How a health budget works

With the BudgetFlex model, the employer defines an annual health budget for each employee. Within this budget, the employee can freely choose from a defined catalog of health services — dental care and prosthetics, professional cleanings, glasses, prevention, alternative medicine, and more.

This is different from a fixed benefit package: instead of the employer choosing which specific treatments are covered, the employee decides how to allocate their budget based on their own health needs. One employee might use it for dental work, another for glasses, a third for Heilpraktiker treatment.

The employer pays a flat monthly premium per employee. The employee receives the budget — and the flexibility to use it.

Two tiers: Komfort and Premium

BudgetFlex is available in two product tiers. Both offer the same core budget concept, but the Premium tier provides broader coverage and removes certain sublimits:

Feature	Komfort	Premium
Budget levels	€300 – €1,500/year	€300 – €1,500/year
Glasses / contact lenses	Max. €80/year	No sublimit
Professional dental cleaning (PZR)	Sublimited	No sublimit
Pregnancy / birth benefits	—	Up to €300/year additional
Kinderkrankentagegeld	€15/day	€15/day
Family extension	✓ Available	✓ Available
Minimum company size	10 employees	10 employees

No budget reduction for mid-year starts. Pre-existing and already-started treatments are covered. Both tiers can be combined with classic component tariffs. All covered services are reimbursed within the chosen annual budget.

Representative employer premiums

The employer pays a flat monthly premium per employee — the same amount regardless of the employee's age or health status:

Annual budget	Komfort	Premium
€300	€10.91/mo	€13.68/mo
€600	€19.48/mo	€23.44/mo
€900	€26.88/mo	€31.87/mo
€1,200	€33.89/mo	€39.86/mo
€1,500	€38.95/mo	€45.63/mo

Representative examples for employer-financed BusinessLine contracts. Based on bKV rate table (Nov 2022). Actual current premiums may differ. During extended employee absence (e.g. end of salary continuation or parental leave), the employer's premium obligation may be suspended.

Why employers often prefer a budget model

Employee choice

Employees decide how to use their health budget — dental, glasses, prevention, or alternative medicine. This makes the benefit personal and directly useful, rather than abstract.

Simple for HR

The employer chooses a tier and a budget level. Enrollment and claims are handled digitally. No individual plan selection or medical underwriting required.

No health questions

Group enrollment without individual health assessment. Pre-existing conditions and already-started treatments are covered from enrollment. This eliminates one of the biggest barriers in individual supplementary insurance.

Portable coverage

When an employee leaves the company, they can continue their BudgetFlex coverage privately — at age-dependent premiums and at their own cost. This means the benefit does not simply vanish.

Family extension

If the employer's framework contract includes a family option, employees can extend BudgetFlex coverage to family members at their own cost. Family premiums are age-dependent (not flat), since they are employee-financed rather than employer-financed.

Family members can typically be enrolled without health questions during the initial enrollment window (within the first 3 months of the employer's contract). This allows the employer-provided benefit to become a family health solution — with the employer covering the base and the employee optionally adding family members.

Included services

All BudgetFlex customers have access to additional health services through the partner network:

Specialist and clinic search: Expert recommendations for doctors, specialists, and hospitals — including appointment booking
24/7 medical advice: Around-the-clock medical consultation hotline for prevention, diagnosis, and therapy questions
Digital doctor consultations: Video consultations with physicians — convenient when an in-person visit is not strictly necessary
Digital pregnancy and birth courses: Online courses for expectant parents, including post-birth recovery

These services are provided through cooperation partners and remain available as long as the respective partnerships are active.

Frequently asked questions

How does the health budget actually work?

The employer sets an annual budget (e.g. €600 or €1,200). Within this budget, the employee can use any covered health service — dental cleaning, glasses, Heilpraktiker, prevention checks, and more. The employee submits receipts, and reimbursement occurs within the budget. Once the budget is used, the employee waits until the next year. The budget does not decrease for mid-year starts.

Do employees have to answer health questions?

No. BudgetFlex is a group insurance product — no individual health assessment is required. All employees are enrolled on the same terms. Pre-existing conditions and already-started treatments are covered.

Can family members be included?

If the employer's framework contract includes a family option, yes. The family extension is financed by the employee (not the employer), and premiums are age-dependent. Family members can typically enroll without health questions during the initial enrollment window (first 3 months). This creates a complete health coverage package for the whole family, anchored by the employer-financed base.

What happens when an employee leaves the company?

The employee can continue the BudgetFlex coverage privately, at their own cost. The premium then becomes age-dependent (no longer the flat employer rate). This continuation right means the benefit is not lost — it is portable, which increases its perceived value as an employee benefit.

Is this automatically tax-free for the employee?

Not automatically. Under certain conditions, employer-financed bKV premiums can be treated as non-cash benefits (Sachbezüge) within the statutory monthly threshold — making them free of income tax and social security contributions for the employee. However, this requires proper employment-contract structuring: the employee must be entitled to insurance protection, not to a cash payment. If the monthly threshold is exceeded or the contractual setup is incorrect, standard payroll taxation applies. Professional tax advice is recommended.

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