2. Family members, who do not enjoy privileges and immunities, of staff members of the international organisations (applications for exemption)
These provisions do not apply to family members of staff members of the permanent missions.
Family members, who do not benefit from privileges and immunities, may apply for exemption from the obligation to take out Swiss health insurance if they are covered by the health insurance of the IO to which the principal beneficiary (the staff member) belongs to providing their health insurance cover is equivalent for treatments in Switzerland (cf. Article 6 Paragraph 4 OAMal amended on 1.1.2018).
The following family members of staff members of the IO (holders of an FDFA legitimation card of type “B”, “C”, “D”, “E”, “L”, “P” or “S”) are concerned:
Spouses and children who are Swiss nationals or hold a permit and live in Switzerland (who do not have an FDFA legitimation card);
Spouses and children who are Swiss or Community nationals, live in an EU/EFTA member State and work in Switzerland (with a G permit for non-Swiss cross-border commuters) (who do not have an FDFA legitimation card);
Spouses (i.e. those not recognised as dependent in the Staff Regulations of the IO), children (unmarried, over 25), relatives in ascending line or other family members who have been admitted to Switzerland for family reunification and hold an FDFA legitimation card of type “H” (cf. section 2.6 – other family members - of the Guidelines for the IO).
These persons are required to present a written request for exemption to the competent cantonal authority (health insurance Service of the canton of residence or the canton of work for the cross-border commuters). The request must be accompanied by a written attestation from the health insurance of the IO that provides all the necessary information (cover offered for treatments in Switzerland). They have three months (imperative deadline) in which to present a written request for exemption; the period beginning as of the date of affiliation to the health insurance of the IO. Once this period has passed, the person will no longer be exempted.
The persons who were already affiliated to the health insurance of the IO before the entry into force of the amended ordinance have three months (imperative deadline) as of 1 January 2018 to present a written request for exemption. Once this period has passed, the person will no longer be exempted.
Persons who are granted exemption from health insurance must, if necessary, terminate in writing their insurance policy (basic coverage according to LAMal). They must enclose with the letter of termination a copy of the decision on exemption issued by the competent cantonal authority. The health insurance policy will be terminated as of the date on which the person is exempted. Persons who have concluded a private supplementary health insurance policy will only be able to terminate this cover in accordance with the procedures set out in the general conditions of insurance.
In accordance with OAMal, persons who have been granted exemption will no longer be able to reconsider their exemption nor their decision to renounce exemption. This means that as long as they remain affiliated to the health insurance of the IO, they will not be able to ask to be insured by a Swiss health insurer. If the health insurance of the IO terminates the policy because the conditions allowing the person to be insured are no longer met, the person must inform in writing the competent cantonal authority in order to be able to be covered by a Swiss health insurer. If the person is affiliated to the health insurance of another IO (for example, because the principal beneficiary is hired by another IO), they must inform in writing the competent cantonal authority and present a new request for exemption.
If the person is hired as staff member by an IO, their status will change and they will enjoy privileges and immunities. Their situation is then governed by Article 6 paragraph 1 OAMal. The person must inform in writing the cantonal authority that granted them exemption when they were affiliated as a member of family.