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Social security Like most things administrative in France, the social security system is a minefield of bureaucracy. Here is a short guide to stepping through it. The French social security system, which the French call la Sécu, is divided into four different categories, which are called régimes. The régime général is for salaried employees working in trade and industry. The régime social des indépendants (RSI) covers the self-employed. The régime agricole is for agricultural workers, and the régimes spéciaux are for special categories of workers like civil servants or railway workers. The régime général, which covers some 80 percent of French citizens, divides up into four sectors: health insurance and accidents at work; retirement; family income support; and the collection of contributions. Contributions are collected by the URSSAF (Union de recouvrement des cotisations de sécurité sociale et d’allocations familiales), which has 105 offices around the country. You’ll need to contact the office nearest you. The URSSAF then passes the money on to the ACOSS (Agence centrale des organismes de sécurité sociale) for distribution to the various funds, called caisses, which are responsible for paying out benefits and making reimbursements. There are different caisses for the different sectors mentioned above. Once you begin working for a French company, your employer is required to provide you with a French social security number. Then you become eligible for reimbursements of medical expenses under the mandatory contributions refund system, called the régime obligatoire. 12
You will be issued a carte vitale, which you must present at all doctor’s visits and which allows them to access a central file, not on your medical history, but your administrative standing. EMPLOYEES If you are an employee, social security contributions are automatically deducted from your salary each month. It’s likely that payments to a mutuelle will also be deducted. The national healthcare caisse for salaried employees is the CNAMTS (Caisse nationale d’assurance maladie des travailleurs salariés) and reimbursements for medical treatment are paid out by the CPAM (Caisses primaires d’assurance maladie). Family income support is paid out by the CAF (Caisses d’allocations familiales). SELF-EMPLOYED If you are self-employed, you’ll be expected to register directly with the URSSAF to pay your charges or the contributions you pay into the system. The URSSAF website (www.urssaf.fr) helps you calculate how much you need to pay. Contributions from the self-employed go to one of the 31 CMR (Caisses d’assurance maladie régionales). Those working in the arts need to contact the Maison des artistes to organise their Social security cover. If you are paid in royalties, called droits d’auteur, you can register with the AGESSA (Association pour la gestion de la sécurité sociale des auteurs). Find out more online in our article “A guide to the French social security”. USEFUL RESOURCES Assurance maladie en ligne: www.ameli.fr CAF: www.caf.fr AGESSA: www.agessa.org CANAM: www.canam.fr URSSAF: www.anglais.urssaf.fr
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