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Health insurance: precarious employees know the reference amount of the employer’s contribution

If, since 2016, all employees have the right to benefit from assistance from the employer to finance their health coverage, the terms of application differ according to the status of the employee. In the vast majority of cases, the complementary health is imposed but also financed at least 50% by the boss. However, some exceptions are provided for by the national interprofessional agreement (ANI). The employer can thus exclude from the company mutual fund certain employees whose fixed-term or temporary contract is less than 3 months, or even if the employee works 15 hours or less per week.

In this case, the employer must provide an alternative financing called “health payment”, calculated on the basis of the participation enjoyed by full-time employees in the same category. However, it happens that the contribution cannot be determined for the category of the employee, specifies the government, because no equivalence can be operated for example. In this case, the aid received by the employee is obtained according to a reference amount, a kind of spare tire. For 2022, a decree from the Ministry of Health published on May 2 sets it at 19.30 euros. It was only 16.34 euros in 2021.

To obtain the final aid received by the employee on a part-time basis or on a contract of less than 3 months, a coefficient of 125% must be applied to this amount, ie 24.13 euros per month. This increase is slightly lower for employees on permanent contracts since for them, a coefficient of 105% is applied.

A complex calculation

This exceptional case is however rare, and most often, the calculation of the health payment is made as follows:

• amount paid each month to employees in this category to finance group health coverage
• multiplied by the number of hours worked each month
• divided by 151.67

Here is a concrete case provided by the government. If the employer pays a monthly lump sum contribution of 60 euros for each of the employees in a category, an employee on a permanent contract in this same category working 50 hours per month will receive aid of 19.78 euros (i.e. an amount slightly higher than the fixed benchmark) to which the coefficient of 105% is applied. The monthly amount to be paid for this employee is 20.77 euros. A sum ultimately three times lower than that enjoyed by the rest of the employees.

Often, these health payments are introduced at the unilateral initiative of employers, but also through collective branch agreements or company agreements. Failing this, the employee on a fixed-term contract or on a mission can ask himself to exercise this right if the accompanying health cover is less than 3 months. Employees benefiting from individual coverage or complementary health insurance at the time of their hiring can also continue to benefit from it until the expiry of the contract.