When preparing for retirement, compare Evin law continuation and another individual policy in terms of benefits, people covered, deadlines and cost. The continuation offered to the former employee is itself a paid individual policy: it retains exactly the same mandatory group health expense cover that the employee had when leaving the company.
Another individual supplementary policy is worth examining on the basis of its own benefits and price. The choice depends on the household’s needs and the offers received: a premium alone is not enough to compare the protection provided.
Two options, two starting points
After retirement, the insurer sends an offer to continue the benefits on an individual basis. This new policy is paid for, is not time-limited and covers only health expenses, not protection insurance.
For another individual supplementary health policy, anyone can take out a policy individually and can also take one out for the benefit of one or more family members. The level and nature of supplementary health benefits vary by policy. Ask for a detailed offer before comparing the options.
In both cases, the comparison concerns supplementary health cover. Depending on the policy chosen, it can supplement reimbursement by the French health insurance system in full or in part. If you need protection insurance, examine the protection you are seeking separately: the continuation offer described for the retiree covers only health expenses, not protection insurance.
Benefits: start with the group policy, then read the other offer
The starting point for continuation is the mandatory group health expense cover you have when you leave the company. Find its description and compare it with the offer received: it will serve as a reference when reading another policy.
For the individual supplementary health policy you are considering for retirement, examine the details of the benefits rather than just the plan name. Some policies allow full or partial reimbursement of services not reimbursed by Social Security. Check the categories that matter to you and the conditions stated in each offer.
The amount reimbursed by the supplementary policy may be stated as a percentage of the reimbursement base or in euros. For a useful comparison, identify how each benefit is described and ask the provider to clarify the reimbursement applicable to your anticipated expenses. Also look at what you would have to pay yourself, rather than assuming that the same description means the same reimbursement.
A supplementary insurer may also offer assistance services, such as telephone assistance or help with housework. If you are interested in these services, ask for a description and compare them with those in the other offer, without confusing them with reimbursement for care.
Beneficiaries: examine each family member’s situation
The continuation offer presented upon retirement is addressed to the former employee individually. For family members, ask the insurer to clarify who could be covered and on what terms before choosing this solution for the household.
Another individual policy can also be taken out for the benefit of one or more family members. This makes it worth requesting an offer for the people you wish to insure, then comparing the benefits and premium for that same group.
If your comparison concerns you alone, say so in your requests. If it concerns several people, check each person’s situation and keep a record of the answers. You can then compare offers based on the same needs, rather than prices intended for different beneficiaries.
Deadlines: plan ahead for the continuation offer
For an employee retiring, the insurer sends the continuation offer no later than 2 months after the end of the contract. The employee must request to benefit from this offer no later than 6 months after the end of the employment contract.
Note the end date of the employment contract and the corresponding deadlines. If you wish to consider another offer, request it early enough to have time to read the benefits, question the providers and make your decision. A price offer or estimate helps prepare the comparison: check the application process and effective date before committing.
Cost: compare the premium and its reference basis
Continuation is paid for. Rates may not be more than 50 % higher than the overall rates, including employer and employee contributions, applicable to active employees.
The progressive cap on rates is phased in over 3 years: in the first year, rates are equal to those for active employees; in the second year, they are at most 25 % higher; in the third year, at most 50 % higher. The premium amount is freely set from the 4th year onward.
For another supplementary policy, premium rates are linked to the insured person’s situation and depend in particular on the level of cover chosen, age, status and place of residence. Ask for a price that corresponds to your situation and the group of beneficiaries you have selected.
In your comparison, distinguish the amount requested from the level of protection provided. For continuation, ask for the proposed premium and the reference to the overall rates for active employees; for the other policy, ask for details of the benefits associated with the price. Also ask the providers about the conditions that will apply afterward, particularly beyond the continuation rate cap period.
Before choosing
- Gather the details of the mandatory group health expense cover you have when you leave and the continuation offer.
- Request another individual offer for the same people and the needs you wish to compare.
- Review the reimbursements, how they are described, useful services and premiums; put any remaining questions to the providers.
- Check the continuation deadlines and the procedures specific to the chosen offer before taking out any policy.
These points are general information, not personalized advice. Have your situation and the conditions of the offers clarified before making your decision.
