our Network Partner in France
GAN Eurocourtage
A. TYPICAL LIFE AND DISABILITY BENEFITS
Background :
In France, most plans offer benefits which follow the French Social Security system.
As a result, benefits are expressed as a percentage of annual gross salary, which is divided into different slices :
Slices values in 2011 :
Slice A : 0 EUR until EUR 35 352
Slice C : from EUR 141 409 until EUR 282 816
Depending on the industry sector in which a company
operates, there might be minimum benefits required by National
Agreements (Conventions Collectives).
The National Agreement to which each Company is subject, is related
to the NAF Code.
The purpose of the bellow benefits description is to
show a typical group insurance plan implemented for a given
category of employees.
The benefits and their levels may differ from one company to
another.
I. Life benefits in case of affiliate's death
- Death or Total and Permanent Disablement
- Payment of a lump sum benefit according to family status :
-
Single, widow, divorced without child... 400 % basis salary
-
Single, widow, divorced with1 child.... 450 % basis salary
-
Married without child ........... 450 % basis salary
-
Additional lump sum for each dependent child 100 % basis salary
OR,
- In case of affiliate's death, the beneficiaries, can opt for : the lowest capital amount + a progressive educational allowance of 8%, 10% and 12 % according to child's age.
Accidental Death
Additional benefit of 100 % of the death benefit
- Double Effect (simultaneous or posterior death of
spouse)
payment to the dependent children of 100 % of the death benefit
- Orphan's pension
In case of death of the employee, payment of an
indexed annual orphan's pension to each dependent child equal to
:
8 % of basis salary until age 12
10 % of basis salary from age 13 until age 17
12 % of basis salary until age 21 or 26 if student.
15 % of basis salary if handicaped child regardless of age
II. Disability benefits
- Short and Long term Disability
Waiting period : 90 days
B. TYPICAL MEDICAL BENEFITS
In France, most group medical plans offer benefits which follow the French Social Security system.
Medical complementary reimbursements are usually made in complement to Social Security reimbursements and according to its legal tariffs and conditions.
As a result most of the benefits are expressed in percentage of social security refunds basis.
The purpose of the bellow benefits description is to show a typical group insurance plan implemented for a given category of employees.
The benefits and their levels may differ from one company to another.
Annual social security ceiling for 2010 is EUR 34 620.
1. Hospitalization medical and surgical
Hospital fees: 300 % of Social security Reimbursement basis
Hospitalisation
- 100% real expenses less social security refunds,in conventioned sector
-
90 % real expenses less social security refunds,in non-conventionned sector.
Daily hospital forfeit : 100 % real expenses
Private room / day: 70 EUR limited to real expenses
Accompanying bed + meal /day: 50 EUR limited to real expenses
In case of maternity: additional benefits
-
Indemnity: 175 EUR
-
Overturn costs per day: 175 EUR
-
Private room per day: 70 EUR
-
Assisted medical procreation 200 EUR / year / person
2. Medical care
Prescription drugs reimbursed by social security
100 % of social security tariff less social security refunds
Doctors, generalists and specialists:
300 % of Social security Reimbursement basis
Osteopaths: 30 EUR/ session, with a maximum of 3 / year and person
300 % of Social security Reimbursement basis
Audio prosthesis : Social security tariff less SS refund
Thermal cure (reimbursed by Social Security): Social security tariff less SS refund
Additional lump sum / year / person: + 250 EUR
3. Dental care
|
|
Without GANs network
|
With GANs network |
|
Dental repairs (outside inlays/onlays)......
Inlays / Onlays*......
All prosthesis .........
Parodontology /year / person
Implantology /year/ person
Orthodontia accepted by Social security.......
Orthodontia refused by Social security /year / person |
Social Security tariff less Social security refund
300 % of Social security Reimbursement basis
300 % of Social security Reimbursement basis
100 EUR
250 EUR
250 % of Social security Reimbursement basis
300 EUR
|
100 % of actual costs
350 % of Social security Reimbursement basis
350 % of Social security Reimbursement basis
200 EUR
500 EUR
250 % of Social security Reimbursement basis
300 EUR |
4. Optical aids :
|
|
Without GANs network
|
With GANs network |
|
For children/ year/personn
Glasses............... Frames.................. Lenses ............
For adults / year / person
Glasses ............. Additional cost for progressive glass.....
Frames .......... Lenses...........
Specific treatments/year/pers
Optical Treatment operated with surgery / year / personn |
) ) 125 EUR )
70 EUR
80 EUR
) ) 150 EUR
none
350 EUR |
100 % of agreed costs ) ) 75 EUR
) ) 100 % of agreed costs )
) ) 150 EUR
30 EUR
350 EUR |
5. Prevention:
Unité Insurope - Immeuble Elysées, 7 place du Dôme - TSA 59876
92099 Paris la Défense Cédex
France
Isabelle Dellerie
+33 1 7096 6509
fr.insurope.comUse this link to access a local country specific site on Insurope from a local market perspective. It may be helpful to refer this site to local subsidiaries and advisers as it also covers the mechanics of multinational pooling from a local perspective in the local language.
• Employee Benefits and Multinational Pooling brochure (FR)
• Pension Reform Nov.2010 (FR)
• Indexation impact on benefit plans 2011 (FR)
• Enquête sur le pooling en assurances collectives (FR)
• Insurope Local Service Standards - Primary Data - Monaco