ANI: what should companies do if they don’t yet have complementary health insurance?

By January 1, 2016, all employers will have to offer their employees a health insurance. A decree, published in September 2014, requires the subscription of a collective contract offering a minimum guarantee base, known as the panier de soins. This standard contract covers a set of clearly designated healthcare expenses. General medicine, hospitalization, optical, dental… everything is covered. The law also requires that contributions be shared between the employee and the employer. So, in the end, there’s not much left for company directors to choose from.

What are the formalities to be completed by the end of the year for the 500,000 structures that are not covered? The answer in a few points.

1- Choose an organization

Insurance companies, mutual insurers and provident institutions are likely to provide you with a minimum group contract. As the law imposes precise specifications, the offer from these players is likely to be very similar in terms of coverage and price.

The differences will mainly concern the quality of services (repayment times, online tracking, etc.), any nuances on additional cover that might appeal to you, and advice. On this last point, entrusting the implementation to brokers brings a double advantage.

Firstly, they provide an external, critical view of at least three insurance offers, which they are obliged to propose. Secondly, they help you set up your contract, as they are liable in the event of any problems.

2- Assess your situation with an advisor

With a broker, the matter can be settled in two meetings. The first is to assess your particular situation:

• collective bargaining agreement, in the event that additional guarantees are provided,
• company demographics,
• possible membership exemptions.

For example, employees who are already covered by their spouse’s mutual insurance plan. These employees can opt out of the company mutual insurance plan you offer. Similarly, your contract may contain specific clauses allowing employees on fixed-term contracts to opt out of the group contract, subject to certain conditions. Examining the cases of exemption can significantly reduce the financial impact of this measure.

The second meeting simply consists of choosing from the proposals presented by your broker.

3- Setting up the contract

Once the complementary health insurance has been chosen, the employer must comply with certain formalities. In the absence of employee representatives, the employer can opt for a unilateral decision. In this case, the following documents must be submitted to employees:

• Nominative newsletter
• Unilateral decision specifying the terms and conditions of implementation, contribution rates…
• Membership forms

To relieve the employer of this essential formality, Gerep provides a customized communication pack, as well as a leaflet for employees describing the benefits. It is then up to the employer to send out the package, collect enrolments and exemptions, sign the contract and switch to management mode.

In the end, compliance will cost you little time and trouble… provided you are properly supported. Eliminating the risk involved in setting up a contract, and ensuring that the services provided to employees are of the highest quality, are the key issues involved in extending complementary health insurance to all companies… so that an advantage for the employee does not become a burden for the employer.

What is the employer’s obligation in terms of supplementary health insurance?