No employer health plan: how Swiss cover works

Switzerland has no state health service and no employer health plan in the American sense. Instead, the Health Insurance Act (KVG in German, LAMal in French) makes basic health insurance compulsory, and each person buys it from a health insurance fund recognised by the Federal Office of Public Health (FOPH). For basic cover those funds are non-profit, and only recognised funds may sell it.

Basic insurance is the same across the country. Every fund offers an identical set of benefits and must accept every applicant, with no health questionnaire, no conditions and no waiting period. What differs is the premium, which varies by insurer, canton and premium region and is lower for children and young adults.

The policy belongs to the individual. Each member of a family, adult or child, is insured separately, and the premium is charged per person rather than as a share of income. Nothing in the official guidance requires the employer to buy or pay for it. People on low incomes can apply for cantonal premium subsidies.

Three months to sign up after moving

Everyone who takes up residence in Switzerland must take out basic insurance within three months, whatever their nationality, and the same deadline runs from a child’s birth. A hire who signs up inside that window gets cover backdated to the day residence began, and owes premiums from that day as well.

Sign up late and cover starts only on that date, and a late surcharge is added unless the delay was justified. Someone who never signs up is assigned to an insurer by the canton’s designated authority.

Basic insurance also carries cost-sharing in the form of a yearly deductible and a co-payment share. Employees can lower their premium by choosing a higher deductible or a managed-care model. Hospital treatment is on the general ward of a hospital on the canton’s list.

Where the Swiss employer does carry insurance

The employer’s insurance duty in Switzerland is accident cover. Under the Accident Insurance Act (UVG, or LAA in French), everyone employed in Switzerland is insured against occupational accidents and occupational diseases, and the employer arranges that cover. The occupational accident premium is the employer’s to pay.

An employee who works at least 8 hours a week for one employer is also covered for accidents away from work through that employer, and can ask the health insurer to drop accident cover from the basic policy. That non-work accident premium is normally deducted from pay. Below 8 hours a week, accident cover stays inside the employee’s health policy.

Payroll carries social insurance too. Old-age, disability and income-compensation contributions (AHV, IV and EO) and unemployment insurance are shared between employer and employee. Some employers also put money toward staff health premiums as a perk; how that is treated for tax and social contributions is a point to settle with a local adviser or tax professional before you offer it.

Can an international plan replace Swiss basic insurance?

Usually not. A foreign or international policy does not automatically take the place of Swiss compulsory insurance. The FOPH lists the cases where exemption is possible, among them certain posted workers, students, diplomats and people who work in an EU or EFTA state or the UK. Some of those exemptions are granted only on request and only where equivalent cover valid in Switzerland is in place, and the cantonal authority makes the decision.

A person who simply lives in Switzerland and works remotely for a US company does not appear among those groups. For that employee, plan on the international plan sitting on top of basic insurance rather than replacing it, and leave any exemption question to the canton if the employee’s situation is unusual.

Supplementary insurance: the extras outside basic cover

Switzerland has a second, optional layer. Supplementary insurance is sold under the Insurance Contract Act and adds comfort or extra services, such as a semi-private or private hospital ward, some complementary therapies and routine dental care.

Unlike basic insurance, supplementary premiums are risk-based, and the insurer may turn an applicant down or attach conditions because of their health. For an employer, this voluntary layer, together with an international top-up, is where a benefit can add something the compulsory policy leaves out.

Hiring a Swiss resident: why the employer must be Swiss

Switzerland restricts how workers can be supplied. The State Secretariat for Economic Affairs (SECO) states that neither direct nor indirect staff leasing into Switzerland from abroad is permitted. A foreign-based employer of record therefore cannot lease a worker into the country; it has to work through a Swiss-registered staffing company with the cantonal licence (and the federal one where required).

In practice, a US company employs a Swiss resident either through its own Swiss entity or through a Swiss-licensed EOR or staffing provider. That employer handles payroll social insurance and UVG accident cover, while the employee still buys their own basic health insurance under every setup. Our guide to coverage for EOR staff and contractors abroad sets out the general differences between arrangements.

Sending an existing US employee to Switzerland for a while is a different case, called a posting. Postings of up to 90 days a year need only a notification through EasyGov.swiss, and longer ones need a permit.

Asking us for an introduction

Mithril1 does not sell or advise on health plans. What we can do is introduce you to a benefits partner that handles international and remote-team health coverage. Who qualifies, which plans are available and what they cost are decisions for the partner and the insurer.

Use the quote form on this page: note that your team member lives in Switzerland, say how many people you employ there and whether family members would be covered, and we will forward it to the partner. Hiring in neighbouring countries as well? See our pages on Germany, France and Italy, the international health insurance overview or the employee benefits hub.

A few useful answers

Common questions

Does a Swiss employer provide health insurance?

Not basic health cover. Each resident buys their own basic policy from an FOPH-recognised fund. The employer’s insurance duty is accident cover under the UVG, alongside shared social insurance contributions.

How long does a new Swiss resident have to get health insurance?

Three months from taking up residence. Signing up in time backdates cover to the start of residence; signing up late means cover starts later and a surcharge may apply.

Can a US company's international plan replace Swiss basic insurance?

Not for an ordinary resident employee. Exemptions exist only for listed groups and the cantonal authority decides them, so expect the international plan to work as a top-up.

Can we hire in Switzerland through a foreign employer of record?

SECO states that staff leasing into Switzerland from abroad is not permitted. So a Swiss resident is employed through your own Swiss entity or a Swiss-licensed EOR or staffing provider.

Can Mithril1 arrange health cover for our Swiss employee?

We don’t sell health plans. Once you send your team’s details through the quote form, we can introduce you to a benefits partner, and eligibility, plan choice and cost rest with that partner and the insurer.

International Health Insurance for Remote Employees in Switzerland