What is health payment and how does it work?

The health payment replaces in certain cases the financing by the employer of the compulsory collective mutual insurance of its employees.

Also called “health check”the health payment is an aid paid each month by the company to some of its employees in order to contribute to the financing of individual supplementary health insurance for the reimbursement of their health costs. This system was set up in 2016 with the aim of guaranteeing access for all precarious employees to complementary health insurance. It replaces in some cases the mandatory collective coverage that each company is required to offer to its employees, covering at least 50% of the contributions.

For employees excluded or exempted from collective coverage

This health payment can be set up in different situations. It may be provided for by a branch or company agreement or a unilateral decision by the employer excluding employees on fixed-term contracts, on assignment contracts lasting less than three months, or very part-time (with a weekly work less than or equal to 15 hours), compulsory collective coverage. It may also be requested by employees on fixed-term contracts or on assignment contracts who could benefit from cover by the company’s mutual fund for less than three months and assert their exemption from membership of this mutual fund.

To benefit from the health payment, employees must imperatively prove that they are covered for the entire duration of their employment contract by a responsible complementary health contract. This is a contract meeting specifications set by decree and providing for minimum guarantees and coverage ceilings.

The employees concerned must also not already benefit from any other assistance such as assistance with the payment of complementary health insurance or mutual insurance with financial participation from a public collectivity or even collective and mandatory health coverage, as the main member or beneficiary.

Reference amount

Its amount is calculated by taking into account the amount of the monthly contribution that the company would pay for the financing of the collective coverage of the category to which the employee belongs. This sum must then be multiplied by the number of working hours of the employee in the month, then the product obtained divided by the legal monthly duration of work for full time (151.67 hours). A reference amount is thus obtained. ” If the amount of the contribution cannot be determined, the reference amount is set at €19.80 for 2023 “says Urssaf.