Mutual

After the government, it is the turn of the President of the Republic. Guest on France 5, Emmanuel Macron also criticized complementary health organizations, guilty of imposing increases “unilateral” of rates. The day before, a study by the French Mutualité affirmed that the prices of complementary health insurance will increase on average by 8.1% in 2024, and even 9.9% on average for collective contracts.

Even if it means paying a lot, you might as well make the most of the reimbursement possibilities offered by your complementary health insurance. To help you make your choice, the Directorate of Research, Studies, Evaluation and Statistics (Drees), an organization attached to the Ministry of Health, published its annual report on this subject on December 21. This document analyzes in particular the rate of benefits and management charges which govern each of the three main families of supplementary health insurance: mutual societies – such as Macif, Maif or Aésio -, insurers – Axa, Generali or Allianz -, and provident institutes – Malakoff Humanis or AG2R La Mondiale.

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On average, the reimbursement rate to policyholders reached 81% in 2022, or 1 point more than in 2021. Thus, out of 100 euros contributed, households received 81 euros in the form of benefits last year. But in detail, this ratio varies significantly depending on the nature of the complementary health insurance: 89% for provident institutes, 80% for mutuals and 78% for insurance. These disparities can be explained, among other things, by the nature of the contracts sold. The vast majority of pension institutes distribute collective contracts to company employees. “Companies, which subscribe to these collective contracts for the benefit of their employees, are in fact more in a position to negotiate guarantees at the best price (particularly for dental and optical care, Editor’s note) only individuals in the case of individual contractsunderlines Drees.

Drees

And the opposite, a complementary health insurance with a low reimbursement rate will tend to impose more management costs. So much money the insured will not see the color of. Management costs take three forms: acquisition costs – advertising, marketing and remuneration of intermediaries -, administration costs – expenses generated by the management of contracts – as well as claims management costs – linked to the complexity and the number of care sheets to be processed.

20% of contributions are devoted to management fees

In 2022, these three positions thus swallowed up 20% of the contributions collected by complementary insurance companies, i.e. a level identical to 2021. Insurance companies were the most greedy (22% of contributions), ahead of mutual insurance companies (20%) and provident institutions (14%). Here again, these disparities originate primarily from the preponderance of collective contracts. Pension funds do not spend as much money as insurers to acquire customers, particularly in advertising.

Drees

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2023-12-23 17:10:29
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