Approval of supplementary health insurance tariffs

SFMA approves tariffs and general terms and conditions defined by supplementary health insurers. Tariff adjustments affecting cost trends also undergo preventive auditing.

Prior to offering any supplementary health insurance products, health insurers must have them approved by SFMA. Both tariff calculations and terms and conditions submitted to SFMA are audited. Approval is granted where the legal requirements are met. All tariffs adjusted by insurers also require approval and must be resubmitted to SFMA. Tariff approval is in accordance with Article 38 ISA. Non-abusive tariffs, which do not jeopardise solvency, are approved. As tariff adjustments are generally effective at the beginning of each calendar year, applications for approval must be submitted to SFMA by the end of July of the previous year. Applications must include in particular the technical results of the products in question. Guidelines on submitting applications to SFMA for tariff adjustments in supplementary health insurance set out the content and type of application. Details required to audit tariff adjustments can be entered in the forms provided. Tariffs approved by SFMA are then communicated in the Federal Gazette (Art. 84 ISA).