Facts
On December 8, 2011, the Compensation Fund of Jura sent a circular to insurers practicing compulsory health insurance in the canton, regarding the assumption of uncollectible premiums and cost-sharing as of January 1, 2012. The circular stated that recipients of supplementary benefits to the Old Age and Survivors' Insurance/Disability Insurance and social assistance should not be prosecuted, and that the canton would cover 85% of the unpaid premiums and cost-sharing for these persons.
The insurers contested this decision, requesting that the canton cover 100% of the unpaid amounts. They argued that Article 105i of the Health Insurance Ordinance (OAMal) and Circular No. 51 violated federal law by equating decisions to grant supplementary benefits to the Old Age and Survivors' Insurance/Disability Insurance and social assistance with acts of bankruptcy.
The Federal Tribunal rejected the insurers' appeal.
Considerations
The Federal Tribunal considered that Article 105i of the OAMal constitutes a sufficient legal basis to equate decisions to grant supplementary benefits to the Old Age and Survivors' Insurance/Disability Insurance and social assistance with acts of bankruptcy, since it is well known that the granting of such benefits results from the lack of sufficient financial resources of the beneficiary.
Regarding Circular No. 51 of the Compensation Fund of Jura, the Federal Tribunal specified that it could not prohibit insurers from prosecuting recipients of supplementary benefits or social assistance, as this would make it illusory to recover these amounts one day.…