List of insured persons in arrears

What is the list of insured persons in arrears?

The list of insured persons in arrears is a register that a canton can keep of people who do not pay their basic health insurance premiums despite debt enforcement. In everyday language, it is called the “blacklist”. It is a means of applying pressure: if you are on the list, the health insurer will only pay for emergency treatment for the time being.

The list belongs to basic health insurance under the Federal Health Insurance Act (KVG). It concerns premiums and co-payments for compulsory health insurance. Debts from supplementary insurance under the Insurance Contract Act (ICA) are a matter of private law and do not lead to this list.

It is important to know that the list is not a federal register. Each canton decides for itself whether to keep one. If your canton does not keep one, there is no suspension of benefits for you under this rule. The other consequences of payment arrears, such as debt enforcement and the block on switching, apply everywhere, however.

How it works

Before someone ends up on the list, the claim goes through a procedure laid down by law:

1. Reminder. If you do not pay a premium or co-payment that is due, the insurer sends you at least one written reminder.
2. Demand for payment. No later than three months after the due date, it sends you a demand for payment, separate from any other arrears, with a grace period of 30 days and a notice of the consequences.
3. Debt enforcement. If you still do not pay, the insurer must initiate debt enforcement proceedings. A person may be subject to proceedings at most twice per calendar year for their own arrears and twice for arrears relating to a child.
4. List and suspension of benefits. If you do not meet your obligation to pay premiums despite debt enforcement, the canton can put you on the list. When the canton reports this, the insurer suspends coverage of costs, except for emergency treatment.

If debt enforcement ends with a certificate of unpaid debt (Verlustschein), the insurer reports the claim to the canton. The canton covers 85% of it. The debt does not disappear, however: the insurer keeps the certificate of unpaid debt, and if you pay later, it returns 50% of the amount to the canton.

Within the meaning of the law, you are in arrears from the moment the demand for payment is delivered. From then on, you can no longer switch insurer until everything has been paid. This applies regardless of whether your canton keeps a list.

The insurer may not offset its benefits against your debts. It must therefore pay the bills it covers in full and claim the unpaid premiums separately.

Legal basis

Art. 64a KVG governs the non-payment of premiums and co-payments. Para. 1 requires a reminder, a demand for payment and a 30-day grace period, and para. 2 requires debt enforcement and limits it to twice a year. Under paras. 3 and 4, the insurer reports certificates of unpaid debt to the canton, which covers 85%; if payment is made later, 50% goes back to the canton. Para. 6 blocks a switch of insurer for insured persons in arrears.

The list itself is set out in Art. 64a para. 7 KVG: cantons can record insured persons who do not meet their obligation to pay premiums despite debt enforcement on a list that is accessible only to service providers, the municipality and the canton. When the canton reports them, insurers suspend coverage of costs, except for emergency treatment. The ordinance adds the following: Art. 105b KVV governs the reminder procedure, Art. 105c KVV prohibits offsetting, and Art. 105l KVV governs switching insurer when in arrears.

Example: six unpaid monthly premiums

Luca is 36 and lives in the city of Bern. His premium corresponds to the median for adults with a CHF 300 deductible: CHF 609.30 a month (premiums 2026, municipality of Bern, region 1, with accident cover; source FOPH). He does not pay his premiums for January to June 2026. The calculation shows how the law divides up the claim; default interest and debt enforcement costs are left out for simplicity.

What this means for you

If you can no longer pay your premiums, act early. The further the procedure has gone, the less room for manoeuvre remains.

1. Talk to your insurer straight away. Ask about paying in instalments before the demand for payment arrives. The insurer may not offset benefits against debts, so you can continue to submit bills.
2. Check premium subsidies. If your income is low, the canton reduces your premium. The cantonal rules are under premium subsidy.
3. Look for a cheaper premium. A higher deductible or a GP or Telmed model reduces the premium. Compare in the premium calculator. You can only switch, however, once no amounts for which you received a reminder are still outstanding.
4. Get advice. Debt advice services and your municipality’s social services help with your budget. If you are in a dispute with your insurer, the Office of the health insurance ombudsperson is free of charge.

You can find contact details for all insurers in the profiles under health insurers.

Common mistakes

• Believing the canton has paid the debt. The canton covers 85% towards the insurer; you still owe the full amount.
• Trying to switch insurer to escape the debts. With arrears for which you have received a reminder, your notice of cancellation has no effect.
• Not seeing a doctor in an emergency. Emergency treatment is covered even during a suspension of benefits.
• Assuming the list applies everywhere. Only cantons that keep a list trigger the suspension of benefits. Debt enforcement and the block on switching, on the other hand, apply throughout Switzerland.
• Confusing childhood debts with your own. When you come of age, you can switch insurer at the end of the year despite arrears from your childhood.