Annual balance 2008
17.11.2009 15:37
The Federal Insurance Office announces the amount of compensation payments in the risk structure compensation and in the risk pool for 2008
The 2008 annual compensation is the last compensation according to the so-called old procedure, which is to be replaced by the morbidity-oriented risk structure compensation from 2009, reports the Federal Insurance Office in a press release. It goes on to say:
The risk structure equalization compensates for structural differences between the health insurance companies. In the so-called old procedure these were:
- the different levels of income subject to contributions (basic wage amounts),
- the different distribution of the indirect morbidity risks of the insured, such as age, gender and receipt of a disability pension,
- the different number of family members insured without contributions.
Since 2003, separate insured groups have been formed for insured persons who are enrolled in structured treatment programs (Disease Management Programs - DMPs) - in 2008 there were around 4.6 million insured persons. While the average contribution requirement for the other insured persons was 2,005 euros, these insured persons had a higher contribution requirement. The average amount and the number of insured persons enrolled in the respective treatment programs can be seen in the table below.
| Structured Treatment program |
Average Need for contributions |
Enrolled Insured |
|---|---|---|
| Type 2 diabetes mellitus | 4,851 euros | 2.656.772 |
| Breast cancer | 8,809 euros | 104.295 |
| Coronary heart disease | 4,719 euros | 1.036.997 |
| Diabetes mellitus type 1 | 5,945 euros | 99.413 |
| bronchial asthma | 2,830 euros | 368.604 |
| COPD | 5,248 euros | 279.815 |
Particularly complex benefit cases were additionally financed on a solidarity basis via the risk pool. The health insurance companies were reimbursed for 60 percent of the service expenditure for certain insured persons that exceeded the threshold of 21,352.21 euros. In 2008, this affected around 664,000 insured people.
The compensation volume of both financial equalization procedures amounted to a total of around 19.65 billion euros (previous year: 18.5 billion euros), 18.65 billion euros. Euros in risk structure compensation, around 1 billion euros in the risk pool. 206 health insurance companies (previous year: 227) took part in the compensation process.