Bundesversicherungsamt (zur Startseite)

English Language Information

Recent Org-Chart of the German Federal (Social) Insurance Office

Download Recent Org-Chart here.



Brief report on structure and tasks of the German Federal (Social) Insurance Office


POSITION OF THE BUNDESVERSICHERUNGSAMT UNDER ORGANISATIONAL LAW

The Bundesversicherungsamt (BVA) is an independent, superior federal authority, which works within the portfolio of the Bundesministerium für Arbeit und Soziales (Federal Ministry of Labour and Social Affairs) and was established by law in 1956. As the supervisory authority (on points of law) for statutory pensions and accident insurance, the Bundesversicherungsamt professionally works together with the Bundesministerium für Arbeit und Soziales (Federal Ministry of Labour and Social Affairs), as well as with the Bundesministerium für Gesundheit (Federal Ministry of Health) on matters of health insurance and social nursing care insurance. Within the scope of its supervisory control activities it is only subject to the general instructions of the ministries, however not to any specific instructions in individual cases.


President: Dr. Maximilian Gaßner
Vice-President: Sylvia Bohlen-Schöning


The Bundesversicherungsamt currently has approximately 560 employees, who are divided among 9 departments and 49 sections.
The Bundesversicherungsamt has its head offices at Friedrich-Ebert-Allee 38, in 53113 Bonn.

TASKS OF THE BUNDESVERSICHERUNGSAMT

I. Supervision of the “directly dependent” social insurance institutions and other establishments

As soon as the area of responsibility of a social insurance institution extends across more than three federal states, this insurance institution becomes part of the federal administration (a so-called “directly dependent” or “federally dependent” social insurance institution). These directly dependent social insurance institutions (as at 1 May 2009: 142 insurance institutions, funds and companies for statutory health and accident insurance and pensions, including the Deutsche Rentenversicherung Bund (German Pension Insurance Federation), the Deutsche Rentenversicherung Knappschaft-Bahn-See (German Pension Insurance Institute for Miners, Railway and Maritime Workers), all the substitutional social health insurance institutions and the social nursing care insurance funds set up by the health insurance funds and institutions, as well as all of the industrial and commercial, and two agricultural Berufsgenossenschaften, as well as the following accident insurance institutions; the Unfallkasse des Bundes (Federal Accident Insurance Fund), the Unfallkasse Post und Telekom (Post and Telecom Accident Insurance Fund) and the Eisenbahn-Unfallkasse (Railway Accident Insurance Fund, please refer to the appendix) come under the supervisory legal control of the Bundesversicherungsamt. More than half of all those insured withinthe statutory social insurance system belong to funds and institutions that are looked after by the Bundesversicherungsamt.

The remaining social insurance institutions and funds come under the supervision of the respective federal state in which their respective registered offices are situated.

The supervision of the Deutsche Rentenversicherung Bund (German Pension Insurance Federation) is also within the scope of the supervisory authority of the Bundesversicherungsamt insofar as it accomplishes fundamental and cross-sectional tasks in accordance with Section 138 (1) sentence 3 no. 2 to 4, 6 to 14 and 16 of the Social Code (VI) (Sechstes Buch Sozialgesetzbuch, SGB) for the entire pension insurance system and in connection with the possibility of making binding decisions for all pension insurance funds and institutions.

The supervisory authority of the Bundesversicherungsamt also covers the Spitzenverband der landwirtschaftlichen Sozialversicherung (Central Agricultural Social Insurance Fund),the Zusatzversorgungskasse für Arbeitnehmer in der Land- und Forstwirtschaft (Supplementary Retirement Provisions for Agriculture and Forestry Employees), the Seemannskasse (Seafarers Fund), the Künstlersozialkasse (Artists’ Social Fund) and the Ernst-Abbe-Stiftung (Ernst Abbe Foundation), insofar as these are health and pension funds under the Supplementary Care System Equal Treatment Act, as well as numerous associations of social insurance institutions. Since 29 November 2008, the Bundesversicherungsamt has also been responsible for supervision of the Versorgungsanstalt der deutschen Bezirksschornsteinfegermeister (Pension Institution of the German District Chimney Sweep Master Craftsmen).

1. Advice and Sanction

All the supervisory activities take place in dialogue. The success of the supervisory function is therefore not apparent from the number of sanctions imposed; instead, it primarily makes itself felt through the effectiveness of advisory consultation.

Insofar as an insurance fund or institution fails to correct a breach of the law, despite receiving appropriate advice, within the scope of its legal supervision the Bundesversicherungsamt can issue an obligatory notice (if necessary linked with the order of an immediate execution notice).

The social insurance institutions are obliged by law to use their funds more cost-effectively and economically. Thus, within the scope of its supervisory authority, the Bundesversicherungsamt can also examine the economic performance of the institutions and funds. 

The social insurance institutions can bring appeals against the Bundesversicherungsamt’s supervisory law measures before the social security tribunals.

2. Petitions and Grievances

A significant part of the Bundesversicherungsamt’s supervisory activities involves dealing with petitions, grievances and complaints concerning all branches of social insurance. In 2008, around 4,316 such petitions, etc. were received, primarily concerning health insurance.

Among other things, grievances and petitions make clear the legal and practical problems involved in the implementation of laws, draw attention to incorrect action by the social insurance institutions, and thus provide valuable indications for supervisory audits.

3. Supervisory Audits

The supervisory audits of the insurance institutions and funds are an important source of knowledge for the Bundesversicherungsamt. These audits are carried out continuously according to an audit schedule prepared at the beginning of each year. The Bundesversicherungsamt conducts around 180 of these audits each year; in addition, the health insurance funds are also audited by the health insurance audit service (see Section III.).

4. Contract Award Auditing Agency / Review Agency

The Bundesversicherungsamt performs the tasks of an auditing agency for contracts awarded for deliveries and services according to section 2 of the VOL/A (Standard Conditions of Contract for Works and Services – Part A), section 2 of the VOB/A (Standard Conditions of Contract for Construction – Part A) and freelance services according to the VOF (Standard Conditions of Contract for Freelance Services) under the Law Against Restraint of Competition (GWB).

These are measures taken to fulfil obligations under European Union Directives.

Apart from this, the Bundesversicherungsamt is responsible for the tasks of a review agency for construction contracts awarded by the directly dependent social insurance institutions and funds.


II. Co-Determination Rights

Numerous autonomous legislative acts of the self-governing bodies of the social insurance institutions require the approval of the Bundesversicherungsamt. Above all, the significant tasks involve approval of the insurance institutions’ articles of association (e.g. with regard to raising an additional contribution or premium disbursements by the health funds, mergers of Berufsgenos­senschaften and pension insurance funds and institutions) and approval or criticism of the budgets, staff regulations (including staffing schedules), risk tariffs for accident insurance, reserve fund decisions and assets (especially the purchase of land, loans, investments and construction projects, including any associated leasing transactions. This preventive supervision is very effective. Monitoring by the Bundesversicherungsamt achieves savings of five percent on average in relation to the social insurance institutions’ planned construction volume.

III. Audit of the Legality and Economic Efficiency of the Health Insurances and Nursing Care Funds

Every five years at least, the Bundesversicherungsamt must audit the business, accounting and operational management of the directly dependent health insurance funds and institutions, including their nursing care funds, based on Section 274 (1) SGB V. These audits are carried out by the field offices of the Bundesversicherungsamt in Berlin, Cloppenburg, Duisburg, Fulda, and Ingolstadt. Approximately 90 auditors, which are divided into individual auditing groups, are currently being employed on this task. Apart from serving as a means for checking that applicable law is applied, these audits are intended to inform the responsible parties, to encourage further consideration and to support getting an overview and making decisions. They have an advisory character and do not focus primarily on uncovering individual faults; rather, they are intended to contribute significantly to uncovering weaknesses, and they have a mainly preventive function.

In view of the structural changes in the landscape of the health funds and of the increasing importance of IT, the audit service has adapted its audit procedures accordingly by deploying mainly specialised audit groups and using electronic auditing tools.

Furthermore, audits of the GKV-Spitzenverband (National Association of Statutory Health Insurance Funds) and the national associations of statutory health insurance physicians are conducted in accordance with Section 274 of the Social Code (V) (Sechstes Buch Sozialgesetzbuch, SGB).

IV. Special Administrative Tasks of the Bundesversicherungsamt

Apart from its supervisory authority tasks, the Bundesversicherungsamt is also responsible for a whole range of administrative tasks, of which the following are worth highlighting:

1. Governmental Contributions to the Statutory Pension Insurance

The Federal Government contributes significantly to the financing of social security, specifically the statutory pension insurance. The Bundesversicherungsamt is responsible for the management of these federal contributions and other allocations made to social security by the Federal Government.

In the fiscal year 2009, the volume of federal funds to be allocated by the Bundesversicherungsamt to statutory pension insurance was more than 80 billion euros.

The Bundesversicherungsamt is involved in the administrative securing of the financial funds within the statutory pension insurance system through the federal contributions to the German pension insurance system.

2. Risk Structure Equalisation (RSA)

The Bundesversicherungsamt is responsible for implementing the Risk Structure Equalisation (RSA), which entered into force in 1994. The RSA is the most extensive financial equalisation procedure ever to be set up among the social insurance institutions and funds. All the statutory health insurance funds and institutions, with the exception of the agricultural health insurance funds, participate in the RSA.

The RSA equalises the following structure-related differences between the health insurance funds and institutions:

  • Income differences due to the varying levels of contributory income of the members of a health insurance institution or fund (basic wage totals).
  • Expenditure differences due to the varying distribution of mor­bi­di­ty risks among those insured in a health insurance institution or fund, as well as the varying numbers of non-contributing insured family members.

Morbidity risk has been determined on the basis of the risk factors age, gender and being in receipt of temporary disability benefits since 1994. A distinction is also made on the basis of entitlement to sickness benefit. Between 2003 and 2008, the recording of morbidity risks also took into account any registration in a structured treatment programme for the chronically sick (DMP).  Differences in benefits that were not based on these final risk factors were not accounted for in the equalisation procedure until 2008.

In the annual final equalisation round in 2007, the Bundesversicherungsamt effected a financial transfer of some 17.6 billion euros among a total of 227 health insurance funds. In addition, an amount of approximately 0.9 billion euros was transferred within the risk pool – the equalisation procedure for elaborate treatment cases – in the 2007 equalisation procedure.

As of 2009, in addition to the existing equalisation factors, the RSA will also be based on the morbidity groups set out in a classification model determined by the Bundesversicherungsamt in 2008 and which is still to be verified. The classification model of insured persons allocates the insured persons to morbidity groups according to their diagnoses and prescriptions, on the basis of which similar medical expenses can be expected in the subsequent year. With effect from 2009, risk supplements have been built into the risk structure equalisation for these morbidity groups. In total, there are 106 risk supplements for 80 selected cost-intensive chronic or serious illnesses. The Bundesversicherungsamt is supported by a scientific advisory committee as it works to fine-tune the risk structure equalisation process.

The health fund (see item 3) was set up at the same time as the morbidity-based RSA was introduced. Since 1 January 2009, the health fund has provided the Krankenkassen (health insurance funds) with

  • Contributions to cover their mandatory services
  • Contributions for statutory and discretionary services
  • Contributions for expenditure relating to the development and implementation of structured treatment programmes, and
  • Contributions to cover their administrative expenses.

The total amount of the contributions is calculated by the Bundesversicherungsamt on the basis of the refined morbidity-based RSA, with the health insurance funds being provided with monthly contribution notifications.

As at 1 January 2009, the Bundesversicherungsamt operates this procedure for a total of 193 health insurance funds and institutions, calculating and declaring the level of the supplements and determining each institution’s key indicators for the purpose of the monthly contributions. Moreover, changes to the risk structures of the health insurance funds are taken into account in the scope of three structural adjustments within each annual equalisation procedure. The BVA conducts the final annual equalisation following submission of the health insurance funds’ accounts and business results.

3. Administration of the health fund

With effect from 1 January 2009, the Bundesversicherungsamt will manage the amounts it receives according to Section 271 (1) SBG V in a special fund (health fund). This fund comprises the contributions to be made available for statutory health insurance, broken down according to the contributions received through the collection offices at the single federal contribution rate in force since 1 January 2009 (including contributions from minor employment). It is also comprised of the contributions from pension payments, the artists’ social fund, contributions from the Federal offices responsible for those doing national service and alternative community service, for those in receipt of unemployment benefit on which health insurance contributions are payable according to SGB II from the Federal Employment Agency and the approved communal institutions and for those in receipt of unemployment benefit on which insurance contributions are payable according to SGB III from the Federal Employment Agency, and of federal funds. A further source of income for the fund is the capital revenue earned over the course of each year.

The inflow of funds into the fund is effected exactly to the day / is based on the due dates agreed in each case. The health insurance funds receive a contributions notification informing them of the value of the monthly contributions (Section 39 (2) 2 RSAV). This notification explains the basis for the part contributions to be paid by the health fund within the payment month, the disbursement of which is unavoidably based on incoming contributions, Section 39 (4) RSAV in the version of GKV-OrgWG (Act for the Further Development of the Organisational Structures of Statutory Health Insurance) (BT-Drucksache (Federal Parliament Printed Matter) 16/10609 p. 90). If the amounts received during a disbursement period are insufficient and the contributions cannot be made, the deficit is initially offset from the federal budget, Section 271 (2) and (3) SGB V.

In this context, the Bundesversicherungsamt is responsible for effecting the associated payment transactions (Section 39 RSAV), for the bookkeeping and accounting of the payments (Section 220 (3) SGB V) and for coordination and design of future administrative procedures on the auditing of the health fund (e.g. Section 251 (5) 2 SGB V and Section 271a SGB V).

4. Approval of treatment programmes for the chronically sick

The Bundesversicherungsamt has core responsibility for the approval of structured treatment programmes, the Disease Management Programmes (DMP), covering diabetes mellitus types 1 and 2, breast cancer, coronary heart disease (CHD), asthma and chronic obstructive pulmonary disease (COPD). The primary objective of these DMPs is to improve the care provided for chronically ill insured persons. In particular, the aim is to avoid any complications or further problems related to the chronic illnesses among the affected insured persons. The DMPs are intended to help ensure that care is provided according to need and economically, in order to remedy existing deficiencies in care, such as overprovision, under-provision and incorrect provision in the healthcare system. To this extent, the programmes also strive to reduce the overall treatment costs by avoiding complications, hospitalisation and other consequences.

The Bundesversicherungsamt (BVA) checks whether the programme fulfils the statutory requirements and whether the contracts with the service providers to be submitted at the same time ensure proper implementation. If all the prerequisites are fulfilled, the BVA awards a limited approval for a maximum period of five years. The Bundesversicherungsamt subsequently decides, on the basis of an external evaluation, whether the programme is to be extended or re-approved.

As a means of subsidizing the DMPs, since 1 January 2009 the health insurance funds have been receiving contributions out of the health fund for each registered insured person to cover such expenses as those incurred in relation to documentation or coordination services (flat-rate payment for programme expenses). For 2009, the flat-rate payment for programme expenses is 180 euros per registered insured person.

The Bundesversicherungsamt had approved approximated 22,400 DMPs by the end of December 2008; of these, almost 4,300 were re-approvals. At the end of December 2008, nearly 5.3 million insured persons were registered on DMPs.

5. Financial Equalisation for Social Nursing Care Insurance

The Bundesversicherungsamt is responsible for carrying out the monthly financial equalisation for social nursing care insurance, with approximately 200 nursing care funds at the present time. Only this equalisation makes it possible to have a uniform nationwide contribution for social nursing care insurance of 1.95 percent of the revenues liable for contributions, possibly in addition to a childless person extra contribution of 0.25 percent when applicable. The equalisation replenishes the funds of the nursing care institutions whose monthly expenditure on benefits exceeds their income up to the statutory amount for operating and reserve requirements. Up to 0.75 billion euros currently have to be paid out each month in order to secure the liquidity of the relevant nursing care funds. In order to be able to finance this, those social nursing insurance funds whose monthly income exceeds their expenditure transfer the differential amount which is above their operating and reserve requirements.

The nursing institutions do not employ their own administrative staff; rather, their duties and responsibilities are handled by employees of the respective health care insurance. The expenses of the latter are therefore reimbursed by the nursing institutions in a lump-sum. The Bundesversicherungsamt carries out this reimbursing procedure and does the detailed calculations.

6. Equalisation Fund for Social Nursing Care Insurance 

The Bundesversicherungsamt manages the fund required for ensuring the financial equalisation of social nursing care insurance. This equalisation fund fulfils the function of a fluctuation reserve for all the insurance funds. Alongside the payments made by the nursing care funds, the equalisation fund also receives pensioners’ nursing care insurance contributions directly from the pension insurance institutions, as well as certain contributions payable by the Länder, districts and cities in the capacity of social service providers. Moreover, the equalisation fund receives the contributions forwarded by the health fund (nursing care insurance contributions for recipients of ALG (unemployment benefit) I and II, flat-rate contributions for those doing national service and alternative community service and nursing care insurance contributions from the artists’ social fund).

As the administrator of this money, the Bundesversicherungsamt must invest it securely and profitably in liquid assets.

The equalisation fund also functions as a payment office for the disbursement of funding of up to 25 million euros, which is granted by the GKV-Spitzenverband (National Association of Statutory Health Insurance Funds) for the further development of care-giving structures according to Section 45c and d SGB XI. The financing of this funding is shared equally with the Länder. The private compulsory nursing care insurance sector participates in funding for nursing care insurance, paying ten percent of that portion. In addition there is an annual budget of five million euros for model projects implemented by the GKV-Spitzenverband for the further development of nursing care insurance according to Section 8 (3) SGB XI. For the period from 1 July 2008 to 30 June 2011 an additional budget of 60 million euros is also available for the financing of care support centres according to Section 92c SGB XI.

7. Distribution of the Burden in the Commercial Accident Insurance Sector

For the first time in 2009 – for the equalisation year 2008 – the  Bundesversicherungsamt is conducting an annual burden distribution among the industrial and commercial Berufsgenossenschaften. The newly designed approach to distributing the burden is being introduced step-by-step during a transitional period that will last until 2014. It replaces the previous system of burden distribution in the industrial and commercial accident insurance sector.

Under the new system, each Berufsgenossenschaft bears its own pension burden according to its current economic structure, retaining the “industry-specific principle” and the primary responsibility of each branch of industry for the industrial accidents and occupational diseases suffered within it. Old burdens (the difference between the total actual pension burden of all Berufsgenossenschaften and the total structural burdens calculated using actuarial methods) are shared jointly by all of the Berufsgenossenschaften.

8. Überleitungsanstalt Sozialversicherung (ÜLA – Transitional Social Security Body)

As of 1 January 1992, the powers and outstanding tasks of the ÜLA were transferred to the President of the Bundesversicherungsamt. In particular, this entails the handling of the assets of the joint social security institution of the GDR.

The same applies for the properties, which the social insurance is entitled to as administrative assets and under the reunification treaty are to be qualified as joint property of the social insurance in the acceding territory.

9. Tasks Under the Compensation Pension Act / Agency of the Commission

The Bundesversicherungsamt decides whether to award compensation pensions to victims of National Socialism within the acceding territory, according to the Compensation Pension Act. The Bundesversicherungsamt also decides whether existing claims are to be disqualified or reduced, if the person entitled to the pension is guilty of infringing the rule of law in the former GDR or human rights.

A Commission set up by the Federal Government makes the necessary suggestions. This Commission’s offices are housed in the Bundesversicherungsamt.

10. Training for Social Insurance Institutions’ Employees

The Bundesversicherungsamt is involved in the training of qualified new young staff for the directly dependent social insurance institutions:

  • As the responsible agency in accordance with the Vocational Training Act, the Bundesversicherungsamt is responsible for promoting, advising and monitoring training for qualified social insurance clerks, qualified administrative clerks, qualified office communications clerks and qualified media and information services clerks in the social insurance institutions under its supervision and for holding the interim and final examinations.


    In addition, the Bundesversicherungsamt is responsible for further training examinations in accordance with Section 54 of the Vocational Training Act (BBiG) for state examinations for Specialised Experts in Statutory Pension and Miners Social Insurance, Specialised Experts in Health Insurance and Specialised Experts in Administration.

  • As the examinations body for civil service examinations for candidates for senior civil service careers the senior non-technical civil service in the social insurance, the Bundesversicherungsanstalt examines the candidates of the Deutsche Rentenversicherung Bund (German Pension Insurance Federation) and the Deutsche Rentenversicherung Knappschaft-Bahn-See (German Pension Insurance Institute for Miners, Railway and Maritime Workers) studying at the Social Security Administration Department of the Federal Institute for Public Administration, as well as its own candidates.
11. Maternity Benefits Agency

The Bundesversicherungsamt is responsible for the payment of maternity benefits to female employees that are not themselves member of a statutory health insurance institution. Each year, approximately 22,000 applications for benefits are processed.

12. Political Advice

Advising politicians is not a statutory task of the Bundesversicherungsamt. However, the agency is increasingly called upon as an expert authority to discuss laws.

Appendix

The Funds and Institutions Under the Supervisory Authority of the Bundesversicherungsamt

Institution: Health Insurance (including Social Nursing Care Insurance)

Company Health Insurance Funds: 95

Guild Health Insurance Funds: 6

Substitutional Social Health Insurance Institutions: 8

Agricultural Health Insurance Funds: 2

Miners Health Insurance Funds: 1

------
112

Institution: Pension Insurance

Deutsche Rentenversicherung Bund (German Pension Insurance Federation): 1
Deutsche Rentenversicherung Knappschaft-Bahn-See (German Pension Insurance Institute for Miners, Railway and Maritime Workers): 1
Agricultural Pension Insurance Funds: 2
-----
4

Institution: Accident Insurance

Industrial and Commercial Berufsgenossenschaften: 21
Agricultural Berufsgenossenschaften: 2
Accident Insurance Funds: 3
-----
26


Other:

Spitzenverband der landwirtschaftlichen Sozialversicherung
(Central Agricultural Social Insurance Fund)
Zusatzversorgungskasse für Arbeitnehmer in der Land- und Forstwirtschaft (ZLA)
(Supplementary Retirement Provisions for Agriculture and Forestry Employees)
Seafarers Fund
Künstlersozialkasse (Artists’ Social Fund)
Ernst-Abbe-Stiftung (Ernst Abbe Foundation)
Versorgungsanstalt der deutschen Bezirksschornsteinfegermeister
(Pension Institution of the German District Chimney Sweep Master Craftsmen)
Arbeitsgemeinschaften der Sozialversicherungsträger
(Associations of Social Insurance Institutions)

Date: 1 May 2009



Bundesversicherungsamt
Postal address:
Friedrich-Ebert-Allee 38
53113 Bonn
Tel.: 02 28 / 619 - 0
Fax: 02 28 / 619 - 18 70
eMail: poststelle@bundesversicherungsamt.de
Internet address: http://www.bundesversicherungsamt.de/

Download

nach oben

Diese Seite:

© Bundesversicherungsamt