Prevention Guide: Technical Deep Dive

Prevention Guide for BGM Officers: Full Technical Implementation Under §20b SGB V

Reflects German (GKV) rules. The GKV Prevention Guide (2023) structures BGF in 6 phases: Foundation → Analysis → Planning → Implementation → Evaluation → Quality Assurance. Only PRÄVOS-certified courses qualify for GKV subsidies, billed via the employee's health insurer, not the employer.

6-Phase Model of the GKV Guide: Tasks for BGM Officers

Phase	What to Do	Key Documents
Phase 1: Laying the Groundwork	Secure management mandate, secure budget, establish steering committee, get familiar with the §20b procedure	Written management mandate, steering committee minutes, budget approval
Phase 2: Analyze the Company Situation	Evaluate GBPsych results, analyze absenteeism, request GKV health report, conduct employee survey if needed	Needs assessment document with prioritized focus areas
Phase 3: Planning	Create action plan, select a PRÄVOS provider and verify the certification number, schedule timeline	Action plan with responsibilities and deadlines
Phase 4: Implementation	Organize the course, maintain signed attendance lists, ensure data protection	Signed attendance lists, course materials, provider certification proof
Phase 5: Evaluation	Record participation rate, evaluate feedback, compare absenteeism before vs. after	Evaluation report for management and GKV, participation statistics
Phase 6: Quality Assurance	Document pre-post measurement, apply the PDCA cycle, prepare follow-up planning	Quality assurance form, PDCA record, planning for the following year

PRÄVOS Certification: What BGM Coordinators Must Check Before Booking a Course

PRÄVOS (Prevention and Health Promotion Online Search) is the central certification database maintained by Germany's statutory health insurers (GKV) for prevention courses under §20 SGB V (primary prevention) and §20b SGB V (workplace health promotion, BGF). Only courses with a valid PRÄVOS certification number entitle employees to a GKV subsidy. Without this number, the health insurer pays nothing — even if the course content is good.

How to check: The provider must be able to present a PRÄVOS certification number. It is time-limited (usually 3 years) and content-specific — a provider can be certified for course A but not course B. BGM coordinators should verify: (1) Is the certification number currently valid? (2) Does the course content exactly match the certified offering? (3) Is the course led by a qualified instructor (the instructor must meet their own qualification requirements)?

What happens with an uncertified provider: The employer bears the full cost risk. Employees who attended an uncertified course will not have any subsidy reimbursed by their health insurer. As an employer, you can still use the §3 No. 34 EStG tax exemption — but the GKV subsidy, which often covers 50–75% of course costs, is lost.

Request the PRÄVOS certification number from the provider before booking
Check the certification's validity period (not expired?)
Certification is course-specific — not provider-specific
Instructor qualification proof belongs in the documentation file
Alternative: BAR-recognized rehabilitation sports (§44 SGB IX) also qualify for GKV

Handling GKV Billing Correctly: Direct Reimbursement vs. Collective Billing

Principle: The entitlement to a GKV subsidy lies with the individual employee, not the employer. Each health insurer has its own rules — AOK, TK, Barmer, DAK, etc. differ in the amount and process of the subsidy.

Direct reimbursement model (more common at small companies): Employees pay for the course themselves, submit the receipt to their health insurer, and receive the subsidy directly. For the employer, this creates no billing overhead — they just need to ensure the course is PRÄVOS-certified and issue an employer certificate (name, date, course content).

Collective billing model (more efficient from ~30 employees): The employer pays for the course for everyone, compiles attendance lists, and settles with each employee's health insurer. This requires each employee's health-insurer data (collected in compliance with GDPR), the subsidy amount per insurer, and a standardized billing form (most insurers provide this online). Advantage: employees do not have to pay upfront, and administration is more efficient for the employer with many participants.

Note: Some health insurers only pay for 1–2 courses per employee per year. This varies by insurer — check before annual planning.

Quality Assurance Per the Guide: What Must Be Documented for the Follow-Up Application

Phase 6 of the guide is the phase most often neglected — and the most important for continued GKV funding. Anyone without a quality assurance form may be asked by the GKV to provide evidence of effectiveness when submitting a follow-up application.

What the GKV checks in a follow-up application: Was the needs assessment updated? Were last year's measures evaluated? Did the measure show an effect according to the pre-post comparison? The GKV is not obligated to fund BGF indefinitely — it can withdraw support if no evidence of effectiveness is provided.

Recognized measurement methods: absenteeism pre-post comparison (the simplest method), employee survey (standardized, e.g., COPSOQ or a custom short questionnaire), GKV health report comparison (if the insurer regularly provides a report). For SMEs without statistical resources, a simple 5-question employee feedback survey after each course is enough — documented, evaluated, and included in the evaluation report.

Pre-survey before the measure starts (establish baseline)
Post-survey 3–6 months after the measure (measure the effect)
Compare absenteeism from the prior year to the current year (normalized to full-time equivalents)
Keep course feedback forms (satisfaction, perceived benefit)
Bring it all together in an annual report — even if it's just 3 pages

Related measures & topics

Key takeaways

Only PRÄVOS-certified courses qualify for a GKV subsidy — always check the certification number before booking
GKV billing runs through the employee's health insurer, not the employer
6-phase model per the guide: Foundation → Analysis → Planning → Implementation → Evaluation → Quality Assurance
Phase 6 (Quality Assurance) is the phase most often forgotten — without it, no follow-up application
The PDCA cycle is the conceptual backbone of the GKV guide: live it, and nothing needs to be documented twice

Frequently asked questions

What is the difference between §20 SGB V (primary prevention) and §20b SGB V (BGF)?+

§20 SGB V funds individual prevention courses — employees as private individuals. Courses are subsidized by the individual's health insurer (e.g., a back-care course at a gym). §20b SGB V is workplace health promotion — the employer initiates a company-wide measure, and the GKV subsidizes it as a company program. The difference lies in who initiates it: §20 = individual, §20b = company-collective. For BGM officers, §20b is the relevant provision.

Can online courses receive a GKV subsidy under §20b SGB V?+

Yes — since the pandemic, many health insurers have added digital formats to their PRÄVOS funding. Requirement: the online course must be PRÄVOS-certified (digital courses are certified separately, not automatically covered by a provider's offline certification). Live online courses (with a real-time instructor) are accepted by more insurers than purely asynchronous e-learning formats.

Who pays the GKV subsidy — the health insurer or the employer?+

The health insurer pays the subsidy. The employer pays for the course upfront and organizes the billing. In the direct reimbursement model, the employee pays and gets the subsidy directly from their health insurer. In the collective model, the employer pays, settles with the health insurers, and passes the subsidies along. The employer has no entitlement of its own to GKV benefits — it acts as organizer and intermediary.

How do you calculate the GKV subsidy for 100 employees across 8 different health insurers?+

Each health insurer pays a different amount per employee based on its own bylaws (usually €50–150 per course). Process: (1) Compile an employee health-insurer list (one-time, GDPR-compliant). (2) Ask each insurer for its current reimbursement rate. (3) Allocate course costs across employees. (4) Fill out a billing form for each insurer. Tools: Some BGM platforms automate this process. Manually, collective billing for 100 employees takes about 3–5 hours per course round.

What is the PDCA cycle in a BGM context?+

PDCA = Plan–Do–Check–Act. In BGM: Plan = needs assessment + action plan (phases 2–3). Do = implementing the measures (phase 4). Check = evaluating the impact (phase 5). Act = adjusting the strategy for the next year (phase 6 → back to phase 1). The GKV Prevention Guide is fundamentally a PDCA model — once you internalize it, you understand why quality assurance is not a bureaucratic burden but the core of sustainable BGF.

BGM Per the GKV Guide — No Spreadsheets, No Paperwork

EasyBGM digitally maps all 6 phases of the Prevention Guide — needs assessment, action plan, attendance lists, and GKV-compliant evaluation reports, all in one system.

Try EasyBGM for Free Start the BGM Compliance Check

Sources

Last updated: 2026-06-27. Not legal or tax advice — have your specific case reviewed by a professional.

Apply for GKV Funding for BGFWhat does health insurance pay for workplace health promotion (BGF) — and which measures actually qualify for §20b funding?Building a BGM StructureHow do I build a BGM structure that is well organized and meets the prerequisites for a funding conversation with a German statutory health insurer (Krankenkasse)?Create BGM Action PlanHow do I turn analysis results into a concrete BGM action plan?Using the GKV health report correctlyHow do I get the statutory health insurer's health report — and what do I do with it?Prevention Guide for SMEsPrevention Guide for SMEs: What Small Businesses Under 50 Employees Need to Know About Section 20b