Prevention Guide for CEOs

Prevention Guide for CEOs: What §20b SGB V Actually Means — and What ROI BGF Delivers

Note: this refers to German law. The GKV Prevention Guide sets which BGF measures are subsidized up to €600/employee/year under §20b SGB V. For CEOs: BGF is a duty of care (§618 BGB) protecting against §130 OWiG liability. Median ROI: 1:2.7 (IGA Report 40).

BGF Costs and ROI for 100 Employees (Sample Calculation)

Item	Cost / Benefit	Source
GKV subsidy per employee	up to €600/year — paid by the statutory health insurer	§20b SGB V
Tax exemption §3 No. 34 EStG	up to €600/employee/year — no payroll tax	§3 No. 34 EStG
Combined total funding	up to €1,200/employee/year (health insurer + tax benefit)	§20b SGB V + §3 No. 34 EStG
Avg. cost per sick day	€350–500 (continued pay + overhead)	Federal Ministry of Health 2024
BGM effect on absenteeism	Measurable reduction with well-implemented programs	IGA Report 40 (85% of programs: positive benefit)
ROI on BGF investment (median)	1:2.7 — every euro invested returns €2.70 on median	IGA Report 40 (median of 47 ROI figures)

What the GKV Prevention Guide Means for the CEO Decision

The GKV Prevention Guide is a 150-page rulebook — but CEOs don't need to read it. That's the job of HR and BGM officers. At the CEO level, there are three core decisions: first, grant the mandate (BGF is anchored in BGM governance). Second, approve the budget (an effective program is possible from €300–500/employee/year). Third, set up a health working group and appoint a steering committee.

What CEOs need to understand: the GKV Prevention Guide is the key to funding that benefits the company directly — not the health insurer. Anyone who ignores the guide leaves up to €60,000/year in funding on the table (at 100 employees: €600/employee × 100). That's not just economically inefficient — it's increasingly coming under scrutiny from auditors and works councils.

BGF as Liability Protection: What §618 BGB and §5 ArbSchG Require

§618 BGB obligates the employer to set up and maintain 'rooms, facilities, or equipment that it must provide for the performance of services ... so that the obligated party is protected against danger to life and health to the extent the nature of the service permits.' Mental health has been explicitly included since 2013 (§5 ArbSchG).

§130 OWiG (supervisory duty) can hold CEOs personally liable if they fail to implement workplace health promotion measures and demonstrable harm to health results. BGF documentation (per the GKV Guide) is therefore also liability protection: those who act in a structured, documented way are not acting negligently.

Practical implication: in a wrongful-termination lawsuit over an illness-related dismissal, or in a burnout-related absence followed by a recourse claim, proof of active health promotion is the CEO's strongest protection.

Planning the BGF Budget: What's Realistic for 50 / 100 / 250 Employees?

Rule of thumb: €300–600 gross investment per employee per year for an effective BGF program. After deducting the GKV subsidy (up to €600/employee) and tax bonus (§3 No. 34 EStG: up to €600/employee), actual net cost can drop close to zero — provided the measures comply with the guide and are properly documented.

50 employees: gross budget €15,000–30,000/year → GKV subsidy up to €30,000 → net cost: €0–5,000
100 employees: gross budget €30,000–60,000/year → GKV subsidy up to €60,000 → net cost: €0–10,000
250 employees: gross budget €75,000–150,000/year → GKV subsidy up to €150,000 → net cost: €0–20,000
Additionally: §3 No. 34 EStG tax savings (employer share of payroll costs on benefits in kind) further increase the effective funding rate
In practice: many companies use less than 30% of the available GKV subsidy — due to missing documentation or non-certified providers

Related measures & topics

Key takeaways

GKV subsidy up to €600/employee/year + tax bonus €600/employee/year = up to €1,200 in funding — most companies don't fully use it
Median ROI per IGA Report 40: 1:2.7 — 85% of all analyzed BGF programs show positive benefit
§618 BGB + §130 OWiG: BGF documentation is also personal liability protection for CEOs
CEOs don't need to read the guide — mandate + budget + steering committee are enough as a CEO contribution
Structured BGF shows positive benefit in 85% of programs per IGA Report 40 — implementation quality is what matters

Frequently asked questions

Do I need to read the Prevention Guide as CEO?+

No. The GKV Prevention Guide is an operational HR/BGM document. As CEO, you need to provide the mandate and the budget — operational implementation and applications are the responsibility of HR or the BGM officer. If you don't have one: EasyBGM handles it digitally.

What happens if I don't offer BGF?+

Legally: no direct fines for lacking BGF (unlike GBPsych or BEM). Economically: you forgo up to €600/employee/year in GKV subsidy and the §3 No. 34 EStG tax benefit. Reputationally: employee expectations around employer health offerings are growing — lacking BGF is increasingly a recruiting disadvantage.

How much budget should I plan for BGF?+

Starting point: €300–600 per employee per year (gross budget). After the GKV subsidy and tax bonus, net cost can approach zero. For a first program, health economists recommend at least €200 net investment/employee/year to achieve a measurable effect on sick-leave rates.

What's the difference between BGF (§20b) and BGM?+

BGF (workplace health promotion, §20b SGB V) is one of three BGM pillars: behavioral and structural prevention measures subsidized by statutory health insurers. BGM (workplace health management) is the overarching system of three pillars: BGF + BEM (§167 SGB IX) + occupational safety (§5 ArbSchG). EasyBGM covers all three.

BGF per GKV Guide — No Extra Effort for the CEO

EasyBGM structures the BGF program in compliance with the guide, documents it in a way eligible for GKV subsidy, and automatically sets up the CEO steering committee.

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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?Management Liability in BGMWhat BGM duties does company management have — and what happens if they're violated?BGM Costs for SMEsWhat does a complete BGM (workplace health management) program cost at a mid-sized German company?HR Prevention GuideHR Manager's Guide to Prevention: How to File BGF Applications — and Which Measures Get GKV Subsidies