Health Care Insurance Board

Providing advice on the contents of the basic package

Developments in health care are rapid. Views on of health care, solidarity, the role of the government and the role of the parties involved in health care are also subject to regular changes. This all has an effect on the basic package of insured care. The government must therefore be able to make decisions on this package that are solid, well-substantiated and in keeping with social developments and scientific findings. These decisions are often made based on advice from CVZ on the content and composition of the package for the Zvw [Zorgverzekeringswet, Health Insurance Act] and the AWBZ [Algemene Wet Bijzondere Ziektekosten, Exceptional Medical Expenses Act]. Advice provided by CVZ is based not only on the health care itself, but also on considerations involving finance and society.
In addition to providing advice, CVZ also publishes assessments that are intended to clarify certain aspects of the Zvw and the AWBZ, for example, in response to disputes between health insurers and insured clients.

Apportioning premium funds among health insurers

Care-providers charge health insurers and health care liaison offices for the costs of the care they provide. These costs are mainly covered by the combined premiums paid by insured clients: the nominal (fixed) premiums and the percent premiums. Health insurers collect the nominal premiums. Employers and organisations that pay out allowances deduct the percent premiums from the incomes of insured persons and deposit these into two central funds.
CVZ administrates all percent premiums and apportions them among the health insurers and health care liaison offices. When premiums are being allocated, health insurers are compensated for certain high-risk groups because they are obliged to accept everyone for the Zvw. This is known as risk equalisation.

Implementing regulations for specific groups

CVZ bears responsibility for organising the health care of pensioners and people who live abroad and receive a Dutch allowance or pension. Foreign health insurers organise their medical care locally and charge CVZ for the costs. The same applies to family-members of cross-border workers who are insured in the Netherlands, when these family-members live abroad. CVZ collects the insurance contributions payable for both these groups.
CVZ represents the Netherlands by participating in discussions on regulations for medical care subject to EU-legislation (council regulations) and on conventions with non-EU countries.
Furthermore, CVZ ensures that conscientious objectors receive a certain amount in reimbursement of their health care costs and also collects the unpaid premiums (arrears) from persons who wrongfully neglect to take out insurance and from insured persons who fail to pay their premiums.