insurers in Switzerland, as they are governed by the same law. Pay particular attention to the quality of Services provided, and check whether a pharmacy card is offered.
  • Check your entitlement to premium reductions with the relevant cantonal office.

 

Companies are looking to offer their employees benefits, and access to a group health insurance Contrat is a good way of doing this. This makes the company more attractive and makes it easier to attract talent, both locally and internationally. Faced with ever-increasing premiums, each company can support its employees in different ways and with varying degrees of involvement, depending on its possibilities and needs. These range from financial participation in their salaries, to the provision of advice and assistance from a team of experts, to the creation of framework or group contracts. To provide the best advice and Services, it is necessary to carry out an in-depth analysis with the company of its needs, resources and wishes for employees. The right model and tailor-made Services can then be put in place, taking into account the specific environment of each organization.

The group contract
Group contracts are generally the most participative on the part of the employer. They offer a basic KVG/LAMal contract with one or two packages of supplementary insurance cover, usually at a discount of up to 10%. Depending on the Contrat in place, the health questionnaire relating to supplementary cover can be avoided at the time of subscription. This administrative facility enables all employees to access supplementary benefits regardless of their medical history. The premium (basic and supplementary) can be fully or partially covered by the company. Group invoices are often paid directly by the employer, who then deducts the employee’s share from his or her salary. Coordination and management are often entrusted to an insurance broker, backed up by a team of advisors to answer any questions from employees or the company. This team provides the link between the insured and the insurance company. For the Contrat to be valid and to last, all employees (and any family members) must be affiliated to it, thus ensuring a balanced ratio between claims and premiums. A minimum number of members is generally required. Framework contract
This option reduces the constraints associated with contracts, as the premium is paid directly by the employee. It is not necessary for the entire employee population to be affiliated. Generally speaking, people who are part of the Contrat receive a discount of up to 10% on supplementary insurance. On the other hand, enrolment is carried out in the same way as for an individual policy, with a medical questionnaire for supplementary insurance and the possibility of the insurer refusing cover. It is essential for the company to surround itself with a team of experts in order to delegate questions relating to coverage. Co-payment for health insurance directly from salary
No framework or group contract is required here, leaving employees free to choose their own basic and supplementary insurance. More and more companies are opting for this solution, offering access to health insurance specialists to help their colleagues choose their coverage. In this case, the premium is paid by the employee, with a financial contribution from the employer.

 

Because of the complexity of the market and the high costs involved, it’s essential to enlist the help of health insurance specialists when choosing both the insurer and the insurance model.

At Loyco, we have a dedicated team of health insurance experts ready to answer your employees’ questions. Our mission is to help organizations design a customized healthcare program, while establishing optimal procedures tailored to the unique needs of each company and its employees.

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