Insurance under KVG 1 | Insurance under VVG 2 | Insurance under UVG 3 | Other 4 | Elimination | Total | ||
2015 | 2015 | 2015 | 2015 | 2015 | 2015 | ||
Net premiums earned | 4,326,652 | 1,549,818 | 145,445 | 0 | –40,160 | 5,981,755 | |
Net cost of claims and benefits | –4,604,727 | –1,143,561 | –128,551 | 0 | 1,074 | –5,875,765 | |
Allocated interest | 0 | 0 | 9,804 | 0 | 0 | 9,804 | |
Risk adjustment between insurers | 375,042 | 0 | 0 | 0 | 0 | 375,042 | |
Policyholder participation | –6,689 | –18,331 | –1,071 | 0 | 0 | –26,091 | |
Net operating expenses | –251,001 | –370,599 | –21,577 | –806 | 42,028 | –601,955 | |
Underwriting result | –160,723 | 17,327 | 4,050 | –806 | 2,942 | –137,210 | |
Investment income | 249,453 | 308,316 | 110,297 | 149,034 | –110,906 | 706,193 | |
Investment expenses | –191,754 | –269,117 | –75,592 | –42,056 | 11,074 | –567,444 | |
Change in provision for investment risk | 20,000 | 15,000 | 0 | –20,000 | 0 | 15,000 | |
Earnings from investments | 77,699 | 54,199 | 34,705 | 86,978 | –99,832 | 153,749 | |
Allocated interest expenses | 0 | 0 | –9,804 | 0 | 0 | –9,804 | |
Other operating income | 5,977 | 4,146 | 886 | 811 | –1,226 | 10,594 | |
Other operating expenses | –2,848 | –2,676 | –573 | –656 | 1,057 | –5,696 | |
Operating earnings | –79,895 | 72,996 | 29,264 | 86,327 | –97,059 | 11,633 | |
Non-operating earnings | 10,827 | 4,407 | –1 | 10,701 | –9,941 | 15,993 | |
Exceptional earnings | –7,057 | 0 | 0 | 10 | 7,000 | –47 | |
Consolidated earnings before taxes | –76,125 | 77,403 | 29,263 | 97,038 | –100,000 | 27,579 | |
Deferred income taxes | 0 | 39,555 | 29,756 | 171 | 0 | 69,482 | |
Income taxes | 0 | –57,971 | –20,948 | –1,227 | 0 | –80,146 | |
Non-controlling interest | 0 | 0 | 0 | –979 | 0 | –979 | |
Consolidated earnings | –76,125 | 58,987 | 38,071 | 95,003 | –100,000 | 15,936 |
1 Insurance under KVG This segment comprises the companies that offer mandatory health care insurance and voluntary daily benefits insurance under the KVG.
2 Insurance under VVG This segment comprises the companies that offer insurance products under the VVG.
3 Insurance under UVG This segment comprises the companies that offer insurance products under the UVG.
4 Other This segment comprises all other companies.
For the first time, the consolidated financial statements are being presented in accordance with the Swiss GAAP accounting and reporting recommendations (Swiss GAAP FER) and they provide a true and fair view of the Group's assets, finances and earnings. Swiss GAAP FER represents a complete body of rules. All recommendations must be applied.
Swiss GAAP FER 41 entered into force for the individual financial statements of KVG health insurers on 1 January 2012. The Helsana Group will apply Swiss GAAP FER 30 (Consolidation) in conjunction with Swiss GAAP FER 41 from financial year 2015. The application of Swiss GAAP FER is voluntary.
The consolidated financial statements include all companies that are directly or indirectly controlled by Helsana. Control means the decisive influence on the operational and financial activities in order to derive the corresponding benefit therefrom. This is usually the case if Helsana directly or indirectly holds more than 50 percent of the voting rights in a company. Companies acquired during the financial year are included from the date on which control over the business activities was transferred to Helsana, and all companies disposed of during the year are excluded from the Group statements from the date of sale.
Purchasing Cooperative HSK Ltd was founded in Dübendorf on 22 December 2015 and included in the scope of consolidation. The first annual financial statement for Purchasing Cooperative HSK Ltd will be prepared as at 31 December 2016 (long financial year) and included in the capital consolidation as at 31 December 2015.
Companies are included in the Group statements based on the full consolidation method. Capital consolidation is carried out using the Anglo-Saxon method (purchase method). Assets and borrowed capital of companies acquired are revalued at the time control changes in accordance with Helsana Group principles; unrealised gains and losses are carried under the relevant balance sheet positions and the remaining difference between the purchase price and goodwill calculated according to the accounting policies of the Group is fully amortised over five years or in the year of consolidation. Any third-party participations in fully consolidated companies are shown separately as minority interests in equity and income.
Companies in which Helsana holds between a 20 and 50 percent stake are stated in the balance sheet at the value corresponding to the pro rata equity capital in line with the equity method.
The balance sheet date for all companies included is 31 December.
As at 1 January 2016, Avanex Insurance Company Ltd absorbed maxi.ch Insurance Ltd as part of a merger in accordance with Art. 3, para. 1A of the Swiss Mergers Act (Fusionsgesetz, or FusG) and assumed its assets and liabilities through universal succession.
All intragroup transactions, relationships and earnings are eliminated as part of the consolidation process.
Valuation is carried out in line with standardised criteria. In general, the principle of the individual valuation of assets and liabilities applies.
Foreign currency positions are converted at current exchange rates at year-end.
The following exchange rates were used:
31.12.2015 | 1.1.2015 | |
Unit / currency | Price | Price |
1 EUR | 1.08737 | 1.20236 |
1 GBP | 1.47536 | 1.54931 |
1 USD | 1.00100 | 0.99360 |
100 JPY | 0.83210 | 0.82880 |
1 CAD | 0.72062 | 0.85789 |
1 AUD | 0.72831 | 0.81314 |
Real estate includes both investment properties and owner-occupied properties, and is stated in the balance sheet at current market values. Market values are estimated at least once every three years by an independent consulting firm. The values are determined using the discounted cash flow method or another recognised method during the intervening years.
Fixed-income securities are stated in the balance sheet using the amortised cost method if the debtor is able to pay the interest and amortisation payments. Periodic changes in the carrying amount are recognised in the income statement. If there are justified doubts about the debtor's ability to pay interest and amortisation payments, fixed-income securities are stated in the balance sheet at their current values.
Equities include equity securities such as stocks and similar securities.
Such assets are marketable and are valued at market price. Any impairments are booked accordingly.
Real estate funds are maintained as a separate position. They are valued at current values.
Derivatives include foreign exchange and options contracts, certificates on equity indices and futures. Forward exchange transactions are used to hedge exchange rate and market price fluctuations and are valued at market values.
Participations include investments in companies that are held for strategic purposes. These participations are valued using the last known pro rata equity (equity method) or valued at cost.
Loans and mortgages are stated on the balance sheet at the nominal value less any necessary write-downs.
Assets from employer reserves are, provided they are not subject to a waiver of usage, stated in the balance sheet at their nominal value and deducted from staff costs accordingly if they are used. The value is reviewed annually and, if necessary, the position is written down.
With intangible assets, a distinction is drawn between purchased software and projects. The latter are amortised on a straight-line basis over the course of their useful life. With purchased software, amounts below CHF 5,000 are expensed.
Projects are generally amortised over a period of five years from launch, up to a maximum of ten years in justified cases. They must provide a benefit over several years. At maximum, they are measured at cost of acquisition or production. These costs must be measurable and allocable to the project. Projects may only be capitalised if they are strategic in nature and involve an investment in excess of CHF 3 million.
Fixed assets are depreciated on a linear basis over the course of their useful life. For fixtures and fittings, acquisitions and collective acquisitions for amounts of more than CHF 5,000 are capitalised. Amounts below this limit are expensed.
Useful life for each asset category:
The value is reviewed annually and the position is written down accordingly.
This position includes expenses during the reporting year that are deducted as an expense in the following financial year, and income that only leads to revenue in the following financial year.
The receivables due from affiliates are valued at their nominal value, taking account of operationally necessary impairments.
Cash and cash equivalents include cash on hand as well as postal and bank account balances. Cash and cash equivalents are valued at their nominal values. Any impairments are booked accordingly.
The position for net technical provisions includes provisions for claims and benefits, actuarial reserves, provisions for profit sharing, technical equalisation reserves and provisions for guarantees as well as other technical provisions.
Provisions for claims and benefits are calculated according to actuarial methods recognised by the supervisory authorities (e.g. chain ladder). In doing so, the following parameters are taken into account for the year of occurrence and the year of processing:
The reserves for annuities are calculated according to the accounting principles pursuant to Art. 108 UVV. The calculation is based on the annuity without cost of living bonuses. For passive co-insurance, we assume our portion of the individual actuarial reserve as reported by the company that carries it.
For collective sickness benefits, provisions for profit sharing are formed for contracts that include agreements on profit sharing. They are calculated as the expected value of the profit sharing paid out after the balance sheet date for the contracts for profit sharing that are in effect through the balance sheet date. The estimate of provisions for profit sharing takes account of the active holdings and the empirical claims experience as at the balance sheet date.
The equalisation reserves and provisions for guarantees protect the capital basis against the affects of unusual fluctuations in the technical result. The are endowed up to a maximum limit of 15 percent of the insurance benefits in line with the technical result. The lower limit is zero.
The other technical provisions include additional actuarial provisions that are valued according to the applicable and approved business plan.
If an outflow of funds is probable, a corresponding provision is formed for legal and actual obligations on an event in the past. The amount of the provisions are determined on the basis of an analysis of the respective result in the past and the economic risk. If time has a significant impact, the provision requirement must be discounted. The provisions are revalued annually.
The provision for investment risk represents the long-term volatilities of the capital market. The provision is based on the total portfolio and is reviewed annually. The target provision for investment risk is calculated on the basis of
If the investments during the reporting period experience above-average losses in value, the provision for investment risk can also be liquidated in the income statement in full or in part. If the investments experience above-average gains in value during the reporting period, the provision for investment risk can also be increased to the target value in the income statement in full or in part.
This position includes deferred income during the reporting year that is credited as income in the following financial year, and expenses for the reporting year that are only paid the following financial year.
This position mainly involves obligations to policyholders or service providers as well as premiums billed in advance. Loans due are also recognised in this position. The liabilities are stated in the balance sheet at their nominal amount.
Name | Sector | Consolidation | Shareholding in % | Capital in CHF m |
Helsana, Dübendorf | Holding | Fully consolidated | 100 | 70.0 |
– Helsana Insurance Company Ltd, Dübendorf | Health insurance | Fully consolidated | 100 | 70.0 |
– Helsana Supplementary Insurances Ltd, Dübendorf | Health insurance | Fully consolidated | 100 | 35.0 |
– LCC Consulting AG, Zurich | Software engineering | Fully consolidated | 100 | 0.1 |
– Helsana Legal Protection Ltd, Aarau | Legal expenses insurance | Equity method | 50 | 3.0 |
– Progrès Insurance Ltd, Dübendorf | Health insurance | Fully consolidated | 100 | 0.3 |
– Sansan Insurance Ltd, Dübendorf | Health insurance | Fully consolidated | 100 | 0.1 |
– Avanex Insurance Ltd, Dübendorf | Health insurance | Fully consolidated | 100 | 0.1 |
– maxi.ch Insurance Ltd, Dübendorf | Health insurance | Fully consolidated | 100 | 0.1 |
– Helsana Accidents Ltd, Dübendorf | Accident insurance | Fully consolidated | 100 | 14.0 |
– Solida Insurance Ltd, Zurich | Accident insurance | Equity method | 50 | 10.0 |
– Helsana Investment Ltd, Dübendorf | Holding | Fully consolidated | 100 | 0.1 |
– indivo Insurance Ltd, Dübendorf | Health insurance | Fully consolidated | 100 | 0.1 |
– SSS Schaden Service Switzerland Ltd, Zurich | Recourse settlement | Fully consolidated | 50.9 | 0.1 |
– Procare Vorsorge AG, Dübendorf | Services | Fully consolidated | 100 | 0.1 |
– Purchasing Cooperative HSK Ltd., Dübendorf | Services | Fully consolidated | 60 | 0.1 |
– Aviga AG, Zurich | Case management | Equity method | 50 | 2.2 |
– Topwell-Apotheken AG, Winterthur | Healthcare sector | Equity method | 24.1 | 0.3 |
Figures in CHF thousand | 2015 |
Premium income | 5,982,627 |
Reinsurers' share | –872 |
Total net premiums earned | 5,981,755 |
Cost of claims and benefits | –6,449,511 |
Co-payments | 638,539 |
Reinsurers' share | 2,349 |
Change in technical provisions | –12,726 |
Loss mitigation costs | –54,416 |
Total net cost of claims and benefits | –5,875,765 |
Personnel expenses | –365,217 |
Administrative offices and operating equipment | –26,781 |
IT costs | –66,545 |
Marketing, advertising and commission | –115,058 |
Other administrative expenses | –17,654 |
Write-downs | –10,700 |
Total operating expenses, net | –601,955 |
Liquid funds (interest) | 6,751 |
Receivables (interest risk adjustment, default interest, etc.) | 3,831 |
Other income | 12 |
Total other operating income | 10,594 |
Liquid funds (interest) | –5,189 |
Liabilities (interest risk adjustment, etc.) | –43 |
Other expenses | –464 |
Total other operating expenses | –5,696 |
Non-operating income, third party | 23,966 |
Non-operating expenses, third party | –7,973 |
Total non-operating income | 15,993 |
Extraordinary income | 10 |
Extraordinary expenses | –57 |
Total extraordinary income | –47 |
Figures in CHF thousand | Ordinary earnings | Realised gains | Unrealised gains | Total 2015 |
Investment income | ||||
Real estate | 18,737 | 0 | 0 | 18,737 |
Bonds | 88,804 | 225,789 | 19,835 | 334,428 |
Equities | 26,369 | 81,783 | 61,041 | 169,193 |
Alternative investments | 0 | 0 | 3,052 | 3,052 |
Real estate funds | 0 | 46,226 | 29,058 | 75,284 |
Currency futures | 0 | 91,753 | 0 | 91,753 |
Investments in other companies | 191 | 1,562 | 9,997 | 11,750 |
Employer contribution reserve | 0 | 209 | 0 | 209 |
Other investment income 1 | 1,787 | 0 | 0 | 1,787 |
Total investment income | 135,888 | 447,322 | 122,983 | 706,193 |
Figures in CHF thousand | Administrative costs | Realised losses | Non-realised losses | Total 2015 |
Investment expenses | ||||
Real estate | 0 | 0 | –1,827 | –1,827 |
Bonds | 0 | –202,591 | –58,795 | –261,386 |
Equities | 0 | –59,033 | –83,827 | –142,860 |
Alternative investments | 0 | –8,379 | –30,423 | –38,802 |
Real estate funds | 0 | –3,674 | –29,177 | –32,851 |
Currency futures | 0 | –63,376 | –10,890 | –74,266 |
Investments in other companies | 0 | 0 | –2,325 | –2,325 |
Employer contribution reserve | 0 | –1,896 | 0 | –1,896 |
Asset management costs | –11,231 | 0 | 0 | –11,231 |
Total investment expenses | –11,231 | –338,949 | –217,264 | –567,444 |
Change in provision for investment risk | 0 | 15,000 | 0 | 15,000 |
Total investment income 2015 | 124,657 | 123,373 | –94,281 | 153,749 |
1 Other investment income comprises retrocession repayments by the custodian financial institution.
Figures in CHF thousand | As at 1.1.2015 | Additions / disposals | Change in valuation adjustment | As at 31.12.2015 |
Real estate | 318,265 | 865 | –1,827 | 317,303 |
Bonds 1 | 3,671,904 | 35,362 | –38,959 | 3,668,307 |
Equities | 1,099,502 | 53,187 | –22,785 | 1,129,904 |
Alternative investments | 109,366 | 51,535 | –27,371 | 133,530 |
Real estate funds | 530,448 | –47,460 | –120 | 482,868 |
Currency futures | –14,005 | 14,005 | –10,891 | –10,891 |
Investments in other companies | 67,072 | 488 | 7,672 | 75,232 |
Loans and mortgages | 10 | –3 | 0 | 7 |
Employer contribution reserve | 8,374 | –1,687 | 0 | 6,687 |
Investments | 5,790,936 | 106,292 | –94,281 | 5,802,947 |
1 The market value of the bonds (excluding accrued interest) is CHF 3,857,356,000 (CHF 3,857,716,000 as at 1 January 2015).
Figures in CHF thousand | Currency | 31.12.2015 | 1.1.2015 | |
Futures | Hedges | USD | –9,389 | –12,747 |
Futures | Hedges | EUR | –2,494 | 299 |
Futures | Hedges | GBP | 992 | –1,557 |
Total currency futures | –10,891 | –14,005 |
Figures in CHF thousand | Office fixtures, fittings and equipment | IT hardware | Vehicles | Total property, plant and equipment | Projects | Software | Total intangible assets |
Net carrying amount as at 1.1.2015 | 6,199 | 7,245 | 93 | 13,537 | 6,136 | 6,620 | 12,757 |
Historical cost | |||||||
Carrying amount as at 1.1.2015 | 143,234 | 50,516 | 567 | 194,317 | 9,204 | 8,276 | 17,480 |
Asset additions | 1,990 | 7,283 | 199 | 9,472 | 42,988 | 10,703 | 53,691 |
Asset disposals | 0 | –6,283 | –98 | –6,381 | 0 | 0 | 0 |
Carrying amount as at 31.12.2015 | 145,224 | 51,516 | 668 | 197,408 | 52,192 | 18,979 | 71,171 |
Accumulated valuation adjustments | |||||||
Value adjustments as at 1.1.2015 | –137,035 | –43,272 | –473 | –180,780 | –3,068 | –1,655 | –4,723 |
Depreciation and amortisation | –2,004 | –6,558 | –121 | –8,683 | –17,397 | –3,796 | –21,193 |
Asset disposals | 0 | 5,877 | 58 | 5,935 | 0 | 0 | 0 |
Value adjustments as at 31.12.2015 | –139,039 | –43,953 | –536 | –183,528 | –20,465 | –5,451 | –25,916 |
Net carrying amount as at 31.12.2015 | 6,185 | 7,563 | 132 | 13,880 | 31,727 | 13,528 | 45,255 |
Figures in CHF thousand | 31.12.2015 | 1.1.2015 |
Accrued interest on investments | 41,328 | 45,528 |
Risk compensation | 280,370 | 323,094 |
Other accrued income and prepaid expenses | 110,972 | 110,269 |
Total deferred charges | 432,670 | 478,891 |
Risk compensation | 89,458 | 114,680 |
Other deferred income and accrued expenses | 33,759 | 26,601 |
Total deferred credits | 123,217 | 141,281 |
Figures in CHF thousand | 31.12.2015 | 1.1.2015 |
Policyholders | 205,550 | 170,492 |
Insurance organisations | 11,234 | 9,408 |
Reinsurers | 0 | 120 |
Related parties | 4,350 | 317 |
Government offices | 35,402 | 35,238 |
Other receivables | 14,633 | 12,529 |
Total receivables | 271,169 | 228,104 |
Policyholders | 402,462 | 316,221 |
Insurance organisations | 2,226 | 1,992 |
Service providers | 212,098 | 71,715 |
Agents and brokers | 1,885 | 1,774 |
Related parties | 3,679 | 2,418 |
Government offices | 3,045 | 3,393 |
Other liabilities | 17,549 | 22,554 |
Total liabilities | 642,944 | 420,067 |
Figures in CHF thousand | Provision for claims and benefits 1 | Actuarial reserve 2 | Provision for policyholder participation | Claims equalisation reserve | Other technical provisions 3 | Total |
As at 1.1.2015 | 1,536,603 | 408,852 | 72,320 | 800,653 | 568,922 | 3,387,350 |
Creation | 1,215,485 | 13,144 | 12,401 | 0 | 12,734 | 1,253,764 |
Release / Use | –1,155,419 | –1,855 | –26,091 | –55,000 | –2,673 | –1,241,038 |
As at 31.12.2015 | 1,596,669 | 420,141 | 58,630 | 745,653 | 578,983 | 3,400,076 |
1 The amount of reinsurance in the provisions for claims and benefits was –1,492,000 as at 31 December 2015 (CHF –5,686,000 as at 1 January 2015).
2 The actuarial reserves were discounted with a technical interest rate of 2.75 per cent for the accident years up to 2013 and 2.0 per cent for 2014 and 2015 (Average term: 18.1 years).
3 The other technical provisions comprise provisions for other compulsory health insurance products (OKP) (models such as HAV / HMO). Ageing reserves were discounted with a technical interest rate of 1.0 per cent (Average term: 39.2 years).
Figures in CHF thousand | Restructuring 1 | Personnel / brokers | Taxes | IT investments | Process risks | Other 2 | Total |
As at 1.1.2015 | 12,225 | 38,970 | 19,958 | 0 | 213 | 76,766 | 148,132 |
Creation | 3,000 | 27,840 | 58,382 | 380 | 0 | 9,551 | 99,153 |
Use | –9,958 | –43,480 | –24,560 | –22 | –213 | –27,365 | –105,598 |
As at 31.12.2015 | 5,267 | 23,330 | 53,780 | 358 | 0 | 58,952 | 141,687 |
1 The restructuring provisions include the costs of the organisational changes that were made as part of the cost reduction programme. The provisions for holiday and overtime claims as well as staff bonuses and broker fees are included under “Personnel / brokers”.
2 The other non-technical provisions include past provisions for subsequent premium corrections. In 2014, the Swiss Parliament decided to correct the imbalances in basic health insurance premiums accumulated from 1996 to 2013 in accordance with Art. 106 of the Federal Health Insurance Act (KVG). The financial correction process will take place between 2015 and 2017.
Figures in CHF thousand | Provision for investment risk | Total |
As at 1.1.2015 | 654,632 | 654,632 |
Creation | 20,000 | 20,000 |
Release | –35,000 | –35,000 |
As at 31.12.2015 | 639,632 | 639,632 |
Employer contribution reserve in CHF thousand | Par value | Waiver of usage | Balance sheet | Release | Balance sheet | Earnings from employer contribution reserve | |
31.12.2015 | 2015 | 31.12.2015 | 2015 | 1.1.2015 | 2015 | Prior year | |
Pension schemes | 6,687 | 0 | 6,687 | –1,896 | 8,374 | 209 | 68 |
Total | 6,687 | 0 | 6,687 | –1,896 | 8,374 | 209 | 68 |
Economic benefit / obligation and pension cost | Funding surplus / deficiency 1 | Economic interest of organisation | Change from prior year / recognised in income statement in reporting year | Contributions recognised in reporting period | Pension cost in personnel costs | ||
31.12.2015 | 31.12.2015 | 1.1.2015 | 2015 | Prior year | |||
Pension plans with funding surplus | 181,465 | 0 | 0 | 0 | 26,216 | 29,443 | 28,856 |
Total | 181,465 | 0 | 0 | 0 | 26,216 | 29,443 | 28,856 |
1 The information is based on the audited 2014 annual financial statements of the staff pension fund foundation of Helsana Insurance Company Ltd.
Within the scope of Group VAT taxation, the Helsana Group is jointly and severally liable to the Swiss Federal Tax Administration. Verein Artisana is also included in the VAT group together with the fully consolidated companies.
Figures in CHF thousand | Transactions with the Helsana Group (net)1 | Investments 2 | Technical provisions 2 |
2015 | 31.12.2014 | 31.12.2014 | |
Name | |||
Solida Insurance Ltd, Zurich | 10,848 | 557,868 | 488,344 |
Helsana Legal Protection Ltd, Aarau | 16,229 | 37,620 | 32,468 |
1 The transactions with associated companies include the sum of the statements of these companies, which include the transferred net premiums less any profit sharing and compensation for administration.
2 The figures have been taken from the 2014 Annual Report.