Portability (health insurance)
The portability is a term that describes from the insurance industry, which have acquired the transfer of rights, the insured with an insurance company to another insurance company or a collective with the same insurance company. Portability is of particular importance in the area of company pension schemes and private health insurance. By transferring the rights, the insured person is in a position to:
- to take the pension entitlements with the company pension scheme to a new employer and to continue the old-age provision without gaps (the decisive factor here is § 4 BetrAVG),
- of private health insurance to take the contribution part for retirement provisions to a new insurer in order to avoid the insured person falling in the tariff level with the new insurer.
Portability in private health insurance between insurers
Until the health reform passed in July 2006 came into force , it was not possible in private health insurance to deduct individual contributions from the insurer's retirement provisions when changing insurance. The reason was the fact that the provisions were not booked individually but per profit group. This resulted in a lock-in effect for the insured : from a certain amount of the provisions, the change of insurance was unprofitable due to the loss of premiums and from an economic point of view no longer worthwhile.
Fundamental changes only came into force with the health reform and the introduction of the basic tariff ; insured persons can - under certain circumstances - take part of the accumulated retirement provisions with them when switching insurance. Sections 146 and 149 of the Insurance Supervision Act (VAG) are decisive for taking along or the amount of the transferable retirement provisions .
Among other things, Section 146 (1) No. 5 VAG stipulates that the retirement provisions are included in the amount that corresponds to the benefits in the basic tariff. However, section 152 (2) sentence 2 VAG restricts portability for existing customers insofar as it excludes retirement provisions for contracts concluded before January 1, 2009. According to the earlier section 12 (1b) sentence 2 VAG a. F. With these contracts, it was only possible to take them along for a period of six months - i.e. until June 30, 2009. For this reason, the limited portability of the aging provisions to another provider continues to be criticized by consumer advocates.
Portability within an insurance company (re-rating)
In addition to the transfer of rights between different insurance companies, retirement provisions can also be transferred between different tariffs within an insurance company. The basis for this is the Insurance Contract Act (VVG), which regulates the tariff change in Section 204 VVG (in the old version until the end of 2007 Section 178 f. VVG) and the resulting transfer of rights by the insured.
Despite the clear legal situation, some insurance companies are trying to avoid the tariff change. The reason is sometimes that the old collective bargaining associations (old tariffs) are deprived of considerable financial resources by taking the provisions with them, thus destroying their original calculation bases. As a result of this effect, insurance companies have to fear massive distortions and ultimately also inefficiency in old tariffs.
According to Section 204 (1) No. 1 VVG, a transfer to a tariff with the same performance is possible in full. If, on the other hand, the policyholder wishes to switch to the basic tariff, similar conditions apply as in the case of the insurance change. The retirement provisions can only be ported if the contract was only concluded after January 1, 2009, or if the policyholder has reached the age of 55 or made an existing claim to a statutory pension or comparable pension before the age of 55. Policyholders with contracts from the period before January 1, 2009 could only apply for the tariff change to the basic tariff in accordance with Section 204 (1) No. 1 VVG by July 1, 2009.
Criticism of portability in private health insurance
Up until January 1, 2009, those insured with private health insurance had no way of transferring pension provisions they had acquired when switching insurance; from a certain period of insurance they were bound to their insurer from an economic point of view. With the introduction of portability via the Insurance Contract Act, this situation has eased, but the regulations still give cause for criticism.
- Existing customers with contracts from before January 1, 2009 in particular, only had a time window of six months. In the case of a later change of insurance, the scenario is similar to the situation before January 1, 2009, the lock-in effect remains a problem. Insofar, there is a particular disadvantage compared to insured persons with contracts after January 1, 2009, in that they can exercise a right of disposal over the individual retirement provisions.
- Especially from the perspective of the insured, the fact that retirement provisions are not created individually but collectively, summarized and inherited when leaving the collective is problematic. The result is the fact that a 100 percent individualization of the retirement provisions is not possible, so despite portability since January 1, 2009 there has been an economic residual risk for the insured.
The consumer advice centers are calling, among other things, for comprehensive reforms of the private system as well as the transfer of provisions for all those insured with private health insurance.
Portability and Citizen Insurance
Due to the increasing problems in the area of financing the health system, different models for citizens' insurance have developed, which want to merge the dual system of private health and statutory health insurance. Constitutional problems arise from this, especially in the area of the portability of retirement provisions from private health insurance, since statutory health insurance is based on the principle of solidarity , while private health insurance is managed as substitutive health insurance according to § 146 VAG like life insurance and, among other things, retirement provisions according to § 341f HGB and § 149 VAG forms.
It is unclear what should be done with the retirement provisions of privately insured persons. Some models provide that the private provisions originally built up for personal provision in old age should flow into the health fund of the integrated health insurance. Otto Depenheuer raised constitutional concerns in a 2006 report for the Association of Private Health Insurance against porting old age provisions beyond system boundaries : The portability of old age provisions between private health insurance and GKV, which does not have any old age provisions, means that the health insurances will collect and dissolve them . This would result in violations of the property rights of the insured as defined in the Basic Law as well as the state protection obligations with regard to retirement provisions. The (potential) transfer of private health insurance reserves into the GKV is a disproportion, especially since no reserves are formed in the statutory health insurance.
Web links
- BVerfG, decision of June 10, 2009 , Az. 1 BvR 832/08 and 1 BvR 837/08, on partial portability within private health insurance.
Individual evidence
- ↑ Tricks from insurers ( page no longer available , search in web archives ) Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. , Consumer center Brandenburg.
- ^ Position paper of the Federal Association of Consumer Organizations, March 29, 2012, (PDF).
- ↑ Health insurance: Study supports citizens' insurance. In: Pharmaceutical newspaper. May 14, 2013, accessed August 1, 2019 .
- ↑ Otto Depenheuer: Constitutional limits of a portability of old-age provisions in health insurance. Brief report - prepared on behalf of the Association of Private Health Insurance eV In: www.pkv.de. October 9, 2006, accessed August 1, 2019 .
- ^ Otto Depenheuer: PKV advises legal action against health reform. In: FAZ. September 28, 2006, accessed August 1, 2019 .
