Health insurance for border-area workers in Switzerland living in France:

Signing of a new France-Switzerland Agreement

On 8 July 2019, an agreement was signed between Federal Councillor Alain Berset, Head of Social Security and Health, and Marisol Touraine, French Minister of Social Affairs and Health, regarding border-region health insurance.
This new agreement allows people who do not have a formal exemption from Swiss health insurance to file an application. It also avoids simultaneous affiliation to health insurance policies in both countries.

What obligations do border workers have?

All people who have not used their formal option right must necessarily correct this situation between 01/10/2016 and 30/09/2017.

A new right of option for those who have not formally exercised this right

• A border-area resident currently affiliated with the CMU will have the right to exercise a new right of option and, as such, return to the Swiss health system under the Federal Health Insurance Act.
• However, a border-area resident currently affiliated with the CMU, who wishes to remain within the French health system will be obligated to exercise his/her right of option not to be automatically affiliated with the Federal Health Insurance Act as of 1  October 2017.
• A double-insured border-area resident (in Switzerland and France) who has not exercised his/her formal right of option has the opportunity to do so again. He/she may either be removed from the CMU or terminate his/her the insurance under the Federal Health Insurance Act.

Procedures

Example 1: The border-area resident in question did not exercise his/her formal right of option

This person must exercise his/her formal right of option between 10/01/2016 and 09/30/2017 with the revised "Choice of applicable health insurance system" form.
This simplified form is not yet available, SRC will inform you when it is available (please do not use the old form!)

The steps are carried out with the health insurance of the Canton where your workplace is located:

Geneva
Health Insurance Department, Route de Frontenex 62, 1207 Genève
022 546 19 00 - sam@etat.ge.ch - www.ge.ch/sam

Vaud
Vaud Office of Health Insurance, Ch. de Mornex 40, 1014 Lausanne
021 557 47 47 - info.ovam@vd.ch - www.vd.ch

Example 2: The border-area resident is double-insured in France and Switzerland

• To be insured in Switzerland:

He/she must ask the insurer under the Federal Health Insurance Act for an E106 form or S1 certificate and send it by registered post to the insurer in France (CPAM, or local sickness insurance fund, of place of residence) to be removed from the CMU.

• To be insured in France:

He/she must exercise the formal right of option to be exempted from insurance under the Federal Health Insurance Act.

Qualibroker-Swiss Risk & Care keeps you informed

Qualibroker-Swiss Risk & Care advisers will make sure to inform you of any new decisions made on this topic (including the population in question), and of course, should you require further information, please do not hesitate to contact us. We will be more than happy to assist you!

Helpful information

• The right of option will take effect between 01/10/2016 and 30/09/2017.

• Border-area residents who have not formally indicated their choice must necessarily formally exercise their right of option to be exempt from insurance under the Federal Health Insurance Act.

• IMPORTANT: If in doubt, contact the Health Insurance Service of the Canton where your workplace is located to request confirmation of the chosen option.

• Only the new right of option allows for the exemption from the Swiss health insurance as of 1 October 2017.

• The right of option is an exemption from the Swiss health insurance. Without this exemption, affiliation with the insurance under the Federal Health Insurance Act will be automatic on 10/01/2017. This may have a negative economic impact for people with small or medium incomes, or those who are married with dependent children.