A quick reminder of the employer’s obligations in terms of membership of a company mutual insurance
According to the provisions of the ANI law, all employers in the private sector must offer their employees a company mutual insurance company including a minimum basket of care. Also known as complementary health insurance, it must be paid for at least 50% by the employer.
Compulsory for all employees, membership of the company complementary health insurance allows them to obtain reimbursement of health expenses not covered by the Health Insurance. This membership obligation is valid regardless of the type of contract, remuneration, seniority or executive status or not.
It is only in exceptional cases that the employee may refuse to subscribe to it.
Employee and employer contributions for complementary health insurance
The great advantage for the employee lies in the company’s financial participation in the financing of this coverage.
Some companies even go so far as to pay for the entire amount. This can happen by unilateral decision of the employer or under collective agreements.
In practice, the cost of membership is borne by the employer’s contributions, which are paid by the employer, and the employee’s contributions, which are the responsibility of the employee.
Identification of the mutual insurance contribution on the pay slip
The pay slip must imperatively make Showing the mutual insurance contributions borne by the employee since it impacts the remuneration.
However, this mention does not apply when:
- The employee is exempt from membership of the company’s mutual insurance company;
- The employer pays 100% of the contributions (reducing the employee contribution to zero).
The main sections of the simplified pay slip
In addition to the gross salary, the simplified pay slip mentions the various deductions and contributions, which makes it possible to determine the net salary. Five categories of contributions appear:
- Health
- Accidents at work – Occupational diseases
- Retirement
- Family
- Unemployment insurance
The mutual insurance contribution paid by the employee appears in the “Health” section in the same way as Social Security deductions and complementary health insurance.
Here’s an important point: company mutual insurance should not be confused with supplementary company provident insurance, even if their objective is identical: to supplement the reimbursements obtained from Social Security. The difference is that the mutual insurance covers routine health care, whereas the Provident insurance, which is not compulsory by the way, intervenes in the event of life accidents: incapacity for work, disability, dependency, or death.
The line relating to the mutual insurance company appears in the Health section of the pay slip under the heading Complementary health insurance.
It should be borne in mind that this contribution is often calculated on a flat-rate basis and the basis most often used is that of the Monthly Social Security Ceiling (PMSS), which is reviewed annually. (i.e. for 2024: €3864 gross per month)
Difference between health insurance and health insurance
How to guarantee precarious employees Individual complementary health insurance? Through the health payment, a lower-cost alternative to the company’s collective coverage.
Since 2016, employers have been required to allow employees to benefit from a Mandatory health insurance, the cost of which is at least 50% covered by the company.
All employees must adhere to this compulsory health coverage, with the exception of employees with precarious status, to whom the health payment scheme is reserved. They receive a monthly payment from their employer to finance the complementary group health insurance.
These are therefore employees who are in one of the following situations:
- On a fixed-term contract for a maximum of 3 months
- Part-time with 15 hours per week or less
- On assignment of 3 months at most (like temporary workers).
The amount paid to the employee each month as a health payment is calculated by taking into account the working time and the amount of the employer’s contribution to the compulsory health insurance company. There is therefore no identical amount for all beneficiary employees.
Setting up the paymentt health
Setting up the health payment can be done at the request of the employee or the employer.
When it is the employee who takes the initiative, he or she just has to ask to be exempted from joining the company mutual insurance when he or she is hired (or when the mandatory mutual insurance is set up).
As part of an employer initiative, the system can be set up:
- by branch agreement, in which case the employees concerned are obliged to accept the health payment;
- by a decision taken unilaterally by the company (DUE).
As part of the health payment, the employee will be covered but this will not have an impact on his payslip.
