Insurance broker / Company health insurance in Germany (bKV) / Policy wording archive
uniVersa Uni Bze: the policy wording in full
Baustein uni-bZE für Zahnersatz und Implantate mit 80 Prozent Erstattung (100 Prozent bei Regelversorgung) einschließlich GKV-Leistung und Zahnstaffel von 750 bis 3.000 Euro in den ersten vier Jahren (KVB-604).
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 uniVersa Uni Bze.
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 | „des Kollektivrahmenvertrages zwischen dem Versicherungsnehmer (Arbeitgeber) und dem …“ | AVB § 15 (6), page 7 |
| Employee funded version on group terms | not addressed | ||
| Spouses, partners and children can be insured | yes | „versicherte Familienangehörige (Ehepartner und Lebenspartner gemäß § 1 …“ | Tarif uni-bZE I b), page 12 |
| Enrolment without health questions | not addressed | ||
| Ongoing treatment and pre-existing conditions covered | no | „vor Vertragsabschluss begonnene oder angeratene Behandlungen besteht kein …“ | Tarif uni-bZE III.1, page 11 |
| Waiting periods | none | „Die Wartezeiten nach § 3 AVB/bKV entfallen für die unter I genannten Personen, sofern …“ | Tarif uni-bZE II, page 10 |
| Both statutory and privately insured persons are eligible | no | „Personen, die bei einem Träger der deutschen gesetzlichen Krankenversicherung (GKV) …“ | Tarif I, page 9 |
| 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 | „haben die ausscheidenden Personen das Recht, den Vertrag als Versicherungsnehmer in …“ | AVB § 15 (7) b), page 7 |
| Continuation without new health questions or waiting period | not addressed | ||
| Cover suspended during parental leave, sick pay periods or unpaid leave | no | „von Erwerbsunfähigkeit oder im Falle des Ruhens des Arbeitsverhältnisses“ | AVB § 15 (5) a), page 7 |
Health budget
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Annual budget per insured person | not addressed | ||
| Selectable budget levels | not addressed | ||
| Budget usable freely across all benefit areas of the catalogue | not addressed | ||
| Sub-limits inside the budget (e.g. glasses at most half) | not addressed | ||
| Pro rata budget when cover starts during the year | not addressed | ||
| Carry over of unused budget to the next year | not addressed | ||
| Budget increase after a claim free year or extra budget | not addressed | ||
| 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 | not addressed | ||
| Dental treatment (fillings, root canal, periodontal) | not addressed | ||
| Dentures (crowns, bridges, prostheses) | yes | „80 % der Kosten für Zahnersatz, wenn die Rechnung vollständig oder teilweise …“ | Tarif uni-bZE III.2.1 b), page 11 |
| Implants | yes | „orale Implantate inkl. Knochenaufbau“ | Tarif uni-bZE III.1.1, page 11 |
| Orthodontics | not addressed | ||
| Graded dental limits in the first years | yes | „Ab dem fünften Kalenderjahr entfällt die summenmäßige Begrenzung.“ | Tarif uni-bZE III.3.1, page 11 |
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 | no | „der Altersgruppen 0 bis 15 Jahre, 16 Jahre bis zum Erreichen der gesetzlichen …“ | AVB § 8 a (2), page 5 |
| Premium adjustment (trigger and procedure) | yes | „werden alle Beiträge dieser Beobachtungseinheit vom Versicherer überprüft und, soweit …“ | AVB § 8 b (1), page 5 |
| Minimum term of the group contract | yes | „Vertrag wird für die Dauer von zwei Jahren geschlossen.“ | AVB § 13 (2), page 6 |
| Notice period for the company | yes | „Ende eines jeden Versicherungsjahres, frühestens aber zum Ablauf einer vereinbarten …“ | AVB § 13 (1), page 6 |
| Ordinary right of the insurer to terminate | none | „Der Versicherer verzichtet auf das ordentliche Kündigungsrecht.“ | AVB § 14 (1), page 6 |
| Reimbursement rate as a percentage of the invoice | yes | „80 % der Kosten für Zahnersatz“ | Tarif uni-bZE III.2.1 b), page 11 |
| Deductible | not addressed | ||
| Statutory health insurance must pay first | none | „Erfolgt eine Vorleistung der GKV nicht, wird ein pauschaler Betrag von 40 % als …“ | Tarif uni-bZE III.2.1, page 11 |
| Deadline for submitting invoices | not addressed | ||
| Territorial scope (domestic, Europe, worldwide) | yes | „Versicherungsschutz erstreckt sich auf Heilbehandlung in einem Mitgliedstaat der …“ | AVB § 1 (4), 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.
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legally only the wording of your own contract in the edition stated there applies.
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Policy wordings and provider
- Legal entity
- uniVersa Krankenversicherung a.G.
- Distribution
- brokers and direct
- Versicherungsbedingungen für die betriebliche Krankenversicherung (KVB-600) Edition: KVB-600 09.26 (AVB KVB-601 05.23, Tarife 08.14 und 11.19) 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 uniVersa Uni Bze and available as plain text.
Volltext uniVersa Uni Bze · As text (Markdown) uniVersa Uni Bze