Additional contribution: effort does not pay off

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Additional contribution from health insurance companies: Delayed payers and high administrative costs generate losses

Since the beginning of 2010, a total of 13 health insurance companies have been demanding an additional contribution from their members. According to an analysis by the consulting company "Steria Mummert Consulting", additional contributions for the health insurers do not bring any financial advantages. The overall administrative effort is too great and does not pay off economically. If the insured do not pay the additional contribution and have to be reminded, the health insurance companies even generate a clear deficit.

Since 2010, 13 health insurance companies have been making an average additional contribution of eight euros per month. Since the additional contribution is not collected directly with the regular cash contributions, those affected must transfer the amount extra monthly. Industry experts estimate that around eight million health insurance patients in Germany are currently affected. In the course of the health care reform, health insurance companies are free to determine the amount of the additional contribution themselves. With this instrument, the health insurers are intended to compensate for impending financial difficulties if the allocations from the health fund are no longer sufficient. Since the regular health insurance contributions can only be increased across the board, the additional contributions should also serve to strengthen the "competition between the health insurers". The German employee health insurance (DAK) was one of the first health insurance companies to experience how thousands of premium-paying members changed health insurance and exercised their special right of termination. Around half a million people changed their health insurance in the first half of last year. Since only a minority of the health insurers currently require such an additional fee, it was easy for the former members to find a new health insurer.

Thousands refuse to pay additional contributions Since the introduction, however, thousands have refused to pay such an additional contribution. Due to their financial situation, many see themselves hardly able to pay the additional contributions. This group of people is likely to include Hartz IV recipients, for whom the job centers have been confirmed by the judge to refuse to cover the costs. According to an analysis by the consulting company "Steria Mummert Consulting", the additional contributions hide an enormous administrative effort. If the delinquent payers vehemently refuse, the cash registers incur additional costs that not only destroy financial benefits, but even cause enormous loss-making business.

High administrative expenditure for health insurance companies According to newspaper reports, around five percent of members of the DAK alone should refuse to pay. On the part of the funds concerned, it has now been announced that it will collect the outstanding claims with the help of the customs authorities. Instead of further reminders, they now want to have garnishment arrears in order to still enforce the payment. However, the very procedure that can only be initiated after several payment requests from the cash registers causes disproportionately high costs. According to "Steria Mummert Consulting", a combination of administration, defaulting payers and willingness to switch is the reason why health insurance companies are currently only making losses when collecting additional contributions.

Supplementary contributions coming soon?
Health economists assume that further statutory health insurance will be dependent on an additional contribution in the future. According to an evaluation published last week, some health insurers ended the financial year with a massive deficit in the millions.

In this context, the German Trade Union Confederation (DGB) has again spoken out against the additional contributions. In a statement, the DGB described the additional contribution as a "head allowance through the back door". “The first to suffer from the head allowance are millions of pensioners and low-wage earners. With a monthly income of 1,000 euros, there is no compensation for head flat rates of up to 20 euros. That corresponds to a de facto additional payment to the health insurance contributions of 240 euros a year, ”criticized the DGB board member Annelie Buntenbach in Berlin today. Buntenbach added that a lot more people will be affected very soon. (sb)

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Image: Gerd Altmann /

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