JAE

JAE- bzw. Beitragsbemessungsgrenze

Beitragsbemessungsgrenze

Die Beitragsbemessungsgrenze beschreibt die obere Grenze des Arbeitseinkommens, bis zu welchem die Beiträge für die Sozialversicherungen unterliegen. Die Beitragsbemessungsgrenze ist nicht zu verwechseln mit der Versicherungspflichtgrenze, die einen Wechsel von der gesetzlichen in die private Krankenversicherung erlaubt. Diese Grenze wird auch Jahresarbeitsentgeltgrenze oder JAEG genannt. Bei der Beitragsbemessungsgrenze geht es um die Höhe der Beiträge für die gesetzliche Kranken-, Renten- und Pflegeversicherung sowie der Arbeitslosenversicherung.
Die Beiträge für die Sozialabgaben richten sich nach dem sozialversicherungspflichtigen Bruttogehalt. Ist das Bruttogehalt höher als die Beitragsbemessungsgrenze, orientieren sich die Beiträge nur an dieser Grenze; das über der Grenze liegende Bruttogehalt hat beitragstechnisch keine Bedeutung. Jedes Jahr passt die Bundesregierung die Beitragsbemessungsgrenze neu an. Wie sie dabei vorzugehen hat, um den Betrag neu festzulegen, regelt der § 68 Abs. 2 S. 1 SGB VI. Während die Beitragsbemessungsgrenzen für die Mehrzahl der gesetzlichen Sozialversicherungen moderat angehoben wurden, erhielt die gesetzliche Rentenversicherung im Jahr 2002 eine stärkere Anhebung.

JAE 2015

Die Beitragsbemessungsgrenze liegt 2015 für die Deutsche Rentenversicherung bei 6.050 Euro im Westen und 5.200 Euro im Osten der Republik. Für die Arbeitslosenversicherung entspricht die Beitragsbemessungsgrenze derjenigen der Deutschen Rentenversicherung. Siehe hierzu § 341 Abs. 4 SGB III. Die Beitragsbemessungsgrenzen für die gesetzliche Kranken- und Pflegeversicherung regelt § 223 Abs. 3 SGB V und § 55 Abs. 2 SGB XI, während die Jahresentgeltgrenze im § 6 Abs.7 SGB V festgeschrieben ist. Die Beträge hierfür sind jährlich 49.500 Euro oder monatlich 4.125 Euro (für das Jahr 2015). Die steuerliche Vorsorgepauschale orientiert sich seit 2004 wieder an der Höhe der jeweils aktuellen Beitragsbemessungsgrenze.

Jahresentgeltgrenze / Versicherungspflichtgrenze

Die Jahresentgeltgrenze oder Versicherungspflichtgrenze bestimmt, ob der Arbeitnehmer den Wechsel von der gesetzlichen zur privaten Krankenversicherung vornehmen darf. Das Jahresentgelt beinhaltet entweder das vereinbarte Jahresbrutto-Gehalt oder zwölf mal das vereinbarte Monatsgehalt zuzüglich Weihnachts- und Urlaubsgeld sowie andere vereinbarte und ähnliche Zuschläge.

PKV

In die private Krankenversicherung wechseln dürfen Arbeitnehmer, deren Jahresentgelt 54.900 Euro (für 2015) oder monatlich 4.575 Euro übersteigt. Die Versicherungspflicht in der gesetzlichen Krankenversicherung regelt § 5 Abs. 1 Nr.1 SGB V; die Versicherungsfreiheit beinhaltet § 6 Abs. 1 Nr. 1 SGB V. Auch den Betrag der Jahresentgeltgrenze wird vom Bundesministerium für Arbeit und Soziales jährlich neu festgelegt. Dies geschieht in einer Rechtsverordnung nach § 6 Abs. 6 SGB V. Die Berechnung orientiert sich an der Lohnzuwachsrate des vergangenen Jahres. Der internationale Vergleich zeigt, dass die meisten Staaten die Versicherungspflichtgrenze nicht kennen oder nicht mehr haben; ihre Bürger sind automatisch zur Nutzung der Gesundheitseinrichtungen berechtigt.

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Gesetzliche

Gesetzliche Krankenversicherung

Die gesetzliche Krankenversicherung ist ein Bestandteil des Gesundheitssystems in Deutschland. Die Beiträge für die Krankenversicherung erhält der Arbeitnehmer nicht ausbezahlt; sie werden direkt mit den Beiträgen zur Arbeitslosen-, Renten- und Pflegeversicherung vom Arbeitgeber an die zuständige Verteilerstelle überwiesen. Seit 2009 ist dies der Gesundheitsfonds. Die Beiträge für die Krankenversicherung bezahlen Arbeitnehmer und Arbeitgeber anteilig; das gilt auch für Rentner, die ihre Rente von der Deutschen Rente beziehen.

Auch wenn der Krankenkassenbeitrag bei allen gesetzlichen Krankenversicherungen derselbe ist, gibt es doch verschiedene Arten der Krankenkassen. Diese sind

• Ersatzkassen (EK)
• Allgemeine Ortskrankenkassen (AOK)
• Betriebskrankenkassen (BKK)
• Innungskrankenkassen (IKK)
• Landwirtschaftliche Krankenkassen (LKK) und
• Knappschaft.

Pflichtversicherung

Bei diesen Krankenversicherungen kann sich jeder Arbeitnehmer pflichtversichern; Minijobber sind automatisch bei der Deutsche Rente Knappschaft zur See versichert.

Leistungen

Die gesetzlichen Krankenversicherungen sind verpflichtet, die Kosten für die medizinische Versorgung ihrer Mitglieder und deren Angehöriger zu übernehmen. Eine ausführliche Beschreibung ist im SGB V zu finden. Der Umfang der verschiedenen Leistungen bestimmen die §§ 2 Abs. 1 und 12 SGB V sowie § 92 SGB V. Der Leistungskatalog der gesetzlichen Krankenversicherungen wird kontinuierlich überarbeitet. Derzeit enthält dieser Katalog Leistungen zur Verhütung, Früherkennung und Behandlung von Krankheiten. Die einzelnen Leistungen sind auf den Websites der gesetzlichen Krankenversicherungen enthalten. Neben den gesetzlich verankerten Leistungen können Mitglieder auch Wahlleistungen buchen.

Wechsel der Krankenversicherung

Jede Person hat die freie Wahl der Krankenversicherung, in der er versichert sein will. Bei einem Wechsel der Krankenversicherungen kommt allerdings § 175 Abs. 4 SGB V zum Tragen. Dieser Paragraf besagt, dass ein Mitglied einer Krankenkasse frühestens nach einer Mitgliedschaft von 18 Monaten die Mitgliedschaft mit einer Frist von zwei Monaten kündigen kann.

 

Zusatzbeiträge

Erhebt die Krankenversicherung jedoch Zusatzbeiträge oder erhöht die bisher geforderten Zusatzbeiträge, kann das Mitglied von seinem Sonderkündigungsrecht Gebrauch machen.
Die Kündigungsfrist verlängert sich, wenn das Mitglied der Krankenversicherung einen Wahltarif mit weiteren Konditionen nutzt. Die Verlängerung der Kündigungsfrist beträgt ein Jahr, maximal jedoch drei Jahre.

Arten der Mitgliedschaft

Mitglieder einer gesetzlichen Krankenversicherung sind in erster Linie die Beitragszahler. Diese sind versicherungspflichtige Arbeitnehmer und Rentner sowie freiwillig Versicherte. Ebenfalls Mitglied der GKV, jedoch kein Beitragszahler sind Angehörige von Mitgliedern, die über die kostenlose Familienversicherung versichert sind.
Wer versicherungspflichtig ist, ergibt sich aus § 5 SGB V und § 2 KVLG 1989. Dies sind in der Regel Arbeitnehmer und Rentner, deren Einkommen unterhalb der Beitragsbemessungsgrenze liegt. Seit Januar 2009 sind alle Bürger in Deutschland aufgefordert, sich bei einer Krankenversicherung ihrer Wahl anzumelden, sofern sie nicht krankenversichert sind.

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