Common Institution KVG (Gemeinsame Einrichtung KVG)

What is the Common Institution KVG?

The Common Institution under the Federal Health Insurance Act, known in German as Gemeinsame Einrichtung KVG, is a foundation run jointly by all health insurers. The Health Insurance Act (KVG) obliges the insurers to set it up; its deed of foundation and regulations must be approved by the Federal Department of Home Affairs (FDHA) (Art. 18 para. 1 KVG). If the insurers failed to meet this obligation, the Federal Council would set up the institution itself.

The Common Institution is not a health insurer. You cannot take out basic health insurance with it, and you do not pay it a premium. It handles tasks that go beyond a single insurer: balancing costs between the insurers, protection against insolvency, and cooperation with foreign social insurance institutions. It is based at Industriestrasse 78, 4600 Olten.

In everyday life you will rarely deal with it, and if you do, it is usually because of a link to another country: as a foreign visitor who needs to see a doctor in Switzerland, as a pensioner living in an EU state, or as a cross-border commuter applying for a premium subsidy.

How it works

The tasks are listed exhaustively in the law. The most important ones:

Risk equalisation

Insurers must accept everyone, without health questions. So that no insurer gains an advantage simply because most of its policyholders are young and healthy, there is risk equalisation. The Common Institution carries it out between the insurers within each canton (Art. 17a para. 1 KVG). Insurers with fewer insured persons at higher risk of illness than the average pay risk levies; insurers with an above-average share receive equalisation payments (Art. 16 paras. 1 and 2 KVG). The indicators are age, sex, a stay in a hospital or nursing home, and pharmaceutical cost groups (Art. 1 VORA). Children under 19 are excluded from risk equalisation (Art. 16 para. 5 KVG).

Insolvency fund

If an insurer becomes insolvent, the Common Institution covers the cost of the statutory benefits (Art. 18 para. 2 KVG). For this purpose it manages an insolvency fund (Art. 47 KVAG). The Federal Office of Public Health (FOPH) formally establishes the insolvency and sets the date from which the fund must pay (Art. 50 KVAG). The fund covers what the insolvent insurer cannot pay: basic health insurance benefits, voluntary daily allowance insurance under the KVG, contributions to risk equalisation and the related administrative costs (Art. 51 para. 1 KVAG). Supplementary insurance under the Insurance Contract Act (ICA, VVG in German) is not included.

International benefits assistance

Anyone with statutory health insurance in an EU or EFTA state or in the United Kingdom who needs treatment in Switzerland receives benefits under Swiss law. The Common Institution is the assisting institution for this and the liaison body with the foreign insurers (Art. 19 para. 1 KVV). Entitlement to benefits, tariffs and co-payment are governed by the KVG. In the other direction, it calculates the cost rates that Swiss insurers use to set premiums for insured persons resident in the EU (Art. 19 para. 2 KVV).

Insured persons resident in the EU, EFTA or the United Kingdom

The Common Institution decides on applications from pensioners and their family members living in these states who want to be exempted from compulsory Swiss health insurance (Art. 18 para. 2bis KVG). Anyone who does not take out insurance in time is assigned to an insurer by the Common Institution (para. 2ter). It supports the cantons with premium subsidies for insured persons in these states (para. 2quater) and itself administers the federal premium subsidy for certain insured persons living there (para. 2quinquies, Art. 66a KVG).

Other tasks

The cantons can delegate further implementation tasks to it in return for compensation (para. 2sexies). It manages the follow-up care fund for living donors under the Transplantation Act (para. 2septies). The Federal Council can assign further tasks to it, in particular to fulfil international obligations, and the insurers can entrust it with joint administrative and technical tasks (paras. 3 and 4).

Legal basis

• Art. 18 KVG: establishment as a foundation by the insurers, approval by the FDHA, tasks under paras. 2 to 4, and financing: the insurers pay for the tasks under paras. 2 and 4 out of social health insurance funds (para. 5); the Confederation pays for the tasks for insured persons in the EU, EFTA and the United Kingdom under paras. 2bis to 2quinquies (para. 5bis).
• Art. 16 and 17a KVG, VORA: risk equalisation within the cantons, carried out by the Common Institution.
• Art. 47–51 KVAG: insolvency fund, its financing, the FOPH’s formal finding of insolvency and the scope of the benefits covered.
• Art. 19 KVV: tasks as liaison body and assisting institution in international relations.
• Art. 103 para. 6 KVV: flat rate for the deductible and retention fee in international benefits assistance.

The Common Institution is supervised by the FOPH; it submits its reports to the FOPH and appoints an external auditor (Art. 45 and 46 KVAG).

Example: holiday accident for a family from Germany

Anna, 40, and her son Ben, 8, have statutory health insurance in Germany and spend their holidays in the canton of Graubünden in July 2026. Both need medical help during their stay: Anna because of a strained muscle, Ben because of a middle ear infection. At the practice they show their European Health Insurance Card, the EHIC.

For people insured in Switzerland, the reverse applies: if you have Swiss basic health insurance and receive treatment in an EU state, the EHIC entitles you to benefits under the law of the country you are staying in. Billing is handled through your own insurer.

What this means for you

1. Usually no direct role. If you live and work in Switzerland without any link to another country, you will hardly ever have contact with the Common Institution. Your point of contact is your insurer; you will find an overview of all insurers under health insurers.
2. Protection if an insurer becomes insolvent. An insurer going bankrupt does not put your basic health insurance benefits at risk. Even so, it is worth looking at reserves and solvency when you choose; the insurer profiles show the key figures for each insurer.
3. Pensioners abroad. If you move to an EU state with a Swiss pension, check early whether you remain insured in Switzerland or can be exempted. The Common Institution is responsible for the exemption.
4. Visitors from Europe. Visitors from the EU should bring their EHIC. Without the card, the practice may have to bill them directly.
5. Premiums remain a matter for your insurer. The Common Institution does not set premiums. You can compare your premium in the premium calculator.

Common mistakes

• Taking the Common Institution for a single health insurance fund. It is not an insurer and does not accept policyholders. Basic health insurance stays with the individual insurers.
• Assuming that treatment is not paid if an insurer goes bankrupt. The insolvency fund steps in for the statutory benefits. Supplementary insurance under the ICA is not covered.
• Contacting it about your own premium or bill. Your insurer is responsible for that. If you are in a dispute with your insurer, the Office of the health insurance ombudsperson can help.
• Missing the deadline for exemption. Pensioners in an EU state who neither take out insurance nor apply for exemption are assigned to an insurer by the Common Institution.
• Confusing the flat rate with the Swiss deductible. The flat rates of CHF 92 and CHF 33 apply only to people with foreign insurance who receive benefits assistance in Switzerland.

How premium subsidies work in your canton is explained on the page premium subsidies.