832.12 federal supervision of Social Insurance Act * 1 (Act on the supervision of insurance, LSAMal) September 26, 2014 (State 1 January 2016) the Federal Assembly of the Swiss Confederation, under art. 117, al. 1, of the Constitution, given the message of the federal Council of February 15, 2012, stop: Chapter 1 provisions general article 1 object and purpose this Act regulates the supervision of the Confederation in the field of social insurance on: a. the sickness funds; b. private insurance undertakings subject to the law of 17 December 2004 on the monitoring of insurance (LSA); c. Reinsurers; d. the joint within the meaning of the art institution. 18 of the Federal Act of 18 March 1994 on health insurance (LAMal).
It has inter alia the protection of the interests of the insured in accordance with the LAMal, in particular by guaranteeing the transparency of social insurance and the solvency of the sickness funds.
RS 961.01 RS 832.10 s. 2 sickness funds sickness funds are legal persons in private law or public non-profit practising social insurance within the meaning of the LAMal.
The sickness funds have the right to practise, in addition to the social health insurance within the meaning of the KVG, supplementary insurance; they can also practise other branches of insurance, the conditions and within the limits set by the federal Council. All these insurance policies are governed by the law of 2 April 1908 on insurance contracts.
The sickness funds may moreover practicing accident insurance in the limits foreseen by art. 70, al. 2, of the Federal Act of 20 March 1981 on accident insurance.
RS 832.10 RS 221.229.1 RS 832.20 s. 3 private insurance undertakings subject to the LSA private insurance undertakings subject to the LSA can practice social insurance insofar as they are for the benefit of an authorization within the meaning of the art. 4-11.
RS 961.01 Chapter 2 authorization to practise social insurance art. 4 regime of the Supervisory Authority authorisation allows the insurers within the meaning of the art. 2 and 3 (insurers) who meet the requirements of this Act and which guarantee the interests of the insured to practice social insurance.
It publishes the list of admitted insurers.
S. 5 authorisation conditions insurers must meet the following conditions: a. take the legal form of the joint stock company, cooperative, association or Foundation; b. have their headquarters in Switzerland; c. have an organization and practice management that guarantee the legal compliance; d. have a sufficient initial capital and be able to meet their financial obligations at any time , featuring in particular reservations necessary; e. have an external auditors approved; f. practice Medicare social principle of mutuality, guarantee the equal treatment of insured persons and affect only for purposes of social insurance resources from it; g. offer persons responsible to ensure that reside in a Member State of the European Union, Iceland or Norway the opportunity to join the social insurance; in special cases, the supervisory authority may exempt from this obligation insurers making the request; h. practice optional daily according to the KVG insurance; i. admit, within the limits of their field activity territory, any person required to ensure and any person who is entitled to enter into a contract of insurance benefits daily; j. be able to satisfy the other requirements laid down by this Act and the LAMal.
RS 832.10 s. 6 delegation of tasks the insurer may delegate tasks to another entity in its group insurance, a federation of insurers or third parties.
It cannot delegate: a. the tasks of branch and the control by the Board of Directors; b. other central tasks of management, including the jurisdiction to make decisions within the meaning of art. 49 of the Federal law of 6 October 2000 on the general part of the law of social insurance (LPGA).
The insurer shall ensure that the monitoring on the tasks that it delegates can be exercised without restriction.
RS 830.1 s. 7 application authorization the authorization request is subject to the supervisory authority.
It must be accompanied by a business plan. It must contain the following information: a. the statutes of the insurer, its Constitution and an extract from the register of commerce (registration); b. the Organization of the insurer and, if necessary, of insurance group which the insurer is party; c. the identity and the curriculum vitae of the members of the organs of administration and management; d. the identity of the body for external review and the review officer who directs the revision; e. directions on persons who hold directly or indirectly, at least 10% of the capital or of the voting rights or which otherwise, can exercise a decisive influence on the management of the insurer; f. indications related to the funding of the compulsory insurance care and voluntary insurance of daily allowances to the meaning of LAMal; g. the opening balance sheet for the sickness; h. the balance sheets and accounts of profit and loss forecast of the sickness for the first three financial years; i. If they exist, the plan of reinsurance and reinsurance contracts; j. directions on ways of identifying, limitation and risk control; k. directions on the territorial scope of activity of the insurer; l. If they exist, contracts and other agreements by which the insurer intends to delegate important tasks to others; the contribution rates of compulsory insurance of care and voluntary insurance of daily allowances; n. the provisions on specific forms of compulsory insurance care provided for in art. 62 KVG and optional insurance of daily allowances within the meaning of the art. 67 to 77 Larson, as well as the General insurance conditions; o. If the sickness plans to perform additional insurance and other classes of insurance, the communication that it filed an application with the Federal surveillance of financial markets (FINMA) Autorité; p. If the insurer intends to practice insurance in the Principality of Liechtenstein, the communication that he filed a petition in this State.
The supervisory authority may require other information and documents that are needed to decide on the request.
RS 832.10 s. 8 changes to the operating plan modification of elements of the operating plan referred to in art. 7, al. 2, let. a, i or k to n, requires the approval of the supervisory authority.
Any modification of elements of the operating plan referred to in art. 7, al. 2, let. b to f, j, o, or p, must be previously communicated to the supervisory authority. A change is deemed authorized if the supervisory authority does not engage a review procedure within a period of eight weeks from the communication.
S. 9 changing the legal structure, transfer of assets and transfer of the number of policyholders the insurer which intends to modify its legal structure or operate a transfer of assets within the meaning of the Act of October 3, 2003, the merger shall forward to the supervisory authority.
The supervisory authority may, within a period of eight weeks from the communication, prohibit a modification or subject it to conditions when its nature or its importance may be prejudicial to the insurer or to impair the interests of insured persons.
An insurer which intends to transfer all or part of its workforce of insured persons to another insurer a treaty must obtain the authorization of the supervisory authority. It permits the transfer if it allows overall to safeguard the interests of insured persons.
RS 221.301 s. 10 entries all insurer which intends to take a stake in another company must notify the supervisory authority when this participation reaches or exceeds 10, 20, 33 or 50% of the capital or of the voting rights of another company.
Anyone who intends to take, directly or indirectly, a participation in an insurer must inform the supervisory authority when this participation reaches or exceeds 10, 20, 33 or 50% of the capital or of the voting rights of the insurer.
Anyone who intends to reduce its holding in an insurer below the thresholds of 10, 20, 33 or 50% of the capital or of the voting rights or modify its participation in such a way that the insurer ceases to be its subsidiary shall inform the supervisory authority.
The supervisory authority may prohibit participation or subject it to conditions when its nature or its importance may be prejudicial to the insurer or to impair the interests of the insured.
S. 11 reservation of other acts the provisions of the law of 6 October 1995 on cartels on the assessment of mergers and the provisions of the law of 3 October 2003 on the merger are reserved.
RS 251 RS 221.301 Chapter 3 exercise of the activity of Insurance Section 1 funding s. 12 system of financing insurers fund social insurance system needs coverage.
S. 13 insurers technical reserves are appropriate technical provisions.
Technical provisions include provisions intended to cover the costs of treatments that have not yet been charged, provisions for insurance cases that have not yet been billed in optional insurance of daily allowances and, if premiums are staggered depending on the age of entry, ageing of the optional daily allowance insurance provisions.
S. 14 reserves in the field of social insurance, insurers provide sufficient reserves to ensure their solvency.
The federal Council regulates the calculation of the minimum level of reserves and solvency. It is based on insurance risks, market risks and risk credit to which the insurer is exposed for all of its activities.
S. 15 fortune linked social insurance insurers are a fortune linked social insurance intended to guarantee the obligations arising from the reports of insurance and reinsurance contracts concluded. They bring the evidence to the authority of monitoring each year; It can request this evidence at any time.
The flow of wealth linked to social insurance is insurance technical reserves.
Assets assigned to fortune linked social insurance shall be designated as such. They can respond to obligations that social insurance is intended to guarantee.
S. 16 approval of premium rates for premiums of compulsory insurance of care and voluntary personal insurance of daily allowances are subject to the approval of the supervisory authority. They cannot be made public or be applied prior to their approval.
The supervisory authority verifies that rates guarantee the solvency of the insurer and the interests of the insured within the meaning of the LAMal.
Premiums the insurer cover the specific costs of the cantons. The place of residence of the insured person is decisive. The insurer takes into account including compensation for the risks, changes in provisions, as well as the size and evolution permanent workforce of insured persons in the given Township.
The supervisory authority does not approve rates when premiums: a. do not respect legal requirements; b. do not cover the costs within the meaning of para. 3; c. exceed way inappropriate costs within the meaning of para. 3; d. cause excessive reserves.
If it does not approve tariffs, the supervisory authority ordered measures to be taken.
Prior to approval of tariffs, the cantons may give their opinion to the insurers and the supervisory authority on the evaluation of the costs for their territory, provided that these exchanges do not extend the approval procedure. The cantons may obtain the necessary information from insurers and the supervisory authority. This information cannot be made public or transmitted to third parties.
If the rates are approved for a duration of less than one year, the supervisory authority requires the insurer to make public with the publication of the rates the duration of approval of the tariffs.
RS 832.10 s. 17 compensation of collected premiums overpayment if, in a township, the premiums collected by an insurer for a given year were markedly higher that costs accumulated in the canton, the insurer may, in the canton concerned, carry out compensation of premiums the following year. The amount of the compensation must be clearly stated and motivated by the insurer in the application for approval. It must be filed with the supervisory authority no later than the end of June of the following year.
Compensation premiums should restore the balance between premiums and costs.
To assess the appropriateness of the compensation's premiums, the supervisory authority is based on the relationship between costs and premiums to the insurer. It takes into account the compensation of risks, changes in provisions as well as the size and the continuing evolution of the number of insured persons in the given Township. It also takes into consideration the whole of the economic situation of the insurer.
The federal Council enacts the necessary implementing provisions concerning compensation for premiums. It intends to do this the insurers.
S. 18 the repayment terms repayment takes the form of a rebate granted by the insurer to the persons insured with him at 31 December of the year for which the premiums are paid. It is carried out during the calendar year in which the application was filed.
S. 19 administrative expenses insurers must contain the social insurance administration costs within the limits imposed by economic management. Particular part of administration costs the costs of intermediaries and advertising expenses.
In its annual accounts, the insurer certifies separately advertising expenses and commissions paid to intermediaries.
Insurers may conclude an agreement aimed at settling the telephone solicitation, the abandonment of services provided by call centers and the limitation of compensation for intermediaries.
Section 2 corporate management and review article 20 warranty of an irreproachable members of organs of administration and management of an insurer and the members of the joint institution must enjoy a good reputation and offer the guarantee of an irreproachable.
Federal Council sets the professional qualifications that persons must submit.
The president of the governing body is unable to preside over the governing body.
The federal Council lays down provisions on the publication of links of interest and on the prevention of conflicts of interest.
S. 21 publication of the system of pay and allowances of governing bodies insurers have their remuneration system in the management report.
They publish in the annual report: a. for the governing body: the total amount of compensation awarded to its members and the amount granted to the Member whose remuneration is the highest, without mention of his name; b. to the governing body: the total amount of compensation awarded to its members and the amount awarded to the Member whose remuneration is higher , without mention of his name.
Insurers set out the reasons for which the amounts of the allowances have changed from the previous year in the management report.
Benefits include: a. fees, wages, bonuses and credit notes; b. the commitment and starting allowances; c. benefits all rewarding additional work.
S. 22 insurers risk management are organized so as to be able, in particular, identify, limit and control all key risks.
The federal Council lays down provisions on the objective of the risk management, its contents and the documents relating thereto and on the monitoring of risks by insurers.
S. 23 internal control insurers are implementing a system of internal control of the activity, efficient and adapted to the size and complexity of the company. They appoint an independent internal review body of the Directorate.
The internal auditors shall establish at least once a year a report and delivers it to the external auditors.
S. 24 reports insurers establish December 31 of each year a report of management consisting of the annual accounts, the annual report and, when the code of obligations (CO) provides, from the Group's accounts.
They hand over their management report on the last year to the supervisory authority, no later than the following 30 April. The decision of the competent body of the insurer concerning the approval of the accounts can be reset later, no later than June 30.
The supervisory authority may request interim reports.
The federal Council lays down provisions relating to the preparation of the accounts. It lays down the requirements that reports submitted to the authority of supervision pursuant to paras. 1 to 3 must satisfy; It may lay down specific requirements for the management report. He may delegate these powers to the supervisory authority.
RS 220 s. 25 External Auditors insurers appoint an external auditors approved; It is responsible for the following tasks: a. carry out regular control of annual accounts and, where appropriate, group accounts (art. 727 ss CO); b. consider the regularity of the management.
Only companies in revision approved as experts-Auditors within the meaning of the law of 16 December 2005 on the supervision of the revision can be mandated.
Only a natural person licensed as expert auditor within the meaning of the Act on the supervision of the revision may exercise the task of the review officer who directs the revision.
RS 220 RS 221.302 s. 26 tasks of the external auditors the external auditors examine: a. If the annual accounts are drawn up, both on the form than on its merits, in accordance with the laws, statutes and regulations; b. If, on the basis of the instructions of the supervisory authority, the provisions of this Act, LAMal and their enforcement orders are met.
The supervisory authority may entrust additional mandates to the external auditors and order specific controls. In the event of irregularities or illegal acts index, costs are borne by the controlled insurer.
The external auditors logs the results of its investigation and its findings in a report within the meaning of art. 728b CO. It presents this report to the authority of monitoring not later than April 30, following.
RS 832.10 RS 220 s. 27 obligation to inform of the external auditors the external auditors shall immediately inform the supervisory authority if it finds: a. criminal offences; b. serious irregularities; c. failure to observe the principles of an irreproachable; d. facts that would interfere with the solvency of the insurer or to infringe in any way the interests of insured persons.
Chapter 4 reinsurance article 28 the Supervisory Authority authorisation regime allows a reinsurer to practice the reinsurance of risks of social health insurance if it meets the requirements of this Act and that it guarantees the interests of the insured.
It publishes the list of approved reinsurers to practice.
S. 29 permission conditions might practice reinsurance: a. the insurers within the meaning of art. 2 with a minimum number of policyholders set by the federal Council; b. private insurance companies which have obtained a permit to practise the reinsurance in accordance with the LSA (private reinsurers).
Reinsurers must meet the following conditions: a. take the legal form of the joint stock company, cooperative, association or Foundation; b. be headquartered in Switzerland; c. have an organization and practice management that ensure compliance with legal provisions; d. be able to fulfil their obligations at any time, in particular established reserves to the sickness funds , or meet the financial requirements of the LSA for reinsurers private; e. have an external review body approved.
RS 961.01 s. 30 request for authorisation shall be submitted to the supervisory authority.
It must be accompanied by a business plan. It must contain the following information: a. when the reinsurer intends to reinsure the risks with another company, terms of surrender for social insurance; b. for the reinsurance of the social health insurance during the next three years, the projected profit and loss accounts and the planned provisions.
Private reinsurer operating plan shall contain in addition the following documents and particulars: a. the Organization of the private reinsurer and, where appropriate, one insurance to which group he belongs b. identity and the curriculum vitae of the members of the organs of administration and management; c. directions on persons who hold, directly or indirectly, at least 10% of the capital or of the voting rights or which , otherwise, can exercise a decisive influence on the management of the reinsurer; d. particulars of the financial endowment of the reinsurer and a certificate of FINMA whereby the reinsurer meets the financial requirements of the LSA for the social practice of reinsurance of health insurance; e. directions on the identity of the body for external review and the person responsible for the implementation of the mandate.
The supervisory authority may require other information and documents that are needed to decide on the request.
RS 961.01 s. 31 amendments to the modification of elements of the operating plan operating plan must be communicated to the supervisory authority.
S. 32 minimum participation of insurers to risks the federal Council fixed the minimum portion of the risk of insurance that insurers must take themselves.
S. 33 contracts of reinsurance reinsurance premiums must correspond to the risks assumed. They are subject to the approval of the supervisory authority.
Reinsurers provide annually to the supervisory authority accounts of profits and losses forecast for the social sickness insurance reinsurance activity and a count for each reinsurance contract.
Chapter 5 Monitoring Section 1 General art. 34 tasks, powers and competencies of the supervisory authority the authority of monitoring control the practice of social insurance. It performs in particular the following tasks: a. to ensure compliance with the provisions of this Act and of LAMal; b. it ensures coverage of an irreproachable; c. to ensure the compliance of the operating plan; d. ensure that insurers are creditworthy, they constitute the reserves and provisions in accordance with the requirements that they manage and invest their assets properly and that all the capital yields return to social health insurance; e. it protects the insured against the abuse.
The supervisory authority shall ensure that insurers sustainably fulfil the conditions for authorisation laid down by law. If the conditions are no longer fulfilled, it requires the restoration of lawful order.
It can instruct the insurers aimed at the uniform application of federal law and conduct inspections with the latter. These inspections may be performed without prior notice. During these, the supervisory authority must have free access to all the information it considers relevant.
It may at any time charge of third parties to verify that this Act is complied with. Costs can be borne by the undertaking concerned if the check reveals irregularities or illegal acts. Mandated persons are not required to keep the secret for the supervisory authority.
The FINMA monitors the practice of insurance referred to in art. 2, al. 2 in accordance with the ICA. The supervisory authority and the FINMA coordinate their monitoring activities. They shall inform as soon as they have knowledge of facts important for the other supervisory authority.
RS 832.10 RS 961.01 s. 35 obligation to educate and to announce monitored companies are required to provide to the supervisory authority, to the external auditors or persons authorised by the supervisory authority all information and documents necessary for the execution of supervision of social insurance.
They are required to provide annually to the supervisory authority of indications on their social insurance activity-related data. The supervisory authority may ask them these directions several times per year.
Insurers should furthermore announce without delay to the supervisory authority facts which are of great importance for monitoring.
S. 36 exchange of information and administrative assistance in derogation from art. 33 LPGA, the supervisory authority may, in the field of social insurance, transmit to other authorities monitoring Swiss and the townships of information and documents not available to the public that they need to accomplish their tasks.
The administrative and judicial authorities of the Confederation and the cantons are required, subject to specific statutory provisions, to cooperate in audits of the supervisory authority and, on written request and motivated, to put at its disposal the necessary documents. Administrative assistance shall be granted free of charge.
RS 830.1 s. 37 publication of decisions by derogation from art. 33 LPGA, the supervisory authority may inform the public about measures it has taken and criminal sanctions that it has imposed.
RS 830.1 Section 2 measures of surveillance art. 38 provisional measures when an insurer fails to comply with the provisions of this Act or of LAMal or comply with instructions of the authority monitoring or when the interests of the insured seem to be threatened in any way, the supervisory authority shall take provisional measures which considers it necessary to safeguard the interests of insured persons.
In particular, the supervisory authority may: a. prohibit the insurer to dispose freely of its assets; b. direct deposit or the blocking of assets of the insurer; c. delegate fully or partially to a third party of the skills belonging to the organs of the insurer; d. transfer the number of policy holders of an insurer to another insurer, pursuant to art. 40; e. order the realization of fortune related social insurance; f. order the revocation of the persons responsible for management general, monitoring, control or management; g. order increases in premiums; h. order the implementation of a financing plan or sanitation; i. appoint a person and assign tasks and special assignments , pursuant to art. 39; j. assign assets of the insurer to the fortune linked social insurance up to the amount of flow defined in art. 15, al. 2; k grant a bankruptcy stay in case of risk of insolvency of an insurer pursuant to arts. 293 to 304 of the Federal law of April 11, 1889, on the prosecution for debts and bankruptcy; l. direct to the insurer the conclusion of a contract of reinsurance.
If detrimental to the situation of an insurer and statutory bodies have not taken sufficient measures, the supervisory authority may take the measures provided for in para. 2, let. g and h, to ensure compliance with the law during the next two years.
RS 832.10 RS 281.1 s. 39 delegate of the supervisory authority the supervisory authority may instruct an independent specialist of the implementation from a supervised company of supervision within the meaning of art. 38 which it has ordered.
It defines the tasks of its delegate. She determines to what extent it can act instead of the organs of the controlled company.
Art. 35 shall apply by analogy to the delegate information skills and monitored business obligation to inform.
The delegate fees are borne by the supervised company. At the request of the supervisory authority, it shall pay an advance of costs. The supervisory authority may exceptionally grant a total or partial exemption from fees.
S. 40 procedure applicable to the transfer of the number of insured persons during the preparation of the transfer of the number of insured persons, the supervisory authority is untied from its obligation to keep secret for the insurers and the federations of interested insurers.
It can transfer to another insurer, subject to its agreement, all or part of the insured of an insurer, with his fortune related social insurance, its reserves and the rights and obligations related to the latter. It sets out the conditions of the transfer by decision.
S. 41 opening of bankruptcy the opening of the bankruptcy of an insurer is subject to the authorization of the supervisory authority. It gave its authorization if there is no possibility of sanitation.
The supervisory authority may ask the bankruptcy court the opening of the bankruptcy of a sickness.
S. 42 loan to overcome a shortage of liquidity the federal Council can, to overcome a temporary shortage of liquidity, lending cash to the market conditions at the joint institution. This loan guarantee may be subject to conditions.
To ensure repayment of the cash loan in five years, the federal Council may decide on an additional premium of 1% on the premium volume of compulsory insurance for care for the benefit of the Insolvency Fund.
Section 3 end of the business of insurance article 43. the supervisory authority withdraw the insurer permission to practice the social health insurance and the reinsurer an authorization to practice the social sickness insurance reinsurance if they so request or if they no longer fulfil the legal requirements.
If permission is completely removed and the fortune and the number of insured persons are not transferred by convention to another insurer, any excess of the assets of insurers is paid to the insolvency of the joint institution Fund.
Whether the authority monitoring removed an insurer permission to practice compulsory insurance care than for some parts of its territorial scope of activity, the insurer must give a portion of its reserves. This amount is divided between the insurers who return to policyholders affected by the limitation of the territorial scope of activity. The supervisory authority may fix the amount and entrust its distribution to the joint institution.
If an insurer or a reinsurer ceases its activity of insurance, the supervisory authority makes a decision on the release of surveillance.
The supervisory authority shall communicate its decision to the office of the trade register and publish it at the expense of the company.
Chapter 6 special provisions applicable to the supervision of insurers s. 44. the supervisory authority may verify the transactions between an insurer engaged in social insurance and other companies.
The supervisory authority may delegate this audit to the external auditors.
The supervisory authority may issue provisions on the risk management and the system of OIOS insofar as insurers are concerned.
The art. 20 (guarantee an irreproachable) and 38, al. 2, let. (f) (revocation of persons), apply by analogy to the holding company.
With regard to the al. 1 and al. 3, the obligation to provide information laid down in art. 35 shall apply mutatis mutandis to the ruling holding company.
Chapter 7 Institution common Section 1 General art. 45 external auditors the joint institution commissioned an external review body. The art. 25 to 27 shall apply by analogy.
S. 46 reports the joint institution presents the supervisory authority an annual report on its activity, no later than 30 June of the following year. The following documents are attached: a. one account operation for each field of tasks; b. a global operating account; c. a balance sheet; d. an overview of the reserves of the field of reduction of premiums; e. the report of the Auditors.
Section 2 Fund insolvency article 47 a common institution Insolvency Fund management manages an insolvency fund to support the costs associated with legal benefits in lieu of insolvent insurers, pursuant to art. 18, al. 2, lAMal.
RS 832.10 s. 48 funding of insolvency the Insolvency Fund is funded through the following sources: a. contributions from insurers; b. the surplus of assets of insurers dissolved whose fortune and strength policyholders were not transferred by contract to another insurer; c. the excess of revenue for pharmaceutical companies reimburse the joint institution on the basis of the control of the economic nature of the drugs entering the list of specialties; d. the product of recourse actions (art. 52 al. (4) s. 49 the insolvency fund the fixed common institution amount the amount of the Insolvency Fund.
S. 50 insolvency an insurer is insolvent if a judicial liquidation procedure is open against him or that he will be able to fulfil its financial obligations in the near future.
The supervisory authority formally noted the insolvency of the insurer on request of the latter, on request of the joint institution or office. It simultaneously sets the time from which the Insolvency Fund has an obligation to allocate benefits and shall inform the joint institution.
S. 51 nature and extended benefits supporting the joint institution supports, at the rate of Insolvency Fund, the amount lacking the insolvent insurer to pay legal benefits. These include the following costs: a. compulsory care insurance benefits costs; b. the optional insurance benefits daily; c. benefits charges to offset the risks provided for in ch. 2, al. 1, the transitional provisions of the amendment of December 21, 2007, of LAMal (risk compensation); d. administrative costs resulting from the granting of the benefits mentioned in the let. a to c.
The joint institution set case-by-case basis the proper way to provide benefits.
It communicates as and when the administration of the liquidation or bankruptcy the amount of the benefits supported by the Insolvency Fund. The advertised benefits are treated as liquidation or bankruptcy claims.
2009 4755 RS 832.10 Section 3 use Art. RO 52. the joint institution assumes, a body or a third party responsible for the insolvency of the insurer, the claims of the insurer to the extent of the statutory benefits that the Fund insolvency has supported in its place. It produces its claims in the bankruptcy proceedings.
When there are several officials, they respond jointly and severally to the joint institution.
The time limits applicable to the rights of the aggrieved insurer shall also apply to rights that were passed to the joint institution. For recourse claims of the joint institution, they do not begin to run until it had knowledge of benefits it must allocate and the head.
The claims used, after deduction of the collection costs, to cover the amount supported by the Fund of insolvency under art. 51. the balance is paid to the mass in bankruptcy.
Claims that do not pass the common institution remain in the mass in bankruptcy.
Chapter 8 provisions criminal art. 53 crimes is punished to a deprivation of liberty from three years at the more or a penalty anyone, intentionally: a. practice without permission social insurance or reinsurance within the meaning of this Act; b. withdraw or strike property belonging to fortune linked Medicare social so that throughput is more covered; c. commits any act having effect of reducing the security of assets allocated to related social insurance fortune.
If the perpetrator acts negligently, it is punishable by a pecuniary penalty of 180 days-fine at most.
S. 54 contraventions shall be punished by a fine of 500,000 francs more than anyone, intentionally: a. violates an obligation under art. 8, 9 and 10 or 35; b. provides, in breach of its obligation to provide information or to communicate within the meaning of this Act, inaccurate information or refuses to provide information; c. does not constitute provisions required by art. 13; d. in its capacity as executing agency within the meaning of this Act, violates its obligations, such as to keep the secret, or abuse its function to the detriment of a third party to obtain a benefit or to provide to a third party an illicit advantage; e. opposes a control ordered by the supervisory authority or makes it impossible in any other way; f. is evading the duty of administrative assistance referred to in art. 32 LPGA and art. 82 lAMal; g. violates the prohibition in art. 62, al. 2, or 64, al. 8, lAMal.
If the perpetrator acts negligently in cases referred to the al. 1, it is punishable by a fine of 150,000 francs at most.
Is punished by a fine of 100,000 francs more than anyone, intentionally: a. violates a decision entered in force of the supervisory authority or a decision of the Court of appeal or not comply; b. interferes with the obligation to ensure referred to the art. 4, 4, 5 and 7 LAMal; c. violates the requirements relating to the procedure for funding and the presentation of accounts; d. violates the requirements for reimbursement of benefits within the meaning of art. 34, al. 1, lAMal; e. violates the requirements for participation in the costs within the meaning of art. LAMal 64; f. violates the requirements relating to the premiums of the insured within the meaning of the art. 61-63 LAMal; g. does not present the management report within the time fixed by law.
If the perpetrator acts negligently in cases referred to the al. 3, let. (b) to (f), it is punishable by a fine of 20,000 francs at most.
The information the supervisory authority or the authorized person has obtained thanks to the collaboration of a person cannot be used against it in a criminal proceeding unless the person concerned gives his consent or such information could have been obtained without his cooperation.
RS 830.1 RS 832.10 s. 55 offences in a company the competent authority may waive the persons punishable and condemn their place the undertaking to pay the fine if the following conditions are met: a. the investigation against persons punishable under art. 6 of the Federal law of March 22, 1974 on administrative penal law would require investigative measures disproportionate to the penalty; b. taken into account fine does not exceed 20,000 francs.
RS 313.0 chapter 9 competent surveillance authority art. 56. the federal Office of public health exercises supervision within the meaning of this Act.
Chapter 10 provisions finals s. 57 running the federal Council runs this Act. It enacts implementing provisions.
S. 58 modification of the law in force the amendment of other acts is set in the annex.
S. 59 transitional provisions insurers must implement the following provisions within two years following the entry into force of this Act: a. have a plan of operation in accordance with art. 7, al. 2, let. a to f and i to p, and hand it over to the supervisory authority; b. ensure, using the bound asset incorporated pursuant to art. 15, the obligations arising from the reports of insurance and reinsurance contracts concluded; c. manage their risks in accordance with art. 22; d have an internal auditors as provided for in art. 23. they must implement the following provisions in the five years following the entry into force of this Act: a. complete the requirements for the delegation of tasks laid down in art. 6; b. guarantee an irreproachable within the meaning of art. 20 s. 60 coordination with the amendment of March 21, 2014 by the LAMal regardless the order in which the amendment of March 21, 2014, of LAMal and this Act come into force, to the entry into force of the second of these laws or their entry into force simultaneously, art. 51, al. 1, let. c, reads as follows: art. 51, al. 1, let. c the joint institution supports, at the rate of Insolvency Fund, the amount lacking the insolvent insurer to pay legal benefits. These include the following costs: c. royalties of risk within the meaning of art. 16, al. 1, lAMal;
2014 3345 RS 832.10 RS 832.10 s. RO 61 referendum and entry into force this law is subject to the referendum.
The federal Council sets the date of entry into force.
Annex (article 58) change other acts the undermentioned acts are amended as follows:...
Models can be found at the RO 2015 5137.
State on January 1, 2016