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IStock / City Presse

It is not always easy to see clearly in the formulas of complementary health, as the jargon used is often incomprehensible.

In 2019, the main federations in the sector therefore made a commitment to the Ministry of Health to improve the readability of guarantees.

It was then a question of harmonizing the wording of the main guarantee items and communicating on concrete examples of reimbursements.

Now it is the turn of management costs and loss ratios to gain clarity.

The ratios highlighted

A decree published in

the Official Journal

of June 5, 2020 and entered into force on September 1 requires health and mutual insurance organizations to detail these elements in their offers and to remind their members of them each year.

And all contracts signed or renewed since 2013 are concerned.

It is also a

sine qua non

condition

to meet the specifications of so-called solidarity and responsible contracts which offer a

package

framed with protections.

In practice, this involves clearly indicating the ratio between the amount of benefits paid by the insurer in the event of illness, maternity or accident and that of the contributions or premiums collected for these guarantees for the entire benefit. agency portfolio.

Likewise, any estimate or contract must henceforth specify the ratio between the total amount of the company's management fees for these coverages and that of the related contributions, while detailing in passing the composition of these invoices.

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  • Silver

  • Legislation

  • Mutual

  • Health Insurance

  • Contract