Social security: affiliation of a public official with the sickness insurance

Verified 18 February 2021 - Directorate for Legal and Administrative Information (Prime Minister)

Your approaches to health insurance vary depending on whether you are a government, territorial or hospital official or a non-permanent employee. These steps are valid regardless of your nationality.

What applies to you ?

What public service do you belong to?
What is your status?

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      Please note

      Any person who deliberately refuses to become affiliated or who persists in not committing the procedure for compulsory membership of a social security scheme shall be punishable by six months' imprisonment and a fine of €15,000, or only one of those two penalties.

      State civil service

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      Holder

      When you are posted to a ministry, you are attached to a mutual society for the coverage of basic benefits paid by the compulsory sickness insurance scheme. According to your department, it is one of the following organizations:

      • Mutual Local Section (SLM)
      • General Mutual Society of National Education (MGEN).

      For your additional services, you have 2 possibilities:

      • Adopt the mutual society that also deals with basic benefits in your department
      • Choose another mutual

      Some complementary bodies benefit from State participation. Their rates take this into account. Check with your human resources department to find out which organization your department has selected.

      You have a single point of contact in the following 3 cases:

      • You don't have any additional coverage
      • Your supplemental agency is also responsible for basic benefits in your department
      • Your supplementary organization has entrusted the management of the basic benefits to the mutual organization which is responsible for them in your department.

      You have 2 contacts if you have chosen a mutual with the following 2 characteristics:

      • Not authorized to administer social security benefits
      • Lack of management agreement between the mutual society and the mutual society responsible for basic benefits in your department

      However, in all cases, your mutual remains the preferred point of contact in the event of a dispute over the amount of additional benefits with the managing body.

      You must report any changes in your personal or professional situation to the organizations responsible for your health coverage (social security and supplementary benefits).

      Tableau - Action to be taken in the event of a change of situation

      Change of situation

      Approach

      Change of employment status

      Submit Form cerfa no. 11545 to the mutual society responsible for basic services

      Change of domicile

      Send a letter with the necessary supporting documents to your social security body and your complementary body

      Birth of child

      Other changes: usage name (marriage or divorce), bank details, etc.

      Contractual

      Your approaches to health insurance and supplementary benefits are identical to those of the private sector employees.

      Your interlocutor is here CPAM: titleContent from your home department.

      You must report to your CPAM any changes in your personal or professional situation.

      Tableau - Action to be taken in the event of a change of situation

      Change of situation

      Approach

      Change of employment status

      Submit Form cerfa no. 11545 to your CPAM (that of the department of your home)

      Change of domicile

      Declare your change of address

      Birth of child

      Declare a birth

      Other changes: usage name (marriage or divorce), bank details, etc.

      Send a letter with the necessary supporting documents to your social security body and your complementary body

      Retired

      When you retire, you're basically raising for your plan health of the general scheme.

      For your additional services, you have 2 possibilities:

      • Adopt the Mutual Society that also deals with basic benefits in your department. For example, the Central Finance Corporation (MCF).
      • Choose another mutual

      Some complementary bodies benefit from State participation. Their rates take this into account. Check with your human resources department to find out which organization your department has selected.

      You have a single point of contact (the SLM or the MFPS agency) in the following 3 cases:

      • You don't have any additional coverage
      • Your supplemental agency is also responsible for basic benefits in your department
      • Your complementary organization has entrusted the management of the basic benefits to the mutual organization that is responsible for them in your department

      You have 2 contacts if you have chosen a mutual with the following 2 characteristics:

      • Not authorized to administer social security benefits
      • Lack of management agreement between the mutual society and the mutual society responsible for basic benefits in your department

      However, in all cases, your mutual remains the preferred point of contact in the event of a dispute over the amount of additional benefits with the managing body.

      You must report any changes in your personal or professional situation to the organizations responsible for your health coverage (social security and supplementary benefits). You must send a letter with the necessary supporting documents to your social security organization and your supplementary organization.

      Territorial civil service

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      Holder

      Depending on the department where you live, it's the CPAM: titleContent or a mutual society which is responsible for basic benefits.

      Indeed, in some departments, CPAM has delegated the management of compulsory cover to one or more mutual insurance bodies.

      To find out which organization manages the basic services in your department, you can ask one of the following organizations:

      • CPAM
      • Mutual societies to which you wish to join
      • Human Resources Department

      You can join an organization of your choice for additional services.

      Your community may have implemented a financial contribution from complementary social protection. Check with your human resources department to see if you can take advantage of them.

      Your contact varies according to your department, and according to the agreements that may exist between CPAM and the mutuelles:

      • If your mutual company is authorized to manage the basic services and manages this activity itself, it is your single point of contact for the basic and complementary services.
      • If your mutual insurance company is not entitled to manage basic benefits but pays its own supplementary benefits, CPAM is your point of contact for social security benefits, whereas your mutual insurance company is your point of contact for supplementary benefits.
      • If your mutual insurance company is not authorized to manage the basic services and has entrusted CPAM with the management of its own supplementary services, CPAM is your point of contact for all your services. However, in the event of a dispute over the amount of supplementary benefits with CPAM, your mutual remains the preferred contact.

      You must report any changes in your personal or professional situation to the organizations responsible for your health coverage (basic and supplementary benefits).

      Tableau - Action to be taken in the event of a change of situation

      Change of situation

      Approach

      Workplace in a new department

      Submit Form cerfa no. 11545 the mutual benefit organization in your new practice department.

      Birth of child

      Send a letter with the necessary supporting documents to your social security body and your complementary body

      Contractual

      Depending on the department where you live, it's CPAM: titleContent or a mutual society which is responsible for basic benefits.

      Indeed, in some departments, CPAM has delegated the management of compulsory cover to one or more mutual insurance bodies.

      To find out which organization manages the basic services in your department, you can ask one of the following organizations:

      • CPAM
      • Mutual societies to which you wish to join
      • Human Resources Department

      Your approaches to supplementary benefits are identical to those of the private sector employees.

      Your contact is the CPAM of your residence department.

      You must report to your CPAM any changes in your personal or professional situation.

      Tableau - Action to be taken in the event of a change of situation

      Change of situation

      Approach

      Change of employment status

      Submit Form cerfa no. 11545 to your CPAM (that of the department of your home)

      Change of domicile

      Declare your change of address

      Birth of child

      Declare a birth

      Other changes: usage name (marriage or divorce), bank details, etc.

      Send a letter with the necessary supporting documents to your social security body and your complementary body

      Retired

      Depending on the department where you live, it's the CPAM: titleContent or a mutual society which is responsible for basic benefits.

      Indeed, in some departments, CPAM has delegated the management of compulsory cover to one or more mutual insurance bodies.

      To find out which organization manages the basic services in your department, you can ask one of the following organizations:

      • CPAM
      • Mutual societies to which you wish to join
      • Human Resources Department

      You can join an organization of your choice for additional services.

      Your community may have implemented a financial contribution from complementary social protection. Check with your human resources department to see if you can take advantage of them.

      Your contact varies according to your department, and according to the agreements that may exist between CPAM and the mutuelles:

      • If your mutual company is authorized to manage the basic services and manages this activity itself, it is your single point of contact for the basic and complementary services.
      • If your mutual insurance company is not entitled to manage basic benefits but pays its own supplementary benefits, CPAM is your point of contact for social security benefits, whereas your mutual insurance company is your point of contact for supplementary benefits.
      • If your mutual insurance company is not authorized to manage the basic services and has entrusted CPAM with the management of its own supplementary services, CPAM is your point of contact for all your services. However, in the event of a dispute over the amount of supplementary benefits with CPAM, your mutual remains the preferred contact.

      You must report any changes in your personal or professional situation to the organizations responsible for your health coverage (social security and supplementary benefits). You must send a letter with the necessary supporting documents to your social security organization and your supplementary organization.

      Hospital civil service

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      Holder

      Depending on the department where you live, it's the CPAM: titleContent or a mutual society which is responsible for basic benefits.

      Indeed, in some departments, CPAM has delegated the management of compulsory cover to one or more mutual insurance bodies.

      To find out which organization manages the basic services in your department, you can ask one of the following organizations:

      • CPAM
      • Mutual societies to which you wish to join
      • Human Resources Department

      You can join an organization of your choice for additional services.

      Your community may have implemented a financial contribution from complementary social protection. Check with your human resources department to see if you can take advantage of them.

      Your contact varies according to your department, and according to the agreements that may exist between CPAM and the mutuelles:

      • If your mutual company is authorized to manage the basic services and manages this activity itself, it is your single point of contact for the basic and complementary services.
      • If your mutual insurance company is not entitled to manage basic benefits but pays its own supplementary benefits, CPAM is your point of contact for social security benefits, whereas your mutual insurance company is your point of contact for supplementary benefits.
      • If your mutual insurance company is not authorized to manage the basic services and has entrusted CPAM with the management of its own supplementary services, CPAM is your point of contact for all your services. However, in the event of a dispute over the amount of supplementary benefits with CPAM, your mutual remains the preferred contact.

      You must report any changes in your personal or professional situation to the organizations responsible for your health coverage (basic and supplementary benefits).

      Tableau - Action to be taken in the event of a change of situation

      Change of situation

      Approach

      Workplace in a new department

      Submit Form cerfa no. 11545 the mutual benefit organization in your new practice department.

      Birth of child

      Send a letter with the necessary supporting documents to your social security body and your complementary body

      Contractual

      Your approaches to health insurance and supplementary benefits are identical to those of the private sector employees.

      Your interlocutor is here CPAM: titleContent from your home department.

      You must report to your CPAM any changes in your personal or professional situation.

      Tableau - Action to be taken in the event of a change of situation

      Change of situation

      Approach

      Change of domicile

      Submit Form cerfa no. 11545 to the CPAM of the department of your new home

      Birth of child

      Send a letter with the necessary supporting documents to your social security body and your complementary body

      Other changes: usage name (marriage or divorce), bank details, etc.

      Retired

      Depending on the department where you live, it's the CPAM: titleContent or a mutual society which is responsible for basic benefits.

      Indeed, in some departments, CPAM has delegated the management of compulsory cover to one or more mutual insurance bodies.

      To find out which organization manages the basic services in your department, you can ask one of the following organizations:

      • CPAM
      • Mutual societies to which you wish to join
      • Human Resources Department

      You can join an organization of your choice for additional services.

      Your community may have implemented a financial contribution from complementary social protection. Check with your human resources department to see if you can take advantage of them.

      Your contact varies according to your department, and according to the agreements that may exist between CPAM and the mutuelles:

      • If your mutual company is authorized to manage the basic services and manages this activity itself, it is your single point of contact for the basic and complementary services.
      • If your mutual insurance company is not entitled to manage basic benefits but pays its own supplementary benefits, CPAM is your point of contact for social security benefits, whereas your mutual insurance company is your point of contact for supplementary benefits.
      • If your mutual insurance company is not authorized to manage the basic services and has entrusted CPAM with the management of its own supplementary services, CPAM is your point of contact for all your services. However, in the event of a dispute over the amount of supplementary benefits with CPAM, your mutual remains the preferred contact.

      You must report any changes in your personal or professional situation to the organizations responsible for your health coverage (social security and supplementary benefits).

      Tableau - Action to be taken in the event of a change of situation

      Change of situation

      Approach

      Change of domicile

      Submit Form cerfa no. 11545 to the mutual benefit organization in your new department of residence

      Other changes: usage name (marriage or divorce), bank details, etc.

      Send a letter with the necessary supporting documents to your social security body and your complementary body