FINMA

What is FINMA?

FINMA, in full the Swiss Financial Market Supervisory Authority, is the federal authority that supervises banks, insurers, fund management companies and other financial institutions. It is an institution under public law with its own legal personality, based in Bern. Its statutory mandate is to protect creditors, investors and insured persons, and to ensure that the financial markets function properly.

In health insurance, FINMA is responsible for only one part. Switzerland separates two worlds:

• Basic health insurance under the Federal Health Insurance Act (KVG): compulsory, the same benefits at all insurers, supervised by the FOPH under the Health Insurance Supervision Act (KVAG).
• Supplementary insurance under the Insurance Contract Act (ICA): voluntary, benefits and premiums vary by product, supervised by FINMA under the Insurance Supervision Act (ISA).

Many health insurers offer both, often through separate companies of the same group. The ISA expressly excludes insurers to the extent that they are subject to special supervision under federal law; for basic health insurance, this is supervision by the FOPH. So FINMA sees an insurer’s supplementary insurance, while the FOPH sees its basic health insurance.

How it works

In supplementary health insurance, FINMA has three main tasks.

Authorisation and ongoing supervision. An insurer needs FINMA authorisation before it may offer supplementary insurance. FINMA then monitors its finances, in particular its solvency: the risk-bearing capital must be at least as large as the target capital.

Tariffs and conditions. For supplementary insurance to social health insurance, the insurer must submit its tariffs and general terms and conditions to FINMA. Using the tariff calculations, FINMA checks whether the premiums are within a range that safeguards the insurer’s solvency on the one hand and protects insured persons against abuse on the other. If an insurer does not comply with the generally binding rules of the industry agreement, FINMA can refuse tariffs or order adjustments. It does not publish the approved tariffs; that is why there is no official premium list for supplementary insurance as there is for basic health insurance.

Insurance intermediaries. FINMA keeps the public register of untied intermediaries. An intermediary is untied if they are in a relationship of trust with you and act in your interest, for example a broker. Only those with a registered office in Switzerland, a good reputation, the necessary professional knowledge and professional liability insurance of at least CHF 2 million are entered. Insurers may not work with untied intermediaries who are not registered. Anyone not listed in the register may not operate as an untied intermediary.

Legal basis

FINMA is based on the Financial Market Supervision Act (FINMASA). Art. 1 FINMASA lists the acts under which it supervises, including the Insurance Contract Act and the Insurance Supervision Act. Art. 4 FINMASA sets out its objectives, Art. 5 FINMASA its legal form, seat and name, and Art. 6 FINMASA its tasks.

For insurers, the ISA applies:

• Art. 2 para. 2 let. b ISA: Insurers are not subject to the ISA to the extent that they are subject to special supervision under federal law. For basic health insurance, this is supervision under the KVAG.
• Art. 4 para. 2 let. r ISA: The tariffs and general terms and conditions of supplementary insurance to social health insurance are part of the business plan that FINMA reviews.
• Art. 9 ISA: Solvency, measured against the target capital.
• Art. 38 ISA: Review of the tariffs subject to approval for solvency and protection against abuse; refusal in the event of breaches of generally binding industry rules.
• Art. 40–45b ISA: Intermediaries, register, duty to provide information, disclosure of remuneration. The cover of at least CHF 2 million is set out in Art. 189 of the Insurance Supervision Ordinance (AVO).

Art. 62 of the Health Insurance Supervision Ordinance (KVAV) requires the FOPH and FINMA to coordinate their supervision where an insurer’s basic health insurance may affect its supplementary insurance, for example if its reserves are too low.

Example: who reviews a premium increase

Ursula, 58, has basic health insurance and semi-private supplementary hospital insurance with the same group. In the autumn she receives two letters with new premiums. The table shows which supervisory authority is responsible in each case.

Question	Basic health insurance	Supplementary hospital insurance
Supervision	FOPH	FINMA
Law	KVG, KVAG	ICA, ISA
Premium approved?	yes, by the FOPH, published on priminfo.admin.ch	tariff submitted to FINMA, not public
Cancellation after premium notification	by 30 November for the end of the year	according to the contract terms
Admission	obligation to accept, without health questions	voluntary, with health questions

What this means for you

In everyday life, FINMA matters mainly in three situations:

1. When you get advice. Ask whether the person is tied or untied. You can check untied intermediaries in the FINMA register. How they are paid is explained on the page intermediary commission.
2. With supplementary insurance. FINMA protects against abusive premiums, but it does not set premiums for you and does not compare products. Read the benefits and cancellation rules in the terms and conditions.
3. If you have problems with an intermediary. You can report improper conduct to FINMA. In a dispute about a claim, the Office of the health insurance ombudsperson is the better point of contact.

This platform is affected too: its operator FinanceRock GmbH is entered in the FINMA register as an untied intermediary under number F01496799. Details are under Disclosure. For basic health insurance, you can compare the premiums approved by the FOPH in the premium calculator, and you can find the insurers under health insurers.

Common mistakes

• Writing to FINMA about basic health insurance. The FOPH is responsible.
• Thinking that “checked by FINMA” means cheap. FINMA checks solvency and abuse, not whether a product suits you.
• Not checking an intermediary. An untied intermediary must be listed in the register. If the entry is missing, they may not operate as an untied intermediary.
• Cancelling supplementary insurance too soon. Unlike in basic health insurance, there is no obligation to accept. Only cancel once the new contract is in place.

We explain how we work with official sources under How we calculate.