The amount of money consists of a lump sum per insured person and a variable part. This depends on various factors such as age, gender or diseases. Because health insurance companies have an unequal structure of insured persons: Some have an above-average number of well-earning and healthy insured persons, others insure an above-average number of sick people and contributors with low incomes. In addition, all health insurance companies receive additional funds to cover other expenses such as administrative expenses. This ensures that health insurance companies are not put at a competitive disadvantage by insuring many chronically ill people or members with low incomes and low contribution payments.
There has been an equalization of risk differences between the health insurance companies since 1994, the so-called risk structure equalization in statutory health insurance, which has since been further developed by various legal regulations. Before the introduction of the health fund, differences in risk were compensated for by payments between the health insurance funds.
With the Statutory Health Insurance Financial Structure and Quality Further Development Act, which came into force on January 1, 2015, the financial foundations of statutory health insurance were further developed and placed on a solid footing. The general contribution rate for statutory health insurance was lowered from 15.5 percent to 14.6 percent. In addition, every health insurance company can charge an individual, income-related additional contribution.