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Part 2 · Provisions for direct insurance and reinsurance  ›  Division 2 · Health insurance › Section 154

Risk equalisation

(1) In order to ensure the continuous ability to meet the obligations arising from the insurance policies, the insurance undertakings offering a standard tariff must participate in the equalisation of insurance risks under the standard tariff, and must, for this purpose, establish and maintain an equalisation system to which they belong. The equalisation system must ensure a lasting and effective equalisation of the differing burdens. Additional expenses arising under the standard tariff on account of pre-existing conditions must be distributed equally among all those insured under the standard tariff; additional expenses arising to ensure the limits named in section 152(3) and (4) are met must be distributed among all participating insurance undertakings in such a way as to bring about an equal burden on those undertakings.
(2) The establishment, design, amendment, and implementation of the equalisation are subject to the supervision of the Federal Institute.

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