A letter from the competent authority for health insurance in the canton where you work (SAM in Geneva, OVAM in Lausanne, KVG in Basle, OCAM in Neuchâtel, etc.) or from a French CPAM asks you to complete the ‘Choice of health insurance system’ form issued by Switzerland and France. It asks you to attach the S1 form (previously known as the E106 form) and an attestation (LAMal) from your Swiss insurer.
With this letter, the administration informs you that it does not know your choice. Have you chosen the LAMal insurance or have you chosen the CMU cross-border worker?
If you have received a letter, it is likely that you have exceeded the three-month deadline for informing the administration of your choice. You are behind in your French and Swiss administrative procedures. You must urgently regularise your situation as soon as possible.
If you are still unsure how to choose between the LAMal cross-border worker and the CMU cross-border worker insurance scheme our team of specialists is at your disposal to give you the best support in this choice and for the procedures between Switzerland and France.
For more information, see our article CMU or LAMal? The cross-border worker’s choice.
What is the S1/E106 form?
The S1 form, formerly called E106, is a certificate (LAMal) from your Swiss insurer. It is recognised by the European health insurance schemes. It certifies that you are covered by the Swiss health insurance scheme and that you do not have to pay contributions to another European system, such as the French Social Security Scheme.
It is required by cross-border workers who opt for the LAMal health insurance. They need it on two grounds:
- When they are in arrears and have received a reminder letter
- When they have notified the administration of their option for the Swiss health insurance system
You will not be able to download the S1 document. The international department of your LAMal insurer issues the S1 form. In order to obtain it, you must have completed the affiliation process with the Swiss health insurer you have chosen.
If you have chosen the Swiss LAMal health insurance, what are the procedures in Switzerland and France?
Informing the authorities of your choice of the LAMal option is necessary for the following reasons:
- Legal: you must provide confirmation to Switzerland that you are in compliance with the obligation to be insured.
- Economic: the reimbursements of health care in France will go through the Social Security system. The S1 form is necessary for the CPAM to invoice the Swiss health insurance system.
- Administrative: you will receive a Carte Vitale (French health insurance card) for your care in France. The French Social Security needs the S1 form to forward information to your Swiss insurer.
The CPAM will reimburse the insurance benefits for your treatment in France. It asks you for your ‘RIB’ (bank details) to refund you but you do not belong to the French contribution scheme!Your Swiss insurer will reimburse the insurance benefits for your treatment in Switzerland.
You pay a premium in Switzerland.
For treatment in France, you are reimbursed into your French account.
For treatment in Switzerland, you are reimbursed into your Swiss account.
1. You have made your choice – the health insurer will process your file
After completing and sending the Swiss insurance offer you have chosen, the insurer will contact you if it needs further information.
In order to ensure a fast process, make sure your application is complete!
Once the insurer has all the required information, it registers your file. This process can take several weeks, depending on the time of year (the final months of the year are a particularly busy time for Swiss insurers).
Effective date of insurance
Even if your insurer takes a month to process your file, you are covered from the effective date indicated on your LAMal offer. You can therefore receive benefits. The same does not apply to your supplementary insurance policies, as these are independent of your basic health insurance.
2. You receive your S1 form (E106 form)
When your file has been processed, the insurer will send you all the administrative documents by post to your home address:
- Your S1 document (E106 document)
- Your insurance policy
- Your Swiss health insurance card (European health insurance card on the back)
- Your first bill
- Direct debit authorisation, if you have requested one
Please note that all your insurance documents will bear the date specified in the contract.
3. Send your S1 form to the CPAM
In order for your treatment in France to be reimbursed and to obtain your Carte Vitale (French health insurance card) you have to forward your S1 (or E106) form to your CPAM (Caisse Primaire d’Assurance Maladie).
Please note that the ‘choice of health system form’ mentions that an attestation (LAMal) from your Swiss insurer or a copy of the S1 form should be sent. Following feedback from our clients, it appears that the processes are specific to each CPAM. It is therefore advisable to send both an original and a copy of the S1 form.
The CPAM will also ask you for other documents which should be sent at the same time to avoid the confusion of going back and forth to the CPAM:
- A RIB (bank details) of your account in France
- Your work contract
- A pre-filled ‘choice of health system form’ to choose the applicable health insurance scheme which the CPAM has to stamp.
If you prefer to send the file to the CPAM by post, it is advisable to keep a copy of all the documents and to send them by registered post.
4. Confirm your choice with the canton where you work
Your CPAM has stamped your ‘choice of health insurance system’ form (either on site or by return of post).
You will now have to send this paper to the competent organisation in your canton of employment (SAM in Geneva, OVAM in Lausanne, KVG in Basel, OCAM in Neuchâtel, etc.). It will validate your right of option. It will keep a copy and will remind you of the final choice you have made.
It is important to send this form promptly to avoid the canton automatically registering you with a LAMal insurance plan that is not suitable for you! You have 3 months to do this.
5. Confirmation from the canton authorities
You have now taken all the necessary steps, the French and Swiss administrations will finalise your registration.
Return of the validated S1 form
The CPAM, which validated your S1/E106 document, will send a copy to your insurer. Your insurer will now be informed that everything is in order on the French side and that, in the event of treatment in France, it will now receive bills from the CPAM.
Carte Vitale (health insurance card) is sent
If you already have a Carte Vitale, the CPAM will send you a letter offering to re-activate it.
To reactivate your Carte Vitale, you need to insert it into an automatic terminal that can be found in the entrances of CPAMs or certain large pharmacies.
If you do not have a Carte Vitale, the CPAM will send you one.
6. The process is finished
Once these steps have been completed, to check that everything is in order, you connect to your Swiss insurer’s WEB homepage and the Ameli.fr WEB portal.
On the Ameli.fr homepage, you check that the ‘attestation of entitlement’ (attestation de droits) document accessible in the ‘My procedures in 2 clicks’ section – (Mes démarches en 2 clics) has a start date for cover which corresponds to the date, mentioned in the S1 form you sent. If this is the case, the process is finished.
What is the status of my application?
Why does it take so long?
These procedures can take some time; the important thing is to identify the point at which you are at and therefore whom you should contact:
- If you are waiting for documents from the insurer, you should contact them.
- If you are waiting for documents from the CPAM, you should contact that organisation. In this situation, we advise you to go there.
If you have chosen the CMU cross-border worker insurance scheme
If you have chosen the CMU cross-border worker insurance scheme, you do not need to obtain the S1 form ‘Registration for LAMal’ (form E106).
Nevertheless, you will not be able to avoid the interaction between the French and Swiss administrations described above.
However, you must quickly inform the CPAM that you have chosen the French health insurance system, which is optional for Swiss cross-border workers. If you breach the three-month time limit after the start of your work in Switzerland, you can no longer use your right of option. The CPAM of your place of residence will refuse you. You will then be obliged to join the LAMal cross-border worker scheme and you will have to obtain the S1 form.
You may have realised, the choice between CMU and LAMal is difficult to make. The administrative procedures between Switzerland and France are numerous. The deadlines are short.
Our team of specialists is at your disposal to provide you with the best support in your choice and for your proceedings between Switzerland and France.
