Regulation on the allocation and assertion of liability amounts by the Association of the Federal Government of the Health Insurance Funds in the event of insolvency or closure of a health insurance fund

Unofficial table of contents

KKInsoV

Date of completion: 04.01.2010

Full quote:

" Regulation on the allocation and assertion of liability amounts by the Association of the Federal Government of the Health Insurance Funds in the event of insolvency or closure of a health insurance fund of 4 January 2010 (BGBl. I p. 2), as defined by Article 14 of the Law of 22 December 2011 (BGBl. 2983).

Status:

Amended by Art. 14 G v. 22.12.2011 I 2983

For more details, please refer to the menu under Notes

Footnote

(+ + + Text evidence from: 14.1.2010 + + +) 

  

Unofficial table of contents

Input formula

On the basis of § 171d (2) of the Fifth Book of the Social Code-statutory health insurance-which is defined by Article 1 (8) of the Law of 15 December 2008 (BGBl. I p. 2426), the Federal Ministry of Health is responsible for: Unofficial table of contents

§ 1 Scope of application

(1) This Regulation shall apply where:

1.

a health insurance company is closed by the supervisory authority, because its performance is no longer secured in the long term (case of closure), or

2.

The insolvency proceedings are opened on the property of a health insurance fund, or the opening of the insolvency proceedings is rejected in a legally binding manner (insolvency case).

(2) In the event of a closure, the Regulation shall apply to the obligations which cannot be fulfilled from the assets of the health insurance fund and which are to be fulfilled by the Association of the Health Insurance Funds in accordance with § 155 (4) and (5) of the Fifth Book of Social Code. To be able to distribute health insurance funds of the cash register which the closed health insurance company has been a member of. If the sickness insurance fund is an operating or inhealth insurance fund and the articles of association of this health insurance fund do not contain any provision pursuant to section 173 (2), first sentence, point 4 of the Fifth Book of Social Code, the Regulation shall apply only to the (3) In the event of insolvency, the Regulation shall apply to the obligations of the sickness insurance fund, for which the Association of the Health Insurance Funds is responsible under Article 171d of the German Health Insurance Fund (BGN). Fifth Book of the Social Code is liable and the non-assets or insolvency can be satisfied. Unofficial table of contents

§ 2 Distribution to the health insurance funds of the cash desk in case of closure

(1) The obligations referred to in § 1 (2) shall be allocated by the Federation of the sickness funds association of the sickness funds according to the number of members to the health insurance funds of the cash register type which the closed health insurance company has been affiliated with. The number of members to be covered by the sickness funds for the month preceding the month in which the allocation is carried out shall be the number of members. As health insurance funds of this type of cash register, the health insurance funds of the other cash registers, which have become effective after 1 April 2007, are also valid for the fulfilment of the obligations referred to in § 155 (5) of the Fifth Book of Social Code. (2) The amount of the individual health insurance funds is determined by the top association of the health insurance funds in the following ways:

1.

The amount to be allocated shall be divided by the sum of the members of the health insurance funds referred to in paragraph 1;

2.

the result referred to in point 1 shall be multiplied by the number of members of each sickness fund, and the result shall be rounded off in two places after the comma.

In the case of the sickness funds referred to in the third sentence of paragraph 1, the number of members shall be determined in accordance with the first sentence by the ratio of the number of members of the health insurance funds of the association concerned to the date on which the application is lodged to the persons concerned. Approval of the association to the sum of the members of the health insurance funds participating in the association and shall be applied to the number of members determined in accordance with the second sentence of paragraph 1. If a health insurance fund, as referred to in the third sentence of paragraph 1, has been involved in other subsequent associations, the ratio shall be re-established for each association in accordance with the second sentence, by applying it to the number of members of this health insurance fund and by the result of the following: is set in proportion to the number of members of all the health insurance funds involved in the association. For the purposes of the calculations referred to in sentences 2 and 3, the number of members shall be based on the date set out in the second sentence. (3) The obligations referred to in Article 1 (2) shall also be divided between the holding and operating sickness funds of which: By way of derogation from the first sentence of paragraph 2, the amount of the individual health insurance shall be determined in accordance with the provisions of the first sentence of paragraph 173 of the fifth Book of Social Code.

1.

The result referred to in the first subparagraph of paragraph 2 shall be multiplied by the number of its members for each of the holding and operating health insurance funds referred to in the first sentence;

2.

the result referred to in point 1 shall be limited to 20 per cent for these sickness funds and shall be rounded off in commercial terms in two places after the comma;

3.

the sum of the results referred to in point 2 shall be deducted from the total amount to be allocated;

4.

the result referred to in point 3 shall be divided by the number of members of the other health insurance funds of the cash register;

5.

the result referred to in point 4 shall be multiplied by the number of its members for each of these health insurance funds and shall be rounded off in two places after the comma.

Unofficial table of contents

§ 3 Distribution to the health insurance funds of the other cash registers at the closure of a health insurance fund

(1) The amount to be allocated to the health insurance funds of the affected cash register (§ 2 (1)) exceeds 2.5 per cent of the total amount of the annual allocations received from the health fund by these health insurance funds, the excess amount shall be transferred to the health insurance funds of the other cash registers. In the case of sickness funds in accordance with Article 2 (1) sentence 3, the amount of the allocation according to the second sentence of § 2 (2) shall be reduced. (2) The calculation of the total amount of the allocations referred to in the first sentence of paragraph 1 shall be determined by the sickness funds of the Federal Insurance Office last notified provisional amount of the allocations under § 39 (2) and (3) of the Risk Structure Compensation Ordinance. The Federal Government of the Health Insurance Funds shall provisionally apply the surpassed amount referred to in the first sentence of paragraph 1 to the health insurance funds of the other cash registers. The payments made by the health insurance funds on the basis of the investigation under the first sentence shall be deemed to be payments. After the annual compensation has been carried out for the respective calendar year, the top association of the health insurance companies lays down the amount of the allocations determined by the Federal Insurance Office in accordance with Article 41 (3) of the Risk Structure Compensation Regulation, and (3) For the distribution of the surging amount to the individual health insurance funds, § 2 shall apply mutagenic to the extent of the surcharge. In the case of the health insurance funds referred to in Article 2 (1), third sentence, the percentage of the members who have not been taken into account for the purposes of the application of the second sentence of paragraph 2 (2) shall be based on the principle of membership. Unofficial table of contents

§ 4 Distribution in insolvency case

(1) For the allocation of the obligations pursuant to § 1 paragraph 3 by the Association of the Federal Government of the Health Insurance Funds, § 2 shall apply. (2) The obligations to be allocated to the health insurance funds of the cash register shall be surmounted in accordance with § 171d (5) sentence 1 of the Fifth Book of the Social Code 1 per cent of the total amount of the annual allocations received from the health fund by the health insurance funds of the affected cash register (§ 2 (1)), the surpassed amount will be transferred to the health insurance funds of the other health insurance funds. Cash types split. In addition, § 3 (1) sentence 2, paragraphs 2 and 3 shall apply. (3) For the obligations laid down in § 171d (1) sentence 1 of the Fifth Book of the Social Code, which are not to be fulfilled by the institution of insolvency protection under the occupational pension law, the following shall apply: (2), if they exceed 1.5 per cent of the total amount of the annual allocations received from the health fund by the sickness funds of the cash in question (Article 2 (1)). Unofficial table of contents

§ 5 Rules of Procedure

(1) The top association of the health insurance companies asserts the amounts to be paid to the individual health insurance funds by communication. The sickness insurance fund has to transfer the amounts claimed to the top association of the health insurance funds within two months. (2) The sickness fund has to transfer the amounts claimed to the top association of the health insurance funds within two months. The federation of health insurance companies can set a shorter deadline if it is dependent on them for the fulfilment of its payment obligations. The payment shall be deemed to be fulfilled with the incriminating value and execution before the acceptance of the bank account on the respective due date. After the period referred to in the first sentence has been exceeded, delay shall be taken without warning. In the case of delay, default interest rates of eight percentage points above the base interest rate shall be paid. Unofficial table of contents

§ 6 Entry into force

This Regulation shall enter into force on the day following the date of delivery. Unofficial table of contents

Final formula

The Federal Council has agreed.