Topics:

• Premium shock for local and international health insurance?
• Limited insurance benefits when travelling abroad to critical countries/territories
• New IPMI solution on the Swiss market

Premium shock for local and international health insurance?

The KVG premiums for 2023 were communicated at the end of September. Depending on the place of residence, franchise and insurance model, the premiums increase substantially after 3 years of relative "premium stability". In the Zurich region, the average increase is 7%. The reasons are diverse: an ageing society, scientific progress with new treatment methods and new medications (some of which are exorbitantly expensive), a COVID catch-up effect and then there is also simply a general expansion of the "consumption" of medical services.

In contrast to this are the so-called posted workers' health insurance premiums (KVG). For a posted person who remains in the KVG during his posting, the already low KVG premiums will fall even further from 1 January 2023. This is at least a small ray of hope for companies that insure their expatriates in a combined insurance model (KVG + IPMI).

Internationally, i.e. in the IPMI sector (group health insurance business), the situation is similar to that in Switzerland. Although "ageing" is less of an issue, since the insured population refers to employees, so-called "medical inflation" is taking place analogously to the development in Switzerland. Statistics support the annually rising costs. Depending on the country/region/statistic, these range between 7% and 14%. Globally, it is around 8%. This is the forecast for 2022, but international insurers have to include the potential increase in 2023 in their premiums, plus significant "normal" inflation and currency fluctuation risks. This means that premiums will increase even more on 1.1.2023.

According to IPMI insurers, special cost drivers in the international context are:

• Significant increase in cancer diagnoses due to missing, delayed examinations during COVID
• Increased mental illness and treatment due to COVID
• Increasing musculoskeletal disorders due to poorly ergonomic workplaces (home office) combined with higher stress levels

The question arises as to how the increase in costs/premiums can be counteracted. Depending on the size of the insured portfolio, the possibilities vary. A large client with its own claims experience and a "tailored plan" can adjust its benefits. For example, the client can also introduce/increase a deductible. Whether one wants to do this in today's competitive environment and in the hunt for talent is another question. A smaller client has to operate within the framework of the available product range and has less leeway in this respect.

Information, prevention, early detection and good case management can help to reduce costs. The IPMI providers offer a wide range of services in this area. Telemedical services are now also included. For the time being, however, expats are hesitant to take advantage of these services. Good and repeated communication by the employer regarding these services is certainly useful and important.

The IPMI providers are also expanding their PPO networks (Preferred Provider Organisation) in order to achieve better rates with the service providers (e.g. USA) and are also encouraging the insured to seek treatment in such networks.
But in the end, the trend only points in one direction. This will probably not change in the future and customers will have to swallow the "annual" premium toad.

Limited insurance benefits when travelling abroad to critical countries/territories

Anyone travelling abroad for private or business purposes must also check their insurance cover. This applies today more than ever. Travel insurers as well as local and international health insurers can limit their obligation to pay benefits. Reasons for this can be sanctions against the host country/travelling country or recommendations from official sources not to travel to a country or region. A source of information for this can be, for example, the FDFA https://www.eda.admin.ch/eda/de/home.html. Primarily Swiss insurers rely on the recommendations of the FDFA. Insurers from other countries use other sources of information and must follow other guidelines/laws. A precise check is mandatory.

New IPMI solution on the Swiss market

In cooperation with MSH France, Swiss Life offers an international health insurance solution for Swiss companies with expats and posted employees abroad. MSH France is handling the contract/claims processing as a TPA (Third Party Administrator). Swiss Life is the licensor, "re" insurer and is also responsible for distribution. For expatriates who are still subject to KVG abroad, Swiss Life works together with Sympany and can also offer vested benefits when the employee/family returns to Switzerland.