Health insurance enrollment is not mandatory for public service employees, unlike in the private sector. While some local authorities may offer financial support or collective contracts, participation is voluntary. Employees can choose from specialized or general health insurance plans. Starting January 1, 2025, a reform will require collective contracts for health coverage, with a 50% employer contribution. Similar changes are anticipated for territorial public service employees, emphasizing welfare financing and additional benefits for sick leave and disability.
Is Health Insurance Required for Public Service Employees?
No Mandatory Health Insurance
In contrast to the private sector, where mandatory health insurance has been a requirement since 2016, employees in the public service—including state, territorial, and hospital staff—are not obligated to enroll in health insurance plans.
Within the territorial public service, certain local authorities might provide collective health insurance contracts or offer financial support for health insurance premiums, but participation remains at the employer’s discretion. Similarly, the hospital public service has similar options, but there’s no standardization across the board.
Freedom to Choose Insurance Providers
State employees who wish to acquire supplementary health insurance can select from specialized mutuals, such as MGEN for educators, or they can opt for more general health insurance plans.
Specialized Health Insurance for Public Employees
Several specialized mutuals cater specifically to various professions within the state public service, including police, military, and education sectors. These mutuals offer tailored contracts that include specific benefits aligned with the unique responsibilities of each role.
Employer Contributions in Public Service
It’s important to note the potential contribution from state employers when selecting a mutual. A reform introduced in 2022 allows for financial support from the state to assist public employees in covering their health insurance costs.
The state currently contributes €15 per month for approved mutuals, applicable to all state public service employees, regardless of their full-time or part-time status.
What Health Insurance Options Exist for State Public Service Employees?
Beginning January 1, 2025, a significant reform in complementary social protection (PSC) will be implemented for state public service employees, aimed at enhancing their health and welfare coverage.
Mandatory Supplementary Health Insurance Coming Soon
From 2025 onward, state administrations will be required to offer collective mutual contracts that cover medical expenses arising from illness, maternity, or accidents. Membership in these plans will be compulsory for all public employees, both permanent and contractual, except for certain specific exemptions.
Public employers will contribute 50% of the monthly premium, making high-quality health coverage more accessible.
Welfare Coverage
In addition to health insurance, a collective welfare contract will also be available, covering risks associated with long-term illness, non-work-related disabilities, and death. Participation in this welfare plan will be optional, with the administration contributing up to €7 per month.
Timeline for Implementation
It’s crucial to be aware that specific ministries, including national education, higher education, research, sports, youth, and associative life, will initiate these collective contracts and their application procedures starting January 1, 2026.
Next Steps for Public Service Employees
Employees will need to terminate their existing individual health insurance plans to enroll in their administration’s collective contract unless they qualify for an exemption. Employers will provide information on how to join, the benefits offered, and the reimbursement details.
Conditions for Exemptions
Certain circumstances allow employees to opt out of mandatory membership. Recognized exemption scenarios include:
- Employees receiving CSS, which replaces CMU-C and ACS, may be exempt.
- Employees covered by a mandatory collective contract (e.g., through a spouse’s employer) may be exempt.
- Employees with an individual contract in effect on January 1, 2025, can request an exemption until their contract ends.
- Employees on short-term fixed-term contracts may also be exempt from joining the collective contract.
What Health Insurance Options Are Available for Territorial Public Service Employees?
No Mandatory Coverage Currently
Similar to state civil servants, territorial civil servants can choose between specialized mutuals catering to specific professions (such as healthcare professionals or social workers) and more general supplementary health insurance. Participation is optional and may include financial support from local authorities.
Local Authority Contributions
Local authorities have two options for supporting their employees:
- Assisting employees who individually subscribe to a solidarity-based contract recognized by authorized providers through financial contributions.
- Conducting a competitive bidding process to select a contract that meets solidarity conditions, followed by signing a participation agreement with the chosen organization.
Anticipated Changes for 2025
Starting January 1, 2025, local authorities will be required to contribute to their employees’ welfare financing, which aims to bolster income during sick leave or loss of autonomy and provide benefits in case of death for beneficiaries.
- Additional daily allowances will be paid to ensure employees receive 90% of their indexed salary and 40% of benefits during long-term sick leave.
- CNRACL civil servants will receive a pension equivalent to 90% of their net salary if they retire due to disability.
- For employees under the general scheme, a pension equivalent to 90% of their net salary is provided in case of second or third category disability, and 66% for first category disability.
Upcoming Changes for 2026
From January 1, 2026, territorial public service employees will also benefit from financial contributions from local authorities…