As a result of historical circumstances, statutory health insurance is provided not by one central fund. The health insurance funds are self-administering corporations under public law and are organised into associations. Self-administration means that insured persons and their employers (but at the approved alternative funds only representatives of the insured) are actively involved in shaping the policies followed by the health insurance fund, via jointly formed administrative councils.
The statutory health insurance funds are like all social insurance funds self-administering corporations under public law. This means that the health insurance funds carry out their legally mandated tasks under government supervision but are organisationally and financially independent. The organs of self-administration are the administrative councils and executive boards of the local, company, guild and alternative health insurance funds. The insured and their employers are usually represented equally in a funds administrative council. Administration is organised as follows for the various kinds of funds:
Representatives sitting on the administrative council are elected by secret ballot every six years by the insured and their employers. The administrative council sets the budget, sets down the articles of the health insurance fund, e.g. in relation to the contribution rates, and elects and monitors the executive board.
Social elections are at the democratic heart of social insurance. Free, closed-ballot elections take place every six years. Insured persons and employers separately elect those who will represent their group from recommendation lists, based on the principles of proportional representation. In the alternative funds, however, the self-administration committees are formed exclusively of representatives of the insured persons.
The administrative council elects the members of the executive board. The full-time executive board manages the day-to-day business of the health insurance fund.
Statutory health insurance is the oldest branch of social insurance. The legal foundations for statutory health insurance are to be found in Book V of the German Social Code (SGB V), in the Farmers Health Insurance Act and in the Reich Insurance Code.
