Remain at zero charge: these mutuals who do not play the game

Some consumers will have unpleasant surprises by discovering the price list of their complementary health in 2020. The reform of the remainder at zero charge takes a new step, the 1st January 2020, with full coverage of glasses and certain dental prostheses (crowns and bridges) by the Sécu and complementary health, who will have to repay more. And this, without increasing their contributions, according to the scenario provided by the government. “'Tomorrow we shave gratis', it does not exist One day or another, everything is paid for”, fumbles Philippe Mixe, president of the mutual Just and the national independent federation of mutuals (FNIM). According to several brokers and comparators surveyed by Challengesindeed, some insurers and mutuals will not hesitate to pass their customers to the fund. On individual contract rates, average increases of 4.5% up to 9% are sometimes Malakoff Médéric (whose activity is 80% on collective contracts, + 2.3% on average), Apicil, Alptis or ASAF & AFPS (subsidiary of Axa) …

Enough to make jump Agnes Agzyn, who refuses to see this milestone of his 100% health reform spoiled by fears about the purchasing power of the French. Because this reform is intended as a real gesture towards the consumers, against a backdrop of worrying crisis of urgencies and whereas the demonstrations of the yellow jackets are more rare but not totally extinct. That is why, this Friday, November 8, a reform monitoring committee, chaired by Agnès Buzyn, was convened. Health Insurance, federations of complementary organizations and user associations were invited. On this occasion, the Minister reminded that the 100% health could not be a reason for tariff increase in 2020, welcoming the commitment of the federations of complementary organizations that respected this commitment. More generally, she stressed the importance of a moderate change in contributions, necessary to guarantee effective access to care for all French people.“, the ministry said after the meeting.

“Taboo” tariff increases

In fact, it has been more than a year since Agnes Buzyn hammered it: it is out of the question that the complementary health effects pass the effects of the zero charge remainder, or RAC 0, on consumers by flaming their contributions. The 35 billion collected each year by the mutuals will suffice, according to her, to absorb the cost of the reform, estimated at 1 billion euros financed 75% by Social Security and 25% by complementary health. “There is no justification today to put on the back of the rest to zero load, 100% health, an increase in tariffs (…) When we use this justification, it annoys me enormously and I do it know, “she said recently. at France Télévisions. The minister was well prepared for today's meeting. According to our information, representatives of a major tariff comparator on the insurance market were received by his firm a fortnight ago to make a point on the trends to wait contributions side in 2020.

Is the minister right to worry? Every year, health supplements increase their rates by 2.5 to 3% on average, in line with the rise in health expenditure. And according to the professionals interviewed by Challenges, The majority of them should play the game with hikes actually in this range next year. Among them, actors such as Mutual Harmony, Ociane Matmut or April will remain in the nails. “We anticipated the implementation of the reform and implemented it in all our networks since last summer,” recalls Laurence Henriet Germain, Director of Performance and Insurance at Harmonie Mutuelle, which will apply a 2.1% increase in contributions for individual contracts (50% of its global activity) in 2020 and will “make a special effort” towards seniors over 60 years by limiting the rise to 1.9%. In 2020, in the end, fares will be the big difference. So, Maaf customers, who have announced a freeze on next year's rates, or Macif, will be among the better off. “As part of the 100% health reform, the members of the responsible individual healthcare contracts distributed by Macif will be able to benefit at no extra cost from a '0 remainder' for optics and dental equipment from January 2020, as well as on hearing aids. as of January 2021. In addition, no impact of the annual inflation of the health costs will be applied on their health contribution “, one specifies within the group. Others will position themselves later, like Allianz, whose rates “will evolve only in May 2020”.

But this year in particular, tariff increases are “taboo”. In other words, “no supplement will risk to justify in writing in its terms and conditions of sale that this increase is due to the zero RAC,” says Clément Janicot, marketing director Santiane, insurance broker. The broker predicts that the addition will be more salty for consumers in 2021, year from which the reform will be fully deployed, and in 2022. “For the moment, in the majority of cases, the increases remain moderate, the actors preferring to smooth these increases to have the least impact on their customers, “added David Trohel, Santiane's Director of Partnerships. And, also, so that it is seen less. Still it is necessary to really compare what is comparable. Rami Karam, director general of Furêts, delays: “With the law 100% health, among others, the health insurance organizations are totally reviewing their offers.Some will change their range.Others will propose the RAC zero in offer of basis with guarantee options, which distorts the comparison of prices from one year to the next. “

Bitter pill

For Amina Walter, executive director of the, who assesses the average cost of health insurance for the French to 892 euros in 2019, the waltz tariffs feared will probably not take place. “The complete deployment of the remainder at zero charge in 2021 will be coupled with the entry into force of the sub-annual cancellation of the complementary health insurance December 2020 (The law of July 14, 2019 establishes a right of cancellation at no cost of complementary health contracts at any time after a period of one year from the first subscription, Ed), she recalls. , consumers will be able to compete more easily, “which could moderate the fare of insurers and mutuals,” abounds Stanislas Di Vittorio, president and founder of

In insurers and mutuals, the pill is hard to swallow. Especially “the com 'of the government” around the tariffs. according to Philippe Mixe, “the evolution of contributions will be mathematical.If the effect of the reform weighs on the budget balance mutuals, tariffs will increase.” Especially since, he recalls, “the impact of the reform on mutuals could be even heavier if health professionals do not play the game”. In his viewfinder, for example, opticians who might be tempted to thwart the pressure on their margins. “The goal of the health law is to make sure they sell their glasses as cheaply as possible, they could push consumers to the consumer, persuading them to buy models or glasses more expensive.”


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