Mandatory Workplace Health Insurance

Mandatory Employer Health Insurance Since 2016

Since January 1, 2016, all private sector employers must offer collective health insurance to their employees. This obligation stems from the National Interprofessional Agreement (ANI) of January 2013 and the Employment Security Law. For more on insurance in France, explore our complete guides.

Employer Obligations

The employer must finance at least 50% of the health insurance premium. The contract must meet a minimum set of coverage, called the "ANI care basket."

Minimum Care Basket

The contract must cover at minimum: full ticket moderateur (co-payment) on consultations and procedures reimbursed by Social Security, hospital daily allowance without time limit, dental expenses at 125% of the base rate, fixed optical allowances every 2 years.

Cases for Exemption from Enrollment

Despite the mandatory nature, some employees can request not to join the company health insurance.

Automatic Exemptions

These exemptions don't require provision in the scheme's establishment act.

**Employees on fixed-term or temporary contracts** of less than 3 months (if the employer offers health payment vouchers) or if the employee has other coverage.

**Very part-time employees** whose enrollment would represent 10% or more of their salary.

**Beneficiaries of Complementary Solidarity Health Insurance** (CSS) or State Medical Aid (AME).

Exemptions Provided in the Establishment Act

These exemptions must be provided in the document establishing the scheme.

**Already covered employees** by their spouse's mandatory health insurance or individual coverage (only until the individual contract expires).

**Employees present at implementation** if funding isn't solely from the employer and they refuse in writing.

**Employees on fixed-term or temporary contracts** of at least 3 months who are already covered elsewhere.

How to Request an Exemption

The request must be made in writing, usually at hiring or when the scheme is implemented. The employee must provide proof of their situation (spouse's health insurance certificate, CSS, etc.) and renew the request annually if the situation continues.

Portability of Rights

Free Continuation After Contract End

If you leave the company (dismissal, end of fixed-term contract, mutual termination), you can keep your company health insurance free of charge for a period equal to your last employment contract, up to a maximum of 12 months.

Portability Conditions

You must be registered with France Travail (formerly Pole Emploi) and the termination must not result from gross misconduct. The benefit ends as soon as you find new employment.

What About Dependents?

Mandatory or Optional Coverage

Depending on the establishment act, dependents (spouse, children) may be covered mandatorily or optionally. If dependent coverage is mandatory, the employer also contributes to the financing.

Definition of Dependents

Dependents are generally the spouse (married, civil partnership, or cohabitant) and dependent children. The exact definition is specified in the contract.

Sector-Specific Features

Collective Bargaining Agreements

Some collective agreements provide for guarantees exceeding the legal minimum, higher employer contributions, and mandatory dependent coverage.

Professional Branches

Some branches have negotiated specific agreements recommending particular insurance organizations, without obligation to join them.

Conclusion

Mandatory employer health insurance has generalized access to complementary health coverage for private sector employees. Even though exemption cases exist, most employees benefit from this collective coverage, often on more advantageous terms than an individual contract.

The information provided in this article is for informational purposes only and may change. Consult your company's HR department for the exact conditions of your scheme.