France: Mandatory Employer-Paid Medical Insurance For All Staff In France

Last Updated: 1 September 2015
Article by Alix Mugnier

Our expert provides details of a new law effective 1 January 2016 that will require all employers to provide medical insurance to staff

Currently in France, basic social security cover does not refund medical expenses in full. In an effort to provide improved health care to all salaried employees, the government has ruled that all companies employing staff in the country must provide additional medical insurance.

Where the employer already provides a medical plan, they will need to make sure it is compliant with the new requirements and take all actions to upgrade their existing plan before 1 January 2016 if necessary.

If the employer doesn't have a medical plan for staff, it must be set up as soon as possible and become effective on 1 January 2016 at the latest.

Key items to be checked in order to comply with the new law:

  • Minimum coverage to be offered by the plan
  • Insurance premium cost split
  • Mandatory enrolment
  • Tax-compliance of the plan – avoiding the taxable benefit status
  • Possible exemptions from the employees' mandatory enrolment
  • Enrolment of employees' dependents: optional or mandatory

Minimum plan coverage

The plan must be compliant with the "contrat responsable" rules. It must cover at least the following medical expenses:

  • The minimum social security fee ("ticket modérateur") for medical visits
  • The minimum daily hospital fee ("forfait journalier")
  • Dental fees
  • Optical fees

Insurance premium cost split

Insurance premiums must be paid at least 50% by the employer. The employer can choose to pay a higher share of the cost.

Mandatory enrolment

Enrolment must be automatic and mandatory for all employees, otherwise it will be regarded as an optional and therefore taxable, benefit.

Plan tax compliance – avoiding the taxable benefit status

In order to be processed as a non-taxable benefit, some formalities when setting up or upgrading your plan must be completed. The type of formalities depends on whether or not your company is affiliated to a Collective Bargaining Agreement (CBA) or Branch which has already defined a structure for the medical plan:

1. Plan set up as part of a Branch or CBA: strict implementation of the CBA criteria

Some branch agreements and collective bargaining agreements have already defined a mandatory medical plan structure, or will do so before 1 January 2016. If you depend on a Branch agreement or a CBA which has negotiated a specific plan structure, you only need to implement or upgrade your plan according to the criteria described in the agreement without further formalities.

2. Plan set up outside a Branch or CBA: "Décision Unilatérale" system

Where you don't depend on any of these agreements, or you judge the structure defined in the agreement insufficient for your staff (for example: poor level of coverage compared to what you already offer or what you want to offer to your staff), you will have to set up your plan or upgrade your plan's conditions by drafting and signing a document called "unilateral decision" in order to establish the plan as mandatory and non-taxable. This system for operating outside of the CBA is called "Décision Unilatérale" in French. The existence and quality of this document is crucial for your plan to qualify as a non-taxable benefit.

The décision unilatérale must be signed by the employer and must be sent or given to each individual employee against signature. Employees can sign all on the same list called "liste d'émargement" or on an individual certificate of information. The décision unilatérale and the list of employees' signatures or individual certificates will be requested by the social security inspector in case of a social security audit ("contrôle Urssaf") in order to assess the compliance of the plan.

Possible exemptions from the employees' mandatory enrolment

Possible exemptions from enrolment must be carefully listed in the décision unilatérale in order to make sure the plan remains non-taxable. The employer must inform the employees of the consequences of refusing the enrolment. In order to benefit from an enrolment exemption, the employee must submit a formal exemption request stating they understand the consequences of not being enrolled. The only possible exemptions reasons are described in the following table:

Exemptions possible under the "Décision Unilatérale" system

Situation covered

Supporting documents needed

Exemption possible until

Employees who started before the plan was set up

No document needed

No limitation

Apprentices or fixed-term contracts of more than 12 months

Certificate of private coverage showing the same level of guarantees

Expiration of the private coverage

Apprentices or fixed-term contracts of less than 12 months

No document needed

End of the 12 month period

Part time employees and apprentices with a low wage

Evidence showing that the employee premium deduction would exceed 10% of their gross salary

No limitation

Employees who already had a private insurance before they joined

Certificate of coverage by private insurer showing the expiration date of the current private coverage

Exemption possible only during the first year. The employee must give termination notice to their private insurer before the automatic renewal, and as soon as their private coverage expires, they will have to be enrolled into the company plan

Employee who is already enrolled as a dependent of their spouse's mandatory company plan

Certificate of registration as dependent of the spouse's mandatory company plan

When the employee ceases to be covered by their spouse's plan, they will have to be enrolled into the company plan

Employees who benefit from the CMU or ACS (government plan offering free insurance to unemployed workers)

Certificate of CMU or ACS coverage

As soon as the CMU or ACS coverage expires

Enrolment of employees' dependents: optional or mandatory

You can decide that your plan will cover your employees only or that your plan will cover the employees and their dependents.
If the plan covers both the employees and their dependents, there are two options: mandatory enrolment of the dependents or optional enrolment of the dependents:

A. Mandatory enrolment of the dependents

If you decide that the dependents' enrolment is mandatory, the employer pays part of the dependent's insurance premium and this part will not be treated as a taxable benefit.

Exemptions to the employees' dependents' enrolment under a mandatory enrolment scheme:

  • Spouses working within the same company - only one spouse will have deductions on their payslip; the main deduction for themselves and the additional dependents deduction for their spouse. The other spouse will not have any deduction from their payslip.
  • Spouse covered by their own company's mandatory plan: they will have to provide a certificate of mandatory coverage.

B. Optional enrolment of the dependents

If you decide that the dependents' enrolment is optional, there can be two situations:

  • The employer pays part of the dependents' insurance premium - this part will be treated as a taxable benefit.
  • The employer doesn't pay a part of the dependents' insurance premium - the employee pays 100% of the dependents' insurance premium - this will not be treated as a taxable benefit.

Your insurer or broker should be your primary point of contact for setting up a plan, or upgrading an existing plan and providing a decision unilatérale template if necessary.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on

Click to Login as an existing user or Register so you can print this article.

Some comments from our readers…
“The articles are extremely timely and highly applicable”
“I often find critical information not available elsewhere”
“As in-house counsel, Mondaq’s service is of great value”

Related Topics
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Registration (you must scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of

To Use you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions