Equality ends with additional insurance

Equality ends with additional insurance

When I first heard about it, I had to swallow hard at first. Then I dug out my documents, did some research, and found out more: women pay higher premiums than men for many coverages. For the annual health insurance change due at the end of November, I’ll explain why this is and what you can do about it.

Let’s do a thought experiment and imagine the following: Susi and Fritz have just finished high school and decided to study at the University of Basel. They move from their parents’ house to the city and meet in the apartment sharing community in Kleinbasel. For the first time, they have their own room, do their laundry and fill the fridge when and how it suits them.

Unfortunately, along with the many advantages that come with being independent, they also have to contend with the less exciting aspects of adult life. Learn how to pay bills, fill out tax returns and take out insurance. At the kitchen table, they discuss liability insurance and premium discounts, exchange insurance advice and together decide to take out additional insurance at the end of November.

They calculate their budget, study different models and consider services until they finally decide on a suitable offer. So far so good. At least until the two of them fish their bills out of the mailbox for the first time and are dismayed to discover that Susi is paying significantly higher premiums than Fritz for the same services.

Susie and Fritz* take out additional insurance with Vivao Sympany this year, Susi would pay CHF 16.60 more per month than Fritz, with EasySana the difference would be 9.40 and with ÖKK 8.80, to name just a few examples. If you imagine the two not 19 years old, but 5 years older, the difference would be even more obvious. In this case, Susi would pay approximately CHF 50 more per month in premiums for the same additional insurance with Vivao Sympany.* When asked by Sympany, she explained the difference as follows:

“Sympany determines the amount of premium for additional insurance based on risk and on the basis of clearly defined criteria. In addition to age and place of residence, this also includes the gender of the insured. Among other things, this is due to the fact that women statistically receive more benefits (keywords: maternity, longer life expectancy) and these higher benefit costs must be covered by higher insurance premiums.

Legal situation

From a legal point of view, health insurance companies have the option of tying the amount of premiums for supplementary insurance to the gender of the insured. This is prohibited with basic insurance. According to “Federal Health Insurance Act (KVG)” the amount of premium for basic insurance can only be affected by factors of age and region. Article 61 stipulates that all sexes pay the same premium for basic insurance (KVG).

Why is it handled differently in supplementary insurance (VVG), I asked myself, and in search of answers I contacted Dr. Nils Rüfenacht turned. Lecturer for Actuarial mathematics at the department of mathematics and informatics, he is giving a lecture on “health insurance” this semester, and he answered me as follows:

“Simply put, the reason why gender cannot be taken into account in tariff classification in basic insurance is that it is a social insurance system in which solidarity is deliberately applied, while supplementary insurance is private insurance.”

“Price for Risk”

Basic insurance is mandatory and guarantees basic medical care for everyone. In addition to basic insurance, there are additional insurances. They are voluntary and cover additional services that are not included in the basic insurance. These include, for example, dental treatment, non-medical psychotherapy, additional comfort in hospitals or alternative medicine.

Because the supplement is voluntary, it can refuse to accept people based on their medical condition. In addition, the premium for additional insurance may depend on the risk that a person poses to the health insurance company. Rüfenacht explains:

“In order for an insurance company to function, it must be able to identify and quantify risks. This is especially true if it is not social insurance with compulsory insurance. We are talking about risk-based tariffs here, while in basic insurance we tend to find socially fair tariffs.

Because women have higher costs on average and are therefore a greater risk to health insurance companies, they often pay higher premiums for additional insurance, especially hospital additional insurance. Childbirth and maternity are two factors that lead to higher costs, among others. Regardless of whether I can or want to have children, as a woman I pay higher insurance premiums while my male contemporaries, who are also able to reproduce, are classified as lower risk by health insurance companies.

Gender does not play a role in determining the price of additional insurance with all health insurance companies, as the above comparison of the premiums of Fritz and Susi showed. The premium was the same for some health insurance companies such as Swica, Sanitas and Concordia. When asked, he confirmed that “in Concordia, gender has no effect on additional insurance premiums.”

Unisex tariffs

If Susi and Fritz did not live in Switzerland, but in the European Union, they would not have to deal with these issues, since the European Union has had equality in health insurance since 2012. So called “unisex rule” states that “premiums and benefits for the same policy shall not differ from one person to another merely because they are not of the same sex”. Why is Switzerland lagging behind here? Nils Rüfenacht gives me the following assessment:

“As I recall, there was a huge uproar in the insurance industry when unisex tariffs were introduced in the EU and insurers in Switzerland were also afraid of it. Why it is not used or not yet used in Switzerland is a purely political question. The insurance company would probably never come up with this idea on its own. And if you’re wondering how long Switzerland had to wait for women’s suffrage or marriage for all, then you shouldn’t be too surprised…»

As long as Switzerland remains content with the status quo when it comes to gender equality, it is worth taking the time to choose a health insurance company, compare premiums, ask the insurer about gender equality and continue to pay close attention to the issue.

* These figures refer to the calculation on comparis.ch, with Susi and Fritz both born in 2002, living in Basel 4057 and the following services would be included in the supplementary insurance: hospital supplementary insurance (flexible), outpatient supplementary insurance (alternative medicine, emergency events abroad, prevention), as well as additional services medicines and aids, search and rescue operations and transport, psychotherapy, glasses and contact lenses, dental treatment and accident supplements.

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