A duty, and half the cost to bear

Cabinet Roussel employs six people and offers supplementary health cover at 48 € a month per person, of which it pays 40 %. The owner thinks he is being generous: surely the law asks nothing of so small a firm. It imposes the duty, and a higher minimum share. Before you read: which text imposes it, and how much does the employer fund?

A duty that does not turn on size

Article L911-7 of the social security code covers businesses whose employees do not have compulsory-membership collective cover for supplementary reimbursement of costs arising from illness, maternity or accident.

Those businesses must give their employees that minimum cover by unilateral decision of the employer. The text sets no headcount threshold: six employees or six hundred, the duty is the same.

The public service page puts it without qualification: every private-sector employer, business and association alike, must offer collective supplementary health cover to its employees.

The text also gives the route where nothing else exists. It is a unilateral decision of the employer, taken in compliance with article 11 of the law of 31 December 1989, and the employees concerned are informed of it.

At least half

The III of the article sets the employer's share in one sentence: the employer bears at least half the funding of the compulsory-membership collective cover.

The word minimum reads both ways. The employer may not go below half, but nothing stops it funding more: the rule is a floor, not an imposed split.

The public service page confirms the reading and draws the consequence for the employee: the employer's financial contribution must be at least equal to 50 % of the premium, the rest remaining payable by the employee.

A 40 % contribution therefore fails the rule, whatever the size of the business and whatever the quality of the policy taken out. The floor bears on the split, not on the absolute amount.

An order of reading, and a comparison

The I of the article sets up a comparison worth handling carefully. The duty covers only businesses whose employees do not already have cover in which each category of guarantee and the share of funding are at least as favourable as those of the II and III.

A business that has already put cover in place therefore does not start from scratch: it compares what exists with the statutory minimum, guarantee by guarantee and on funding, and acts only where what exists falls short.

The comparison runs on two dimensions at once, and they do not offset each other. Cover that is very generous on guarantees but funded at 40 % still falls short on funding, and must be put right on that point.

The content of that minimum set of guarantees is referred to the II of the article and to its implementing decree, which the next module sets out. That is where the basket of care takes its figures.

That referral is why the duty cannot be discharged by reading one article. The obligation and the funding share sit in the statute; what the cover must actually pay for sits in a decree, and a policy is compliant only against both.

It also explains why a broker's quote is not an answer on its own. The comparison the I requires is against the statutory minimum, not against the market, and a policy that looks competitive can still fall below the floor on a single category.