As from January 2016, all companies will have to offer their staff a supplementary health insurance scheme. A government decree published in September 2014 makes it obligatory to take out a group policy with minimum cover, known as the “basket of covers” (panier de soins). This standard policy covers a clearly-defined range of medical expenses. General practitioners, hospitalisation, optical and dental expenses…everything is provided for. The law also enforces a split of premiums between the employee and the employer. As a result, company management really have very little choice
What action do the 500,000 organisations without cover need to take before the end of the year? Just follow these steps.
1- Choose an insurer
A standard (minimum level) group policy in France can be bought from insurance companies, mutual societies or so-called institutions de prévoyance (social insurance bodies). As the law lays down precise policy specifications, quotations from the various players may well be very similar in terms of cover and price.
Differentiating factors will be service quality (medical expense processing time, on-line consultation, etc.), varying degrees of extra cover that might appeal to you and quality of advice. On this last point, entrusting implementation to brokers brings double benefits.
. Firstly, it provides a critical third-party view on at least three insurance quotes, which they are obliged to propose. The broker then provides you with support in putting the programme in place. They can be liable if a problem arises.
2- Examine your situation with a consultant
If you use a broker then the matter can be settled in just two meetings. First all, a meeting to examine your particular circumstances:
- • your collective bargaining agreement to see if extra covers are provided for,
- • staff numbers and profiles,
- • whether any staff are not required to be insured.
You should bear in mind that there are a number of dispensations possible, for example, for staff who are already covered by their spouse’s policy. These staff members may decide to opt out of the company health insurance plan you offer. Or else, your policy may include specific clauses where staff on short-term contracts (CDDs), under certain conditions, can opt out of the group scheme. Examining all these different instances of dispensation may bring down considerably the financial impact of compliance.
The second meeting serves merely to choose between the quotations put forward by your broker.
3- Putting the scheme in place
Once the policy has been chosen, the employer must then obey a certain number of formalities. If there are no staff representatives then the firm may choose to style it as the employer’s unilateral decision. If this is the case then the following documents need to be provided to staff:
- • A personal information letter
- • Details of the unilateral decision setting out how the scheme will be set up and what the premiums will be, etc.
- • An application form.
Gerep provides a customised communication pack including a notice for distribution to staff members setting out the policy cover. This relieves the employer from this essential formality. It is the employer’s responsibility then to send out the documentation and collect the application forms and any requests for dispensation. The employer then signs the scheme policy and moves into administration mode.
In the end, compliance will not waste too much time nor cause too much hassle…provided you have the right support. Cutting out the risks involved in setting up the scheme and ensuring that staff are provided with quality service are the main challenges brought on by the extending of supplementary healthcare schemes to all companies…so that an employee benefit does not become a millstone around the employer’s neck.