Insurers can reinsure by contract the benefits granted under the LAMal/KVG. Insurers with more than 50,000 insureds must be reinsured. Reinsurers must be granted authorisation by the Federal Department of Home Affairs (FDHA) (LAMal/KVG, Art. 12.4. and 14 / OAMal/KVV, Art. 78.5).
This is a financial compensation mechanism between health insurers. Insurers which represent higher risk groups of insureds (more serious illnesses with greater frequency) receive financial support from insurers whose portfolio contains fewer insureds with illnesses.
Risks (risk compensation)
Insurance companies whose portfolios comprise less insured women and elderly persons than the average of total insurers must pay a compensatory amount to the joint institution in support of insurance companies whose portfolios of women and elderly persons exceed this average; this contribution serves to fully compensate the average cost differences between determining risk groups. This is limited to a period of 10 years starting from 1.1.1996, the date of entry into force of the new law (LAMal/KVG, Art. 105 and Ordinance on risk compensation in the health insurance).
Registre de médecine empirique