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If the bills remain unpaid, the insurer can initiate asset seizure. If the liquidation of assets does not generate enough funds to cover the unpaid bills, the insurer will receive 85% of the outstanding debt from the canton in return for maintenance of full insurance coverage for the indebted insured. However, cantons are allowed to sanction those debtors by limiting their coverage to emergency treatment (i.e., by placing them on ��black lists��, which can be viewed by health care providers). Anonymized data was provided by CSS insurance, which is the largest social health insurer in Switzerland with a market share of 16%. This insurer's population of enrollees tends to be somewhat older and more ill than the average Swiss population, but is otherwise http://www.selleckchem.com/products/Gefitinib.html very representative. Our study included insured with a mandatory health insurance contract for the year 2013 (one year after the change in law forbidding autonomous coverage suspension by insurers). We only considered insured from eleven cantons in which premium subsidies were handled by insurers (as opposed to direct subsidy payment to insured), and hence for which subsidy data were available from the insurer. As a limitation for generalization, while all language regions and both urban and rural cantons were represented http://en.wikipedia.org/wiki/NK_cells in this sample, the regions of Central and Eastern Switzerland could not be included. Only one of these eleven cantons (Ticino) had implemented a ��black list�� by 2013. The insurer data contained information on socio-demographic factors (age, sex, family status, http://www.selleckchem.com/products/DAPT-GSI-IX.html place of living, eligibility for premium subsidies), chosen insurance coverage (deductible level, supplementary insurance coverage), medical information (presence of chronic illnesses as defined by pharmaceutical cost groups (Lamers and van Vliet, 2004), amount of reimbursed and out-of-pocket medical expenditures in past year, hospitalizations in past year), and timing of debt enforcement proceedings. Data on household income distributions were obtained from the Swiss Household Budget Survey 2006�C2009 (Haushaltsbudgeterhebung (HABE)). Analyses were performed at the level of ��payers�� for insurance premiums (e.g., parents paying for children). Payers of social insurance premiums were grouped into those with and those without debt enforcement proceedings (control group) in 2013. Those groups were compared with respect to socio-demographic, economic, and medical characteristics (see above) using univariable and multivariable logistic regression. The multivariable model was constructed by adding all variables with a likelihood ratio p-value