Rs 832.102.15 Order The Dfi From October 18, 2011 On The Reserves In The Social Health Insurance (Ore-Dfi)

Original Language Title: RS 832.102.15 Ordonnance du DFI du 18 octobre 2011 sur les réserves dans l’assurance-maladie sociale (ORe-DFI)

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now for only USD$20 per month, or Get a Day Pass for only USD$4.99.
832.102.15 order of the DFI on reserves in the social health insurance (ORe-DFI) from October 18, 2011 (Status January 1, 2016) the federal Department of Home Affairs (FDHA), view the art. 10, al. 5, 11, al. 2 and 13, al. 3, of the Ordinance of 18 November 2015 on the monitoring of the social health insurance (OSAMal), stop: Section 1 assessment of assets and liabilities art. 1 valuation of assets are especially considered to be assets for which there is a great market value species, government bonds and stocks traded.
Financial instruments listed are considered to be comparable to the senses of the art assets. 10, al. 2, OSAMal.
If there is no comparable assets, close the market value can be determined on the basis of a model: a. recognized actuarially; b. based wherever possible on observed market sizes; integrated etc. in the internal processes of the insurance company.

The reference has been adapted to 1 Jan. 2016 in application of art. 12 al. 2 of the Federal ACT of 18 June 2004 on official publications (RS 170.512).

Art. 2 assessment of commitments are especially considered commitments accounts payable, the passive adjustment accounts and provisions.
A suitable provision must be incorporated for the commitments still to be paid.
The assessment must relate exclusively to the mathematical expectation of the commitments. She cannot understand nor supplements implicit or explicit security fluctuation or other supplements for insurance risk or risk capital investments.

Section 2 model for the calculation of the minimum reserves arts. 3 actuarial risk actuarial risk is quantified on a normal year.
It is calculated separately for the mandatory healthcare insurance, insurance of daily allowances (individual and collective) and for reinsurance according to art. 28 of the Federal law of September 26, 2014, on social health insurance (LSAMal).
The distribution of the possible actuarial result is estimated on the basis of a law of Gauss. His average is the result provided by the insurer at the beginning of the year. The variance is calculated for each class of insurance referred to in para. 2, taking into account the risk of random in the benefits as well as fluctuations of unexpected changes in benefits and the risk compensation.
If the insurer did reassure benefits according to art. 28 LSAMal, reducing the risk that results will be taken into account.

RS 832.12 removal has been adapted to 1 Jan. 2016 in application of art. 12 al. 2 of the Federal ACT of 18 June 2004 on official publications (RS 170.512).
The reference has been adapted to 1 Jan. 2016 in application of art. 12 al. 2 of the Federal ACT of 18 June 2004 on official publications (RS 170.512).

Art. 4 market risk market risk is quantified on a normal year.
Quantification of market risk takes into account the risk of possible fluctuation of rates of interest, the course of actions, the exchange rate, the price of real estate and comparable market values for the assets and liabilities.
The distribution of the possible outcome of the financial market is estimated on the basis of a law of Gauss. His average is the result provided by the insurer at the beginning of the year. The variance is calculated on the basis of the risk factors mentioned in para. 2 art. 5 credit risk credit risk includes credit and failure risks that the insurer must take into account for receivables to third parties, especially for government borrowing or to claims against customers or reinsurers.

Art. 6 scenarios in order to cover risks that have a more negative impact on the assessment of assets or liabilities that the risks of a normal year, the hypothetical events or combinations of events (scenarios) are defined and their respective probabilities of occurrence are determined.
The federal Office of public health (FOPH) may authorize an insurer, at his request, to evaluate scenarios according to simplified methods.

Art. 7 procedure of aggregation aggregation of distributions resulting from the actuarial risk and market risk quantification is done by considering these two risks as independent one from the other.
The results of the evaluation of the scenarios are taken into account with their probability of occurrence.
The distribution of possible reserves at the end of the year is determined on the basis of the reserves available at the beginning of the year, given the distribution of risk associate according to the al. 1 and 2, and deducting an amount covering the credit risk.

Art. Electronic 8Formulaire the details of the model used for the calculation of the minimum level of reserves are described in an electronic form. The form is provided in the annex.

New content according to section I of the O of the DFI on Dec. 5. 2011, in force since Jan. 1. 2012 (2011 6257 RO).

Section 3 time for the presentation of the report art. 9. the report on the solvency test, accompanied of the electronic form provided in art. 8, should be given each year to the FOPH to April 30 of the year under review no later than.

Section 4 provisions final art. 10 transitional provision during the first three years following the entry into force of this order, the FOPH can provide on request, according to art. 9, an additional period of two months for the submission of the report.

Art. 11 entry into force this order comes into force on January 1, 2012.

Annex (art. 8) electronic form for the calculation of the minimum level of reserves introduced by section II of the O of the DFI on Dec. 5. 2011 (2011 6257 RO). New content according to section I of the O of the DFI on Dec. 9. in force since Jan. 1, 2013. 2014 (2013 5327 RO).
In accordance with art. 5, al. 1, let. c, of the law of 18 June 2004 on the official (RS 170.512), the electronic publications is not published to the RO. It can be accessed under www.bag.admin.ch > Themes > health insurance > insurers and monitoring > KVG Solvency Test. The current version is from 8 nov. 2013 State on January 1, 2016