Is company supplementary health insurance compulsory? | MIA Assurances

Are you hiring in France and looking for information on setting up a group supplementary healthcare scheme? Here you can find out about your obligations as an employer, and the answers to your initial questions about setting up your group plan. Over and above the legal obligations, remember that optimal health coverage makes a difference to your employees: it’s proof of your ongoing commitment to improving their well-being!

Providing your employees with a supplementary healthcare plan is compulsory!

Since January 1, 2016, all employers have been obliged to provide their employees with a group supplementary health insurance plan. This obligation applies to all companies, whatever their size: VSEs, SMEs, large operations, etc. The “ANI” law requires the company to put in place a supplementary healthcare plan with:

– A financial contribution from the employer who will have to pay at least 50% of the insurance premiums. The balance is paid by the employee.
– A minimum level of coverage.
– The plan being provided to all employees.

You will therefore have to choose a group supplementary health insurance plan to reimburse your employees’ medical expenses, in addition to their Social Security benefits.

In what cases can the employee refuse supplementary health insurance?

In certain specific cases, your employee may ask to be exempted from the company supplementary health insurance scheme. To do this, they will need to make the request to you in writing stating the reason for the request.

Exemption is permitted in the following cases, for example:

    • They already have supplementary health insurance.
    • They are covered by their spouse’s or parents’ supplementary health insurance as a dependent.
    • They have been hired on a part-time basis or on an apprenticeship, and the premium is at least 10% of their salary.

What if my employee leaves the company or is absent?

If your employee is absent from the company while continuing to receive sick pay, for example, they will continue to benefit from the company health insurance plan co-funded by the employer.

Also, if your employee leaves your company (other than in cases of gross misconduct) and is receiving unemployment benefit, they may remain covered under your company’s health insurance plan if they wish. This system of maintaining entitlement is called portability.

However, if your employee chooses to take a break through sabbatical or parental leave, they will not be paid and will therefore not benefit from their supplementary health insurance plan.

How to set up the supplementary health insurance plan

To find out who to contact to set up your company’s group supplementary health insurance plan, you need to identify your situation:

  • It is possible, if it is part of your collective bargaining or branch agreement, that the choice of insurer is imposed on your company.
  • Sometimes a collective agreement has been negotiated internally with your staff representatives: this collective agreement may determine the choice of your insurer.
  • Lastly, if this is not the case or if your company has fewer than 50 employees, you are free to choose your insurance partner and must in this case formalize your choice by drafting a document describing the scheme. This document is called the décision unilatérale de l’employeur (unilateral decision by the employer) (DUE). The DUE will be sent to your CSE for consultation 3 months before the plan comes into force.

To get the best advice on choosing your supplementary health insurance provider, please feel free us.

Use it to enhance your employer brand and build employee loyalty

Remember that even though setting up a supplementary health insurance scheme for your employees in France is compulsory, you can turn it into a loyalty lever by offering a comfortable level of coverage and/or a contribution to premium payments of more than 50%. The well-being and health of your employees is an important part of your employer brand!

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