Evin law (continuation of group health and protection cover)
A 1989 law that governs group supplementary social protection and notably allows former employees, retirees or the unemployed, to keep their health cover at a capped rate.
The December 31, 1989 law strengthening protections for persons insured against certain risks, known as the Evin law, governs group health and protection contracts taken out by employers for their employees. It sets several protective principles: a ban on the insurer excluding an employee for health reasons from a compulsory group contract, cover for the consequences of illnesses predating enrollment, and continuation of benefits in payment if the contract is terminated. Its article 4 is the best known: it allows former employees who retire, receive a disability pension or are unemployed and receiving benefits to keep, individually and without a health questionnaire, the health cover they had, at a rate capped relative to active employees, progressively raised to 150 percent over three years. For the insurer, this mechanism creates structural adverse selection: former employees who keep the cover are, on average, those who need it most, and the rate cap makes active members of the group contract bear part of their cost.
Hypothetical case, under the rule in force since 1 July 2017: an employee retires and asks to keep her company health plan. In the first year her contribution may not exceed that of active employees, then 125 percent in the second year and 150 percent in the third, while her average care cost for the insurer is well above that of an active employee.
Follow the research
One letter a week. First, the week's underwriting note, when one is published: a dated, argued decision, signed by Paul Bernardski. Then what the observatory published on cyber risk, political risk and insurance. No account, no tracking.
No spam, one-click unsubscribe, no data ever sold.