Insurance broker for private health insurance: role, commission and differences

The difference between a broker and a tied agent is clearly defined by law. Brokers under § 34d GewO work on behalf of the client and can arrange contracts with all insurers. Tied agents are usually bound to one or several specific insurers. We recommend asking about broker status before every consultation and, if needed, looking at the license documents. With a broker, you are also entitled to a written record of the advice under § 62 VVG.

A broker's work starts before the first plan comparison and does not end when the contract is signed.

Needs analysis: clarifying your personal situation, meaning income, profession, health status, family situation and your goals and expectations of private health insurance.

Anonymous risk enquiry: before recommending a plan, the broker asks several insurers anonymously which pre-existing conditions can be insured on which terms. This protects you from records being created through direct contact and gives a realistic picture of the market.

Plan comparison across the market: all relevant insurers are included. The result is a documented plan proposal with reasons, not a one-sided recommendation of a provider.

Support with the application: answering the health questions correctly is a critical step. From more than 5,000 applications with health questions, we know the wording and assessment patterns of the providers.

Ongoing support: changes in your life situation, premium adjustments, plan optimization under § 204 VVG and the handling of claims are part of a broker's long-term work.

The broker is paid through an acquisition commission that the insurer pays when a plan is arranged. There are no direct costs for the client.

It is important that the premiums with the insurer are identical to buying directly. The commission is already included in the plan. Buying directly without a broker does not lead to lower premiums, because insurers set their calculation regardless of the sales channel.

Commissions are the same at almost all private health insurers. There is therefore no financial incentive to recommend an insurer only because of a higher commission. The commission clawback over five years strengthens this effect, because if the client cancels within five years, the broker pays back part of the commission to the insurer. The alternative, a fee-based advisor with comparable market coverage, typically costs a fee of several hundred euros.

The legal difference is clear. A broker under § 34d GewO works on behalf of the client, a tied agent on behalf of one or several insurers.

Single-company agents: work exclusively for one insurer. They can only arrange plans of this provider, and a comparison across the market is not possible.

Multi-company agents: work for several insurers but are bound to them. Providers outside this group are not considered.

Brokers: not permanently bound to any insurer. The advice duties under § 60 VVG and § 62 VVG are stricter for brokers than for tied agents. Under § 62 VVG, clients are entitled to a written record of the advice.

In practice, this means you choose a broker if you prefer a comparison across the market and the stricter legal framework for advice.

Experiences with a broker differ greatly depending on how specialized the broker is. A generalist broker who arranges private health insurance alongside car, household contents and life insurance usually has less insight into the rejection and acceptance patterns of private health insurers than a specialist.

When choosing, we recommend asking for the exact number of applications with health questions the broker has handled. That is the most honest measure of experience in private health insurance. Someone who has submitted over 5,000 applications with health questions to insurers knows the differences between providers from practice, not from the brochure.

For very complex situations such as chronic conditions, mixed situations involving Beihilfe (i)BeihilfeThe state healthcare allowance for civil servants. The Beihilfestelle pays a fixed share of medical costs, the Beihilfesatz, and private insurance covers the rest.More about Beihilfe → or links abroad, a broker specialized in private health insurance is advisable. For simpler cases, such as a switch without pre-existing conditions after exceeding the Jahresarbeitsentgeltgrenze (i)JAEG · JahresarbeitsentgeltgrenzeThe annual income threshold in Germany. Employees who earn more than this per year may leave statutory health insurance and switch to private health insurance.More about JAEG →, brokers with a general focus are often enough.

A broker under § 34d GewO is not limited to specific insurers. We consider all relevant providers on the market. There are no exclusive partner contracts that would restrict the comparison.

Under § 62 VVG, a broker's clients are entitled to a written record of the consultation. It states which options were discussed, which recommendation was made and on what basis. This record protects the client and creates transparency.

No. The premium is identical to buying directly. The commission is already included in the plan and is paid by the insurer, not by the client.

Yes. Plan optimization under § 204 VVG is a focus of its own. Existing customers can have an internal plan change with their current insurer checked, without changing provider or going through new health questions.