Combating Uninsurance: Local Deals for Home Insurance Access

Montreuil, France – Facing rising costs and concerns over access to healthcare, the city of Montreuil has launched a negotiated health insurance plan for its 115,000 residents, and approximately 2,500 municipal employees. The initiative, announced on March 22, 2026, is part of a growing trend among French municipalities seeking to address gaps in coverage and affordability, particularly for seniors and independent workers.

The move comes as more and more French communities are negotiating collective contracts for both health and home insurance, aiming to help residents optimize expenses although maintaining adequate coverage. According to Vincent Kaufmann, director of health for Montreuil, an initial survey in 2017 revealed a significant number of residents lacked supplemental health insurance and had been forced to forgo medical care due to high out-of-pocket costs.

While employers in the public sector are not currently obligated to offer supplemental health coverage to their employees, the city of Montreuil’s plan extends to its workforce. Here’s a key component of the city’s strategy, recognizing that municipal workers also face financial pressures and potential gaps in their existing coverage. The city issued a call for proposals to identify a partner capable of providing attractive offers for both the general population and its employees.

The broader context for these local initiatives is a national effort to improve supplemental health coverage within the French public sector. An ordinance issued in February 2021 reformed the legal framework for supplemental health insurance for public sector employees, with provisions codified in the General Code of the Civil Service as of March 1, 2022. This legislation addresses both health insurance (“complémentaire frais de santé”) and more comprehensive disability and death benefits (“prévoyance lourde”).

Nationally, the participation of local authorities and public establishments in financing supplemental health insurance for their employees was optional until December 31, 2024. However, a decree issued in April 2022 mandates contributions from these entities towards supplemental health coverage. The French government has been progressively implementing collective contracts to improve medical expense coverage for state employees, with mandatory adherence required in most cases, except for specific situations.

The trend extends beyond Montreuil, with cities like Paris, Lille, and Grenoble also actively negotiating similar contracts. These initiatives are particularly focused on vulnerable populations, such as seniors who face increasing premiums and may no longer have employer-sponsored coverage, and independent workers who often lack access to collective insurance schemes.

The Centre de Gestion de l’Oise, a resource center for territorial public service, is facilitating participation in a “prévoyance” risk coverage convention for non-mandating communities. Collectivities interested in joining must complete a questionnaire and submit it to the Centre de Gestion before proceeding.