Should Companies Provide Health Insurance in the Netherlands?

Healthcare insurance for expats is a mandatory requirement. Expats are expected to obtain at least basic health insurance within four months of their stay in the Netherlands, and to pay for health insurance once they have obtained a residence permit, or when they start working in the Netherlands. Dutch companies should make sure that their expat employees have the appropriate health insurance as required by law.

Health insurance in the Netherlands is based on Zorgverzekeringswet (ZVW) healthcare insurance law and the AWBZ general law on exceptional medical expenses. ZVW healthcare insurance law is used for short-term medical care relating to general doctor visits, drug prescriptions, hospital stays and so forth. AWBZ general law on exceptional medical expenses provides special and long-term medical care for the elderly, disabled or the chronically ill.

The healthcare system is subsidised by means of taxes and monthly premiums, whose amount is set on a yearly basis. Employers pay a percentage of their employee’s income to the tax authorities, and employees also pay a fixed percentage of their income to the tax authorities. The monthly average premium that individuals pay to their health insurance provider for basic healthcare is about 92 euros per month, which can increase depending on the chosen health insurance coverage and the provider.

Trade Unions and Premiums

A majority of the work sectors have a "Collective Bargaining Agreement" (CAO) under Dutch Labour Law. CAO applies to employment contracts that contain agreements between employers and various trade unions representing the employees. Several employers have agreements in place with insurance companies that provide decent policy rates, whereby the company pays for part of the insurance premium. Not all health care is covered by the standard package, but some additional packages can be added to the basic package. However, what is paid for by employers, or agreed on by the CAO depends on what is negotiated.

In the Netherlands individuals can obtain health insurance through their employer, or they can obtain insurance directly from various health insurance companies. Employers pay for premiums by calculating the income-related contribution as a percentage of the income. In 2015 employers paid 7,65 % of their employee’s income-related contribution as taxes, while employees paid a fixed percentage of 9,65 % of their income to the tax authority. Other sources of income, such as self-employed income are paid by the individual with a reduced percentage. A combination of premium paid by an employer and by an individual is possible, but this depends on how high the income from employment is compared to the maximum premium income.

Advantages of Providing Health Insurance to Employees

Companies should provide health insurance packages for employees and join forces with other health insurance providers. Proposing a health insurance package within a company will attract and retain qualified employees, as well as offer options to permanent employees, and temporary expat employees. Working together with a health insurance provider will allow the company to have simple administration procedures. Employees will be able to view and compare premiums, packages and rates online at any time and decide on their yearly options. Invoices and payment plans can be done easily and automatically within the company to the health insurance provider.


In the Netherlands, companies do provide health insurance to employees and this is done through income-related contribution, and through bargaining with the CAO. More companies should include more health insurance packages and benefits, by joining forces with other health providers to offer the best rates, polices and premiums. This will allow employees to have more options and opportunities to choose which package appeals to them.


Maybeline Whitter