The Expenditure Compensation Act (Aufwendungsausgleichsgesetz, AAG) regulates in which cases a reimbursement of continued salary payments is possible for the employer. The data is transferred using an approved accounting program.
Continued payment of wages in case of illness or maternity
In the event of illness or maternity, employers are obliged to continue to pay their employees' wages. This is of course associated with financial burdens for the respective company, since during this time the usual workload cannot be performed - but the expenses remain nevertheless. To compensate for this, employers receive a full or partial refund of the continued payment of wages.
Reimbursement of the continued payment of wages? Your health insurance for employers is there for you!
With the AAG and the reimbursement of continued salary payments, a distinction must be made between two apportionment funds: U1 refers to the continued payment of wages in case of illness and concerns all companies with no more than 30 employees. The U2 pay-as-you-go fund (maternity), on the other hand, basically includes every employer. The amount of the contributions to be paid is based on the pensionable gross salary of the employees. These contributions are paid solely by the employer.
Which expenses are not reimbursed?
Provisions in the articles of association reduce the right to reimbursement
By regulations in the statutes of the health insurance company, the reimbursement can be reduced in terms of percentage. Furthermore, regulations in the statutes often provide that the reimbursement of the employer's share of the total social security contribution is already compensated with the corresponding percentage. Many health insurance companies also offer a choice between two or more reimbursement rates for different contribution rates.
No reimbursement claim outside the EFZG regulations
Remuneration that is not continued within the framework of the obligations under the EFZG (https://www.haufe.de/personal/entgelt/entgeltfortzahlung-vorerkrankungen-richtig-anrechnen_78_428286.html) is not refundable. This includes, for example, remuneration that
- on the basis of collective bargaining agreements - for a period of more than six weeks,
- is paid during the first four weeks of employment,
- is paid if the child is ill.
Cessation of work due to illness
The remuneration paid for the remaining hours of work in the event of the cessation of work during the course of a working day due to illness (e.g. in the event of an accident at work) does not constitute continued remuneration within the meaning of the EFZG. For this reason it is not refundable.
No refund in case of quarantine
The reimbursement of employer's expenses in the event of illness presupposes incapacity to work within the meaning of the Continued Remuneration Act. In the case of quarantine, this is usually not the case, which is why reimbursement under the U1 apportionment is not possible.
Limitation of continued remuneration to the contribution assessment ceiling (U1 procedure)
Frequently, the statutes of the health insurance fund contain the regulation that the reimbursable remuneration is limited to the contribution assessment ceiling of the pension insurance. In order to calculate the claim for reimbursement in the event of incapacity to work for a partial month, the actual remuneration and the continued payment of remuneration in the relevant month are reduced in proportion to each other so that together they reach at most the income threshold.
A limitation of the reimbursable remuneration to 1/30 of the monthly income threshold for the calendar day is therefore not limited - irrespective of the method of calculating the continued remuneration on a working day, a work day or a calendar day.
Calculation of levy U1: Example
An employee is absent due to illness for 5 working days. His continued remuneration is based on working days. His monthly salary is 7,700 EUR. The month in question comprises 22 working days. The statutes of the health insurance company contain the following regulations:
- Reimbursement of employer expenses in the amount of 70 percent. This covers the reimbursement of the employer's contributions.
- For reimbursement, the salary is only taken into account up to an amount equal to the contribution assessment ceiling of the general pension insurance (2020: 6,900 EUR).
Result: The continued remuneration amounts to (7,700 EUR : 22 x 5 =) 1,750 EUR. This amount is (1,750 EUR : 7,700 EUR x 6,900 EUR =) 1,568.18 EUR reimbursement basis. Of this amount the health insurance company refunds (70% of 1.568,18 EUR =) 1.097,73 EUR.
A reduction of the eligible (continued) salary (here: 1,568.18 EUR) to 5/30 of the monthly contribution assessment limit of the general pension insurance (2020 = 1,150 EUR) is not permitted.
Which expenses are reimbursed?
Reimbursement of the gross salary including employer's contribution
Within the framework of the reimbursement procedure, the employer will be reimbursed in full for the remuneration continued to be paid due to the prohibition of employment and the employer's contribution to the total social insurance contribution. If the employer has to bear the full amount of the contributions for trainees (so-called low-income earners), the total amount is to be included in the reimbursement. Not reimbursable are the apportionment contributions to be paid by the employer alone and the insolvency money apportionment.
Reimbursement of remuneration paid to third parties
It also replaces the remuneration components that the employer has paid to third parties on behalf of the employee, such as capital-forming benefits or contributions to company pension schemes. Special benefits paid out during a period of prohibition of employment are not refundable.
No limitation of reimbursement to the income threshold
Also no limitation of the gross remuneration is permissible only up to the height of the contribution assessment ceiling in the general old age pension insurance. A provision in the articles of association can only provide for the lump-sum reimbursement of the employer's share of the total social security contribution in the event of employment prohibitions. The lump-sum reimbursement can also be structured without consideration of contribution assessment ceilings.
Reimbursement in the event of a reduction in earnings
Also eligible for reimbursement is the remuneration received by female employees who change employment or type of remuneration due to a prohibition of employment and thereby earn less.
Contribution to maternity allowance
During the protection periods, the employer is obliged to pay a maternity allowance supplement. The protection periods cover the period of basically six weeks before the presumed date of delivery, the day of delivery and eight or twelve weeks (in the case of multiple and premature births) after delivery.
The maternity allowance supplement is payable in the amount of the difference between the net remuneration per calendar day and EUR 13. This maternity allowance is reimbursed in full. As the maternity allowance is not a contributory wage, there is no need to pay and thus no refund of the employer's share of the total social insurance contribution.