Every private-sector employer must offer employees collective supplementary health insurance (complémentaire santé, often called “mutuelle”), from the first hire. Setting it up and managing it have direct consequences for payroll.
The essential rules
- A minimum basket of care must be covered, possibly improved by the collective agreement.
- The employer funds at least half of the premium.
- The scheme is collective and mandatory, except for exemptions provided by the texts.
- It is set up by an agreement, a collective agreement or a unilateral decision by the employer given to employees.
Exemptions
Some employees can, at their request and with supporting documents, be exempted from joining: for example those already covered by their spouse’s insurance under certain conditions, or some employees on short contracts. The request must be formalised and kept.
In payroll
The employer’s contribution benefits, under conditions and within limits, from a favourable social security regime; it is however added to the employee’s taxable income. A compliant scheme is the condition for these advantages.
Common mistakes
- Accepting an oral exemption or one without supporting documents: in an inspection, the social advantage can be challenged.
- Applying a contract that does not comply with the basket of care or the collective agreement.
- Forgetting portability of cover for an employee who leaves, in the cases provided.
- Not updating payroll when rates or categories change.
Before choosing a contract
- Check the obligations of your collective agreement.
- Compare cover, prices and services, for employees and their dependants.
- Formalise the set-up document and inform employees.
Our support
As part of the payroll service: compliance review of the scheme, payroll set-up, management of exemptions, arrivals and departures. See payroll and HR
Frequently asked questions
Is the company director concerned?
The president of an SAS, treated as an employee for social security, can benefit from the scheme under conditions. The majority manager of a SARL falls under other schemes.
What happens when an employee leaves?
They can, under conditions, keep their cover free of charge for a limited period: this is portability.
Can we freely choose the insurer?
In principle yes, unless the collective agreement recommends or requires otherwise, which must be checked.
Can an employee refuse the mutuelle?
Only in the exemption cases provided by the texts, on written request with supporting documents. Otherwise, membership is mandatory.
Is protection insurance (prévoyance) also needed?
It is mandatory for executives (cadres) and provided by many collective agreements for other employees. Check according to your sector.