Social Insurance (Austria)

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organization
Umbrella organization: Umbrella organization of social insurance agencies
Founding year: 1948 (Main Association of Austrian Social Insurance Institutions)
2020 (Umbrella Association of Social Insurance Institutions)
Tasks: Cooperation, coordination and service for the individual carriers
Logo: Hvb logo.gif
10 social security agencies

(some beams have multiple branches)

4 health insurance carriers
3 pension insurance carriers
3 accident insurance carriers

In terms of budget and the group of people affected, the Austrian social insurance is the main institution of social security in Austria .

organization

The Austrian social insurance has the right of self-administration (Art. 120a ff. B-VG ), in that the statutory (professional) interest groups send representatives to the organs of a social insurance carrier who conduct the business of the social insurance without instructions.

The insurance carriers and the main association including their institutions and facilities are subject to federal supervision . The Federal Minister for Social Security, Generations and Consumer Protection is responsible for the supervision of the main association, the pension insurance institution and the pension institutes, while the Federal Minister for Health and Women supervises the other insurance carriers. In matters that fall within the sphere of activity of both Federal Ministers or exclusively within the sphere of activity of the other Federal Minister in each case, the Federal Minister who exercises the supervision must establish agreement with the other Federal Minister (Section 448 (1) ASVG ).

carrier

General competence means that these insurance carriers are responsible for all those groups of people for whom no special law applies.

Some carriers are organized centrally. They have a main office and branch or regional offices in the federal states or districts. Some are organized decentrally with regional offices, each with their own executive bodies in the federal states.

For officials no pension insurance institution exists because instead of a pension entitlement to rest pleasure (or care benefit is for survivors) with respect to service agencies. The paying body is the pension service of the insurance company for public employees (formerly the Federal Pension Office ).

One of the 15 Austrian health care institutions (KFA) is responsible for some of the state and municipal employees. These are not social insurance carriers and do not belong to the umbrella organization of social insurance carriers .

Umbrella organization

The umbrella association of social insurance agencies was founded in 1948 as the main association of Austrian social insurance agencies.

Among other things, he is responsible for safeguarding the general and macroeconomic interests of the social security agencies (e.g. assessing draft laws, observing economic developments) and representing the social security agencies vis-à-vis foreign institutions (e.g. participating in the conclusion of social security agreements with other countries).

Since 1969, the main association has also been responsible for assigning social security numbers , which apply to all insurance carriers. This unique number makes it easy to switch from one insurance company to another.

Principles and tasks

Financial flows in the Austrian healthcare system
      Bonuses → Private insurance   Special services    
                             
                        Catalog services ( after DRG )      
        Contributions → Health insurance (
compulsory insurance) 		         
                         
        Taxes FA →                        
          → BM (Fin) countries → BGA          
       
                Art. 15a BV-G   ↓ budget   ←      
Country Fund (
LGF) 		   
                →   →          
             ↓    
population   Deductibles   Fund KA ←                  
     
 AN , AG (←) → ←   fee   ←    
        Private KA                
    some deductibles *   ← PRIKRAF ←      
     
              Expense coverage        
or. (←) → Outpatient clinic ←        
                   
    some deductibles *           Flat rate
+  individual services 		       
  (←) → (practicing)
doctor 		←        
          Exp. f. Drugs
+  of pharmacy services 		 
    Prescription fee **                          
patient (←) → pharmacy ←        
                   
    ↑                        
        reimbursement        

(Fin) Ministry of Finance distributes the budget for the Ministry of Health ;
* flows directly to KV carriers;
** flows via pharmacy to health insurance providers;
(←) partly direct reimbursement or exemption for mandatory verse.
Reds: Government Sector,
Yellows: Private Sector

Diagram according to Ziniel (2005)

The principle of compulsory insurance prevails in Austria . The benefit requirement for one year is almost entirely covered by the premium income for the same year, i. H. The accumulated capital essentially only serves as a short-term fluctuation reserve (sustainability reserve, generation contract, financing principle). The benefits are mainly provided as benefits in kind that are the same for all insured persons (principle of solidarity) or as contribution-based cash benefits (e.g. pensions, sickness benefits). In addition to insurance benefits in the narrower sense, the tasks of social insurance also include health care , safety advice and rehabilitation .

Not all persons with compulsory insurance are insured in all branches. If you are only insured in individual branches of social insurance (e.g. accident insurance), one speaks of partial insurance . In contrast to full insurance if you are compulsorily insured in all areas. (Unemployment insurance, which is not part of full insurance, has a special position.)

Legal bases

Branches of social security

Health insurance

The health insurance in Austria does the insurance cover cases of illness , disability due to sickness and the maternity off. It provides benefits in kind (medical treatment, hospital care, ...) as well as cash benefits (sick pay, maternity allowance, ...) and is divided into two subgroups.

Compulsory insurance

In Austria, health insurance is compulsory, which means that every employee whose gross salary is above the marginal earnings threshold is also insured. This type is regulated by law in the ASVG (General Social Insurance Act). The health insurance itself cannot be selected, but depends on the respective employer and its location. For example, there is the Austrian Health Insurance Fund for all employees, which is responsible for people who are not self-employed. In addition, there are separate health insurances for federal employees, railway workers and mining workers (BVAEB) as well as for entrepreneurs, farmers and other self-employed persons who are insured for health, accident and pensions with the Social Insurance Institute for Self-Employed Persons (SVS). Unlike the ÖGK, the latter has a deductible of 20% for outpatient treatment (which can be reduced to 10% through successful participation in a preventive program), which the insured person has to pay, but offers more benefits than the ÖGK. For BVAEB policyholders, there is a 10% deductible for outpatient treatment. In the case of employed persons, the insurance contributions are deducted directly from the gross salary or wage by the employer as part of the wage accounting and transferred to the health insurance fund together with the portion that the employer has to pay to the state in addition to the gross salary (so-called employer contributions) . Employees whose gross salary is below the annually adjusted marginal earnings threshold and are therefore not compulsorily insured in health, pension and unemployment insurance can voluntarily take out insurance with the responsible health and pension insurance (self-insurance for marginal employment). Unlike compulsory insurance, the amount of the monthly contribution for voluntary self-insurance does not depend on the gross salary, but is subject to an annual adjustment and is the same for all self-insured persons.

Private insurance

In addition to compulsory insurance, every Austrian is free to take out various private supplementary health insurance policies with an insurance company of their choice. In addition to the special class insurance, which guarantees a free choice of hospital and doctor as well as more comfort in the event of a hospital stay, such as a two-bed room with shower, toilet, TV and telephone, many insurers now also offer policies that cover additional costs for visits to the dentist or costs for cures and alternative healing methods.

Accident insurance

The accident insurance covers the insured events of the occupational accident and the occupational disease and has to eliminate the consequences with all available means as well as possible.

In addition to benefits in kind, the Austrian accident insurance also provides cash benefits, mainly in the form of accident pensions. Cash benefits only if the accident occurred on the way to work or while doing it. There is no cash benefit for disability following a leisure accident.

Pension insurance

The pension insurance covers the insured events of old age, death as well as reduced ability to work or disability; in addition, rehabilitation services are provided. It provides mostly cash benefits, mainly in the form of pensions. (The term "pension" is not used in Austria for old age pensions, but only for benefits from accident insurance.)

Since 2020 there are only three pension insurance carriers:

  • Pension Insurance Institution (PVA)
  • Social Insurance Institution for the Self-Employed (SVS)
  • Insurance company for public employees, railways and mining (BVAEB)

There is no pension insurance institution for civil servants because the civil servant pension is provided by the service authorities. However, this does not preclude civil servants from making their own pension contributions in the course of harmonization.

Welfare
funds Welfare funds (e.g. for doctors, tax advisors, etc.) have a special position. These are compulsory supplementary pension insurances for these professional groups prescribed by the respective professional associations, but the insurance carriers are private companies.

unemployment insurance

The insured event of unemployment is covered by the unemployment insurance, which is basically part of the Austrian social security system, but is not carried out on the principle of self-administration, but is handled by the federal government via the labor market service .

budget

Income of around EUR 41 billion (2006) was offset by expenditures of EUR 44.1 billion as follows:

  • Health insurance EUR 12.4 billion
  • Accident insurance EUR 1.3 billion
  • Pension insurance EUR 27.4 billion

Exact figures and detailed statistics can be found on the homepage of the main association.

history

The Social Security is at the present time an important pillar of the welfare state . Its roots go back to the Middle Ages , whereby initially the self-help organizations, and later especially the miners' "brother shops", were of great importance. The brother's shop was responsible for providing medical treatment and death benefits, and for taking care of the disability. Community aid based on solidarity proved to be indispensable in the mining activities associated with great dangers.

  • 1859: New trade regulations issued
The trade regulations for the first time regulated questions of accident and health insurance for workers.
  • 1868: Establishment of the General Workers' Sickness and Invalid Fund
This fund was the predecessor of the Vienna Regional Health Insurance Fund (WGKK).
  • 1887: accident insurance
Industrialization increased the number of accidents at work and occupational diseases. In order to avert the risk of individual claims for damages against the employers, which under certain circumstances could mean the ruin of a company, the employers were legally merged into a risk community that is jointly financed by all employers and has to pay for any damages.
  • 1889: health insurance
A statutory regulation of social insurance in today's sense came about for the first time in 1889. All commercial and industrial workers and employees, with the exception of agricultural workers, were covered by the statutory health insurance. The self-government was introduced.
  • 1906: pension insurance
Statutory pension insurance was introduced in 1906 for the "private civil servants", i.e. employees.
  • "Connection" to the Third Reich
Self-administration was abolished, organization based on the NS model was taken over into state administration and the Reich Insurance Code (RVO) applied. Since German law came into effect, the workers received pension insurance for the first time.
  • Social Security Transition Act
After the liberation from fascism and the re-establishment of the Republic of Austria, the social insurance transition law of June 12, 1947 was put on a new organizational basis. The most important measure was the reintroduction of self-administration and the establishment of the main association of Austrian social insurance institutions as an umbrella organization.
  • 1956: ASVG
The General Social Insurance Act (ASVG), which came into force on January 1, 1956, replaced the previously applicable laws in the field of social insurance. It summarized health, accident and pension insurance for workers and employees in industry, mining, trade, commerce, traffic and agriculture and forestry and also regulated the health insurance of pensioners.
For some special insurance, social security laws outside of the ASVG remained.
The ASVG is divided into ten parts. In the meantime, numerous changes and amendments to the law have been made in line with the ongoing socio-political development.
  • 1958: Commercial Self-Employed Pension Insurance Act (GSPVG)
With effect from January 1, 1958, the self-employed traders were included in the system of compulsory pension insurance for the first time (BGBl 292/1957), after there had already been pension insurance from the chambers. Since 1979 Commercial Social Insurance Act (GSVG).
  • 2001: Dissolution of the company health insurance fund of the Austrian State Printing Office
dissolved from 2001 by decision of the Ministry of Social Affairs of October 2, 2000.
The insured were included in the Vienna Regional Health Insurance Fund.
  • 2003: Dissolution of the Pengg company health insurance fund in Thörl near Aflenz
dissolved from 2003, according to Section 600 (6) ASVG in the version of Federal Law Gazette I No. 140/2002
The insured were included in the insurance company of the Austrian mining industry.
  • 2003: Merger to form a pension insurance company
On January 1, 2003 the merger of the pension insurance company for workers and the pension insurance company for salaried employees (§ 538a ASVG) took place.
  • 2005: General Pension Act (APG)
Uniform pension law for all employees with pension insurance in Austria.
  • 2005: Merger to form the insurance company for railways and mining
On January 1, 2005, the insurance company of the Austrian railways and the insurance company of the Austrian mining industry merged (§ 538h ASVG).
  • 2006: Merger to form the company health insurance company voestalpine Bahnsysteme
On January 1, 2006, the BKK Alpine Donawitz and BKK Kindberg merged (Section 538o ASVG in the version of Federal Law Gazette I No. 71/2005 ).
  • 2006: Dissolution of the Semperit company health insurance fund
as of October 1, 2006 by regulation BGBl. II No. 348/2006 .
  • 2016: Dissolution of the company health insurance fund Austria Tabak
as of December 31, 2016 by regulation BGBl. II No. 303/2016 .
  • 2018: Social Insurance Organization Act (SV-OG)
On December 13, 2018, the Austrian National Council passed the Social Insurance Organization Act (SV-OG) to merge the existing 21 into five social insurance institutions. The nine regional health insurance funds are to be merged to form the Austrian Health Insurance Fund (ÖGK), the Public Employees Insurance Company (BVA) and the Insurance Company for Railways and Mining (VAEB) to become the Insurance Company for Public Employees, Railways and Mining (BVAEB), the Social Insurance Institute for Farmers (SVB) and the social insurance institute for the commercial economy (SVA) to the social insurance institute for the self-employed (SVS). The pension insurance institution (PVA) and the general accident insurance institution (AUVA) will remain in place. The new organizational structure is valid from January 1st, 2020.

Subsidiaries

The main association of Austrian social insurance institutions has founded the social insurance chip cards Betriebs- und Errichtungsgesellschaft mbH.

All health insurance carriers founded the IT services of Sozialversicherung GmbH.

The social insurance institute for farmers and the social insurance institute for commercial enterprises founded SVD-Büromanagement GmbH for the joint implementation of back-office matters, to which the insurance institute for public employees and the insurance institute for railways and mining later joined.

Web links

Individual evidence

  1. ^ The ideological foundations of the self-administration of the Austrian social insurance company BKK der Wiener Verkehrsbetriebe, 2001
  2. ↑ No light in the darkness of the "luxury health insurance funds". Wiener Zeitung, accessed on June 3, 2020 .
  3. ^ The Organization of the Austrian Social Insurance Social Security 2012, pp. 340/341
  4. ↑ Reproduced in: Ch. Herber; J. Weidenholzer (Ed.): Assessment approach of the implementation of the health reform 2005 . Linz 2007, p. 133 (PDF, ooegkk.at, accessed on July 20, 2014) - there “Ziniel (2005)” without further details.
  5. ↑ a b A short history of the welfare state. In: addendum.org. December 2, 2017, accessed August 24, 2020 .
  6. ^ Social insurance: State printing company health insurance fund dissolved on December 31, 2000. Main Association of Social Insurance Institutions (OTS), accessed on August 24, 2020 .
  7. ^ Structural reform in the Austrian health insurance . Retrieved May 13, 2019.
  8. ^ Social security chip cards Betriebs- und Errichtungsgesellschaft mbH
  9. ↑ IT services from Sozialversicherung GmbH