The complementary health products market - France

1.1 Introduction

A complementary healthcare is a guarantee offered by a insurance company to supplement the benefits provided by social security for health care costs. There are three families of complementary healthcare the mutuals s, the private insurers and the pension institutions These guarantees cover all health expenses partially reimbursed by social security, including: medical consultations, prescribed medicines, medical analyses, hospitalisation, optical and dental expenses.

In 2017, 95% of French households benefited from supplementary health insurance coverage . There are currently more than 600 complementary health organisations, two-thirds fewer than in 2010, and the number of provident institutions has been halved. Supplementary health insurance accounts for 91% of the turnover of mutual insurance companies and almost half of that of pension funds.

The market is in the midst concentration The market has become more fragmented: many players have grouped together, resulting in a decrease in the number of organizations on the market. Mutual health insurance companies are governed by the Mutual Code: they are non-profit legal entities under private law. Provident institutions such as Radiance Groupe Humanis are covered by the Social Security Code. They are partnerships under private law subject to strict regulations. Finally, health insurance companies are subject to the Insurance Code. They have the status of private companies and are increasingly present on the health market. They include AXA and Groupama

In addition, new players riding the wave of digitalisation of the economy are establishing themselves on the market and offering more flexible and competitive coverage. Thus, the Alan insurtech, which offers complementary health insurance for companies, had more than 140,000 users in January 2021.

The current issue is the reform of complementary health care . Indeed, the government is seeking to address the difficulties of companies, especially SMEs, in finding an insurer for their employees. To this end, it had provided for the introduction of appointment clauses, a measure denounced by insurers and invalidated by the Constitutional Council.

The cOVID-19 health crisis has had a major impact on the complementary health products market. Indeed, the various players in the sector are on the front line in the face of the pandemic, and their economic patterns and their actions are put to the test by it. For example, players positioned primarily in the personal insurance sector were able to take advantage of the drop in claims to finance commercial actions for the benefit of their customers while at the same time carrying out promotional actions aimed at self-employed workers and small businesses, which were hard hit by the crisis but have little insurance cover at home. Conversely, players exposed to professionals were unable to finance this type of commercial gesture and saw the controversy over their clients' operating losses increase their legal risk, not to mention the potential commercial impact on their image and customer relations.