Statutory health insurance has been funded since 1 January 2009 via the Health Fund, which is operated at the Federal Insurance Office as a special fund of the Federation. The Health Fund is financed from premium income coming from the health insurance funds, based on a contribution rate that is identical for all health insurance funds, as well as from a federal subsidy provided from taxes. The federal contribution has been provided since 1 January 2004 as a flat-rate sum to compensate for the many non-insurance benefits provided by statutory health insurance, for instance for non-contributory insurance periods of women on maternity leave or for the much reduced health insurance contributions made by “Hartz IV” benefit recipients.
With effect as from 1 January 2015, the uniform contribution rate has been set by law at 14.6 percent. The employers’ share has been fixed at 7.3 percent, so that health insurance fund members will have to fund future expenditure increases in the healthcare sector, and the concomitant income that is needed, solely via their supplementary premiums. Health insurance funds that can not cover their financial needs with the allocations from the health fund can raise a percentage supplementary premium from their members in addition to the uniform contribution rate of 14.6 percent (§ 242, § 242a SGB V). Co-insured children or partners (family insured) do not pay an additional contribution rate.
The statutory health insurance “Schätzerkreis” group of assessors, consisting of the Federal Insurance Office, the Federal Ministry of Health and the National Association of Statutory Health Insurance Funds, plays a central role in establishing the average supplementary premium. The experts meet at regular times of the year in order to assess the financial situation of the Health Fund (income/expenditure situation). At their autumn meeting, they submit a recommendation for the average supplementary premium for the coming year, which is then established by the Federal Government.