832.102
KVVOAMAL
CH
CH
Art. 95 Verordnung vom 27. Juni 1995 über die Krankenversicherung (KVV) - c. Prämien
KVV; 1. Teil: Obligatorische Krankenpflegeversicherung; 5. Titel: Finanzierung; 2. Kapitel: Prämien der Versicherten
Art. 95 KVV · c. Prämien
Die Prämien für die Versicherung mit wählbaren Franchisen müssen von denjenigen der ordentlichen Versicherung ausgehen. Die Versicherer haben dafür zu sorgen, dass die Versicherten beider Versicherungsformen im versicherungstechnisch erforderlichen Masse an die Reserven und an den Risikoausgleich beitragen.
Die Versicherer legen den Betrag, um den sie eine Prämie herabsetzen, aufgrund versicherungsmässiger Erfordernisse fest. Sie halten die in Absatz 2 bis und Artikel 90 c vorgeschriebenen maximalen Prämienreduktionen ein.
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Die Prämienreduktion je Kalenderjahr darf nicht höher sein als 70 Prozent des von den Versicherten mit der Wahl der höheren Franchise übernommenen Risikos, sich an den Kosten zu beteiligen.
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Gerichtsentscheide zu dieser Bestimmung (11)
36.2004.3 · ti (Art. 95 OAMal)
Insured v. Health Insurer Regarding Deductible Application for Hospitalization
Cited in the appeal filing and in the reasoning regarding the actuarial principles for setting premiums with optional deductibles, which the court references when upholding the carrier's calculation.
36.2004.3 · ti (Art. 95 cpv. 1 OAMal)
Insured v. Health Insurer Regarding Deductible Application for Hospitalization
Cited in the reasoning concerning the basis for setting premiums for optional deductibles, which the court references when upholding the carrier's calculation.
36.2004.3 · ti (Art. 95 cpv. 1 bis OAMal)
Insured v. Health Insurer Regarding Deductible Application for Hospitalization
Cited in the reasoning concerning the amount of premium reduction based on actuarial needs, but not explicitly used in the dispositive orders.
36.2004.3 · ti (Art. 95 cpv. 2 OAMal)
Insured v. Health Insurer Regarding Deductible Application for Hospitalization
Cited in the reasoning concerning the actuarial principles for setting premiums, which the court references when upholding the carrier's calculation.
36.2002.106 · ti (art. 93 - 95 OAMal)
Insured's Appeal Against Health Insurance Premium Recovery and Cost-Sharing Amounts
Cited to define the optional deductible insurance scheme chosen by the appellant.
36.2002.106 · ti (art. 95 cpv. 2 lett. d OAMal)
Insured's Appeal Against Health Insurance Premium Recovery and Cost-Sharing Amounts
Cited to determine the maximum premium reduction allowed for optional deductibles.
TA.1998.72 · ne (art.93 et 95 OAMal)
Sibling Early Termination Rights Following Legislative Premium Increase
These articles were cited in the reasoning to explain the basis for optional deductibles and the reduction rate, which led to the premium change, although not directly in the operative part of the final order.
TA.1998.72 · ne (art.95 al.2 litt.b OAMal)
Sibling Early Termination Rights Following Legislative Premium Increase
This article regarding the reduction rate set by the Federal Council was cited in the reasoning, but not in the operative part.
36.2001.93 · ti (Art. 95 cpv. 2 lett. d OAMal)
Insured Subject vs. Health Insurer on Annual Deductible Application Across Calendar Years for Single Accident Treatment
Cited to confirm the 40% premium reduction corresponding to the CHF 1'500.- maximum optional franchigia.
36.2002.106 · ti (Art. 95 cpv. 2 lett. d OAMal)
Insured Person v. Health Insurer on Arrears Calculation and Time-Barred Cost-Sharing
Cited in the reasoning to explain the maximum premium reduction for optional deductibles, relevant to confirming the correct premium calculation.
36.2004.3 · ti (art. 95 OAMal)
Insured v. Health Insurer: Application of Optional Deductible to Accident Claim
Cited in the reasoning to support the method of premium reduction applied by the insurer for optional deductibles, which the final decision found compliant.