Employer paid false health insurance amount

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This is a little bit complicated, so please bear with me, because I REALLY need advice.

 

I worked for my former employer in two contexts: for five months as a part-timer student through a jobs agency, and then for 6 months directly employed by them, full time. When my full-time employment commenced in August, they continued processing me as a student and, as a result, never subtracted the correct amount of health insurance from my monthly salary, even though I was full-time and earning €2,300 per month.

 

Up to this point, I was still using my EHIC card and free Irish state health insurance because I was never encouraged not to. Despite this, I still wanted full German coverage and began trying to register with the AOK. They were never satisfied that I had provided enough documents, and kept requesting more, even though I have never had any health insurance issues or a serious illness. They demanded documents to prove that I had cancelled my Irish health insurance, but since I was only on limited state cover through my family, the Irish health service felt I was not under a policy that needed to be cancelled. Eventually, in November, they sent me the E104 form that the AOK requested it. I submitted it, and heard nothing. I wrote again a month later, and they asked for my contract from work to prove that I was employed. I submitted it, and heard absolutely nothing from them since, no matter how often I wrote.

 

Until today, when an AOK employee contacted me to inform me that I had been paying far too little health insurance and am now legally required to foot a bill that they're going to send me this week. My former employer said this should be 4 X €230, since the period August to mid-October were semester holidays and not applicable, and I terminated my employment exactly 4 months later, in mid-February.

 

My former employer also suggests that the blame lies with me for not 'noticing' their mistake, or that the blame lies with the tax office, or that whatever blame lies with them, it's sufficient to simply wish me good luck with my problem.

 

And regarding the AOK, I tried from the very beginning of my employment to register properly, but for 6 months they simply just did not process my application.

 

With whom does the ultimate responsibility lie here? Am I legally obliged to simply swallow and pay the €920 fine I'm expecting?

 

Thank a LOT for reading,

 

Fionn

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With whom does the ultimate responsibility lie here? Am I legally obliged to simply swallow and pay the €920 fine I'm expecting?

 

It is not a fine, rather an outstanding balance that was not correctly deducted at source by your employer. You should probably have been paying about 189€/month for health insurance and 29€/month long-term care insurance between October and February. Did your company deduct any payroll taxes from your wages (pension, unemployment, etc)?

 

If it makes you feel any better, your employer can also expect a bill for their share of social security contributions.

 

You should be able to arrange a payment plan with the AOK.

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Thanks a lot for your helpful reply. I will check the exact numbers on my pay checks later this evening.

 

I find it quite peculiar that I'll have to pay so much money to a health insurance company that could neither process or reject my application within the space of 7 months. In August, I received a certificate to confirm that the AOK would support my Irish EHIC details pending the completion of my registration for direct insurance. After this, I received nothing more from AOK.

 

I'm not very impressed that two organisations failed to be able to do anything to avoid this.

 

Also, if I'm obliged to pay the outstanding balance to the AOK, am I also obliged to become a proper AOK member or can I proceed with my new employer-initiated TK registration instead?

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1. I would never recommend the AOK to anyone. Go with TK. I would have expected your employer to do the necessary in getting you medical insurance - it strikes me as very weird you had to do this yourself. Don't let your employer kid you any of this is your fault.

 

2. Your employer is trying to pull a fast one if they are arguing that you do not need to pay from Aug to Oct because of student holidays. Look at your contract. You were a full time employee from August, no longer a student? You will be liable for back-payments from August onwards.

 

3. Don't know who your employer is but this does not bode well for your future with them. Are they a small, chaotically run company? Start looking for pastures new.

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I would change as fast as you can! It would be even sweeter if your salary rises - get a German friend to write them a letter stating how unsatisfied you were with their administration abilities. I have had up and down times in my life and one year they told me they were only keeping me because I had been insured with them for so many years! This was all done standing at the reception desk. However when an up time came (bringing me near the limit of 50,000) i got a personal welcome from Mr Oily (not his real name!!), his card with a direct line to call him and he would personally sort any problems out for me! We had a cup of coffee and small biscuits, brought to his desk and as I left he gave me a free cookbook!!

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Thanks a lot for all of your helpful replies!

 

Firstly, yes, I'm not planning to continue with the AOK. I've heard a lot of horror stories recently and the TK has been heartily recommended, particularly for foreigners.

 

Secondly, my former employer is also a disaster. This situation is quite messy and should never have been allowed to happen, particularly since it was them who advised me to proceed in the manner which started all of this back in August. They're a start-up company, but they're quite large and, honestly, have a reputation for extremely poor employee relations and general HR incompetence. Thankfully, I quit in January and have confidence in my new employer.

 

Sadly, featherlight was correct. I am liable for costs beginning in August. I got a bill from the tax office for €1,544 today. Quite a substantial sum.

 

Would it be worthwhile seeking legal advice? This whole situation started because my former department boss, a law graduate, decided to 'get one over' on HR by apparently proving to them that I only needed to pay student rates until mid-October. They accepted it without questioning him, I was just told that my documents were accepted and processed, and when it came to October, HR weren't competent enough to even correct an already wrong situation.

 

If my former boss hadn't told HR to pay student rates in August, a correct health insurance policy would have been obligatory, my student documents would never have been accepted and this wouldn't have happened.

 

Should I seek legal advice? Could it be beneficial? And if yes, is it possible without paying huge sums of money?

 

Thanks again.

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First, I think the 1500€ bill was for health insurance and not taxes, right?

 

Second, were you a student in the summer and eligible to be considered a Werkstudent during this time?

 

Third, normally you can't change Kassen during the first 18 months. Sorry.

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1. It's for health insurance. My former employer told me that the 'Lohn-/ und Gehaltsabrechung' was processed by the tax office. I'm getting something else from AOK in the post though.

 

2. I was a student in the summer (no classes, just research). AOK told my former employer that my contract was obviously going to continue past October, so it could not be treated as a Werkstudent contract.

 

3. I was never actually properly registered with the AOK though. My registration was never processed properly, all I ever received was a certificate from them saying that they were supporting my EHIC card. Does this still mean that I'm an AOK member anyway and can't switch?

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You should be able to file a claim through the Arbeitsgericht, from what you say it sounds like you have a strong case. You will need a lawyer though, shop around, sometimes you can get ones cheaper than others. It's not really a complicated case and if you have all the facts and are telling the truth you should win. I had the unfortunate experience of taking a former employer to court (there were 18 of us though) we all won and got a nice "price" out of it at the end. Don't let the bastards pull a fast one on you, they think you won't do anything because in their eyes you're a dumb Ausländer... little do they know!

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My former employer told me that the 'Lohn-/ und Gehaltsabrechung' was processed by the tax office. I'm getting something else from AOK in the post though.

 

I don't know what the tax office has to do with any of this. Who was the first bill from then?

 

 

2. I was a student in the summer (no classes, just research). AOK told my former employer that my contract was obviously going to continue past October, so it could not be treated as a Werkstudent contract.

 

You should double check on this. If the company correctly does the registration, I'm not sure how much the Kasse has to say in the matter.

 

A friend of mine (third country national finishing his masters) started a full-time job in August. Since he was still writing his thesis when he started, he wanted to be taxed as a student. I suggested that he have his company register him as a Werkstudent for the summer and then change the registration to a regular employee from the beginning of the semester (he thought he could take advantage of his student status as long as he was working on the basis of his study permit). AFAIK this worked, but I'll ask him again to make sure.

 

 

3. I was never actually properly registered with the AOK though. My registration was never processed properly, all I ever received was a certificate from them saying that they were supporting my EHIC card. Does this still mean that I'm an AOK member anyway and can't switch?

 

How well do you speak German? You might depending on many factors such as how far AOK has processed your application and the competence of the people you ask, be able to convince the TK to do take over everything, but I really don't know if it'll be possible.

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You should be able to file a claim through the Arbeitsgericht, from what you say it sounds like you have a strong case.

A case against the first employer on what grounds? All they did was incorrectly register her as being a student when she should have been an employee. They can also argue that it was her fault for not submitting the forms the AOK wanted in August. Why do you think she has a case?

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You should be able to file a claim through the Arbeitsgericht, from what you say it sounds like you have a strong case.

 

 

 

A case against the first employer on what grounds? All they did was incorrectly register her as being a student when she should have been an employee. They can also argue that it was her fault for not submitting the forms the AOK wanted in August. Why do you think she has a case?

 

Maybe I'm being obtuse, but as far as I can see there are no grounds for a case. The OP is not being asked to pay a fine, what he needs to pay is the balance from the back contributions that were, granted, incorrectly filed by his employer. However, the Krankenkasse is of course entitled, and of course wants to have, the difference between the contributions paid and what the OP actually should have paid during the time in question.

 

EDIT: I'm assuming the ex-employer also got a hefty bill for their share of the contributions.

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A case against the first employer on what grounds? All they did was incorrectly register her as being a student when she should have been an employee. They can also argue that it was her fault for not submitting the forms the AOK wanted in August. Why do you think she has a case?

 

Or "he" even. :)

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As long as the ex-employer is paying the portion that he/she should have. If OP is stuck with all of that, as well, then I would certainly fight for the employers share.

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The OP is "only" been billed for his share. Companies prefer hiring Werkstudenten since they save quite a bit on social security costs. It is therefore also in their best interest to register him for as long as legally possible as a Werkstudent.

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Some updates.

 

In my pay check, the only deductions were Lohnsteuer, Solidaritäts-Zuschlag and Rentenversicherung.

 

The AOK phoned me yesterday and said that while it will be tricky to move insurance companies, they understand that the registration situation has not been ideal and are processing a complete membership finally. They indicated that the fault came from my former employer for not providing them with correct information while I worked there. The company processed me a student and since I had an EHIC card from Ireland already, the AOK had no reason to believe I actually needed to change insurance companies. For me, it's still incompetence because I was telling them the reality for 7 months. But anyway, at least I'll be insured properly...

 

So the fault, apart from me not 'noticing' the mistake, lies entirely with the HR department in my former company. If it's correct that they were allowed to process me as a Werkstudent until mid-October, then the fault lies in them not actually processing my documents properly at all. Paying somebody for a 40 hour week as a Werkstudent for 6 months is not really a great statement about the competences of HR staff in such a large company.

 

Despite this, I'm also concluding that, realistically, I have no choice but to swallow and just pay the outstanding costs.

 

Can I expect information from either the AOK or my former employer about how these costs should be paid? And is it certain that I can arrange a payment plan? I really don't want to pay it in one go.

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Two more updates:

 

1. The HR employee from my former employer who was responsible for my incorrect paperwork phoned me this evening and told me that she spoke to the CEO, and he agreed that the company would cover 50% of my part of the overdue expenses. It sounded like a positive development, but:

 

2. I met a former colleague afterwards, who told me that he had a similar problem in the past, and his lawyer girlfriend helped him comprehensively resolve his case. He told me that the employer is responsible for filing correct health insurance documentation. If they do not, they are liable for the total expenses incurred from their administrative mistake. He said that my former employer, even though they are offering to share the costs, are still trying to pull a fast one on a situation they are required to take full responsibility for.

 

He said he's going to send me full proof. But in the mean time, is he barking up the wrong tree? Is he mistaken?

 

What makes me wonder is that my former employer mentioned that they have to discuss a payment plan for me with AOK. If I am liable for damages, shouldn't AOK be contacting me directly?

 

I'm attaching the letter I received from AOK yesterday.

post-119774-13319455228488_thumb.jpg

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In my pay check, the only deductions were Lohnsteuer, Solidaritäts-Zuschlag and Rentenversicherung.

 

What about Arbeitslosenversicherung?

 

 

If it's correct that they were allowed to process me as a Werkstudent until mid-October, then the fault lies in them not actually processing my documents properly at all.

 

It seems that there is a special clause that after you finish your last exam, you can't be a Werkstudent anymore. I found a website that might be able to help you determine if you should have qualified.

 

 

Paying somebody for a 40 hour week as a Werkstudent for 6 months is not really a great statement about the competences of HR staff in such a large company.

 

There are actually situations where it is possible for students to work 40/hrs a week as Werkstudenten (e.g. mid-July to mid-October) and it used to be the way that many students financed their studies.

 

 

And is it certain that I can arrange a payment plan?

 

Yes, just don't let them try to make you pay Saumniszuschläge.

 

 

1. The HR employee from my former employer who was responsible for my incorrect paperwork phoned me this evening and told me that she spoke to the CEO, and he agreed that the company would cover 50% of my part of the overdue expenses.

 

They are now willing to pay half of your overdue contributions (or are they just talking about interest and fines)?

 

 

2. I met a former colleague afterwards, who told me that he had a similar problem in the past, and his lawyer girlfriend helped him comprehensively resolve his case. He told me that the employer is responsible for filing correct health insurance documentation. If they do not, they are liable for the total expenses incurred from their administrative mistake. He said that my former employer, even though they are offering to share the costs, are still trying to pull a fast one on a situation they are required to take full responsibility for.

 

What does he mean by expenses? If there are interest or fines, then the employer should be liable. I'm not sure whether they are liable for paying your overdue contributions.

 

 

What makes me wonder is that my former employer mentioned that they have to discuss a payment plan for me with AOK. If I am liable for damages, shouldn't AOK be contacting me directly?

 

You need to be very careful with the terms you're using to avoid confusing the issue further. What do you mean by damages? Beiträge nachentrichten just refers to paying overdue contributions and has nothing to do with damages.

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