#2014-1025Decree No. 2014-1025 on Supplementary Health Insurance Guarantees for Employees
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This decree establishes supplementary health insurance guarantees for employees in France. It outlines the minimum coverage requirements that employers must provide, including full coverage for certain healthcare costs, a daily allowance for hospitalization, and specific reimbursements for dental and optical care. Additionally, it specifies conditions under which employees can opt-out of the mandatory coverage.
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Key Changes
- Introduction of full coverage for certain health costs for employees
- Establishment of minimum reimbursement rates for optical and dental care
- Provision for opt-out of mandatory coverage under certain conditions
Obligations
What this law requires
Employers must provide full coverage of employee cost-sharing (participation) as defined in article R. 322-1, with specified exclusions for mental health services and certain co-payments and franchise amounts
Employers must cover the daily hospitalization allowance (forfait journalier) without time limitation as specified in article L. 174-4
Employers must provide dental care coverage at a minimum of 125% of the insurance reimbursement base rates for prosthetic and orthodontic dental treatments
Employers must establish optical device allowances with minimum amounts of €100 (single vision -6.00 to +6.00 dioptries), €150 (combined), or €200 (high correction or progressive lenses) per equipment
Employers must limit eyeglass coverage to one equipment (two lenses and frame) per two-year period, except for minors or justified vision changes which allow annual renewal