The time for cheap checkouts is over.

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Do you remember Aerosana, Avanex, Maxi, Sansan and Progrès? They no longer exist. They were all merged with their parent fund Helsana. Or they were called Arcosana, Intra, Sanagat. These were CSS trademarks. Along with Arcosana, CSS’s latest subsidiary was also integrated into the parent company in early 2023. Groupe Mutuel was once made up of 16 different funds; today there are six more. “We are currently considering a merger. All options are open,” says Martigny. In addition, Swica operates a separate health insurance fund with Provita. Here, too, all options are open.

There was something special about all these funds: they belonged to the same health insurance group and provided exactly the same benefits as the maternity and nursing funds; but demanded a different, often lower premium than the parent fund. They were called discount registers.

The reason for this oddity is in one sentence: Risk equalization did not function well enough. Without risk compensation, health insurers with many older insureds would have to charge significantly higher premiums than insurers with younger insureds, which experience has shown to result in lower costs on average.

That is why this balancing mechanism exists. This means that health insurers with above-average healthy insured must pay insurers with above-average sick insured through this risk compensation.

But how are sick and healthy insured persons counted? The older, the higher the average cost. Initially, the risk structure was fixed exclusively by gender and age. But this was not enough, and there was a big difference in premiums between insurers. In early 2012, a stay in a hospital or nursing home for at least three consecutive nights was added as a third criterion. And since this year, the consumption of medicines by clients for the previous year is also recorded to measure the risk.

Because of improved risk leveling, low-cost health insurance companies had to pay more for risk leveling. This means that because they had higher costs, they had to adjust premiums upwards. Because with a perfectly functioning balance of risks, only administrative costs and customer service can justify the various premiums.

Therefore, it no longer makes sense for health insurance companies to have multiple subsidiaries with equally high premiums. Thus, the classic inexpensive registers are also obsolete.

It’s hard to believe: there are also changes in the Swiss healthcare and health insurance system that can be viewed positively.

Source: Blick