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Freedom from health insurance and company pension scheme: effects on employers and employees
Many high-earning employees switch from compulsory statutory insurance to private or voluntary health insurance. This not only has consequences for individual security – company pension schemes (bAV) are also affected.
1 When are employees exempt from health insurance?
An employee is no longer compulsorily insured in statutory health insurance if their regular annual salary exceeds the annual salary limit (JAEG):
- JAEG 2026: 77,400 € gross (6,450 € monthly)
- For old cases with private KV before December 31, 2002: 69,750 €
Important: In addition to the monthly salary, contractually secured one-off payments (e.g. Christmas bonuses) also count towards the annual salary. Fluctuating income (e.g. commissions) must be realistically estimated.
2 Effects on the company pension scheme
If regular wages are reduced through salary sacrifice (Entgeltumwandlung), this can result in compulsory insurance being reinstated. Employers must check whether the BAV salary sacrifice (Entgeltumwandlung) falls below the JAEG - with the result: Return to statutory health insurance!
This also means that the decision in favor of a company pension scheme can have an impact on the health insurance status – both for those with statutory and private insurance.
3 Employer obligations and design options
For those with voluntary statutory health insurance:
- • Employers pay a subsidy for health insurance, max. 508.59 € monthly (2026)
- • A subsidy is also due for nursing care insurance: 1.8% or 1.3% in Saxony (max. 104.63 €)
For privately insured people:
- • Employers pay half of the contribution (including family insurance), max. €471.32 per month
Obligation for company pension advice:
- • Employers must point out the possible impact on health insurance
- • Strategically coordinated company pension advice prevents employees from having to return to statutory health insurance unintentionally
4 What happens if salary changes?
- Salary increase during the year: Freedom from insurance possible from the following year
- Salary reduction (e.g. through part-time, parental leave, short-time work): Re-entry into compulsory insurance is possible
A so-called predictive check is mandatory - even for new hires or multiple jobs.
Our recommendation for companies
- Regularly check whether employees with high compensation are changing their insurance status through salary changes or salary sacrifice (Entgeltumwandlung)
- Document the check – especially in the case of company pension agreements or changes
- Use our employer tool for a quick assessment
Frequently asked questions about health insurance freedom
Any questions about the company pension scheme and compulsory health insurance?
We advise you individually on the effects and legally compliant design in your company.
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