Many residents blame the price hikes for mandatory health insurance on administrative costs generated by health insurance providers. A moneyland.ch analysis based on official data from the Federal Office for Public Health (FOPH) for 2024 shows whether or not there is truth in that assumption.
The official figures paint a clear picture: Health insurance companies spent an average of 190 francs per insured person on administering mandatory health insurance in 2024. That is less than 16 francs per person and month. Running costs include the costs of employee salaries, office space, IT, advertising, and sales commissions. The actual benefits paid out for medical expenses do not count towards running expenses. The running expenses per insured person did not change significantly between 2023 and 2024.
Big differences between health insurance providers
“There are major differences in running expenses from one health insurance company to another,” observes moneyland.ch analyst Felix Oeschger. The most efficient insurance provider spend less than 100 francs on running expenses per insured person and year. The least efficient spends more than 500 francs per person and year on running expenses.
A number of small mandatory health insurance providers are among the most efficient. These include Krankenkasse Luzerner Hinterland (95 francs per person and year), Sumiswalder Krankenkasse (102 francs), and Sodalis (125 francs). But the same applies on the other end of the scale, with Switzerland’s second-smallest mandatory health insurance provider, the Krankenkasse Birchmeier, having running expenses of 513 francs per person and year.
A look at the 12 biggest mandatory health insurance providers also reveals huge differences. CSS is the most efficient of these, with running expenses of 154 francs per insured person and year. Assura has running expenses of 262 francs per person.
1.74 billion francs of administrative costs
The total running expenses for administering mandatory health insurance in 2024 came to 1.74 billion francs, or 4.5 percent of total premiums paid (risk-adjusted). “The cost of the medical insurance itself is, by far, the biggest expense, accounting for around 95 percent of money collected in premiums,” says moneyland.ch analyst Felix Oeschger.
But the ratio of running costs to insurance varies broadly between different mandatory health insurance providers. The insurers with the lowest expense ratios are Krankenkassen Luzerner Hinterland (2.4 percent), Sumiswalder (3.1 percent), and Sodalis (3.8 percent). Of the 12 biggest mandatory health insurance providers, CSS and Helsana have the lowest expense ratios, at 3.8 percent each, while Assura has the highest ratio (6.7 percent). The Glarner Krankenkasse has the highest running expense ratio across all Swiss health insurance providers, at 10.1 percent.
A breakdown of running expenses
The bulk of the 1.74 billion francs of total running costs across all Swiss health insurance providers combined was spent on salaries, social security, and other employee-related expenses. Together, mandatory health insurance providers spent 1.22 billion francs on employees. Miscellaneous running expenses are the second biggest cost, at 368 million francs. Advertising costs and sales commissions take a distant third and fourth place, at 73 million 50 million francs respectively. 30 million francs was lost to value depreciation of company assets.
Methodology
Independent online comparison service moneyland.ch analyzed running expenses using official data published by the Federal Office of Public Health (FOPH). The cost efficiency of health insurance providers is also shown in the interactive health insurance comparison on moneyland.ch.
The analysis accounted for two key figures:
- Running expenses per insured person, minus depreciation.
- Administrative costs as a percentage of the risk-adjusted premiums: This figure shows running expenses including depreciation in relation to insurance premiums, minus risk compensation.
Evaluations for the mandatory health insurance providers below account for all the providers in the insurance group collectively.
- Groupe Mutuel: Mutuel, Philos, Avenir, Supra, Easy Sana, AMB.
- Visana-Gruppe: Visana, Sana 24, Vivacare, Galenos.
The analysis does not account for health insurance providers that existed in 2024, but will no longer exist in 2026, unless they were part of one of the insurance groups listed above.
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