In Belgium EHFCN has several members:

  • The Social Information and Investigation Service (SIIS)
  • The Control Office of the Mutual Health Funds and the National Unions Mutual Health Funds
  • The National Institute for Health and Disability Insurance (RIZIV/INAMI)
  • The Intermutualistic College (CIN/NIC)
  • Cigna
  • The Federal Public Service Health, Food chain safety and environment

The Social Information and Investigation Service (SIIS)

The Social Information and Investigation Service (SIIS) is a strategic organization which develops a vision on the fight against social fraud, based on the knowledge and skills of the various (inspection) services involved in the fight against social fraud and with scientific support.  Subsequently this vision is translated into concrete strategies and operationalized through a biannual Action Plan on fighting social Fraud.   In this way, the SIIS also contributes to the execution of the Action Plan of the Federal College for Combating Fiscal and Social Fraud.

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The Control Office of the Mutual Health Funds and the National Unions Mutual Health Funds

The Control Office of the Mutual Health Funds and the National Unions of Mutual Health Funds was created in 1990. It is a public interest institution under the supervision of the Ministry of Social Affairs. A mutual health fund is a private non-profit association of individuals aiming at promoting the physical, psychological and social well-being, within a spirit of providence, mutual assistance and solidarity.

The Control Office is managed by a Council, composed by a chairman and six members named by the King for a renewable period of six years: two members chosen among the civil servants of the National Institute for Health and Disability Insurance; four members chosen on behalf of their legal, social, financial or actuarial skills.

Besides taking part in the execution of the compulsory insurance, the mutual health funds must at least organize one service of complementary insurance in order to intervene financially in favor of their members in the cost for prevention and treatment of sickness and invalidity, or grant benefits in case of disablement or when the situation is such that the physical, mental or social welfare can be improved. Additionally, they must supply aid, information, guidance and assistance in order to improve the physical, mental or social welfare.

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The National Institute for Health and Disability Insurance (RIZIV/INAMI)

The National Institute for Health and Disability Insurance (INAMI) organises and financially manages healthcare insurance in Belgium.
From within INAMI the Service for Medical Evaluation and Control (SECM) is developing highly efficient systems and tools of evaluation, prevention, detection and investigation of improper use of the federal healthcare resources (€18 billion) by healthcare providers and suppliers. This results in active surveillance of good medical practice and the imposition of appropriate sanctions. Joining the Network has allowed INAMI to adopt “best practices” in tackling healthcare fraud in Belgium and throughout Europe.

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The Intermutualistic College (CIN/NIC)

The Intermutualistic College is an organisation in which all Belgian Sick Funds are represented. The most important role of a Sick Fund is to execute or to carry out all legal dispositions concerning the Belgian health insurance. This primarily means: managing a sizeable membership administration, reimbursing healthcare bills from all kinds of healthcare providers, and paying benefits in case of an incapacity to continue working as a contracted labourer, employee, or self-employed. These expenses are funded by Government advancement. Sick Funds must provide detailed information to the government in order to justify their expenses. Sick Funds are paid a certain fee by the Government to perform these tasks.

In addition to these important tasks, every Sick Fund provides a variety of services and benefits, for which the Sick Funds ask a membership fee.

All Belgian citizens must be member of a Sick Fund of their own choice, or by default will automatically become member of a Sick Fund service provided by the government. Because Sick Funds have mutual interests, face the same problems and challenges, it is only logical they should consult with each other on different levels. The Nationaal Intermutualistisch College is the highest level of consultation between Belgian Sick Funds.

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Cigna Health Insurance │Global Health Service Company

Cigna (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. Cigna has 35,000 employees who service over 80 million customer relationships throughout the world.

Within its international division, a dedicated unit focuses on the needs of International Organisations. This unit, headquartered in Belgium, has over 50 years of experience in designing, implementing and managing international group health insurance and employee benefits programmes for international and locally recruited staff from Intergovernmental (IGO) and Nongovernmental (NGO) organisations. These programmes cover medical as well as incapacity, disability and life benefits, with a specific focus on keeping employees healthy and productive through a range of health and well-being services.

The International Organisations unit is specialised in servicing customers in remote areas as well as central hubs with five service centres in each time zone (Miami, Antwerp, Madrid, Nairobi and Kuala Lumpur) and local representations on every continent.

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Federal public service Health, Food chain safety and environment

Federal health care related competences : We organize health care in Belgium. Our areas of expertise include, among others, hospital financing, health care policy and emergency medical aid co-ordination.  This page will be updated shortly.

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