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First-time employment in Germany

We are delighted that you are joining us! To make your membership perfect, we need a few details. Please complete the following application form. Thank you very much!

Confirmation

Please confirm that you were previously insured abroad and are taking up employment in Germany for the first time.*

I was previously abroad and am taking up employment in Germany for the first time

Name of the health insurance company*

Information on checking of entitlement to membership

I am an employee of one of the following companies: Mercedes-Benz Group AG, Daimler Truck Holding AG or the eligible subsidiaries or I am starting to work for the companies mentioned.*

Yes

I currently work at:*

My plant, where I work:*

I am employed as ...*

Type of internship*

I am doing a voluntary internship

I am doing a compulsory internship which is prescribed in the study regulations

Employer at time of start of membership of Mercedes-Benz BKK

Name of the employer*

Street and house number

Zip code*

City*

Telephone number of the employer/human resources department

Personal data

Gender*

First name*

Last name*

Date of birth*

Place of birth*

Country of birth*

Address in Germany

c/o

Street*

House number*

Zip code*

City*

Country*

Phone number (important for inquiries)

Our tip: The quickest way to clarify questions is by telephone. This information is voluntary.

E-mail address

Nationality*

I would like to be served at the following Mercedes-Benz BKK customer center*:

Start of employment

Proof of insurance number (formerly social security card) for first-time employment in Germany

I need a proof of insurance number (formerly social security card). Please send this to me.

Co-insurance of family members

I have family members who I would like to insure free of charge.

Terms of use and privacy policy*

I have taken note of the terms of use and privacy policy.

Form completed in full. Please re-check your entries before submitting the form.

Fields marked with an * are mandatory.

Sie sind bereits bei uns versichert und möchten Ihre Angehörigen familienversichern?

Der schnellste Weg ist online: das spart Zeit und Porto!

Einfach in unserer App oder unter "Meine Mercedes-Benz BKK" anmelden und in der Rubrik "Online-Formulare/Familienversicherung" das Web-Formular ausfüllen, abschicken, fertig! Es ist keine Unterschrift erforderlich. Wir kümmern uns um alles Weitere.

Sie sind noch nicht registriert? Dann sollten Sie das schnell nachholen. Unter "Meine Mercedes-Benz BKK" stehen viele Services für Sie bereit.

Sie möchten den Antrag lieber herunterladen und per Post verschicken? Das geht natürlich auch. Bitte denken Sie daran, den Antrag an unsere zentrale Postadresse zu schicken: Mercedes-Benz BKK, 28178 Bremen.

Anträge für die Familienversicherung