Do you have health care insurance in Germany? Then you can look forward to a net increase in your account at the end of January. This is due to the new allocation of the supplemental premium of the statutory health care funds, which is now paid in equal shares by employees and employers as of 1 January 2019. In 2018, this supplemental premium was still paid in full by employees.
Why do we have this supplemental premium in addition to the general contribution?
The health care funds in Germany are funded by a general contribution to the statutory health care insurance (GKV), which has remained fixed at 14.6% since 1 January 2015. The contribution rate is paid in equal shares by employees and employers (7.3% each).
Each statutory health care fund is, moreover, permitted to levy an individual supplemental charge. This serves to cover the fund’s expenses and balance its financial situation. The funds may determine the rate of the charge at their discretion. This provision is intended to promote competition between the statutory health care funds and to reward institutions who offer good services to contributors as cost efficiently as possible.
What factors do the health care funds take into account when determining the supplemental premium?
The Federal Ministry of Health defines an average rate for the supplemental premium, taking into account the assumptions and forecasts of the ‘Schätzerkreis’ [statutory group of assessors, monitoring current developments and forecasting future developments relating to the cost of health care]. This body operates under the auspices of the Federal (Social) Insurance Office [Bundesversicherungsamt] and is composed of experts from the Federal Ministry of Health, the Federal Insurance Office and of the German National Association of Statutory Health Insurance Funds [GKV] (source: Federal Insurance Office). Other experts may be consulted as well if necessary. The body is chaired by a representative of the Federal Insurance Office. The experts of the Schätzerkreis examine the official statistics related to the statutory health care insurance for the current year and provide forecasts for the developments over the next year based on those findings.
What is the current rate of the average supplemental premium?
In 2018, the average supplemental premium rate was still at 1.0%. For 2019, the average rate was reduced by 0.1 percentage point to 0.9%. At that time, the average supplemental premium collected by the statutory health care funds was at 1.07% (source: Federal Ministry of Health, December 2018). It is now possible to relieve the burden on insured members by reducing the supplemental premiums.
What does this mean for my statutory health care insurance?
Each statutory health care insurance fund is still permitted to individually fix the rate of the supplemental premium. However, in the light of the high level of reserves, a provision was adopted that the funds are not permitted to increase their supplemental premium rates if their financial reserves are higher than their expenditure for one month.
Moreover, if a fund introduces a supplemental premium or increases the current rate, its insured members have a special right of termination. This means that the member can terminate membership up to the end of the month in which the new supplemental premium takes effect. Statutory health care insurance funds must inform their insured members by letter about the average rate of the supplemental premiums and the special right of termination.
For further information, please see https://www.aok-business.de/niedersachsen/fachthemen/sozialversicherungsrecht/beitraege/