5 June 2026
FOPH: Insurers Authorised to Proactively Inform Insured Persons of Cost-Efficient Options
The Federal Council amended the Health Insurance Oversight Ordinance (HIOO) at its session of 5 June 2026, with effect from 1 July 2026, implementing the first step of the cost-containment measures adopted by Parliament on 21 March 2025.
From 1 July 2026, insurers are authorised to proactively inform insured persons of lower-cost treatment options, suitable alternative insurance models, and preventive measures –for example, by alerting a patient to the availability of a generic substitute for a prescribed branded preparation to avoid a higher co-payment. The amendment also addresses the reimbursement of excess premium income: where an insurer's premium receipts in a given canton significantly exceed cumulative costs, the resulting surplus will in future be paid to the canton rather than to insured persons whose premiums are fully covered by public funds, thereby avoiding reimbursements to individuals who did not bear the premium costs themselves.
For more information, see here.
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