Minimum number of participants

The minimum number of insured individuals is one of the first criteria that narrows down the selection of potential insurers—and is often the reason why a desired plan is out of the question for a company.

Why Insurers Require a Minimum Number

The favorable terms of supplementary health insurance (bKV) are based on the fact that the insurer does not calculate the risk for each individual, but rather for a group. This approach only works if the group is large enough and its composition is not selectively chosen.

If the groups are too small, a single claim could throw off the calculations. For this reason, insurers either require a minimum number of insured individuals or offset the risk in other ways—such as through a medical examination, which negates the main benefit of supplementary health insurance.

How much do the requirements differ?

The range of options on the market is considerable. Some insurers will cover even very small groups, while others require double-digit numbers of participants. In addition, there are two variations of this requirement:

• Absolute minimum: a fixed number of insured individuals
• Minimum quota: a percentage of the workforce, for example, in the case of voluntary participation

In employer-funded models with mandatory participation, the requirement is usually easier to meet than in voluntary or self-funded models—where, as experience shows, only a portion of the workforce enrolls, and disproportionately so those who are expected to need benefits.

What Happens If the Threshold Is Not Met

If the minimum number of participants is not reached, there are three options:

• Another insurer with lower requirements — the most obvious option, because the range is wide
• Accept the health screening — this will allow access, but it will no longer be guaranteed for all employees
• Expand the group of participants, for example by including additional companies within a group

What doesn't work: keeping the group small while still expecting group rates. The subsidy model, which is often chosen as a workaround in such cases, is treated as cash wages for tax purposes and negates the entire benefit.

Growing and Shrinking Workforces

The minimum number of insured individuals is not a one-time hurdle when signing the contract. If the number of insured individuals falls significantly below the agreed-upon threshold, insurers may require adjustments. For companies with a highly fluctuating workforce, this issue should be clarified before the contract is signed.

What to Look for When Comparing Options

• What is the minimum number of participants —in absolute terms or as a percentage?
• Does it apply permanently or only at the time of signing?
• What happens if the amount falls below the threshold during the term of the current contract?
• Can multiple companies within a group be consolidated?

Conclusion

The minimum number of employees determines which insurers make the shortlist in the first place—and should therefore be considered at the beginning of the selection process, not at the end. Because market requirements vary widely, this is rarely a deal-breaker for smaller companies; rather, it is primarily a matter of choosing the right provider.