How many employees do you need for company health insurance in Germany?
In short
How many employees you need depends on the plan: most German insurers offer company health insurance (betriebliche Krankenversicherung, bKV) from 5 to 10 employees, and a few plans for small teams start at 3. Hospital or sick pay modules may need 20 or more. Below three staff you will hardly find a group contract in Germany.
Published minimum group sizes and premiums for company health insurance in Germany, 2026. Limits change with new plans.
Example
Typical range
Smallest group size in the market
from 3 employees
Most common minimum for budget plans
5 employees
Some budget plans
only from 10 insured employees
Sick pay and hospital-only plans
sometimes from 20 or 50 employees
Premium for a EUR 300 budget
from about EUR 10 per employee a month
Guide values as of October 2026, from published plan terms and comparison sites.
The exact minimum depends on the plan and is confirmed in the offer.
Worked example
Design agency in Munich with 7 staff
The founders want to give company health insurance to all permanent staff after probation. Two people are still on probation.
Total staff
7
Past probation
5
Minimum for the budget plan
5 employees
Premium for a EUR 600 budget
about EUR 19 to 26 per person a month
With 5 insured people the minimum is reached. A plan starting at 10 would not work; the two new hires join after probation.
Why insurers set a minimum group size
Company health insurance usually comes without health questions or waiting periods. Insurers can only do that because they cover a mixed group of healthy and less healthy people. The smaller the group, the higher the risk that mainly employees with upcoming treatment sign up.
That is why plans set a minimum. Budget plans start lower because the annual budget caps the payout per person. Modules with high single costs, such as hospital cover or sick pay, need larger groups.
Type of plan
Usual minimum
Employer-paid budget plan
3 to 10 employees
Dental and check-up modules
5 to 10 employees
Hospital modules
often 10 to 20 employees
Sick pay (Krankentagegeld)
sometimes 20 to 50 employees
Who counts and who has to join
What counts is the number of employees actually insured, not the size of the whole company. A firm with 12 staff that only wants to cover 4 team leads will not qualify for a plan with a minimum of 5.
In employer-paid contracts, many plans require everyone in the defined group to be covered, for example all permanent staff after probation. If employees co-pay, a participation rate of 75 to 90 percent of the group is common.
Defining the group fairly
Employers may decide how many employees get company health insurance, but only by objective criteria: all staff, a department, managers or everyone with a certain length of service. Picking individual favourites breaches the German principle of equal treatment.
Criteria such as age or gender are not allowed. Mini-jobbers and apprentices can be included if they belong to the group; some plans exclude interns and temporary helpers.
Options for firms with one or two employees
With fewer than three employees there are hardly any group contracts for company health insurance in Germany. The employer can take out a normal supplementary policy as policyholder for one employee and pay the premium, but then health questions and waiting periods apply as with any individual policy.
A cash subsidy towards a policy the employee buys is simpler, but it counts as salary and is fully taxed. Growing firms are best off planning the bKV for the point when they reach the minimum size.
Step by step
Decide which group should be covered and count the people.
Look only at plans whose minimum fits that number.
Check whether everyone in the group must join or a participation rate is enough.
Set rules for new hires and probation.
Write the benefit commitment and involve the works council if there is one.
Checklist
Number of insured employees meets the plan minimum
Group defined by objective criteria
Participation rate known and achievable
No health questions confirmed for your group size
Rules for joiners and leavers in the contract
Common mistakes
Comparing company size instead of insured headcount with the minimum
Choosing individual employees without an objective criterion
Overlooking that small groups may still face health questions
Falling below the minimum after departures without knowing what the contract says
Questions and answers
Frequently asked
What happens if we drop below the minimum later?
The contract decides.
Some plans continue, others may be adjusted or cancelled.
Ask before signing.
Can a freelancer insure themselves through a bKV?
No.
Company health insurance is a benefit for employees.
Self-employed people without an employment contract take out private supplementary insurance
instead.
Do part-time employees count fully?
Yes.
The insurer covers the person, not the hours, so every part-timer counts as one.
Can employees opt out?
In employer-paid contracts this is usually not foreseen.
Where staff co-pay, anyone who declines counts against the participation rate.
I am an expat employee. Can I join if I have private health insurance?
Usually yes.
Most bKV plans accept employees with statutory or private health insurance in Germany.
