The Supplementary Plan is a provision within the benefits provided by the Society which seeks to minimize a member’s share of large medical bills which could have a severe impact on their financial stability.
It is not applicable to holders of a Temporary Appointment of less than three months or to secondary dependents.
Beyond an accumulated amount of CHF 2,800.- per member or CHF 4,600.- per family within a calendar year, the Supplementary Plan is activated, and the Society pays 100% of the costs above these amounts. In the Internal Rules, the Supplementary Plan is also referred to as "supplementary benefits." It applies only to benefit categories for which it is listed as applicable in Annex III of our Internal rules, and it is applied automatically once a member or family members have cumulatively reached the indicated thresholds, no subscription, enrolment, or additional contribution is required.
Please see some examples below.
| 1 | A hospital bill of CHF 30,000.- is accepted for reimbursement at 90%, hence CHF 27,000.- is reimbursed under basic benefits. The Society’s member would remain liable for the balance of CHF 3,000.-. In this example, the Society would reimburse in total CHF 27,000.- plus 100% of the portion the member is liable for in excess of the CHF 2,800.- threshold, in this case CHF 200.-. The total amount reimbursed is CHF 27,200.-. |
| 2 | The hospital bills CHF 50,000.- for hospitalization in a private room. At the same hospital, a semi-private room would have cost CHF 40,000.-.CHF 40,000.- is thus accepted for reimbursement at 90%, hence CHF 36,000.- is reimbursed under basic benefits. In this example, the Society would reimburse in total CHF 36,000.- plus 100% of the portion the member is liable for in excess of the CHF 2,800.- threshold, in this case CHF 1,200.-. Total amount reimbursed is CHF 37,200.-. The member remains fully liable for the difference in cost for having a private room. |