Since January 1, 2016, the ANI law (National Interprofessional Agreement) requires all private companies to offer compulsory employer mutual insurance to all of their employees, regardless of their seniority or the nature of their contract.
VSEs, SMEs, large groups: no structure is exempt. According to legifrance, this obligation arises from law no. 2013-504 of June 14, 2013 relating to job security.
Mandatory employer mutual insurance is a collective supplementary health contract taken out by the company to supplement Social Security reimbursements: medical consultations, hospitalization, optical, dental. For a consultation with a general practitioner billed at €30, Social Security only reimburses €17.50 after deduction of the fixed contribution. Mandatory employer mutual insurance covers all or part of this remaining cost.
According to the economie.gouv website, the contract must respect a minimum basket of care guaranteeing:
- Full reimbursement of the user fee
- The hospital package without time limit (€20 per day in public hospital)
- Optical costs: between €100 and €200 depending on the level of correction, renewable every 2 years
- Support for prosthetic dental care
In practice, many employees testify that employer mutual insurance has allowed them to significantly reduce their out-of-pocket costs for expensive items such as optics or dental care, which are often poorly covered by Social Security alone.
Please note: individual employers (home employment) are not subject to this obligation. The public service is the subject of a progressive reform: according to service-public, since January 2025, certain ministries have set up complementary collective health financed 50% by the State, with generalization planned for January 2026 in the hospital and territorial public services.
Can I refuse to join compulsory employer mutual insurance?
In principle no: membership in compulsory employer mutual insurance is automatic for all employees. The law, however, provides for strict cases of exemption, allowing certain profiles to be exempt. These exemptions are either of public order (the employer cannot object) or conditional according to the terms of the company contract.
According to Entreprise.service-public, since April 2024, employees covered as beneficiaries by another collective and compulsory contract can exempt themselves from the membership obligation on their own initiative, whether this coverage is optional or compulsory.
| Employee situation | Type of waiver |
| Already covered by the compulsory mutual insurance of another employer | Public order |
| Covered as a beneficiary of a compulsory collective contract | Public order (since April 2024) |
| Beneficiary of the Solidarity Health Supplement (C2S) | Public order |
| Fixed-term contract or temporary contract of less than 3 months | Conditional |
| Part-time (less than 15 hours/week) | Conditional |
| Employee hired before the establishment of mutual insurance by unilateral decision | Conditional |
| Covered by a current individual contract (until its expiry) | Conditional |
To activate an exemption from compulsory employer mutual insurance, the employee must make their request in writing and provide annual proof of their other coverage. In the case of multiple employers, an employee already covered by the mutual insurance of one of them can legally refuse to join the others.
Who pays compulsory employer mutual insurance?
The mutual malakoff humanis for employer based on shared financing. According to urssaf, the employer must finance at least 50% of the total price of the contribution, regardless of the level of guarantees chosen. The employee pays the balance, taken directly from their pay slip.
This sharing of costs makes employer mutual insurance generally more advantageous than an individual contract taken out alone. The employee portion of contributions is also deductible from the income tax base. On the employer side, the employer’s share is exempt from social charges under certain conditions linked to compliance with the responsible contract.
Special case – Alsace-Moselle: the information provided by urssaf specifies that in the departments of Haut-Rhin, Bas-Rhin and Moselle, a compulsory local regime already covers a larger part of care. Contributions to compulsory employer mutual insurance are reduced accordingly, up to the corresponding benefit differential.
Coverage for beneficiaries (spouse, children) is not imposed on the employer, but can be provided for by sector agreement or unilateral decision by the company.
Can I keep my personal mutual insurance?
The answer depends on your contractual situation.
In permanent contracts in the private sector, membership in compulsory employer mutual insurance is the rule. If you already have a current individual contract, you can request a temporary exemption until it expires. Upon renewal, you join the collective plan.
In the event of a permanent exemption (entitled to a collective contract, C2S beneficiary, multi-employer), you keep your personal contract without obligation to join your company’s employer mutual insurance company.
At the end of your employment contract, portability allows you to keep employer mutual insurance free of charge for a period equal to your unemployment compensation period, up to 12 months. According to urssaf, this maintenance of guarantees does not apply in the event of dismissal for gross negligence.
Concretely, an employee dismissed and compensated for 6 months by France Travail will benefit from the maintenance of their compulsory employer mutual insurance during these 6 months, without any additional contribution payable by them.
