Compulsory insurance limit
The annual income limit (Jag), including compulsory insurance limit is, one in Germany social security operand that determines at what level of the regular annual salary no longer an employee in the public health insurance liability insurance must be. The insured can then decide to switch to private health insurance. The annual income limit thus delimits the market between statutory and private health insurance and has therefore been the subject of health policy controversy for many decades.
The annual income limit does not have to be the same as the income threshold. In Germany, for example, the general compulsory insurance limit in statutory health insurance has been well above the contribution assessment limit since 2003.
Relevant annual wages
Regular annual wages are either the currently contractually agreed gross annual salary or, if a monthly salary has been agreed, twelve times the last agreed monthly salary (plus vacation, Christmas bonus and similar surcharges). Income is taken into account when determining the regular annual wage if it is almost certain that it will be paid at least once a year (e.g. due to a contractual arrangement). This means that for an employee who received € 2,400 a month from January to November and € 2,500 gross in December through a salary increase, an annual wage of € 30,000 (€ 2,500 × 12 months) as of December 31 must be taken as the basis, provided that he will also receive € 2,500 a month next year. The remuneration actually received in the year is not added up, i.e. not 11 × € 2,400 + € 2,500 = € 28,900. This calculation would only apply if the employee had received a vacation or Christmas bonus of € 100 in addition to his salary of € 2,400 and only received € 2,400 in January. A mini job up to 450 euros is not included in the annual wage. Family components are not taken into account. For people who were privately insured without insurance on December 31, 2002 because they exceeded the annual income limit, the lower so-called special annual income limit applies.
Current regulation
| General limit (Section 6 (6) SGB V) |
Special limit (§ 6 Abs. 7 SGB V) |
|||||
|---|---|---|---|---|---|---|
| year | yearly |
Change compared to previous year |
yearly |
Change compared to previous year |
||
| absolutely |
in percent (rounded) |
absolutely |
in percent (rounded) |
|||
| 2000 | € 39,574 | € 39,574 | ||||
| 2001 | € 40,034 | € 460 | 1.16% | € 40,034 | € 460 | 1.16% |
| 2002 | € 40,500 | € 466 | 1.16% | € 40,500 | € 466 | 1.16% |
| 2003 | € 45,900 | € 5,400 | 13.33% | € 41,400 | € 900 | 2.22% |
| 2004 | € 46,350 | 450 € | 0.98% | € 41,850 | 450 € | 1.09% |
| 2005 | € 46,800 | 450 € | 0.97% | € 42,300 | 450 € | 1.07% |
| 2006 | € 47,250 | 450 € | 0.96% | € 42,750 | 450 € | 1.06% |
| 2007 | € 47,700 | 450 € | 0.95% | € 42,750 | 0 € | 0.00% |
| 2008 | € 48,150 | 450 € | 0.93% | € 43,200 | 450 € | 1.05% |
| 2009 | € 48,600 | 450 € | 0.93% | € 44,100 | € 900 | 2.08% |
| 2010 | € 49,950 | € 1,350 | 2.78% | € 45,000 | € 900 | 2.04% |
| 2011 | € 49,500 | −450 € | -0.91% | € 44,550 | −450 € | -1.00% |
| 2012 | € 50,850 | € 1,350 | 2.73% | € 45,900 | € 1,350 | 3.03% |
| 2013 | € 52,200 | € 1,350 | 2.66% | € 47,250 | € 1,350 | 2.94% |
| 2014 | € 53,550 | € 1,350 | 2.59% | € 48,600 | € 1,350 | 2.86% |
| 2015 | € 54,900 | € 1,350 | 2.52% | € 49,500 | € 900 | 1.85% |
| 2016 | € 56,250 | € 1,350 | 2.46% | € 50,850 | € 1,350 | 2.73% |
| 2017 | € 57,600 | € 1,350 | 2.40% | € 52,200 | € 1,350 | 2.65% |
| 2018 | € 59,400 | 1,800 € | 3.13% | € 53,100 | € 900 | 1.72% |
| 2019 | € 60,750 | € 1,350 | 2.27% | € 54,450 | € 1,350 | 2.54% |
| 2020 | € 62,550 | 1,800 € | 2.96% | € 56,250 | 1,800 € | 3.31% |
Against wage employed workers and employees in the statutory health insurance if their regular year labor of charge (the hunter does not exceed § 5 1 para. 1 no. I. V. m. § 6 para. 1 no. 1 SGB V). Employees who regularly receive higher pay, are exempt from compulsory insurance in the statutory health insurance. The exemption from insurance comes into effect at the end of the calendar year in which the JAEG is exceeded. It is not necessary that the employee actually earned a salary of this amount in the year in which his regular salary exceeds the annual wage limit. Rather, it is sufficient that his annual salary exceeds the annual income limit in the course of a year. “Insurance-free” means that a person is not compulsorily insured in statutory health insurance; However, she is obliged to take out health insurance ( Section 193 (3) VVG) and can choose between voluntary health insurance or private health insurance . Newcomers to the profession whose wages are likely to be above the JAEG are exempt from insurance from the start.
If an employee's income falls below the JAEG in the current calendar year, compulsory insurance applies immediately. However, under certain conditions (see Section 8 SGB V ), you can be exempted from compulsory insurance.
The exemption from the compulsory insurance according to § 8 SGB V basically affects the respective compulsory insurance relationship based on which the exemption was brought about (BSG of May 25, 2011 - B 12 KR 9/09 R). This applies to all exemptions listed in § 8 SGB V.
The exemption is effective as long as the offense relevant to the exemption continues uninterrupted and would result in compulsory insurance without the exemption. The first exemption, according to Section 6, Paragraph 3, Clause 1 of SGB V, excludes a simultaneous compulsory insurance due to other circumstances (e.g. due to a second job with another employer).
History of changes
- Until 1969 there was no "automatic" change in the annual income limit. Rather, the German Bundestag decided on its change on a discretionary basis, which regularly led to political controversy. In order to “depoliticize” the border, it has since been determined that it changes annually in line with the average gross wage and salary bill.
- The general annual wage limit for 2003 was raised from 40,500 euros to 45,900 euros in order to expand the group of people subject to compulsory insurance and thus the number of contributors to statutory health insurance. This increase in the JAEG would have made a large number of privately insured persons subject to insurance again. This is why the special annual wage limit was introduced; it applies to employees who were exempt from insurance on December 31, 2002 because they exceeded the JAEG applicable on that day and were fully insured with a private health insurance company. The special annual wage limit is linked to the level of the limit applicable up to December 31, 2002; since then, according to Section 223 (3) SGB V and Section 55 (2) SGB XI, the contribution assessment limit for statutory health and long-term care insurance has corresponded to it .
- From March 26, 2007 to December 31, 2010, a person with statutory health insurance was only exempt from compulsory health insurance after his income had exceeded the JAEG in each of the three previous calendar years and his income was also likely to exceed the JAEG in the following year. There were also no exceptions for young professionals who, for example, switched directly from studying to a well-paid job. If they were employees, there was a minimum waiting period of 3 years, so that the earliest possible change to private health insurance was possible in the 4th year of employment ( Section 6 (4) SGB V).
- The obligation to take out medical expenses insurance has existed since January 1, 2009.
Development of the annual wage limits
The JAEG changes annually in the ratio in which the gross wages and salaries per employee have developed from the previous calendar year to the previous calendar year. The amount of the JAEG is set by the Federal Ministry of Labor and Social Affairs in an ordinance ( Section 6 (6 ) SGB V ).
International comparison
Most other states do not have a compulsory insurance limit: in tax-financed health systems, all citizens are “automatically” entitled to use the health facilities and co-finance them in their capacity as taxpayers. Most statutory health insurance schemes are designed as “citizens' insurance” so that all legitimate residents are included in the health insurance system regardless of their income. The health insurance systems in Switzerland and the Netherlands, in which private health insurances carry out compulsory insurance, are also designed as citizens' insurances. In the Netherlands there was a compulsory insurance limit until the end of 2005; it was at the same time the “insurance eligibility limit”: people whose income exceeded this limit had to leave the statutory health insurance and take out private health insurance. There was an insurance eligibility limit in Germany until the 1930s.
Web links
Individual evidence
- ↑ According to the law, it exists from 2003; for comparison purposes, the values from previous years are also used here
- ↑ New assessment limits for 2015. Federal Government, November 28, 2014, accessed on June 8, 2015 .
- ↑ New assessment limits for 2016 Federal Government, last accessed on November 9, 2015.
- ↑ New assessment limits for 2017 Federal Government, accessed on July 24, 2017.
- ↑ New assessment limits for 2018 Federal Government, accessed on September 27, 2017.
- ↑ New assessment limits for 2019 Federal Government, accessed on November 6, 2018.
- ↑ New assessment limits for 2020 online-pkv.de, accessed on September 6, 2019.
- ↑ That will change in 2011 for private health insurance . ( Memento from October 15, 2013 in the Internet Archive ) Association of private health insurances. V .; Retrieved February 21, 2011.
- ↑ B 12 KR 9/09 R . lexetius.com. May 25, 2011. Retrieved November 17, 2019.
- ^ A b Walter Hamann: Health economic analysis of control problems in the statutory health insurance . Diss. Verlag Kleikamp, Cologne 1981
- ^ For example, for Great Britain: European Observatory on Health Systems and Policies. United Kingdom of Great Britain and Northern Ireland . WHO, Health Services in Transition. 1999. Retrieved February 21, 2011.
- ↑ See, for example, for Austria: European Observatory on Health Systems and Policies Austria . WHO, Health Services in Transition. 2006. Retrieved February 21, 2011.
- ↑ See, for example, on Switzerland: Stefan Greß, Ralf Kocher, Jürgen Wasem: Competition-oriented reforms in the Swiss health system - a model for regulated competition in German statutory health insurance? In: Perspektiven der Wirtschaftsppolitik , 5, (1) 2004, pp. 59–70.
- ↑ Maral Manouguian, Stefan Greß, Jürgen Wasem: The Dutch health insurance reform - a model for the German GKV-WSG? In: Health and Social Policy , 11–12 / 2006, pp. 30–34.
