As an employer, you must provide all your employees who do not have supplementary cover, regardless of their length of service with the company, with a supplementary reimbursement scheme for health expenses.
The decision to exempt one of your employees is not yours to make, AND THEN THE SITUATION OF THE EMPLOYEE WILL ALLOW HIM TO BE DISPENSED.
The waiver is an option offered to your employees who wish to do so; under no circumstances is it automatic.
On hiring, you must send a membership form to each employee who has no steps to take. They will then receive a certificate of affiliation to the complementary health insurance scheme.
At the time they receive this form, if they so wish and if it is in a case provided for by law and included in your DUE (unilateral declaration by the employer), your employee may then ask you to be exempted.
He must formulate his request for exemption in writing and he must provide you with proof that he is in one of the authorised cases.
The receipt must be renewed each time it is due.
Cases of exemption authorized by law
The cases in which your employee can request the exemption are the following, provided that you have included these cases in your unilateral declaration of employer (UED) :
- He or she already benefits from a mutual insurance company as a rightful claimant,
- He already benefits from an individual mutual insurance company,
- He is a very part-time employee and the contribution is at least 10% of his salary,
- He has a fixed-term contract of less than one year and is covered by a mutual insurance company,
- He's an apprentice.
All of these are cases where your employee can apply for an exemption, not cases where he or she is automatically exempted.
The risks involved
If one of your employees is not affiliated to the mutual insurance company, even though he has not requested it, your company's entire supplementary insurance scheme may be affected in the event of a URSSAF inspection.
The contributions of all your employees may, for the non-prescribed period, be considered as salary supplements on which social security contributions may be recalled.
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