Basic health insurance analysis: Helsana defends its market leadership
Every year, Comparis examines the basic insurance portfolio of the largest health insurers in Switzerland. Here you’ll find the latest results.
23.06.2026
iStock/Valerii Evlakhov
1. Which health insurer had the strongest customer growth?
Comparis examines the portfolio of basic policyholders at the largest Swiss health insurers on an annual basis. The analysis reveals: The largest increase between 2025 and 2026 was recorded by the Lucerne-based CSS. At the beginning of 2026, its growth amounted to over 90,000 insured persons, or 6%. It is now the second-largest health insurer in Switzerland.
2nd place goes to the Dübendorf-based Helsana with 69,000 new policyholders. It is thus defending its position as market leader. In 3rd place in terms of growth last year is the Bern-based Visana Group with an increase of 41,500 insured persons.
Overall, the percentage increase for the large health insurers was relatively moderate: Unlike in previous years, it was in the single-digit range.
The greater the premium increases, the larger the premium differences between the insurers and the switching rates. Moderate premium increases also prevent the risk of an insurer being much cheaper than its competitors and gaining a large number of customers, which it later loses again with higher premiums. It is noteworthy that the two largest health insurers, Helsana and CSS, are steadily increasing the gap between themselves and their competitors, now accounting for almost one third of basic policyholders.
2. Which health insurer has lost the most customers?
The greatest loss was suffered by the Martigny-based Groupe Mutuel. Their customer base shrank by 44,000 policyholders, which corresponds to a decrease of 4% of their policyholder base.
In percentage terms, has the Aquilana the strongest decline in policyholders. With over 4,500 people, it has lost 7% of its customers.
In the last five years, Assura lost the most basic health insurance customers, with a total of 275,000. This corresponds to a loss of 27.9%. However, in 2025 it was able to gain 17,000 customers again.
With limited reserves, Groupe Mutuel has less leeway in premiums than its major competitors and is losing customers again after a short period of growth. Aquilana, Concordia and KPT are once again losing some of the customers they previously gained through low premiums.
3. Distribution of insurance models by income
An additional representative survey by Comparis has shown: Around a quarter of respondents have remained loyal for years to the standard model of their health insurer for years. There are differences depending on household income:
34% of people with a gross monthly income up to 4,000 francs are insured in the standard model. In 2021, this figure was still 41.8%.
16.5% of people with a gross monthly income over 8,000 francs are insured in the standard model. In 2021, it was 21.2%.
With the alternative insurance models there has been a significant shift in the last five years. In 2021, 47.4% were still insured under the family doctor model were insured; by 2026, this figure will be only 42.1%.
On the other hand, the proportion of people insured under the Telmed model has risen by 5.5 percentage points to 18.9% has HMO model also been gaining in popularity: in 2021, 7.4% of respondents chose the model – by 2026, this figure will have risen to 10.3%.
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4. More than 75% choose the highest or lowest deductible
77% of those surveyed choose either the lowest (300 francs) or the highest (2’500 francs) deductible. Of the levels in between, the 500-franc deductible makes up the largest share: 9.5% of all respondents choose this.
Overall, the CHF 300 deductible in almost all models the most frequently chosen option. This is particularly evident in the family doctor model (20.2% of those insured under the family doctor model) and in the standard model (11.3% of those with standard insurance).
In contrast, policyholders in the HMO model more often choose the highest deductible (4.9%) than the lowest (3.7%). In other models, too, the maximum deductible of 2’500 francs is popular: It ranks second in the family doctor model (14.7%) and the Telmed model (7.9%).
This representative survey was carried out by the market research institute Innofact on behalf of comparis.ch in April 2026, and involved 1’034 adults from across Switzerland. Representativeness means that the participants in a survey reflect the entire target group well. This means that important characteristics such as age, gender or region of residence are distributed similarly to the entire population. This makes it easier to apply the results to everyone.
5. Archive of basic insurance analyses
In 2025, Helsana expand its customer base by 108’000 policyholders – that was an increase of 7.6%. The largest number of policyholders was lost by the Berne-based insurer KPT and Groupe Mutuel. Both insurers lost around 77’000 policyholders. In percentage terms, the loss was highest at Aquilana : it lost a quarter of its policyholders.
The winner of the switching season was the Lucerne-based insurer Concordia. At the beginning of 2024, its growth amounted to 70’800 insured persons, or 11.3%. It was able to attract new policyholders in almost all regions of Switzerland. A massive loss was suffered by the company domiciled in Pully (VD) Assura. Their customer base shrank by 115,000 policyholders.
The KPT has set a record with 195,100 additional basic insured persons: record No health insurer has recorded such a large increase in one go since the introduction of mandatory basic insurance in 1996. The The industry leaders are the losers this year, such as Assura and Helsana.
The CSS Group and ÖKK attracted the largest share at the beginning of 2022 new customers for basic insurance. Groupe Mutuel has managed to stabilise its portfolio after major losses in recent years. Assura came off worst in the large and medium health insurers category.
In the last five years, there has been one very big loser in the health insurance scene: the Valais-based insurer Groupe Mutuel. Their share of basic insurance policyholders has shrunk by 304’900, or just over a quarter. From 2020 to 2021, the group headquartered in Martigny (VS) lost a further 15’000 basic insurance policyholders and now serves 955’000 people.
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This article was first published on 17.05.2021
