Basic insurance is compulsory, and personal

The Dutch system rests on the Health Insurance Act, the Zorgverzekeringswet or Zvw. Under it, everyone who lives or works in the Netherlands must carry standard health insurance, known as the basisverzekering. Nobody receives it automatically from the state or through a job: each person chooses a private health insurer and buys the standard package from it.

Insurers cannot pick and choose for that package. They must accept anyone who applies, and they charge the same premium whatever the applicant’s age or health. No income level lets a person opt out.

Long-term care runs under a separate national scheme, the Wlz. Anyone insured under the Wlz also falls under the Zvw and needs a Dutch policy. The CAK enforces the duty to be insured, and a person who receives a letter from the CAK has three months to take out a policy before a fine follows.

What reaches the employer’s payroll

Because the employee buys and pays for the standard policy, a Dutch employer is not the one providing basic health insurance. The employer’s share arrives through payroll instead, as the income-related Zvw employer levy, the werkgeversheffing Zvw, charged on salary.

The Belastingdienst set that levy at 6.10% for 2026, down from 6.51% in 2025, and it applies only up to a yearly income maximum, which is EUR 79,409 for 2026. Both are 2026 figures and can change from year to year, so check the current figure before you build a hiring budget. People whose income does not come from employment, such as the self-employed and pensioners, pay a lower income-related contribution themselves, set at 4.85% for 2026.

Before any of this, an employer registers with the Tax Administration for payroll tax and social security purposes. Check withholding, the levy and the tax treatment of any health benefit you add with a local adviser before the first Dutch payslip goes out.

Four months to get insured after arrival

For a hire who moves to the Netherlands to take the role, timing matters. A newcomer must take out Dutch insurance as soon as possible and no later than four months after arriving. Taken out in time, the cover runs from the day of arrival. After the four months the policy is not backdated, and care received before it started is not reimbursed.

The newcomer also registers with their municipality, and that step does not wait for insurance: it can happen before a policy is in place.

Families follow the same pattern. Children under 18 must be insured but pay no premium for the standard package, and parents register a newborn with an insurer within four months of the birth.

A US employer and the SVB’s decision

The government names one exception to the rule that people coming to live or work in the Netherlands need a Dutch insurer: the case where the person’s employer is outside the Netherlands. Then home-country insurance can be enough under certain rules, and the Social Insurance Bank, the SVB, decides whether the person is insured under the Dutch schemes.

Whether a Netherlands resident hired locally by a US company falls inside or outside the Dutch schemes is settled case by case by the SVB, not by the employer. The SVB looks at where the employer is based and at social security agreements. It lists the United States as a treaty country for postings, though a posting is a temporary assignment of an existing employee, which is a different situation from hiring someone who already lives there.

Once the SVB treats your employee as insured in the Netherlands, the standard Dutch policy is required and a global plan can only sit on top of it. Raise the question with the SVB well before the start date, so the employee knows which rule applies to them.

Supplementary cover and global plans as a benefit

Supplementary insurance, the aanvullende verzekering, is the voluntary layer. It pays for care outside the standard package, such as physiotherapy or dental care, and it can come from a different insurer than the basic policy. Unlike the standard package, it is underwritten: an insurer can ask about health first or turn an applicant down.

That voluntary layer is where an employer has room to add something. You could contribute towards an employee’s supplementary cover, or fund an international plan that tops up the Dutch policy rather than replacing it. Either way, the basic policy stays in the employee’s name.

Hiring routes and who arranges cover

A US company with no establishment in the Netherlands can still have to withhold Dutch payroll taxes for staff who live or work there, and it registers with the Belastingdienst as an employer before hiring. From there, a US company has three broad routes: register as a non-resident employer, set up a Dutch entity, or use a registered payroll or employer of record (EOR) provider.

Foreign businesses that supply workers in the Netherlands, such as payroll companies and temporary agencies, must register with the Dutch Business Register, the KVK. If a supplier fails to pay payroll taxes, the Tax Administration can hold the business using the workers liable, so ask any provider for its KVK registration. Our page on health coverage for EOR staff and contractors abroad compares the arrangements.

Under every route, the employee still buys their own standard policy. What changes is who runs payroll and who could offer a supplementary or international benefit. A Dutch hire can also touch your US employment practices and cyber policies; read insurance changes for remote teams for those lines.

How to ask for an introduction

When you want to look at international cover that tops up the Dutch policy for a team member, we can introduce you to a benefits partner experienced in health coverage for people working abroad and for remote teams. Eligibility, plans and pricing are for the partner and the insurer to decide.

Start with the quote form on this page. Tell us how many people work for you in the Netherlands, whether partners or children would be included, and whether the SVB has already ruled on their status, and we will send it on to the partner. Hiring elsewhere in Europe too? See our pages for Germany and the UK, the overview of international health insurance for remote employees, or the employee benefits hub.

A few useful answers

Common questions

Does a Dutch employee buy their own basic health insurance?

Yes. Everyone who lives or works in the Netherlands buys the standard package from a private insurer, which must accept them and charge the same premium whatever their age or health.

What does the employer contribute towards Dutch health care?

The employer pays the income-related Zvw levy on salary: 6.10% in 2026, up to an income cap of EUR 79,409. Both are 2026 figures, so confirm the current ones with the Belastingdienst.

Is a Netherlands resident working for a US company insured under the Dutch scheme?

The SVB decides that case by case, looking at where the employer is based and at social security agreements. Once it treats the employee as insured in the Netherlands, the Dutch standard policy is required.

Where does a global health plan fit for a Dutch employee?

As a top-up. For anyone insured under the Dutch schemes, the standard policy stays compulsory, and an international plan adds to it.

International Health Insurance for Remote Employees in the Netherlands