1.5 million insured persons affected Switzerland's largest health insurance company struggles with reserve problems
CSS's reserves have shrunk drastically in recent years. This has resulted in a disproportionate rise in premiums for the more than 1.5 million people with basic insurance. The federal government is monitoring the situation closely.
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- CSS, Switzerland's largest health insurer, is struggling with a sharp fall in reserves and an inadequate solvency ratio.
- CSS is not alone in this: one in four health insurers did not meet the federal requirements at the beginning of 2024.
- In order to rebuild its reserves, CSS is now significantly increasing its premiums for 2025.
As the CH-Media newspapers reported on Monday, the reserves of Switzerland's largest health insurer, CSS, have shrunk by almost CHF 1 billion in the last three years.
The solvency ratio, which measures the financial stability of the health insurance company, has fallen from 205 to 84 percent and is therefore below the legal minimum of 100 percent.
CSS is not alone in this: a total of eleven out of 44 health insurers did not meet the federal requirements at the start of 2024 - that's one in four insurers. In addition to CSS, these include major providers such as Assura and four Groupe Mutuel (GM) health insurers. The Federal Office of Public Health (FOPH) is monitoring the situation and expects an improvement by 2025.
These eleven insurers need to strengthen their reserves
- Mutuel (GM) - solvency ratio: 97 percent
- Genossenschaft Krankenkasse Steffisburg - solvency ratio: 97 percent
- Assura - solvency ratio: 88 percent
- Caisse-maladie de la Vallée d'Entremont - solvency ratio: 88 percent
- Philos (GM) - Solvency ratio: 87 percent
- CSS - solvency ratio: 84 percent
- Genossenschaft Glarner Krankenversicherung - solvency ratio: 77 percent
- EGK - solvency ratio: 74 percent
- Caisse-maladie Supra (GM) - Solvency ratio: 65 percent
- Easy Sana Assurance Maladie SA (GM) - solvency ratio: 52 percent
- KLuG Krankenversicherung - solvency ratio: 24 percent
Source: Federal Office of Public Health (FOPH)
Confederation and parliament demanded reserve reduction
CSS cites the reduction in reserves forced by the Federal Office of Public Health (FOPH) and former Health Minister Alain Berset as the reason for the financial imbalance. Following the Covid-19 crisis, health insurers were urged to cushion premium increases by reducing their reserves. At CSS, this reduction took place at a time of above-average benefit costs and weak financial markets.
Parliament also exerted pressure on the insurers at the time. With his parliamentary initiative from September 2020, FDP National Councillor Philippe Nantermod even wanted to oblige the insurers to reduce their reserves if they exceeded 150% of the minimum level.
This went too far for Berset, who repeatedly warned of strong fluctuations in reserves and high premium jumps. In the end, Berset prevailed and the reduction in reserves for 2023 and 2024 remained voluntary.
CSS premiums rise disproportionately
In order to rebuild the reserves, CSS is now increasing its premiums for 2025 disproportionately. As a result, CSS has lost ground to the competition in 41 out of 42 premium regions. It was only able to maintain its position in the canton of Obwalden. "It was clear to CSS that 2025 would be a catch-up year, which is reflected in the deterioration in premiums," CSS spokeswoman Sabine Betschart told CH Media.
However, the health insurer emphasizes that this lays the foundation for it to "consistently continue its policy of below-average premiums" in the coming years.
The FOPH is monitoring the situation at CSS and other insurers with insufficient reserves "intensively". However, it is primarily the responsibility of the individual insurers to take measures to bring the solvency ratio back up to 100 percent.
