Employee Insurance

I would like become a member of TK as of:
(Intended arrival date in Germany, in case you are not in Germany)

Personal information

Title

Date of birth

If no German pension insurance number has been assigned, we will require the following information:

(As per your passport)

Your previous health insurance cover details

I was last insured abroad or lived abroad

I was last

compulsorily insured

voluntarily insured

privately insured

insured as a dependant

I am exempt from health and long-term care insurance cover.

Important: Please Upload a copy of your exemption letter.
(Max filesize: 1 MB, Accepted Formats: pdf, jpg, png)
or
later, send to: publicinsurance@pegaone.com

Details on employment

I have been employed from/since (Expected employment start date)

My gross monthly pay is: (Check neither if between €450 and €5362.50)

Up to 450 EUR monthly (mini-job)

more than 5,362.50 EUR monthly

Important: Please include any bonus payments pro rata.

This is my first employment in Germany as an employee.

Details on employer

I am a shareholder in this company.

I am self-employed.

Details on pension payments
(Leave blank if unsure)

I draw a pension or have applied for a pension.

I receive pension payment e.g. company pension, lump-sum payments/instalments

Details on dependants
(In case you are accompanied by your spouse / children)

I would like to insure my dependants exempted from contributions. Please send me an application for non-contributory dependants' insurance

Details on long-term care insurance

I am mother/father to at least one child.

Important: Please Upload proof (e.g. copy of the birth certificate).
(Max filesize: 1 MB, Accepted Formats: pdf, jpg, png)
or
later, send to: publicinsurance@pegaone.com

For queries

Sign Clear

Please sign (legal representative, if applicable) below:
(Relax it doesn't have to be perfect)

We require personal data (social data) in order to carry out our tasks correctly. The legal basis for this is Section 284 German Social Security Code, Book V [SGB V] and Section 94 German Social Security Code, Book XI [SGB XI]. The information about TK's data processing pursuant to Article 13 DSGVO [EU General Data Protection Regulation] is available on tk.de/dataprotection.

Hereby I am informed that TK informs the sales partner for billing purposes about a membership that has come about.

Personal information

Your previous health insurance cover details

Details on employment

Details on employer

Details on pension payments(Leave blank if unsure)

Details on dependants(In case you are accompanied by your spouse / children)

Details on long-term care insurance

For queries

Details on pension payments
(Leave blank if unsure)

Details on dependants
(In case you are accompanied by your spouse / children)