The National Federation of French Mutual Insurance (FNMF) released the figure at the beginning of January: health contract contributions should experience an average increase of 4.7% in 2023. The increase was 3.4% in 2022. figures that relate only to mutual insurance companies, thus excluding insurers and provident institutions.
The increase remains contained below the level of inflation recorded in 2022 (5.9%). “It’s been more than 20 years since anyone mentioned inflation. The comparison of the evolution of contributions was made rather with that of Ondam (National health insurance expenditure target). But inflation now weighs on health expenditure, and the evolution of expenditure is linked to that of reimbursements”, underlines Victor Vidilles, deputy director general strategy and influence of the MNT (Mutuelle nationale des territories – VYV group), which covers more than one million beneficiaries.
Reimbursement progress
Director General of Territoria Mutuelle (25,000 beneficiaries in health), Nicolas Piotrowski estimates that three-quarters of the increase in contributions is linked to 100% health, which has enabled a greater number of people to equip themselves with hearing aids or to benefit from dental prostheses, and resulted in higher expenses and an increase in reimbursements. The rest comes from catching up on non-expenditure linked to confinements.
According to the FNMF, the health expenditure of members increased by 10.1% between 2019 (last classic year before the health crisis and the episodes of confinement) and 2022. In detail, the internal study of the federation (which makes basing this estimate on data collected from 35 mutuals representing nearly 18 million policyholders) distinguishes the growth of collective contracts (5.7%) and that of individual contracts (4.1%).
A difference that can also be found in the mutuals covering territorial agents. “In participation agreements, the increase depends on the profit and loss account of the contract, which must be at least in balance”, recalls Eric Marazonoff, president of the MNFCT (National mutual fund for local government officials, 70,000 people protected) .
Increase of 0.5 to 4.5%
In detail, the MNFCT flirts with the overall evolution of contributions, with an average increase of 4.5% for individual contracts. “With us, contracts with entry-level guarantee levels, which did not benefit from reimbursement in audiology and dental prosthesis, are the most impacted by 100% health”, indicates Eric Marazonoff.
Territoria Mutuelle posted an increase of 2 to 3% on individual health contracts, with again a more marked increase for the first ranges, impacted by 100% health.
At the MNT, the increase in health contributions is 2% on average, with an increase that is also distributed differently depending on the offers. “In individual terms, basic contracts covering only major risks such as hospitalization and guaranteeing a minimum on medicines increase by 1%, because these are the expenses that are the least sensitive to inflation. The most complete offers increased by 2.8%,” explains Victor Vidilles.
These figures, however, remain an average calculated on the entire portfolio of the mutual, so all ages of members combined. It is therefore necessary to add an annual change linked to the age of each person, between 0.5% and 2.5% depending on the situation. “We are thus managing to maintain the increase in compliance with the principle of solidarity since the gap must remain at 1 to 3 between the contributions by the youngest and the oldest. Especially since we maintain the level of contributions unchanged from the age of 67, ”congratulates Victor Vidilles.
Towards greater employer participation?
Could the increase in contributions curb the enthusiasm of territorial employers, while the legal framework for employer participation in supplementary social protection (PSC) is under consideration?
“The ball is in the court of trade unions and employers. If the latter want the agents to be well cared for, the participation will have to be significant, ”said Eric Marazonoff. Still, employers are watching with suspicion the increases in contributions that could induce an increase in their participation.
The negotiation could also weigh on the evolution of the contributions, predicts Victor Vidilles. “If the legal framework retains a reduced solidarity gap of 1 to 2 as requested by some employers who think they are doing the right thing, the repercussion could be an increase in labeled contributions of 30 to 40% for the youngest (30-45 years old). Some will no doubt wish to go on contracts outside the PSC, far from the initial ambitions of the reform”.
