Prevention Guide: Technical Deep Dive

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

Note: refers to German law. The GKV Prevention Guide structures the WHP process in six steps: preparation → using and building structures → analysis → planning measures → implementation → evaluation. WHP under § 20b needs no certification; if you want funding from a health insurer, agree the project with the insurer in advance. The ZPP seal applies to courses under § 20.

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

Phase	What to Do	Key Documents
Phase 1: Preparation	Clarify the occasion and goals, secure the management mandate and budget, get familiar with the § 20b procedure	Written management mandate, budget approval
Phase 2: Using and Building Structures	Set up a steering committee or health working group, involve employees and the works council, bring in the health insurer and external partners	Steering committee minutes, membership and responsibilities
Phase 3: Analysis	Evaluate GBPsych results, analyze absenteeism, request GKV health report, conduct employee survey if needed	Needs assessment document with prioritized focus areas
Phase 4: Planning Measures	Draw up the measures plan and agree it with the funding insurer before starting, select providers (for prevention courses under § 20: check the ZPP seal), schedule dates	Action plan with responsibilities and deadlines
Phase 5: Implementation	Organize the course, maintain signed attendance lists, ensure data protection	Signed attendance lists, course materials, proof of the instructor's qualification (for § 20 courses: ZPP certificate)
Phase 6: Evaluation	Evaluate participation rate and feedback, compare absenteeism before/after and pre-post measurements, feed the results into the next plan (PDCA)	Evaluation report for management and the health insurer, participation statistics, planning for the following year

What must WHP coordinators check before booking a course?

Prevention courses under § 20 SGB V (individual behavioural prevention: exercise, nutrition, stress management, substance use) are checked by the Zentrale Prüfstelle Prävention (ZPP), a cooperation of the health insurers. Certified courses carry the ZPP seal “Deutscher Standard Prävention” — only for these does the insurer reimburse part of the course fee to its insured persons. No certification is provided for workplace health promotion under § 20b SGB V: there the insurer funds a project agreed with the company in advance.

How to check: for a prevention course under § 20, ask to see the ZPP certificate or look the course up at zentrale-pruefstelle-praevention.de. Certification is usually valid for three years (online courses initially one year) and covers the course concept together with the instructor's qualification — a provider can be certified for course A but not for course B. WHP coordinators check: (1) Is the certification currently valid? (2) Does the course content match the certified offer? (3) Is the course run by the certified instructor?

What happens with a non-certified course: the insured persons get no reimbursement under § 20 from their insurer. As a WHP component the same measure can still be funded — if it is part of an overall concept agreed with the insurer; the guide excludes isolated one-off measures by external providers from funding. The employer benefit can be tax-free under § 3 No. 34 EStG if the measure is implemented within the workplace health promotion process — only your tax adviser can confirm this.

For § 20 courses: request the ZPP certificate 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
Rehabilitation sport is a different route (medical prescription, § 64 SGB IX) — not a substitute for prevention courses or WHP

How do you assign health insurer funding correctly?

Principle: the two routes work differently. For prevention courses under § 20 the insurer reimburses its insured persons; each insurer sets amount and procedure in its statutes — AOK, TK, Barmer, DAK etc. differ. For WHP under § 20b the insurer funds the company, not the individual.

§ 20 route (course reimbursement): employees attend a ZPP-certified course, submit the provider's certificate of attendance (model form of the GKV-Spitzenverband) to their health insurer and receive the reimbursement directly. The employer has no billing effort — it only makes sure the course is ZPP-certified.

§ 20b route (project funding): the company agrees in advance with one or more health insurers which services will be funded. Billing per employee is excluded; if several insurers take part, they split their share, e.g. by membership share. The company does not need the individual employees' insurer data for this. The guide requires the company to contribute its own money and/or staff time.

Note: the guide limits course reimbursement under § 20 to at most two courses per insured person per calendar year; an individual insurer may be stricter. Check before annual planning.

What must be documented for the follow-up application?

The evaluation (phase 6) is often neglected — yet continued funding from the health insurer depends on it. Anyone who cannot present an evaluation 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 WHP 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

The ZPP seal “Deutscher Standard Prävention” applies to prevention courses under § 20 — no certification is provided for WHP under § 20b.
Course reimbursement (§ 20) goes through the insured persons, WHP funding (§ 20b) as a company project agreed in advance — never per person.
Six steps per the guide: preparation → structures → analysis → planning measures → implementation → evaluation.
The evaluation (phase 6) is 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 (WHP)?+

§ 20 SGB V funds individual prevention courses — employees as private individuals. Courses are subsidised by each person's own health insurer (e.g. a back course at a gym). § 20b SGB V is workplace health promotion — the employer initiates a company measure and the insurer funds it as a company project. The difference lies in who carries it: § 20 = individual, § 20b = company-wide. Certification by the Zentrale Prüfstelle Prävention exists only for § 20 courses; none is provided for § 20b. For WHP coordinators, § 20b is the relevant provision (German law).

Can online courses be subsidised by the health insurer?+

Yes, as a prevention course under § 20 SGB V — if the ZPP has certified the digital offer. Digital courses are certified separately, not automatically through the provider's in-person certification; online courses and self-learning programmes initially for one year. Each insurer decides which formats it reimburses. In a WHP project under § 20b, services can be supported digitally — no certification is provided there.

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

For prevention courses under § 20 the health insurer reimburses part of the course fee to its insured persons; the employees submit the claim themselves. For WHP under § 20b the insurer funds the company project agreed in advance; the company makes its own contribution. The employer has no entitlement to this funding — it is the insurer's project partner.

How do you organise insurer funding for 100 employees with 8 different health insurers?+

For WHP under § 20b: approach one insurer with which part of the workforce is insured (or the regional WHP coordination office) and agree the project in advance. Other insurers can join as a cooperation project and split the share, e.g. by membership share — billing is not per person. For prevention courses under § 20, each insured person submits to their own insurer; each insurer sets the reimbursement amount in its statutes. In neither route does the employer have to bill eight insurers.

What is the PDCA cycle in a WHP context?+

PDCA = Plan–Do–Check–Act. In WHP: Plan = analysis + planning measures (phases 3–4). Do = implementing the measures (phase 5). Check = evaluating the impact (phase 6). Act = adjusting for the next year (back to preparation and analysis). The GKV Prevention Guide is fundamentally a PDCA model — once you internalize it, you understand why evaluation is not a bureaucratic burden but the core of WHP that works over the long term.

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Sources

Last updated: 2026-10-15. Not legal or tax advice — have your specific case reviewed by a professional.

Apply for GKV Funding for WHPWhat does health insurance pay for workplace health promotion (WHP) — and which measures actually qualify for §20b funding?Building a WHP StructureHow do I build a WHP structure that is well organized and meets the prerequisites for a funding conversation with a German statutory health insurer (Krankenkasse)?Create WHP Action PlanHow do I turn analysis results into a concrete WHP 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