Mutual insurance: everything you need to know about territorial labelling
Like other civil servants, civil servants and local government employees must take out health insurance. Within the framework of’such a contract of’Insurance, they can benefit from’financial assistance from the local authority for which they work. Obviously, as it is a’As is the case for most public aids, this contribution is correlated to conditions. For example, the mutual insurance company chosen by the’A territorial agent’s contract must be labeled, in addition to respecting a number of other requirements’other basic conditions characteristic of solidarity contracts. But precisely, what does a labelled mutual insurance company imply? ? What requirements must be met? ? Qu’What are its advantages for the State?’agent ?
Labelled mutual health insurance, what it implies
A labelled mutual insurance is a contract of’In addition, the health insurance company that has received a label from the’State, through the’ACPR (Autorité de Contrôthe Prudential and Resolution Committee). L’ACPR is a state structure in France that regulates the banking and insurance sectors. To benefit from this label, the contracts concerned must be responsible and supportive. Thanks to this label, the agents of the territorial civil service can benefit from’a dedicated health insurance with advantageous terms and conditions.
This contract is different from others in the framework of the ACPR’health coverage. In fact, a mutual insurance company with the territorial public service label implies that the public authorities and their affiliated public establishments allocate financial assistance to their agents on behalf of their health insurance. This financial support can take two forms:
- the first possibility is that the’The health insurance agent selects his or her own individual contract with a mutual insurance company’a company with the territorial public service label. In this configuration, the’The aid allocated by the local authority may be paid directly to the employee’agent/civil servant,
- the second option is to proceed by call for tenders’offers to contract with a labeled mutual health insurance company. In this case, we speak of a participation agreement. Beneficiary employees can then claim selective rates and levels of coverage.
In all cases, it is essential to specify that the financial contribution of local authorities and their affiliated structures is optional. These state entities are under no obligation to offer a labelled contract to their employees.
In the’The second option is to proceed with a call for tenders, in the event that a local authority decides to use the label’if the local authority wishes to accompany its agent, it can set a fixed amount for this contribution. It also has the possibility of modulating the’allocation on the basis of the’s remuneration index’beneficiary territorial agent. The contribution may include family members, gender or.
In the same way, the label is granted for 3 years, renewable.
The requirements associated with the label
Established by Decree 2011-1474 of November 8, 2011 and effective in 2012, the subscription of a “label” contract is not mandatory’a labelled mutual insurance company for the territorial civil service has several advantages. At the same time, this labeling is subject to many requirements for insurers. In fact, the contracts proposed in the framework of the’Such health coverage must comply with the provisions of the’European Union. C’the treaty that organizes the regime applicable to social aid.
In addition to this requirement, there are other types of health insurance’other more factual.
For example, intergenerational solidarity is a fundamental principle of the labelled health mutual insurance for the local civil service. It implies that the younger agents and territorial civil servants pay a higher contribution than the older ones. Nevertheless, the ratio between the highest and lowest contribution must remain within the limit of 3. Likewise, the nature of the position held by the employee can be taken into account’The employee’s gender or state of health may not affect the amount of the premiums.
In addition, the’If you are a member of a local civil service accredited contract, you must not be required to fill out a medical questionnaire or have a time limit’age. As a’territorial agent benefiting from this contract, if you have a large family, the amount of your contribution cannot exceed what is legally applied to a family with 3 children. They can also benefit from’a label contract, retired civil servants have the same level of guarantees as the agents still active.
Some examples of labelled mutual insurance companies
There are many mutual health insurance companies in France. However, not all of them have the territorial public service label. Similarly, it is difficult to list all those that are labelled. As an indication, you will find among the ACPR approved mutual insurance companies
- Aviva Assurances,
Civil servants who are eligible for a health insurance contract can also take out an insurance policy’labelled health insurance
The following are eligible for a labelled health insurance plan civil servants, as soon as’they work in a local authority or a public institution. Retired agents may also be eligible, as long as you are posted in another country’they were civil servants at the time of their retirement. You’As you will have understood, several health insurance profiles are available’public employees can consider a contract of insurance’health insurance partially financed by the public employer. But, does this mean that this subscription is coercive for them ?
Absolutely not. Every agent of the territorial public service is free not to subscribe to a mutual insurance company with a label as part of your health insurance. In fact, this mutual insurance company is to be distinguished from the mutual insurance company of the ACPR’a company established and made mandatory by the ANI law since 2016 for private sector companies. This freedom of the’agent s’even extends to the subscription of’an individual mutual insurance.
S’If they wish, they can freely subscribe to a contract with a label under the participation agreement.
The advantages of’a labelled mutual insurance company
Although optional if you are a civil servant, the labelled health mutual insurance has several advantages for you. In fact, the, you benefit from’responsible and supportive health coverage, for a reduced amount, given the contribution of your community. At the same time, the approved contracts are accessible and adapted to all the professions associated with the territorial civil service: firemen, municipal police officers, local and territorial government employees, etc.
In this case’In this case, the prices are reduced compared to a private health insurance.
In addition, it should be noted that the guarantees offered through these contracts are very protective. Similarly, you can subscribe to the labelled health insurance of your choice, with coverage in line with your health needs. This detail is important and makes all the difference.
Indeed, the best health coverage is the one that depends on your health profile.
Better yet, the contract of’labelled insurance is extendable to your family members. In addition, you will keep the same rates and health benefits, as in the case of the public sector’If you are transferred to another local authority, the amount of your contribution may not exceed. Similarly, if younger employees pay more than older ones, the amount of their contribution cannot be more than three times higher than that of the older ones. In addition, you will be able to benefit from the same rates and benefits as in the case of the public sector’in principle, ACPR-approved mutual insurance companies are eligible for the CSS.
The characteristic guarantees of’a labelled mutual health insurance
A health insurance with the ACPR label should allow you to reduce the amount you have to pay for your health insurance’insured, l’agent or the territorial civil servant in the’occurrence. In this vein, the contract that you take out as a’the agent must reimburse the co-payment, as long as you respect the associated care pathway. Similarly, it must The contract will guarantee the payment of the daily hospital fee and the extra costs incurred by the insured’fees doctors who are members of the ACPR’OPTAM.
In addition, the mutual insurance company covers the costs inherent in certain medical procedures and excluded from social security. However, some health expenses will be covered by the contract with the ACPR label only if you subscribe to higher formulas. Thus, not all osteopathic care will be covered by the labelled mutual insurance company.
In addition, each certified mutual company reserves the right to modulate its offers and include some additional services. Packages on alternative medicine, the bonus of’age, the’home help, assistance coverage, optical and dental care… are possibilities to this effect. Some approved contracts even exclude the waiting period for a health insurance plan.