Daily sickness benefits insurance reform: What will change for employers?
New rules for daily sickness benefits insurance will come into force on 1 January 2027.
The revised portability agreement (Freizügigkeitsabkommen, FZA) between insurers introduces two important improvements: companies will have greater protection if they are unable to find replacement insurance cover, and responsibilities for ongoing sickness claims will be more clearly defined when changing insurers. The reform is supported by insurers representing more than 90% of the Swiss daily sickness benefits insurance market.
What happens if a company can no longer obtain daily sickness benefits insurance?
From 2027, a new safety net will help ensure that affected companies can obtain insurance cover.
Until now, companies whose daily sickness benefits insurance was cancelled could face difficulties finding a new insurer. Replacement cover was sometimes particularly difficult to obtain in cases involving high claims costs or numerous long-term illnesses. Without insurance, employers had to finance their statutory obligation to continue paying salaries during illness themselves (risk of uninsured liability under Article 324a of the Swiss Code of Obligations).
A binding allocation procedure will now be introduced through the Swiss Insurance Association (SIA). If a company can demonstrate that it has been unable to find an insurer, supported by at least three written refusals, an insurer will be assigned to it.
Two important conditions apply:
- Premium cap: The premium rate may not exceed three times the previous rate (a maximum increase of 200%).
- Minimum contract term: The insurer may not terminate the contract through ordinary cancellation or following a claim during the first two years.
The safety net provides greater security but may involve significantly higher premiums.
Who pays daily sickness benefits when a company changes insurers?
If responsibility is unclear, the previous insurer must initially continue paying the daily sickness benefits.
Previously, changing insurers could lead to payment delays if employees were already ill or if an illness became apparent during the transition period.
The revised FZA establishes clearer rules on the strict obligation to make advance payments. The previous insurer must initially continue payments, while the insurers involved subsequently determine which party is ultimately responsible for the costs.
This is intended to prevent interruptions in daily sickness benefits payments.
What should employers consider now?
Despite the additional protection, reducing sickness absence at an early stage and regularly reviewing insurance arrangements remain essential.
Two measures are particularly important:
1. Strengthen workplace health management
Long-term illnesses, particularly those associated with mental health issues, often lead to substantial increases in claims costs and can jeopardise the continuity of insurance cover.
Through Verlingue Workplace Health Management, Verlingue works with specialised healthcare partners to help companies reduce sickness absence, provide early support to employees who are ill and facilitate their return to work.
2. Review insurance cover at an early stage
If claims costs are rising or cancellation appears likely, an early market review is advisable.
Verlingue’s specialists assess existing daily sickness benefits insurance arrangements and proactively support companies with market tenders and negotiations.
Conclusion: Greater security for employers
The 2027 reform strengthens protection for companies and employees. The new safety net reduces the risk of being left without replacement insurance, while the obligation to make advance payments provides greater clarity when changing insurers.
Proactive management of daily sickness benefits insurance remains essential to help prevent high claims costs and rising premiums.
Verlingue supports companies in reviewing their daily sickness benefits insurance and establishing effective workplace health management.