How to choose your Mandatory healthcare insurance?
A mandatory healthcare insurance in France is much more than just a legal requirement: it has an important leverage effect to ensure employee well-being, For employers, especially those from foreign companies, choosing the right mutuelle can be complex. Here are the essential criteria and key steps for setting up a suitable mandatory healthcare scheme.
A mandatory healthcare insurance in France is much more than just a legal requirement: it has an important leverage effect to ensure employee well-being, For employers, especially those from foreign companies, choosing the right mutuelle can be complex. Here are the essential criteria and key steps for setting up a suitable mandatory healthcare scheme.
What are the criteria for choosing a mandatory healthcare plan?
Selecting a mandatory healthcare insurance plan involves more than simply complying with the rules. It also means opting for a solution that meets the needs of employees and the company's strategy.
Respecting the legal framework: the "minimum care basket”
By law, all mandatory healthcare insurance plans must cover a certain number of minimum benefits, including:
- Full coverage of the co-payment for care reimbursed by Social Security.
- Coverage of hospitalization costs, including the fixed daily rate.
- Partial coverage of dental and optical expenses.
It is therefore essential to check that the offer you are considering meets these criteria.
Adapting to employee needs
- Every company has different employee profiles. For example:
- Young professionals: Prioritize optical and dental benefits.
- Older employees: Pay particular attention to cover for expensive or chronic medical care.
- A good contract should also offer options for additional reimbursement or for extending coverage to dependents (spouse, children)
Ease of administration
- A mutual healthcare insurance plan should simplify the employer's task, with :
- An intuitive interface for managing enrolments and terminations.
- A dedicated contact to manage the plan.
- A smooth process for integrating employees on short or part-time contracts.
Quality of service for employees
Employees expect fast reimbursements, responsive customer service, and modern tools such as mobile applications for consulting their reimbursements or sending in receipts.
Value for money
Price remains a key criterion, but it must be taken into account with the guarantees offered. An offer that is too inexpensive may not meet employees' expectations, which could undermine their satisfaction.
The various steps to set up a mandaotry healthcare insurance scheme
Setting up a madatory healthcare insurance scheme requires a rigorous methodology to ensure compliance with the law while satisfying employees’ expectations.
Identify specific legal obligations
First and foremost, check the rules applicable to your sector. Some collective bargaining agreements impose specific guarantees or designate a mandatory mutual insurance organization. For example, in the building and civil engineering sector, mutual insurers must include cover tailored to the needs of professionals working in the field.
Assess employee needs
Carry out an analysis of your employees' expectations and needs. This can be done through:
- Internal surveys or polls.
- Best market practice in your industry
- Interviews with employee representatives, particularly if you have a social and economic committee (CSE).
This will help you identify priorities, such as enhanced optical care, hospital coverage or flexibility for dependants.
Research and compare offers
Once you have identified your needs, it is time to compare the options offered by insurers and brokers. Request several quotes and study:
- Coverage included.
- Optional extras.
- Total cost (employer and employee share).
Some specialized brokers can simplify this step by proposing solutions tailored to your sector and your constraints.
Negotiate contract terms
Once you have made your choice, talk to the insurer to personalize the contract:
- Add specific cover if required.
- Adjust reimbursement levels.
- Specify management procedures (enrolments, terminations, etc.).
Formalize the implementation
Mandatory healthcare insurance must be formalized in a legal document. This may take the form of:
- A collective agreement negotiated with the social partners.
- A unilateral decision by the employer.
- A company referendum.
This document sets out the rules for membership and the cover offered. It also sets up who is paying what between the employer and the employees.It must be sent to all employees to ensure complete transparency.
Informing and supporting employees
Clear communication is essential if employees are to understand the benefits and functioning of their mutual plan:
- Distribute an explanatory leaflet detailing benefits and procedures.
- Organize information sessions to answer their questions.
- Set up contact channels to support them (email, hotline, etc.).
Monitoring and adjusting
The implementation of a mutual insurance plan should not be set in stone. Regularly assess employee satisfaction through surveys or informal feedback. Adjust cover or change provider if necessary.Don’t forget that prices increase each year, one of the factors being the reevaluation of the French Social Security ceiling (PASS/PMSS).
Choosing and implementing a mandatory healthcare insurance scheme in France is a process that requires both rigor and strategy. By following the key criteria and steps described, you can guarantee coverage that is tailored to employees' needs, while complying with legal obligations. This helps to boost employee satisfaction, loyalty and the attractiveness of your company.
To ensure you make the best choice, don not hesitate to consult a specialized broker.