Aid (service law)

from Wikipedia, the free encyclopedia

The allowance is financial support in cases of illness , birth , care and death for German civil servants , soldiers and judges , their children and their spouses, provided the latter do not exceed certain income limits.

Legal basis

In Germany there is a law on subsidies for federal, state and municipal officials.

Section 80 (6) BBG contains the authorization to issue a corresponding ordinance for federal civil servants. The Federal Aid Ordinance (BBhV)appliesand the implementation according to Administrative regulation issued in accordance with Section 145 (2) BBG.

The state civil servant laws contain corresponding authorizations. The federal states have their own state aid regulations, some of which correspond to the BBhV, but sometimes deviate from it significantly. Municipal officials can also be included in the state aid regulations, for example in North Rhine-Westphalia. Organizationally, the pension funds are entrusted with granting the aid.

In the aid ordinances, the scope of benefits is specified and it is determined which medical services, aids and the like are “eligible”. Basically, this only applies to what is medically necessary. Aid is granted on request by the respective employer as a percentage after submission of the bills (to be paid by the beneficiary) for health-related expenses and in the states of Berlin, Brandenburg, Bremen, Hamburg and Thuringia optionally as a lump sum to the contribution of the statutory health insurance (GKV) for voluntary Insured .

The earlier state aid regulations, as mere administrative regulations based on the materiality theory, did not meet the constitutional requirements of the legal reservation .

Municipalities and public employers can reinsure themselves against the financial burdens from the payment of subsidies, depending on state law, through voluntary or compulsory membership in a subsidy fund (also: pension compensation fund) .

Reform considerations

According to the case law of the Federal Constitutional Court, the current system of granting subsidies is not one of the traditional principles of the professional civil service , which is why there is no constitutional obligation to grant benefits in the form of subsidies. The alimentation only needs to be sufficient to cover medical expenses and the like. cover the like.

In some cases, civil servants are required to be included in statutory health insurance, as would be associated with citizens' insurance , which has not yet been introduced. Various arguments are given for this, such as the cost burden on employers, risk selection at the expense of the statutory health insurance or equal treatment demands with regard to the scope of services. Changes to the state aid law of the federal states are also discussed from this point of view.

Scope of services

The basis for granting medical aid for medical expenses are the costs according to the fee schedule for private medical treatment ( GOÄ and GOZ ) if the service is generally eligible for aid. In inpatient treatment, optional services ( head physician treatment or twin room surcharge) can no longer be taken into account, or can only be taken into account with a personal contribution or for an additional monthly fee. In dentistry, there are sometimes considerable differences between the reimbursements of the allowance and those of the health insurances, for example, professional dental cleanings are usually eligible and the orthodontic indication groups of the statutory health insurance are not relevant for orthodontic treatment of underage patients . For certain expenses, e.g. B. for pharmaceuticals, the calculation basis is reduced by deductibles.

At least half of the eligible expenses are covered for active civil servants and 70 percent for retired civil servants, spouses or partners . For spouses and life partners, however, only if their income is below a certain limit (e.g. 18,000 euros in the previous calendar year). The remaining part of the medical costs is usually covered by the beneficiaries through private health and long-term care insurance (possibly with supplementary allowance tariffs).

In some countries, a flat-rate cost-containment allowance is deducted from the aid due , the amount of which depends on the grade , e.g. B. in North Rhine-Westphalia 150 to 750 euros annually. The reduction cannot be compensated for by insurance, which does not violate the duty of alimentation or care , because these do not require that expenses in the event of illness are fully covered by benefits from a health insurance that complies with the subsidy and supplementary benefits.

If the civil servant voluntarily takes out statutory health insurance, which is required in individual cases to be eligible for insurance, subsidies are usually only granted if the benefits in kind from the statutory health insurance are not claimed, but reimbursement of costs according to Section 13 SGB V is chosen. The civil servant must bear the contribution to the statutory health insurance alone if the employer does not provide the option of reimbursing half of the contribution as a flat-rate allowance upon irrevocable request by the civil servant. This corresponds to the employer's share for compulsorily insured employees or the contribution subsidy for voluntarily insured employees. Whether the decision in favor of the health insurance subsidy is financially advantageous for the civil servant depends on various factors, in particular the level of salary, the number of those who are co-insured in the statutory health insurance scheme and the contribution amount of private health insurance, which is influenced by the age at which you start and previous illnesses.

In some federal states, some groups of civil servants (e.g. police officers ) are granted free medical welfare instead of the allowance , as are the police officers of the federal police according to Section 80 BBesG .

Active soldiers receive free medical care , their family members and retired professional soldiers and their family members are eligible for assistance.

Eligibility for child aid

For children, 80 percent of the eligible expenses are regularly reimbursed. The entitlement to allowance for children requires that they are eligible for the family allowance, which depends on the entitlement to child benefit . In principle, it ends at the age of 18, for children in school or vocational training at the latest at the age of 25.

Students who are subject to compulsory insurance as such can be exempted from compulsory membership in the statutory health insurance scheme with regard to a parent's entitlement to benefits. The application is only permissible and irrevocable at the beginning of the course. If the eligibility for subsidies no longer applies and there is no obligation or entitlement to insurance in the statutory health insurance scheme according to general rules, the only option is to take out private insurance. Students who may not have the priority family insurance in the statutory health insurance are then required to be insured as students, at the latest until they turn 30.

statistics

As of June 30, 2015, there were a total of 133,720 civil servants and 190,260 pension recipients, including those persons for whom federal state aid law is applicable according to the law regulating the legal relationships of persons falling under Article 131 of the Basic Law , so a total of 323,980 in the immediate federal area. The federal government's aid expenditure in 2015 amounted to approx. 339 million euros for active persons and approx. 1.13 billion euros for pension recipients, making a total of approx. 1.47 billion euros. Based on the year 2015, this results in arithmetical aid expenditures per capita for active civil servants in the amount of 2,534 euros and for pension recipients in the amount of 5,940 euros. Administrative costs are not included in these figures.

In 2017, almost half of the members of private health insurance were eligible for subsidies.

Legal sources and texts (web links)

Federal Law (Germany)

State law (Germany)

Free State of Bavaria

Hamburg

Hesse

North Rhine-Westphalia

Schleswig-Holstein

Individual evidence

  1. ^ Ordinance on aid in cases of illness, care and childbirth (Federal Aid Ordinance - BBhV) of February 13, 2009 (Federal Law Gazette I p. 326)
  2. ↑ General administrative regulation for the Federal Aid Ordinance (BBhVVwV) of June 26, 2017, GMBl 2017 No. 31–33, p. 530
  3. ↑ The Federal Aid Regulation (BBhV) website of the Continentale health insurance , accessed on February 11, 2019
  4. ↑ State aid regulations in the federal and state levels Website of the German Beamtenwirtschaftsring e. V., accessed on February 11, 2019
  5. ↑ cf. § 16 BVO NRW Ordinance on grants in cases of birth, illness, nursing care and death (State aid ordinance NRW - BVO NRW) of 5 November 2009
  6. ↑ The introduction is planned in Saxony. "Civil servants of the Free State of Saxony are given the opportunity to take out statutory health insurance without any disadvantages." Coalition agreement 2019 to 2024 , p. 63.
  7. ^ Judgment of the Federal Administrative Court of June 17, 2004 - 2 C 50.02
  8. ↑ Financial dictionary online
  9. ^ Subsidy fund of the pension compensation fund of the municipal associations in Schleswig-Holstein - VAK ( Memento of the original from June 21, 2015 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice.  @1@ 2Template: Webachiv / IABot / www.vak-sh.de
  10. ↑ BVerfGE 58, 68 <77 and 77>; 79, 223 <235>; 83, 89 <98>; 106, 225 <232>
  11. ↑ Jendrik Scholz: Inclusion of civil servants in statutory health insurance (GKV): Are there ways towards citizens' insurance in state politics? Social Security. Journal for Labor and Social Affairs 2018, pp. 103–111
  12. ↑ Florian Staeck: Civil servants and GKV - Hamburg's reform shapes ÄrzteZeitung online, August 13, 2018
  13. ↑ Information sheet on dental services (PDF) Federal Office of Administration. 2018. Retrieved January 17, 2019.
  14. ↑ cf. z. B. Section 49 BBhV
  15. ↑ § 12a State Aid Ordinance NRW (BVO NRW)
  16. ^ Judgment of the Federal Administrative Court of March 20, 2008 - 2 C 49.07
  17. ↑ § 13 SGB V
  18. ↑ § 8 paragraph 4 sentence 1 number 1, sentence 2 BBhV
  19. ↑ Subsidy and statutory health insurance Answer of the federal government to a small inquiry, BT-Drs. 18/11738 of March 29, 2017
  20. ↑ Figures report by private health insurance 2017 p. 26