832.10
KVGLAMAL
CH
CH
Art. 5 Bundesgesetz vom 18. März 1994 über die Krankenversicherung (KVG) - Beginn und Ende der Versicherung
KVG; 2. Titel: Obligatorische Krankenpflegeversicherung; 1. Kapitel: Versicherungspflicht
Art. 5 KVG · Beginn und Ende der Versicherung
Bei rechtzeitigem Beitritt (Art. 3 Abs. 1) beginnt die Versicherung im Zeitpunkt der Geburt oder der Wohnsitznahme in der Schweiz. Der Bundesrat setzt den Versicherungsbeginn für die Personen nach Artikel 3 Absatz 3 fest.
Bei verspätetem Beitritt beginnt die Versicherung im Zeitpunkt des Beitritts. Bei nicht entschuldbarer Verspätung entrichtet die versicherte Person einen Prämienzuschlag. Der Bundesrat legt dafür die Richtsätze fest und berücksichtigt dabei die Höhe der Prämien am Wohnort der versicherten Person und die Dauer der Verspätung. Für Versicherte, bei denen die Entrichtung des Beitragszuschlages eine Notlage zur Folge hätte, setzt der Versicherer den Beitragszuschlag herab, wobei er der Lage der Versicherten und den Umständen der Verspätung angemessen Rechnung trägt.
Bei verspätetem Beitritt eines Kindes ist der Prämienzuschlag von den Eltern solidarisch oder von einem Elternteil geschuldet, soweit sie oder er die Verspätung verschuldet haben.
Die Versicherung endet, wenn die versicherte Person der Versicherungspflicht nicht mehr untersteht.
Gerichtsentscheide zu dieser Bestimmung (93)
BGE 129 V 159 (Art. 5 cpv. 2 LAMal)
Health insurance: Canton lacks authority to retroactively assign voluntarily insured resident or to impose late-joining premium surcharge; that assessment belongs to the insurer, not administrative or judicial authorities.
Ground for annulling the cantonal authority's decision on the premium surcharge and the ex officio affiliation, as the insurer is competent to decide on the surcharge.
730.2024.206 · bl (Art. 5 Abs. 2 KVG)
Late Objections to Health Insurance Surcharge Upheld
Provides the legal basis for the premium surcharge due to late joining.
VBE.2024.398 · ag (Art. 5 Abs. 2 KVG)
Late Health Insurance Enrollment Surcharge Reduced Due to Excusable Delay
This provision is cited as the legal basis for imposing a premium surcharge due to late joining the compulsory health insurance.
KV.2023.10 · sg (Art. 5 Abs. 3 KVG)
Swiss Health Insurance Obligation During Short-Term Foreign Stay
Cited in the reasoning (E. 3.1) regarding the termination of insurance obligation, though not explicitly in the operative part, it forms part of the grounds for the decision structure leading to the conclusion based on Art. 3 Abs. 1 KVG.
S 2022 49 · zg (Art. 5 Abs. 2 KVG)
Late Enrollment Surcharge for Lapse in Foreign Health Insurance Coverage
Cited in the reasoning section (E. 4.3.1.1, E. 4.3.2) as the basis for applying the rule that insurance begins at the time of application in case of late entry, which justifies the court's decision regarding the insurance start date.
KV.2022.00051 · zh (Art. 5 Abs. 2 KVG)
Student Denied Swiss Health Insurance Exemption Due to Inadequate Foreign Coverage
Specifies that insurance coverage begins at the time of joining, even if the joining is delayed, and that premiums cannot be claimed retroactively.
KV.2022.00019 · zh (Art. 5 Abs. 3 KVG)
Appeal Regarding Mandatory Health Insurance Coverage Termination Date Amidst Outstanding Premiums
The court annulled the decision regarding the termination of insurance as of June 30, 2018, pending further clarification on whether this provision applied.
KV.2022.00019 · zh (Art. 5 Abs. 3 KVG)
Insurer Coverage Dispute and Foreign Residence Determination
Cited as the basis for the annulment of the challenged decision regarding the end date of mandatory insurance as of June 30, 2018, pending further clarification.
II 2022 29 · sz (Art. 5 Abs. 3 KVG)
German National's Appeal for Swiss Health Insurance Exemption Denied
Cited when discussing the termination of Swiss insurance coverage upon relocation abroad, although not the main ground for dismissing the appeal.
VBE.2021.462 · ag (Art. 5 Abs. 2 KVG)
Mandatory Health Insurance Enrollment and Premium Surcharge in Switzerland
Cited as the legal basis for the imposition of a premium surcharge in case of inexcusable delay.
KV.2021.00053 · zh (Art. 5 Abs. 2 KVG)
German National v. Swiss Health Insurance Obligation
Cited to explain that if the accession to insurance is late, insurance begins at the time of accession, which is relevant to the court's final considerations regarding the start date of coverage.
S 2021 30 · gr (Art. 5 Abs. 3 KVG)
Cantonal Appeal Regarding Retroactive Cancellation of Mandatory Health Insurance for Incarcerated Foreign National
Cited in the reasoning regarding the termination of insurance, but deemed not applicable because the initial insurance obligation never existed.
A/3363/2019 · ge (Art. 5 al. 2 LAMal)
Health Insurance Late Affiliation Penalty Domicile Dispute
The ruling on the penalty amount (reduction/suppression) is linked to the concept of 'gêne' (hardship), which is regulated by this article.
A/2982/2019 · ge (art. 5 al. 2 LAMal)
Insurer's Failure to Warn on Retroactive Health Insurance Deadline
This article was cited in the reasoning when discussing that the excusable nature of the delay only affects the premium surcharge, not the start date of coverage, although the final order ultimately grants retroactive effect based on Art. 9 Cst.
KV.2019.00083 · zh (Art. 5 Abs. 2 KVG)
Insurance Obligation Start Date Based on Excusable Reliance on Official Assurances
The court modifies the decision regarding the start date of insurance and implicitly confirms the condition for applying a premium surcharge mentioned in this article by ruling that no surcharge applies.