Compulsory ANI and complementary health law

From a national inter-professional agreement to a law

The acronym “ANI” designates a national inter-professional agreement, negotiated and signed by the various social partners. The main unions of employees and employers jointly define an agreement which applies to all sectors of activity and at national level.

The law on job security of June 14, 2013 is more commonly called “ANI law” because it transposes the ANI of June 14, 2013. It enshrines new rights for employees and imposes new obligations on employers, including the generalization of complementary health insurance to all employees.

This measure promotes better coverage of health costs for all employees. Health Insurance, one of the five branches of Social Security, in fact covers part of health costs. But the remainder of the charge remains substantial and may be difficult to bear for certain households, in the absence of subscription to complementary health coverage which until then was optional.

The compulsory nature of complementary health coverage ensures that all employees in the private sector receive quality coverage of their health costs. The financing of contributions is provided jointly by the employer (50% minimum) and the employee (50% maximum).

A minimum level of guarantees, called “care basket”, is specified by decree n ° 2014-1025 of September 8, 2014.

What are the stages of the implementation of the ANI law?

  • June 2013 – June 2014: negotiations within the professional branches

Trade unions and employers’ organizations must enter into negotiations to determine the content and levels of guarantees, the distribution of contributions between the employer and the employee, exemptions from affiliation at the initiative of the employee, etc.

  • July 2014 – December 2015: negotiations within the company

Companies not concerned by a branch agreement or whose agreement offers guarantees lower than the minimum “basket of care” must enter into negotiations in order to conclude a company agreement.

  • January 1, 2016: implementation of the compulsory supplementary health contract

In the absence of a branch or company agreement, the employer is required to set up, by a unilateral decision, additional collective cover including the minimum guarantees included in the “basket of care”.

Which companies and which employees are affected by the ANI law?

Supplementary health coverage in France concerns all companies in the private sector and all their employees.

Affected companies

All employers in the private sector have the obligation to offer compulsory complementary health coverage:

The ANI law applies from the first employee recruited into the company or association.

Employees concerned

All employees are affected by the system, whatever the nature and duration of the contract:

However, exemptions are possible, under conditions, for the following cases:

  • Coverage by another mutual as a beneficiary before entering the company;
  • Coverage by additional individual health insurance (exemption until expiry of the current individual contract);
  • Beneficiary of complementary solidarity health (CSS);
  • Very part-time employee;
  • Employee on fixed-term contract or assignment contract of less than 3 months;
  • Employee on fixed-term contract or assignment contract of 3 months to one year;
  • Employee on fixed-term contract or assignment contract of one year or more;
  • Apprentice.

Who pays the contributions for a collective complementary health insurance?

The employer must pay at least 50% of the amount of the contribution. It can also decide to pay more than 50%, or even the entire amount of the contributions. This choice may depend on a collective agreement, a branch or company agreement, or a unilateral decision by the employer.

In the case of a responsible contract, the employer’s contribution is exempt from social contributions, within the limit of an amount of contributions paid for an employee over the year not exceeding 6% of the annual social security ceiling (PASS) and 1.5% of the employee’s gross annual remuneration. The total exempt contributions cannot exceed 12% of the PASS.

The Social and Economic Committee (CSE), which replaces the Works Council, can also assume responsibility for all or part of the part of the contributions devolved to the employee. This support can give right to an exemption, under conditions and within the limit of the fixed ceilings.

What are the guarantees of a “company mutual organization”?

Collective contracts taken out under the ANI law must comply with certain obligations.

The minimal care basket

The minimum care basket guarantees a certain level of reimbursement of health costs to all insured persons. In particular, it offers support for:

  • user fees for consultations, procedures and services reimbursable by health insurance;
  • of the entire daily hospital rate;
  • dental costs up to 125% of the conventional rate;
  • optical costs with a minimum package renewed every two years (annually in the event of vision changes or for children).

Companies generally opt for contracts that meet the specifications responsible and solidarity contracts:

  • Provide floors and ceilings for guarantees;
  • Exclude the assumption of certain expenses;
  • Encourage respect for a coordinated care pathway;
  • Promote practitioners who are members of OPTAM (Controlled practical pricing option);
  • Same subscription conditions for everyone (no health questionnaire.

Solidarity contracts allow you to benefit from tax advantages.

The 100% health reform

The 100% Health reform provides for insureds benefiting from a solidarity contract 100% reimbursement of dental costs, optics and hearing aids with a choice of equipment and fully reimbursed care.

Professionals (dentists and dental prosthetists, opticians and eyewear, hearing aid professionals, etc.) must offer baskets with services and equipment that meet strict specifications. The insured who has subscribed to a solidarity contract can opt for a prosthesis or a “100% health” treatment, fully reimbursed, or opt for a more expensive solution with an out-of-pocket charge.

The device was gradually deployed between the 1is January 2019 and the 1is January 2021.

Portability of rights

An employee can claim the portability of the rights and guarantees associated with the “company mutual organization” if:

  • The termination of the employment contract occurs for a reason other than gross negligence;
  • The termination of the employment contract gives the right to coverage by unemployment insurance;
  • No exemption from supplementary health coverage has been requested by the employee.

Rights are maintained for:

  • a duration equal to the last employment contract, or to the accumulation of the last consecutive employment contracts with the same employer;
  • a maximum duration of twelve months.

This maintenance of rights is free. It ceases if a new job is occupied by the insured.

How to choose a complementary health insurance within the framework of the ANI law?

AÉSIO Mutuelle offers various complementary collective health coverage solutions that meet the criteria of the ANI law:

  • Minimum care basket;
  • Responsible and solidarity contracts.

Contact our advisors to take stock of your needs.