Company health insurance funds: statutory funds with close ties to companies

Historically, company health insurance funds came into being in the 19th century, when large companies set up their own healthcare for their workforce. The founding company managed the fund, and its members were exclusively the company's own employees. This origin explains the name.

Today this has changed fundamentally. Most company health insurance funds have opened up to all insured people and compete for members with the AOK, the substitute health insurance funds and the guild health insurance funds. Some are still focused on certain industries or groups of companies, but the majority are open to everyone.

What sets company health insurance funds apart from other funds is often extra benefits specific to each fund, for example in prevention, supplementary dental cover or vaccinations. These differences are not structural, however, but competitive offers within the legal framework. The contribution rate is made up of the general contribution rate set by law and a Zusatzbeitrag set by each fund. A company health insurance fund provides statutory cover, not private benefits. If you want private medical care, you need your own contract in private health insurance.

For private health insurance, company health insurance funds matter mainly as the starting point of a switch. Many self-employed people, freelancers and employees above the Jahresarbeitsentgeltgrenze are first insured in a company health insurance fund and have to decide whether a switch makes sense.

This switch requires that your regular annual pay exceeds 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 → and also the threshold for the following year, or that self-employed work begins. Membership in a company health insurance fund alone does not make a switch possible. What matters is income, not the type of fund. If you exceed the threshold as an employee, you remain a voluntary member unless you leave. You must actively cancel your membership and take out private health insurance at the same time.

You must cancel with a notice period of two months to the end of a month, and you must give the fund proof of your new membership. If you coordinate both in good time, you switch without a gap in cover. In the comparison of benefits between statutory and private health insurance, company health insurance funds play no special role. What decides the switch is your personal state of health, your income and the benefits you want, not which statutory health insurance fund was responsible for you before. So plan the switch early and meet the notice periods.