Insurance broker / Company health insurance in Germany (bKV) / Policy wording archive
Continentale arbeitgeberfinanzierte Smile: the policy wording in full
Zahntarif Smile mit Leistungshöhe von 750 bis 3.000 Euro je Kalenderjahr: 75 Prozent zusammen mit der Vorleistung für Zahnersatz und Implantate sowie Zahnprophylaxe bis 200 Euro (Stand 01.11.2025).
German market: tariffs for people living in Germany.
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Everything about this policy
What the policy covers: 68 points, each with its clause
Quotes are shortened. The full German wording of each point is on the German page for Continentale arbeitgeberfinanzierte Smile.
Group contract and enrolment
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Minimum number of insured employees for the group contract | not addressed | ||
| Employer funded version (the company pays the premium) | yes | „Versicherungsnehmer ist der Arbeitgeber.“ | Teil I Einleitung, page 3 |
| Employee funded version on group terms | not addressed | ||
| Spouses, partners and children can be insured | not addressed | ||
| Enrolment without health questions | not addressed | ||
| Ongoing treatment and pre-existing conditions covered | yes | „erstreckt sich der Versicherungsschutz auch auf Versicherungsfälle, die vor Beginn des …“ | § 3 (1) RB/BKV 2020, page 3 |
| Waiting periods | none | „Es bestehen keine Wartezeiten nach § 197 Versicherungs- vertragsgesetz“ | § 4 RB/BKV 2020, page 3 |
| Both statutory and privately insured persons are eligible | yes | „Versicherungsfähig nach diesem Tarif sind Personen, die in der deutschen gesetzlichen …“ | Teil II A) Personenkreis, page 29 |
| Maximum age at enrolment | not addressed | ||
| New employees join without health questions (registration deadline) | not addressed | ||
| Continuation as individual cover on leaving the company | yes | „kann die versicherte Person im unmittelbaren Anschluss daran das …“ | § 20 (1) RB/BKV 2020, page 7 |
| Continuation without new health questions or waiting period | not addressed | ||
| Cover suspended during parental leave, sick pay periods or unpaid leave | yes | „Auf Antrag des Versicherungsnehmers erfolgt das Ruhen des Versicherungsverhältnisses …“ | § 15 (1) RB/BKV 2020, page 6 |
Health budget
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Annual budget per insured person | yes, up to EUR 3,000 | „Je versicherte Person und Kalenderjahr gilt eine vereinbarte Leistungshöhe für die …“ | Teil II B I, page 29 |
| Selectable budget levels | yes | „Je versicherte Person und Kalenderjahr gilt eine vereinbarte Leistungshöhe“ | Teil II B I, page 29 |
| Budget usable freely across all benefit areas of the catalogue | yes | „Je versicherte Person und Kalenderjahr gilt eine vereinbarte Leistungshöhe für die …“ | Teil II B I, page 29 |
| Sub-limits inside the budget (e.g. glasses at most half) | yes | „Erstattet werden die Kosten für zahnprophylaktische Leistungen / PZR, Fissurenversie …“ | Teil II B II 1., page 29 |
| Pro rata budget when cover starts during the year | yes | „verringert sich die vereinbarte Leistungshöhe für dieses Jahr um jeweils 1/12 für jeden …“ | Teil II B I, page 29 |
| Carry over of unused budget to the next year | not addressed | ||
| Budget increase after a claim free year or extra budget | yes | „Die vereinbarte Leistungshöhe nach Abschnitt B I erhöht sich nach der nachfolgenden …“ | Teil II B IV, page 30 |
| Additional benefit beyond the budget in severe cases (e.g. hospital, serious illness) | not addressed |
Outpatient benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Glasses and contact lenses | not addressed | ||
| Laser eye surgery (LASIK and similar) | not addressed | ||
| Check-ups beyond the statutory programme, without age limits | not addressed | ||
| Vaccinations including travel vaccines | not addressed | ||
| Non-medical practitioners and naturopathy | not addressed | ||
| Osteopathy | not addressed | ||
| Remedies such as physiotherapy, occupational and speech therapy | not addressed | ||
| Medicines and dressings including co-payments | not addressed | ||
| Medical aids such as insoles and braces | not addressed | ||
| Hearing aids | not addressed | ||
| Private doctor treatment and fees above statutory rates | not addressed | ||
| Specialist appointment service | not addressed | ||
| Telemedicine and video consultation | not addressed | ||
| Outpatient psychotherapy or psychological counselling | not addressed |
Dental
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Professional dental cleaning | yes, up to EUR 200 | „Erstattet werden die Kosten für zahnprophylaktische Leistungen / PZR, Fissurenversie …“ | Teil II B II 1., page 29 |
| Dental treatment (fillings, root canal, periodontal) | not addressed | ||
| Dentures (crowns, bridges, prostheses) | yes | „Erstattet werden zusammen mit der Vorleistung der GKV oder PKV bis zu 75 % der Kosten …“ | Teil II B II 2., page 29 |
| Implants | yes | „Erstattet werden zusammen mit der Vorleistung der GKV oder PKV bis zu 75 % der Kosten …“ | Teil II B II 2., page 29 |
| Orthodontics | not addressed | ||
| Graded dental limits in the first years | not addressed |
Hospital
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Single room | not addressed | ||
| Two bed room | not addressed | ||
| Senior consultant or chosen doctor in hospital | not addressed | ||
| Daily hospital cash | not addressed | ||
| Substitute cash if elective services are waived | not addressed | ||
| Free choice of hospital including private clinics | not addressed |
Further modules and services
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Daily sickness allowance | not addressed | ||
| Long term care module | not addressed | ||
| Travel health insurance abroad | not addressed | ||
| Benefit on diagnosis of serious illness | not addressed | ||
| Medical second opinion | not addressed | ||
| Health services for the company (prevention, employee counselling, app) | not addressed |
Contract, premium and claims
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Uniform premium regardless of age and sex | not addressed | ||
| Premium adjustment (trigger and procedure) | yes | „Ergibt diese Gegenüberstellung eine Abweichung von mehr als 10 %“ | § 10b (1) RB/BKV 2020, page 5 |
| Minimum term of the group contract | yes | „Der Kollektivversicherungsvertrag wird zunächst für die Dauer von einem …“ | § 16 RB/BKV 2020, page 6 |
| Notice period for the company | yes | „sofern er nicht durch den Versicherungsnehmer oder den Versicherer mit einer Frist von …“ | § 16 RB/BKV 2020, page 6 |
| Ordinary right of the insurer to terminate | yes | „Zur ordentlichen Kündigung des Kollektivversicherungsvertrages ist der Versicherer nach …“ | § 17 (2) RB/BKV 2020, page 6 |
| Reimbursement rate as a percentage of the invoice | yes | „Erstattet werden zusammen mit der Vorleistung der GKV oder PKV bis zu 75 % der Kosten …“ | Teil II B II 2., page 29 |
| Deductible | not addressed | ||
| Statutory health insurance must pay first | yes | „Die Leistungen des Versicherers nach diesem Tarif werden nur in Ergänzung zu …“ | Teil II B, page 29 |
| Deadline for submitting invoices | not addressed | ||
| Territorial scope (domestic, Europe, worldwide) | yes | „Der Versicherungsschutz erstreckt sich auf Heilbehandlung in Europa.“ | § 1 (5) RB/BKV 2020, page 3 |
Austria and Spain specifics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Designed for the tax free provision up to 300 euros a year (Austria) | not addressed | ||
| Own provider network (benefits only from network doctors) | not addressed | ||
| Reimbursement option (free choice with refund) | not addressed | ||
| Co-payment per visit or service | not addressed | ||
| Taken out through flexible remuneration (tax free up to 500 euros per person) | not addressed |
Evaluated by NAMMERT from published policy wordings.
Despite care, a value may be misread;
legally only the wording of your own contract in the edition stated there applies.
Please report errors, we correct them the same day.
Policy wordings and provider
- Legal entity
- Continentale Krankenversicherung a.G.
- Distribution
- brokers and direct
- Allgemeine Versicherungsbedingungen für die arbeitgeberfinanzierte betriebliche Krankenversicherung (Teil I, Tarife mit Tarifbedingungen, Besondere Bedingungen) Edition: 01.11.2025 Original from the insurer (PDF, German)
Full text of the wording
The full text exists only in German. It is printed on the German page for Continentale arbeitgeberfinanzierte Smile and available as plain text.
Volltext Continentale arbeitgeberfinanzierte Smile · As text (Markdown) Continentale arbeitgeberfinanzierte Smile