832.102 KVVOAMAL

CH

Art. 4 Ordinanza del 27 giugno 1995 sull'assicurazione malattie (OAMal) - Lavoratori distaccati all’estero

OAMal; Parte prima: Assicurazione obbligatoria delle cure medico-sanitarie; Titolo 1: Obbligo d’assicurazione; Capitolo 1: Disposizioni generali

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Art. 4 OAMal · Lavoratori distaccati all’estero

Rimangono soggetti all’assicurazione obbligatoria in Svizzera i lavoratori distaccati all’estero, come pure i loro familiari ai sensi dell’articolo 3 capoverso 2 che l’accompagnano, se: a. erano assicurati d’obbligo in Svizzera immediatamente prima di essere distaccati all’estero e b. lavorano per conto di un datore di lavoro che ha il domicilio o la sede in Svizzera.

Per i familiari, l’obbligo d’assicurazione decade se esercitano all’estero un’attività lucrativa che implica l’assoggettamento a un’assicurazione malattie obbligatoria.

L’assicurazione obbligatoria si protrae per due anni. A domanda, l’assicuratore la protrae per sei anni in tutto.

Per le persone considerate distaccate all’estero ai sensi di una convenzione internazionale di sicurezza sociale, la protrazione dell’assicurazione corrisponde alla durata autorizzata da questa convenzione. La stessa regola è applicabile alle altre persone che, in base a siffatta convenzione, sono soggette alla legislazione svizzera durante un soggiorno temporaneo all’estero.

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Decisioni giudiziarie che applicano questa disposizione (12)

C-1405/2019 (Art. 4 Abs. 4 Ziff. 2 Bst. a KVV)

Hospital Denied Specialized Surgery Contract Due to Insufficient Case Volume

This provision was implicitly considered when discussing the criteria for quality assessment.

S 2021 17 · gr (Art. 4 Abs. 1 KVV)

Appeal Against Denial of Health Insurance Premium Reductions After Deregistration

The appeal was dismissed because the appellant could not be considered as a person seconded under this provision, thus lacking entitlement.

C-6920/2016 (Art. 4 Verordnung vom 27. Juni 1995 über die Krankenversicherung (KVV, SR 832.102))

Child Benefits for Stepchildren: Thai Domicile Over Swiss Address

Specifies exceptions regarding mandatory health insurance for posted workers.

KV.2016.00036 · zh (Art. 4 Abs. 1 KVV)

Swiss Health Insurance Obligation for Posted German National in UK

This provision was used to establish that the appellant remained subject to mandatory Swiss health insurance as an employee sent abroad by a Swiss employer.

KV.2016.00030 · zh (Art. 4 Abs. 1 lit. a KVV)

Insurer's Right to Terminate Mandatory Health Insurance Due to Lack of Residency

Cited in the reasoning for background law concerning posted workers, but not explicitly in the dispositive orders (1-4).

KV.2016.00030 · zh (Art. 4 Abs. 1 lit. b KVV)

Insurer's Right to Terminate Mandatory Health Insurance Due to Lack of Residency

Cited in the reasoning for background law concerning posted workers, but not explicitly in the dispositive orders (1-4).

36.2014.12 · ti (Art. 4 OAMal)

Insured Reliance on Insurer's Assurance V. Retroactive Cancellation of Health Insurance

This article was central to the dispute, as the court ruled it was incorrectly applied by the insurer, leading to the successful appeal.

36.2014.12 · ti (Art. 4 cpv. 1 OAMal)

Insured Reliance on Insurer's Assurance V. Retroactive Cancellation of Health Insurance

The court concluded this article was incorrectly applied by the insurer, as international agreements should have governed the case.

TVR.2005.Nr.32 · tg (§ 4 Abs. 2 TG KVV)

Social Assistance Obligation Regarding Health Insurance Premiums Post-Benefit Suspension

The court applied this article, noting the social assistance authority's option to cover either the outstanding premiums or the medical costs incurred during the suspension period.

36.2014.12 · ti (Art. 4 OAMal)

Insurer Liable for Incorrect Advice on Cross-Border Insurance Coverage

Cited by the insurance company in their defense to argue that the applicant was correctly covered as a seconded worker, but the Tribunal found this article inapplicable in favor of the AELS Convention norm.

TVR.2006.Nr.29 · tg (§ 4 Abs. 2 TG KVV)

Insurer's Right to Suspend Benefits Upheld; Municipality Discretion on Premium Arrears Confirmed

Cited as the basis for clarifying that the municipality does not have an unconditional duty to assume premium arrears.

AM.5.22.ap.TF.9.2 · vd (art. 4 OAMal)

Appeal Regarding Retroactive Swiss Health Insurance Coverage for Detached Worker's Family in the US

This article concerning detached workers and family members is discussed as the legal basis potentially applicable to the applicants.