Ordinance on Premium Reductions in Compulsory Health Insurance (Premium Reduction Ordinance, PVV) (Prämienverbilligungsverordnung, PVV) - Scope (PVV)

1. This regulation governs the implementation of premium reductions for mandatory health care insurance in accordance with the Introductory Act of March 25, 1996, to the Federal Health Insurance Act (EG KVG).

1. The Compensation Office Basel-Landschaft (abbreviated: Compensation Office) is entrusted with the execution of the premium reduction.

2. The canton reimburses the Compensation Office for the expenses incurred in the execution of the premium reduction.

1. The premium reduction is determined based on the tax assessment. In special cases, it is determined during the application procedure.

1. The premium reduction is calculated and paid based on the final tax assessment.

2. If the legally binding assessment deviates from the final assessment that served as the basis for calculating the premium reduction, the insured person may apply for an adjustment of the premium reduction in writing within one year from the date the assessment becomes legally binding.

1. Social welfare authorities are entitled to perform all legal actions for claiming premium reductions on behalf of the persons they support.

2. Social welfare authorities report to the compensation office the beginning and end of the dependency on social welfare of persons receiving social assistance.

3. The compensation office reports to the relevant social welfare authority the beginning and end of the entitlement to premium reductions of persons receiving social assistance, as well as the amount of the entitlement and any changes to its amount.

4. The notifications according to paragraphs 2 and 3 shall be made with the indication of the social security number.

1. The standard premium amounts to

a. * CHF 383 per month for adults;

b. * CHF 318 per month for young adults;

c. * CHF 164 per month for children.

1bis

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1ter

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2. In the event of changes to the standard premiums, the Government Council shall inform the competent commission of the Cantonal Parliament.

1. The disbursement of the premium reduction to the health insurer occurs periodically.

2. There is no minimum amount required for the disbursement of the premium reduction or for its reimbursement.

1. Persons receiving premium reductions must immediately and in writing notify the compensation fund of

a. * Changes of address,

b. * Departure abroad,

c. * Termination of their mandatory health care insurance.

2. ...

3. The relatives of a deceased person who received premium reductions and formed a calculation unit must immediately and in writing notify the compensation fund of the death.

1. Upon relocation to another canton, the entitlement to premium reduction ends at the end of the current year.

1. The Procedure Based on Tax Assessment Applies to the Following Persons

a. * Individuals starting from January 1st after reaching the age of 25, who meet the requirements for a premium reduction based on the final tax assessment from two years prior;

b. * Young adults from January 1st after reaching the age of 18 until December 31st after reaching the age of 25, for whom no educational allowance is granted under the Federal Act on Family Allowances, who are married or in a registered partnership, or who are granted a child deduction for state tax purposes, and who meet the requirements for a premium reduction based on the final tax assessment from two years prior.

c. * ...

2. For persons who reached the age of majority in the previous year, contrary to paragraph 1 letter b, the final tax assessment of the previous year is decisive.

1. The compensation fund typically sends an application form ex officio to persons pursuant to § 9.

1bis. If the application form cannot be delivered ex officio, the eligible person may submit a written request by the end of the entitlement year.

2. The application form includes the calculation of the premium reduction.

3. Persons who wish to claim the premium reduction shall complete the application form with the required information, sign it, and submit it within 1 year from the delivery by the compensation fund.

4. Persons living in an unseparated marriage or an unseparated registered partnership shall sign the application jointly.

1. The application procedure for premium reduction applies to the groups of persons as outlined in §§ 13-18c.

1. Individuals who move from abroad to the country may submit a written application for premium reduction to the compensation fund by December 31 of the year following the year of relocation.

2. The relevant annual income for the entitlement year and the calculation unit are determined according to the tax assessment of the former canton of residence applied to § 9 of the Implementing Act to the Health Insurance Act (EG KVG).

3. ...

4. The calculation and payment of the premium reduction are carried out according to § 3a.

1. Individuals who move from abroad and are not subject to withholding tax may submit a written application for premium reduction to the compensation fund by December 31 of the year following the year of arrival.

2. The relevant annual income within the meaning of [§ 9 Para. 1 EG KVG](https://bl.clex.ch/data/362/de/art9) is determined for the entitlement year based on the final tax assessment for the previous year and is extrapolated to a full year.

3. The calculation unit is determined analogously to [§ 9 Para. 4 EG KVG](https://bl.clex.ch/data/362/de/art9), but based on the circumstances of the previous year.

4. The calculation and disbursement of the premium reduction are carried out in accordance with § 3a.

1. Young adults from January 1 following the completion of their 18th year until December 31 following the completion of their 25th year, who do not fall under § 9 Abs. 1 Bst. b at the time of dispatch of the application forms, can submit a written application for premium reduction to the compensation fund by December 31 of the year in question.

1bis. If the application form is sent to the eligible person ex officio, the application can be submitted within 1 year from the receipt of the form.

2. The relevant annual income is determined based on the tax assessment of the year preceding the last. For individuals who reached the age of majority in the previous year, the tax assessment of the previous year is applicable. For individuals who reached the age of majority in the previous year and are subject to withholding tax, 70% of the gross income from the previous year is applicable.

1. For individuals submitting an application pursuant to § 14a, the determination of entitlement is based on the relevant annual income of the parents as follows

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| a. **\*** | The relevant annual income of parents residing in the canton is based on the tax assessment of the year before last. This is obtained ex officio. For persons subject to withholding tax, § 18c para. 4 applies accordingly. | | |

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| --- | --- | --- | --- |

| b. **\*** | The relevant annual income of parents residing in another canton is based on the tax assessment applied under [§ 9 EG KVG](https://bl.clex.ch/data/362/de/art9) of the residence canton of the year before last. This must be submitted with the application. For persons subject to withholding tax, § 18c para. 4 applies accordingly. | | |

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| --- | --- | --- | --- |

| c. | The relevant annual income of parents residing abroad is not considered. | | |

2. If the parents of the applicant are taxed separately, the relevant annual income is determined individually for each parent according to para. 1.

3. The income and asset circumstances of all persons who form a calculation unit together with the parents or with one parent are included in the calculation of the relevant annual income of the parents.

4. A calculation unit includes the parents of the applicant, provided they are living in an undivided marriage, or in other cases, each parent individually as well as those persons who are recorded with them or him as tax subjects through the tax assessment.

1. Individuals who submit an application under § 14a are entitled to premium reduction if the relevant annual income of their parents, as determined under § 14b, is not more than 2.75 times greater than the maximum limit of the relevant annual income of the respective calculation unit, as stipulated by the decree of September 21, 2006, regarding income limits and the percentage in premium reduction. Paragraph 1bis remains reserved.

1bis. For calculation units without minor children, the income limit according to paragraph 1 is increased by a flat-rate maintenance supplement for young adult persons for whom the parents receive an education allowance under the Federal Act of March 24, 2006, on Family Allowances. The maintenance supplement amounts to

a. for one young adult person: CHF 21,000;

b. for 2 young adult persons: CHF 37,000;

c. for each additional young adult person: an additional CHF 11,000.

2. If the parents of the applicant do not live together in an unseparated marriage, they are entitled to a premium reduction if the relevant annual income of each parent individually does not exceed the limit according to paragraph 1 or paragraph 1bis. If both parents are entitled to a maintenance supplement according to paragraph 1bis, it is attributed to the parent with the higher relevant annual income.

1. Persons residing in a member state of the European Community who are entitled to premium reductions under Swiss federal law may submit a written application for premium reduction to the compensation office by December 31 of the entitlement year, provided that the relevant point for compulsory health insurance is located in the canton of Basel-Landschaft.

2. They are entitled to a premium reduction for the first time in the calendar year following the commencement of health insurance.

3. The entitlement ceases during the year at the time when the insured person's health insurance obligation in Switzerland ends.

4. The relevant annual income for the entitlement year corresponds to 80% of the gross income of the preceding year, adjusted to the purchasing power of the country of residence. In the first entitlement year, the gross income earned in the year of commencement of health insurance is annualized.

1. Individuals who claim a right to premium reduction due to other reasons may submit an application for premium reduction to the compensation fund. The application must be submitted in writing by December 31st of the entitlement year.

2. The relevant annual income as per § 9 para. 1 EG KVG is determined for the entitlement year based on the legally binding tax assessment for the previous year.

3. The calculation unit is determined analogously to § 9 para. 4 EG KVG, but based on the conditions of the previous year.

4. The disbursement of the premium reduction is suspended until legally binding tax data is available.

1. Persons whose relevant annual income or calculation unit changed in the previous year may submit an application for premium reduction adjustment.

1bis. Persons whose relevant annual income or calculation unit have changed, as well as young adults who have started or completed an education, may submit an application for premium reduction adjustment.

2. The application must be submitted in writing to the compensation fund by December 31 of the entitlement year.

3. The relevant annual income as defined in § 9 para. 1 of the Cantonal Health Insurance Act is determined for the entitlement year based on the legally binding tax assessment for the previous year.

3bis. For persons subject to withholding tax, the relevant annual income for the entitlement year is determined based on the relevant gross income of the previous year.

4. The calculation unit is determined analogously to § 9 para. 4 of the Cantonal Health Insurance Act, but based on the conditions of the previous year.

4bis. Newborn children are taken into account from the beginning of the month of birth.

5. The calculation and disbursement of the premium reduction are carried out according to § 3a.

1. Persons who are registered in the withholding tax register will receive an application or request form from the compensation office ex officio.

1bis. Persons who wish to claim premium reductions must complete the application or request form with the required information, sign it, and submit it to the compensation office within 1 year of receipt.

2. Persons who are not registered in the withholding tax register or have not received an application or request form under paragraph 1, and who reside or stay in the canton, can submit a written application for premium reduction to the compensation office by December 31 of the entitlement year.

3. They are entitled to premium reductions for the first time in the calendar year following the year of relocation.

4. The relevant annual income for the entitlement year corresponds to 70% of the gross income of the year before last. In the first year of entitlement, the gross income achieved in the year of relocation will be annualized.

5. The calculation unit is determined analogously to § 9 paragraph 4 of the EG KVG.

6. Persons who have been legally married since at least the year before last of the reference year are combined into a calculation unit.

7. For persons who reached the age of majority in the year before the reference year, the relevant annual income and calculation unit are based on the circumstances of the previous year.

1. Objection may be raised against

a. the calculation of premium reduction on the application form,

b. the full or partial rejection of premium reduction,

c. repayment orders,

d. the full or partial rejection of requests for waiver of repayment,

e. * the deferral of premium reduction.

2. The objection must be submitted in writing and with justification to the compensation office within 30 days of delivery of the application form or the decision.

3. The objection procedure is free of party compensation and cost-free. Furthermore, the Administrative Procedure Act applies to the procedure.

1. The following are repealed

a. The Ordinance of October 3, 1995, on the implementation of the premium reduction in health insurance (Ordinance I on Premium Reduction),

b. The Ordinance of October 3, 1995, on the responsibilities in the implementation of the premium reduction in health insurance (Ordinance II on Premium Reduction),

c. The Ordinance of September 24, 1996, on the payment default of health insurance policyholders,

d. The Ordinance of November 7, 2000, on the standard premium for the premium reduction in health care insurance,

e. The Ordinance of October 17, 2000, on the premium reduction in health insurance for the year 2002,

f. The government council resolution No. 1634 of October 16, 2001, on the adjustment of health insurance premium reduction for 2002.

1. This regulation shall enter into force on January 1, 2003.