In France, company health insurance has become a central part of employees’ social protection. But is it really compulsory for all companies and all employees?
The answer is yes, with a few important nuances.
Is company health insurance compulsory in France?
Since 1 January 2016, the law has required private-sector companies to set up group health insurance.
In practical terms:
- All private-sector employers are concerned.
- The size of the company is irrelevant.
- All employees must be able to benefit from it.
This obligation stems from the National Interprofessional Agreement (ANI) of 2013, which made health coverage in companies universal.
- A company with a single employee is therefore just as concerned as a large group.
What must the employer offer?
A collective and compulsory scheme.
The cover must be offered to all employees, without distinction (except in specific regulated cases).
- permanent or fixed-term contracts, full-time or part-time;
- with no length-of-service condition (apart from limited exceptions).
A financial contribution from the employer
The employer cannot simply offer health insurance: it must fund it.
- a minimum coverage of 50 % of the contribution;
- the remainder is borne by the employee.
In some collective bargaining agreements, this contribution may be higher.
A minimum level of cover
The health insurance must comply with a minimum care package (known as the “ANI package”).
This base notably includes:
- reimbursement of the co-payment (ticket modérateur);
- coverage of the daily hospital charge (forfait hospitalier);
- minimum cover for optical and dental care.
These benefits ensure a basic level of protection for all employees.
Are all employees required to join?
The main grounds for a waiver:
In certain cases, an employee can request a waiver (with supporting evidence):
- an employee already covered by their spouse’s health insurance;
- an employee on a short fixed-term or assignment contract;
- an employee receiving the Complementary Health Solidarity scheme (CSS);
- an employee already covered by a temporary individual policy;
- an employee present when the scheme was set up (in certain cases).
- Important: the request must be made in writing, otherwise membership is automatic.
How to set up company health insurance?
A company can establish its health insurance through:
- a collective agreement (sector-wide or company-level);
- a referendum among employees;
- a unilateral decision of the employer (DUE).
Each method of setting it up has different implications, particularly in the event of a waiver.
Information obligations
The employer must inform each employee of:
- the benefits offered;
- the cost and how it is split;
- the terms for joining or for a waiver.
This step is essential for compliance.
What happens in the event of non-compliance?
Failing to set up compliant health insurance can have significant consequences for the company.
It can lead to:
- a URSSAF reassessment;
- the loss of tax and social advantages;
- a risk of litigation with employees.
Company health insurance is therefore a legal issue as much as a social one.
A lever beyond the obligation
Even though it is compulsory, health insurance should not be seen solely as a constraint.
It can also become a real lever for the company:
- strengthening its appeal;
- retaining employees;
- improving quality of life at work.
Many companies choose to go beyond the legal minimum (higher coverage, enhanced benefits and so on).
Key takeaways
Company health insurance is today an unavoidable obligation for employers.
Key points:
- compulsory since 2016 for all private-sector companies;
- minimum funding of 50 % by the employer;
- group cover with minimum benefits;
- compulsory membership except in cases of waiver.
When well managed, it becomes a structuring element of the company’s social policy.
