{"id":9883,"date":"2019-11-14T00:00:00","date_gmt":"2019-11-14T00:00:00","guid":{"rendered":"https:\/\/abeille-preprod.eliott-markus.cloud\/complementaires-sante\/"},"modified":"2019-11-14T00:00:00","modified_gmt":"2019-11-14T00:00:00","slug":"complementaires-sante","status":"publish","type":"post","link":"https:\/\/abeille.law\/en\/complementaires-sante\/","title":{"rendered":"Les compl\u00e9mentaires sant\u00e9 doivent \u00eatre adapt\u00e9es \u00e0 la r\u00e9forme du \u00ab 100 % sant\u00e9 \u00bb"},"content":{"rendered":"

Depuis le\u00a01er<\/sup>\u00a0janvier\u00a02016, toutes les entreprises doivent faire b\u00e9n\u00e9ficier leurs salari\u00e9s d\u2019une compl\u00e9mentaire \u00ab\u00a0frais de sant\u00e9<\/em>\u00a0\u00bb comportant des garanties minimales, le fameux \u00ab\u00a0panier de soins<\/em>\u00a0<\/strong>\u00bb, et financ\u00e9e au moins pour moiti\u00e9 par l\u2019employeur.<\/p>\n

Cette couverture doit \u00e9galement respecter le cahier des charges des contrats responsables qui fixe le d\u00e9tail des garanties \u00e0 prendre en charge et \u00e0 exclure. Ce respect est effectivement indispensable pour que la contribution patronale au financement de la compl\u00e9mentaire \u00ab\u00a0frais de sant\u00e9<\/em>\u00a0\u00bb soit notamment exon\u00e9r\u00e9e de cotisations sociales.<\/p>\n

Un remboursement int\u00e9gral<\/h2>\n

Afin de r\u00e9duire les frais de sant\u00e9 des Fran\u00e7ais et permettre un meilleur acc\u00e8s aux soins, le gouvernement a mis en place un plan \u00ab\u00a0100\u00a0% sant\u00e9<\/em>\u00a0\u00bb pr\u00e9voyant que certains frais m\u00e9dicaux engag\u00e9s par les salari\u00e9s leur seront enti\u00e8rement rembours\u00e9s.<\/p>\n

Ainsi, l\u2019acquisition d\u2019\u00e9quipements d\u2019optique et d\u2019aides auditives ainsi que les frais de soins dentaires proth\u00e9tiques<\/strong> devront bient\u00f4t \u00eatre int\u00e9gralement rembours\u00e9s par la S\u00e9curit\u00e9 sociale et les compl\u00e9mentaires sant\u00e9, qu\u2019elles soient individuelles ou collectives.<\/p>\n

\u00c0 noter :\u00a0ce remboursement int\u00e9gral concernera uniquement les \u00e9quipements d\u2019optique de classe\u00a0A, les aides auditives de classe\u00a0I et certains frais dentaires (certaines proth\u00e8ses mobiles ou fixes, par exemple).<\/p><\/blockquote>\n

Se conformer au 100\u00a0% sant\u00e9<\/h2>\n

Dans le cadre du plan \u00ab\u00a0100\u00a0% sant\u00e9<\/em>\u00a0\u00bb<\/strong>, les garanties composant le cahier des charges des contrats responsables qui doit \u00eatre respect\u00e9 par les compl\u00e9mentaires \u00ab\u00a0frais de sant\u00e9<\/em>\u00a0\u00bb ont \u00e9t\u00e9 renforc\u00e9es.<\/p>\n

Les employeurs doivent donc se rapprocher de leur organisme assureur afin de mettre leur contrat collectif d\u2019assurance sant\u00e9 en conformit\u00e9 avec ces nouvelles garanties \u00e0 compter du\u00a01er<\/sup>\u00a0janvier\u00a02020 pour l\u2019optique et certains soins dentaires et du\u00a01er<\/sup>\u00a0janvier\u00a02021 pour les aides auditives et le reste du panier dentaire.<\/p>\n

Ils doivent \u00e9galement modifier, dans ces m\u00eames d\u00e9lais, l\u2019acte instituant la compl\u00e9mentaire sant\u00e9 dans leur entreprise (accord d\u2019entreprise, accord r\u00e9f\u00e9rendaire, d\u00e9cision unilat\u00e9rale). Cette mise en conformit\u00e9 est, en effet, indispensable pour que les employeurs conservent l\u2019exon\u00e9ration de cotisations sociales sur les contributions patronales finan\u00e7ant la couverture sant\u00e9 de leurs salari\u00e9s<\/a>.<\/p>\n

Exception :\u00a0les employeurs n\u2019ont pas \u00e0 modifier ces actes si ces derniers se contentent de renvoyer au cahier des charges du contrat responsable ou aux garanties du contrat collectif d\u2019assurance sant\u00e9 souscrit par l\u2019entreprise. Mais alors, pour que l\u2019exon\u00e9ration de cotisations sociales soit maintenue, ce contrat collectif d\u2019assurance sant\u00e9 doit, au\u00a01er<\/sup>\u00a0janvier\u00a02020, puis au\u00a01er<\/sup>\u00a0janvier\u00a02021, \u00eatre conforme \u00e0 ces nouvelles garanties.<\/p><\/blockquote>\n

Pour \u00ab\u00a0tenir compte des d\u00e9lais inh\u00e9rents \u00e0 la n\u00e9gociation collective<\/em>\u00a0\u00bb, la Direction de la S\u00e9curit\u00e9 sociale fait toutefois preuve d\u2019une certaine tol\u00e9rance. Ainsi, les employeurs dont la convention collective, l\u2019accord d\u2019entreprise ou l\u2019accord r\u00e9f\u00e9rendaire ne sera pas conforme au nouveau cahier des charges des contrats responsables au\u00a01er<\/sup>\u00a0janvier\u00a02020 ne perdront pas l\u2019exon\u00e9ration de cotisations sociales si le contrat collectif d\u2019assurance sant\u00e9 conclu aupr\u00e8s de leur organisme assureur est, lui, conforme \u00e0 ces nouvelles garanties.<\/p>\n

Attention :\u00a0cette tol\u00e9rance ne s\u2019applique pas lorsque c\u2019est une d\u00e9cision unilat\u00e9rale qui instaure la compl\u00e9mentaire \u00ab\u00a0frais de sant\u00e9<\/em>\u00a0\u00bb dans l\u2019entreprise<\/a>.<\/p><\/blockquote>\n

Pour plus d’informations, n’h\u00e9sitez pas \u00e0 consulter le D\u00e9cret n\u00b0\u00a02019-21<\/a> du 11\u00a0janvier\u00a02019, JO du\u00a012\u00a0et le D\u00e9cret n\u00b0\u00a02019-65<\/a> du 31\u00a0janvier\u00a02019, JO du 2\u00a0f\u00e9vrier.<\/p>\n","protected":false},"excerpt":{"rendered":"

Les employeurs doivent modifier leur couverture « frais de santé<\/em> »<\/strong> d’ici la fin de l’année afin que leurs salariés bénéficient d’un remboursement intégral<\/strong> des frais d’optique<\/strong> et de leurs soins dentaires prothétiques.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[190],"tags":[],"class_list":["post-9883","post","type-post","status-publish","format-standard","hentry","category-juridiques"],"acf":[],"yoast_head":"\nLes compl\u00e9mentaires sant\u00e9 doivent \u00eatre adapt\u00e9es \u00e0 la r\u00e9forme du \u00ab 100 % sant\u00e9 \u00bb | Abeille Avocats<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/abeille.law\/complementaires-sante\/\" \/>\n<meta property=\"og:locale\" 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