Family Encyclopedia >> Health

What is special about health insurance for civil servants?

What is special about health insurance for civil servants?

Unlike employees in the private sector, civil servants do not benefit from collective health insurance set up by the employer. Employees are entitled to collective company mutual insurance, the cost of which is borne at least 50% by the employer.

Civil servants, for their part, must take out mutual insurance individually to be able to benefit from complementary health insurance. If their contributions are not half-financed by their employers, there are still some particularities of the mutual insurance for civil servants which are interesting.

Mutual insurance offered by specialized organisations

The particularity of mutual health insurance for civil servants is that it is offered by specialized organizations entirely dedicated to civil servants. These specialized mutuals are really interesting for professions that require special precautions. Law enforcement, doctors, teachers or territorial agents can, for example, subscribe to a specialized mutual insurance company in order to benefit from protections that will not necessarily be found with generalist mutual insurance companies. In addition, the agent benefits from preferential rates thanks to these specialized mutual insurance companies.

Currently, there are five of these specific organizations:the Mutuelle générale de l'Éducation nationale for teachers and national education personnel, the Mutuelle Humanis nationale for the health and social sector, the Mutuelle nationale territorial territorial agents, the European Foreign Affairs Mutual for expatriate agents and the General Mutual for the Economy, Finance and Industry for agents of this ministry. However, it has been possible for the civil servant to choose another mutual since the decree of November 2011. Thanks to this openness, the generalist organizations are able to offer equally interesting formulas to the different categories of civil servants. By putting the mutuals in competition, the civil servant is able to find an affordable offer presenting the guarantees sought. This process is carried out using an online health insurance comparator.

Aid from public establishments for the financing of mutual funds for civil servants

Civil servants are currently excluded from the system put in place by the ANI law of 2016 providing for collective mutual insurance for employees in the private sector. According to the law, the collective mutual must be financed at least 50% by the employers, which constitutes a definite advantage. If civil servants do not benefit from such a scheme, certain financial aid may be granted to support civil servants in subscribing to their mutual insurance scheme. Thus, since the 2011 decree, public establishments and local authorities have been able to participate in the financing of the mutual insurance companies of their agents.

As this participation is not compulsory, not all establishments will agree to it. Financial assistance takes the form of a preferential rate granted when subscribing to a mutual insurance company with a specialized organization such as those mentioned earlier. On the other hand, when the offer is taken out with a general insurance company, the aid takes the form of a payment of a more or less high sum to the civil servant.

Towards the establishment of additional social protection for civil servants

It is well known that the Social Security Health Insurance is not able to cover all the health costs of its members. The latter are therefore exposed to sometimes very substantial out-of-pocket expenses in the event of illness, hence the interest of taking out complementary health insurance. The burden of this mutual insurance may nevertheless remain significant for civil servants, which has prompted the Ministry of Transformation and the Civil Service to consider additional social protection for civil servants.

The implementation of this initiative will take place gradually according to the categories of public functions. With regard to the State civil service, the participation of the public authority in the mutual insurance contribution for agents has already taken effect since January 2022. It corresponds in particular to 25% of the average mutual insurance contribution for civil servants estimated at 60 euros by the government, i.e. 15 euros per month. In a few years, this participation should reach 50% and it will be the same for the hospital public service, and the territorial public service.