Swiss KPT TOB EN

Table of Benefits

Suisse international healthcare plans
Corporate Group Schemes
Valid from 1^st January 2026

This Table of Benefits provides an overview of the treatments and medical services you are covered for, as listed in this document.Contents

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The following plans are only available for corporate groups of three employees or more. These plans represent supplemental cover to the mandatory Swiss Health Insurance.

Details of our pre-authorisation process can also be found in our Benefit Guide. Benefits marked with a √ are covered in full, subject to the maximum plan limit.

Core Plans

	Suisse Premier	Suisse Club
Maximum plan limit	CHF 9,750,000	CHF 1,462,500
In-patient benefits
Hospital accommodation Pre-authorisation required	Private room	Semi-private room
Intensive care Pre-authorisation required	√	√
Prescribed drugs and dressings Pre-authorisation required In-patient and day-care treatment only	√	√
Surgical fees, including anaesthesia and theatre charges Pre-authorisation required	√	√

	Suisse Premier	Suisse Club
Physician and therapist fees Pre-authorisation required In-patient and day-care treatment only	√	√
Surgical appliances and materials Pre-authorisation required	√	√
Diagnostic tests Pre-authorisation required In-patient and day-care treatment only	√	√
Organ transplant Pre-authorisation required In-patient treatment only	√	√
Psychiatry and psychotherapy Pre-authorisation required In-patient and day-care treatment only 10 month waiting period applies	√	CHF 13,780
Accommodation costs for one parent staying in hospital with an insured child under 18 Pre-authorisation required	√	√
Emergency in-patient dental treatment	√	√

	Suisse Premier	Suisse Club
Other benefits
Day-care treatment Pre-authorisation required	√	√
Kidney dialysis Pre-authorisation required In-patient, day-care and out-patient treatment	√	√
Out-patient surgery Pre-authorisation required	√	√
Nursing at home or in a convalescent home Pre-authorisation required Immediately after or instead of hospitalisation	CHF 5,525	CHF 3,680
Rehabilitation treatment In-patient, day-care and out-patient treatment; must commence within 14 days of discharge after the acute medical and/or surgical treatment ceases	CHF 5,750	CHF 3,900
Local ambulance	√	√
Emergency treatment outside area of cover For trips of a maximum period of six weeks	√ max. 42 days	√ max. 42 days

	Suisse Premier	Suisse Club
Medical evacuation Pre-authorisation required	√	√
Where necessary treatment is not available locally, we will evacuate the insured person to the nearest appropriate medical centre. Pre-authorisation required	√	√
Where ongoing treatment is required, we will cover hotel accommodation costs. Pre-authorisation required	√	√
Evacuation in the event of unavailability of adequately screened blood. Pre-authorisation required	√	√
If medical necessity prevents an immediate return trip following discharge from an in-patient episode of care, we will cover hotel accommodation costs. Pre-authorisation required	Max. 7 days	Max. 7 days
Travel costs for one person accompanying an evacuated person Pre-authorisation required	CHF 3,900	CHF 3,900
Travel costs of insured family members in the event of an evacuation Pre-authorisation required	CHF 2,600 per event	CHF 2,600 per event
Repatriation of mortal remains or burial expenses Pre-authorisation required	CHF 13,000	CHF 13,000

	Suisse Premier	Suisse Club
Travel costs of insured family members in the event of the repatriation of mortal remains Pre-authorisation required	CHF 2,600 per event	CHF 2,600 per event
CT and MRI scans In-patient and out-patient treatment	√	√
PET and CT-PET scans Pre-authorisation required In-patient and out-patient treatment	√	√
Oncology Pre-authorisation required In-patient, day-care and out-patient treatment	√	√
Purchase of a wig, prosthetic bra or other external prosthetic device for cosmetic purposes	CHF 260	CHF 260
Routine maternity Pre-authorisation required In-patient and out-patient treatment 10 month waiting period applies	√	√
Complications of pregnancy and childbirth Pre-authorisation required 10 month waiting period applies	√	√

	Suisse Premier	Suisse Club
Home delivery	CHF 1,300	X
In-patient cash benefit (per night) Where treatment has been received free of charge	CHF 195, max. 25 nights	CHF 195, max. 25 nights
Emergency out-patient treatment Where these benefit amounts are reached, any additional costs may be reimbursed within the terms of any separate Out-patient Plan	CHF 975	CHF 975
Emergency out-patient dental treatment Can also be reimbursed within the terms of any separate Dental Plan	CHF 975	X
Palliative care Pre-authorisation required In-patient, day-care and out-patient treatment	√	√
Long term care Pre-authorisation required In-patient, day-care and out-patient treatment	√ Max. 90 days per lifetime	√ Max. 90 days per lifetime

	Suisse Premier	Suisse Club
Additional Core Plan services
Employee Assistance Programme** Offers access to a range of 24/7 multilingual support services as follows: Confidential and professional counselling up to five sessions per issue, per calendar year (in-person, phone and video) Legal and financial referral services Wellness website access	√	√
Travel Security Services** Offers 24/7 access to personal security information and advice for all your travel safety queries. This includes: Emergency Security Assistance Hotline (not a free phone number) Country intelligence and security advice Daily security news and travel safety alerts	√	√
Olive** Our Health & Wellness support program includes, for example: Fitness app Access to wellness resources	√	√

Suisse Premier

Suisse Club

MyHealth Digital Services

Manage your cover online with our app or portal anytime, anywhere
Submit and track progress of claims
Access your policy documents, health services, payment details and more

√

Second Medical Opinion Service**

Offers access to expert help on the best treatment options available, if you have been diagnosed with a serious illness or had surgery recommended

√

** Certain services that may be included in your plan are provided by third party providers. If included in your plan, these services will show in your Table of Benefits. These services are made available to you subject to your acceptance of your policy’s terms and conditions, as well as the service’s terms and conditions as set out by the relevant third party service provider. By accepting the third party service providers’ terms and conditions, you enter a separate contractual relationship directly with them. Their services may be subject to geographical restrictions. Full details of the third party service providers’ terms and conditions are available in their websites and in the relevant application and/or platform where services may be hosted. The third party service providers are independent data controllers, and we recommend that you review their privacy notices to understand how they process your personal data. The third party service providers offer non-insurance services that are not intended to be a substitute for in-person medical consultations, diagnosis, treatment, assessment or care. You understand and agree that the insurer, its reinsurer and their administrators are not responsible or liable for any claim, loss or damage, directly or indirectly resulting from your use of any of these third party services.