Become a member that easy

Form of address*

Title

First name *

Name affix

Surname *

Date of birth *

Birthplace *

Country of birth *

Phone number

Email *

I agree that energie-BKK is allowed to inform or provide me with advice about benefits, products or service offers or about a customer survey. I can cancel my consent at any time - in whole or in part - by contacting energie-BKK.

by email*

by phone*

by mail*

* Please tick as appropriate

How did you hear about us? ( multiple selection possible)

First name *

Surname *

KV-number (look at your electronic health card) *

Please transfer to the bank account details provided to you by the recruiter

Yes

Specify the last four IBAN digits

I will submit my bank details separately.

Current occupation *

Statutory pension

Yes

Social security benefits (e.g. occupational pension)

Yes

Further benefits (e.g. capitalised pension)

Yes

Foreign pension

Yes

Earned income (from independent work)

Yes

Please indicate RV-Nr.

Please indicate name at birth

Please indicate place of birth

Yes

Relevant data for the nursing care insurance contribution

Receipt of benefits since

I receive unemployment benefit

Yes

Unemployment benefit, type II (Hartz IV)

Yes

A blocking / idle period has been imposed

Yes

Do you have an artists` social insurance cover?

Yes

An artists` social insurance cover application is submitted

Yes

Statutory pension

Yes

Social security benefits (e.g. occupational pension)

Yes

Further benefits (e.g. capitalised pension)

Yes

Foreign pension

Yes

Earned income (from independent work)

Yes

Relevant data for the nursing care insurance contribution

Non-contributory

including contribution payments

Yes

Relevant data for the nursing care insurance contribution

Part-time

Full-time

Yes

Relevant data for the nursing care insurance contribution

Previous type of insurance *

Special conditions are attached to the possibility to switch from a private health insurance to a compulsory health insurance.
I.a., a registration is merely possible up to an age of 55. We gladly provide advice by phone to avoid obstacles. For this purpose, please provide us with your phone number and at what times we can reach you best.

I can best be contacted

Habitual residence in the Federal Republic of Germany since

Please indicate RV-Nr.

Please indicate name at birth

Please indicate place of birth

Previous health insurance *

Kündigungsstatus *

Yes

Family members:

Following family members can be insured without contribution:

children; stepchildren*; grandchildren and foster children
spouses; civil partners

If…

their place of residence or habitual residence is in Germany,
they are no members of a statutory health insurance,
they are not full-time self-employed,
they do not achieve a monthly income of 470.00 Euro in 2021 (earnings within the meaning of the income tax law, e.g. investment income, taxable scholarships, income from rent and leasing, etc),
*either accomodated or mainly supported by a member.

The insurance for children can be covered…

until the age of 18,
until the age of 23, if not employed,
until the age of 25, if they are in school education or vocational training.

Options for an extension of the family insurance.

We may extend the family insurance beyond the 25th birthday due to the legally required military and civilian service, where appropriate. Voluntary services according to "Jugendfreiwilligen-" or "Bundesfreiwilligendienstgesetz", commenced at July 1, 2011 will be considered in an extension beyond the 25th birthday. The actual perion of service, at a maximum of 12 months, will be recognised.

We provide insurance for children suffering from a disability and consequential inability to take care for themselves without age restrictions (§ 2 Absatz 1 Satz 1 SGB IX). The disability must have been present when the child already has been insured as a family member.

Important to know!

If your spouse is privately insured, your children can be co-insured as family member on the follwoing conditions: The privately insured spouse is...

not related to the child
has a total income of less than 5,362.50 Euro per month (value for 2021) or
has a lower income than the energie-BKK member.

Notice. A seperate application form with signature is necessary. Subsequently, you have the possibility to fill in the form online and hand it in, printed and signed. Alternatively, we submit this form to you by post. (Checkboxes) postal application requested.

Yes, I want to co-insure my children; stepchildren*; grandchildren and foster children.

Yes, I want to co-insure my spouses; civil partners.

Social security benefits (e.g. occupational pension)

Further benefits (e.g. capitalised pension)

Earned income (from independent work)

Have you been assigned to a German pension insurance number (RV-Nr.), yet?

I have (a) child(ren)

I receive unemployment benefit

Unemployment benefit, type II (Hartz IV)

A blocking / idle period has been imposed

Do you have an artists` social insurance cover?

An artists` social insurance cover application is submitted

Social security benefits (e.g. occupational pension)

Further benefits (e.g. capitalised pension)

Earned income (from independent work)

I have (a) child(ren)

Is your current health insurance non-contributory or including contribution payments?

I have (a) child(ren)

Part-time/Full-time?

Are you currently insured with entitlement to sickness benefits?

I have (a) child(ren)

Previous type of insurance*

I can best be contacted

Habitual residence in the Federal Republic of Germany since

Have you been assigned to a German pension insurance number (RV-Nr.), yet?

Previous health insurance

THANK YOU VERY MUCH FOR YOUR APPLICATION FOR MEMBERSHIP!

Personal details (*mandatory fields)

I was promoted

Requested commencement of insurance cover

Please select your current occupation

Trainee

Data on the employer

Other income, aside from your current wage. (Please, tick as appropriate)

Have you been assigned to a German pension insurance number (RV-Nr.), yet?

I have (a) child(ren)

Data on the employer

Issuing authority

Data on the employer

What income do you receive?

II have (a) child(ren)

Is your current health insurance non-contributory or including contribution payments?

I have (a) child(ren)

Distinction between full-time or part-time self-employment.

Are you currently insured with entitlement to sickness benefits?

Name of the University

I have (a) child(ren)

How were you insured so far?

Have you been assigned to a German pension insurance number (RV-Nr.), yet?

Do you want to co-insure family members without contribution?

Personal details Edit

How did you hear about us?

I was promoted

Requested commencement of insurance coverEdit

Please select your current occupationEdit

Current occupation Edit

Official Edit

Issuing authority Edit

Artist/Publicist Edit

Trainee (Internship) Edit

PensionerEdit

Pension claimant Edit

Self-employed Edit

Student Edit

Other Edit

Previous type of insuranceEdit

co-insure family members without contributionEdit