general regional health insurance

AOK logo

Regional branch in Recklinghausen

AOK building in Leipzig , built 1923–1925 by Otto Droge

AOK building in Erfurt , built in 1930 by Theo Kellner

Headquarters of the AOK in Magdeburg

Under the name Allgemeine Ortskrankenkasse ( AOK ) there are currently eleven legally independent health insurance companies in Germany , with which a total of more than 26.3 million people, i.e. around a third of the German population, are insured.

General

The AOKs appear in public as AOK - Die Gesundheitskasse with a uniform appearance. Each AOK is both health insurance and national association within the meaning of SGB V , as well as in personal union care insurance within the meaning of SGB XI . As state corporations under public law, they are subject to the specialist and legal supervision of the respective state ministries responsible for health policy. The autonomous law (statute law) is constituted by its own self-governing bodies made up of representatives of employers and employees: the executive boards and the representative assemblies . The current administrative business is carried out in accordance with Section 36 SGB IV perceived by the management.

The AOKs together have around 61,600 employees and around 1,270 business outlets (as of July 1, 2016). According to the AOK Federal Association, the eleven AOKs had 19,566,735 members on average in 2016. This corresponds to a market share of 35.2 percent and a little over a third of Germany's population. The total income of the AOK community in 2016 was around 84 billion euros. In contrast, all AOKs provided a total of 78.6 billion euros for service expenditure. That was expenditure of 3,127 euros per insured person. Treatment in hospitals was the largest item of expenditure in 2016 at 35.9 percent (28.3 billion euros).

history

The local health insurance funds were founded in 1884 immediately after the introduction of statutory health insurance in 1883 by Chancellor Otto von Bismarck . Initially there were 8,200 of them who were assigned the workers when they were not otherwise insured. From 1892 white-collar workers and homeworkers could also become members alongside commercial workers. Over time, the AOKs were organized at the district level and also reduced in the wake of the district administration reforms.

In many large towns, buildings were built for the administration, which today are still often referred to as AOK buildings or health insurance buildings and are sometimes still used as such. The Health Structure Act of 1992, with the introduction of the free choice of health insurance providers for the insured and free competition among health insurance companies, led to a further wave of mergers among the almost 300 AOKs at that time to eleven (see section: Structure ). Since the end of primary responsibility in 1996, it has also been possible for the supervisory authority to close local health insurances in the event of insufficient performance. However, this has never happened before.

organization

structure

After the merger waves, triggered by the Health Structure Act of 1992, the AOKs achieved a reduction from 300 to 17 health insurance funds, which mostly extended to exactly one federal state. Since the structures of the health insurance funds have grown historically in some cases, coverage at the state level, especially in the old federal states, was not always possible (example: formerly AOK Rheinland, formerly AOK Westfalen-Lippe). Since June 30, 2006, some health insurers have also merged across borders. There are currently the following AOKs in Germany:

Health insurance	Seat	Insured (04/01/2019)	Remarks
AOK Baden-Württemberg	Stuttgart	4,434,606
AOK Bavaria	Munich	4,586,111
AOK Bremen / Bremerhaven	Bremen	259,622
AOK Hessen	Bad Homburg vd H.	1,686,481	The planned merger with AOK PLUS on January 1, 2011 failed
AOK Lower Saxony	Hanover	2,802,375	As of April 1, 2010, incorporation of the Lower Saxony guild health insurance fund
AOK Northeast	Potsdam	1,754,966	since January 1, 2011, emerged from AOK Berlin-Brandenburg and AOK Mecklenburg-Western Pomerania
AOK Northwest	Dortmund	2,887,377	since October 1, 2010, emerged from AOK Westfalen-Lippe and AOK Schleswig-Holstein
AOK Plus	Dresden	3,326,212	since January 1st, 2008, emerged from AOK Sachsen and AOK Thuringia, planned merger with AOK Hessen failed
AOK Rhineland / Hamburg	Dusseldorf	3,035,011	since July 1, 2006, emerged from AOK Rheinland and AOK Hamburg
AOK Rhineland-Palatinate / Saarland	Eisenberg	1,207,929	since March 1, 2012, emerged from AOK Rheinland-Pfalz and AOK Saarland
AOK Saxony-Anhalt	Magdeburg	785.322

As a special feature, the AOKs have offices in France and the Netherlands. The service point on Mallorca was closed at the end of 2017.

AOK federal association

Headquarters of the AOK-BV in Berlin-Mitte

AOK Buddy Bear at Rosenthaler Strasse 31 in Berlin-Mitte

The AOKs are represented by the AOK Federal Association as a working group within the meaning of the Social Code ( SGB X ) in the form of a society under civil law. The core tasks of the AOK Federal Association are the representation of interests vis-à-vis federal politics and at the European level, vis-à-vis the National Association of Statutory Health Insurance Funds and the contractual partners of the AOKs at the federal level. In addition, there is the development of new products, brand maintenance and financial management in the liability association of the AOK community. The Federal Association has its seat in Berlin at Rosenthaler Str. 31. Until October 2008 the Federal Association was located in Bonn. Martin Litsch has been CEO since January 1, 2016. The deputy chairman of the board is Jens Martin Hoyer. Annually changing (alternating) chairmen of the supervisory board of the AOK Federal Association are Volker Hansen (employer side) and Knut Lambertin (insured side).

Since 1995, the AOK Federal Association awards, together with the Berlin Medical Association and the AOK Northeast annually award Berlin Health Prize . The AOK Federal Association publishes, among other things, the monthly G + G (Health and Society) magazine.

Before January 1, 2009, the AOK Federal Association was a corporation under public law . After the establishment of the National Association of Statutory Health Insurance Funds through the Statutory Health Insurance Act, the Federal Association was converted into a civil law company on January 1, 2009 . Sovereign tasks that the AOK Federal Association and the other central health insurance associations had performed up to then were transferred to the National Association of Statutory Health Insurance Funds by the GKV-WSG on July 1, 2008.

Scientific institute of the AOK

The Scientific Institute of the AOK (WIdO), founded in 1976, is an independent unit with around 75 employees within the AOK Federal Association without its own legal personality. It is divided into the research areas of outpatient analyzes and care, pharmaceuticals, drug information systems and analyzes, medical care, workplace health promotion, remedies and care, health policy and system analyzes, integrated analyzes and hospitals. The institute publishes health and social policy issues in its quarterly G + G Wissenschaft (GGW) , which is enclosed with the journal Society and Health (G&G) .

Collaboration in EDP and IT

In cooperation with SAP , the AOK is developing industry software that is intended to cover the entire area of statutory health insurance. AOK Systems GmbH was founded for this purpose, developing the program and implementing it at the checkouts. The oscare program has been marketed since 2005. It has already been passed on to other statutory health insurances such as B. the Barmer GEK and the Knappschaft sold. The client is pursuing the goal of developing standard software in the field of statutory health insurance in which the constantly changing legal requirements can be implemented.

In order to further develop IT and to use synergy effects, several health insurance funds have joined together to form a working group called gkv informatik . These include the AOKs from Berlin, Brandenburg, Mecklenburg-Western Pomerania, Rhineland / Hamburg, Saxony-Anhalt, Schleswig-Holstein, Westphalia-Lippe and the Barmer GEK. Together they cover around 23% of the people with statutory health insurance in Germany. Since October 2006 the gkv Informatik has been operating a joint data center in Wuppertal-Lichtscheid.

On January 1, 2007, AOK Plus, together with AOK Bayern, outsourced the entire IT to the kubus IT company and set up another shared data center in Bayreuth.

The AOKs Hessen , Thuringia , Rhineland-Palatinate and Saarland decided to work together in their IT departments in the last millennium and then founded the ARGE based in Ziegenhain in Hesse. In 2007, the ARGE was transformed into IT | S | Care - IT services for the healthcare market . After AOK Thuringia switched to kubus IT through the merger to AOK PLUS in 2008, AOK Baden-Württemberg joined IT | S | Care. The social data of a total of 6.7 million insured persons of the participating AOKs are processed and managed by IT | S | Care. The company is based in Frankfurt, the central data center was in Stuttgart until 2017. ITSCare was the AOK's first IT service provider to outsource its data center infrastructure to an external IT service provider, T-Systems. Since 2017, he has been operating the infrastructure with data center and network services as well as decentralized services such as the service desk and workplace

Development of the number of AOKs

graphic

The following graphic shows the reduction in the number of AOKs from 1995 to 2019:

Web links

Commons : Allgemeine Ortskrankenkasse - Collection of pictures, videos and audio files

Individual evidence

↑ Statutory health insurance: members, co-insured relatives and sick leave: monthly values January-August 2018 (PDF; 98.4 kB)

↑ AOK Federal Association: Facts and Figures 2017 (PDF; 801 kB) Retrieved on September 5, 2018 .

↑ On the early history of the local health insurance funds cf. Collection of sources on the history of German social policy from 1867 to 1914 , Section II: From the Imperial Social Message to the February decrees of Wilhelm II (1881–1890), Volume 5: Statutory health insurance and the registered auxiliary funds, edited by Andreas Hänlein, Florian Tennstedt and Heidi Winter, Darmstadt 2009; Collection of sources on the history of German social policy from 1867 to 1914, III. Department: Expansion and differentiation of social policy since the beginning of the New Course (1890–1904), Volume 5, The statutory health insurance, edited by Wolfgang Ayaß , Florian Tennstedt and Heidi Winter, Darmstadt 2012.

↑ 45th dfg insured person ranking / May 16, 2019, p. 2

↑ ^a ^b aok.de: AOK Hessen remains independent . (No longer available online.) Formerly in the original ; accessed on June 10, 2020 . ( Page no longer available , search in web archives )@1@ 2Template: Dead Link / www.aok.de

↑ AOK and IKK have merged ( Memento from April 4, 2010 in the Internet Archive )

↑ AOK service centers abroad . In: bayern.aok.de . Retrieved November 17, 2017.

↑ Annual Report of the Federal Court of Auditors - Comments 2016 Volume II . In: www.bundesrechnungshof.de . Retrieved November 17, 2017.

↑ aok-bv.de: The self-administration . Retrieved June 10, 2020 .

^ AOK Federal Association, Berlin Medical Association , AOK Nordost (Ed.): 20 Years of the Berlin Health Prize . Berlin 2015 (PDF).

^ GKV drug index

↑ G + G Science. Scientific institute of the AOK, archived from the original on December 11, 2018 ; accessed on December 10, 2018 (information about the publication).