Company health cover: enrolment, waivers and payroll deregistration

Quick answer. Since 1 January 2016, every French private-sector employer must offer collective health cover funded at least 50 %. Enrolment is mandatory at hiring, except for written and justified waiver cases. On departure, the employee keeps the cover for free (portability) for up to 12 months while compensated by France Travail.

Collective health cover looks like a one-off formality once the contract is signed with the insurer. In reality, it lives through every employee arrival and departure. A missed enrolment, an undocumented waiver or a late deregistration creates gaps between your payslips, your declarations and the insurer's member lists. These gaps always catch up with you, usually at the worst moment: an audit, a conflictual exit, or a care reimbursement refused to the employee.

This article describes the payroll process for company health cover seen from the firm: what to collect at hiring, how to handle a waiver, and how to manage deregistration and portability on departure. We deliberately set aside the setting-up of the scheme itself, which is another topic, to focus on the day-to-day flow of arrivals and departures that a payroll team handles.

The obligation stems from the national interprofessional agreement (ANI) of 11 January 2013, enacted by Law no. 2013-504 of 14 June 2013 on employment security. Since 1 January 2016, every private-sector employer must offer collective health cover to its employees.

Three conditions frame this scheme. The employer funds at least 50 % of the contribution. The contract complies with a minimum care basket defined by regulation. The contract is so-called responsible, which conditions its favourable social and tax treatment.

Enrolment in the collective contract is in principle mandatory for all employees from hiring. This mandatory nature is the counterpart of the social advantage attached to the scheme: because everyone is covered, the employer share benefits from favourable treatment, within certain limits. The only admitted exits are the waiver cases set out in the texts and reflected in the founding act of the scheme.

Enrolment is triggered at hiring, alongside the pre-hire declaration and the first payslip. The useful reflex is to handle health cover at the same time as the rest of the onboarding file, rather than pushing it back to the first payslip.

Here is the sequence we apply in the files we manage through our payroll and HR service:

1. From signature, collect the enrolment documents or the employee's written waiver request.
2. Enrol the employee with the insurer (enrolment form, any dependants, effective date).
3. Report the employee contribution on the payslip and apply the social treatment of the employer share.
4. Keep the supporting documents in the employee's file, whether an enrolment or a waiver.
5. Check consistency between the insurer's list and the headcount actually paid.

The employee contribution appears on the 2026 payslip, on the line dedicated to health cover. The employer share, however, is not fully exempt: it is partly reintegrated into the social and tax base. Many employers underestimate this point, because health cover is sometimes presented as an entirely neutral benefit, which it is not.

Waiver cases are tightly framed. They appear notably in article D911-2 of the Social Security Code and must be reflected in the act setting up the scheme (unilateral decision, collective or referendum agreement). An employee cannot refuse the cover for personal convenience: they must fall within a provided case and request it in writing.

The rule common to all these situations: a waiver is requested, not presumed. It must be set out in writing, dated, and supported by the relevant document. Without that written request, the employer remains required to enrol the employee, and the absence of enrolment can be reclassified.

When the employee leaves, the cover stops in principle on the end date of the contract. Deregistration must be sent to the insurer, and the last contribution correctly stopped on the final pay settlement. But that is not always the end of the story: portability may extend the cover for free.

The exit steps follow a simple logic:

1. Deregister the employee with the insurer on the contract end date.
2. Stop the employee contribution on the final settlement payslip.
3. Check whether the departure opens the right to portability.
4. Inform the employee and the insurer of any cover maintenance.
5. Track adjustments with the insurer until the file is closed.

Portability is the free maintenance of health and provident cover after departure, provided by article L911-8 of the Social Security Code. It applies when the termination opens the right to unemployment insurance, except for gross misconduct.

The employee keeps the cover for a period equal to their last employment contract, capped at 12 months, as long as they are compensated by France Travail. The maintenance is free for the former employee: it is funded by the scheme's pooling, not by an individual contribution. That is why portability also concerns the employer and the payroll team: it must be reported to the insurer and the compensation rights traced.

The underestimated risk here is plain oversight. An employee deregistered too quickly, with no portability flag, may end up with no cover when they were entitled to it. If care is refused to them, the dispute quickly traces back to the employer. Portability is not a commercial option: it is a right, and its handling is part of the exits to secure.

Several situations fall outside the standard flow and deserve separate handling.

Internal multi-enrolment is found in companies with several establishments or several agreements. The same group may fall under distinct schemes, which complicates payroll. We cover this in our analysis of multi-agreement payroll by establishment.

The director is not in the same framework. A director treated as an employee may, depending on the scheme structure, fall under the collective contract; a self-employed director follows another logic, which we detail in our article on the self-employed director's health and provident cover.

Short contracts and temporary work raise the question of a minimum cover duration and the relevance of a waiver. It is better to settle this at hiring than to adjust six months later.

Four errors recur regularly in the files we take over.

The first is the oral waiver. An employee states they are covered by their spouse, the employer believes it, and nothing is written. In case of an audit, the absence of a written record voids the waiver and the employer should have enrolled them.

The second is the employer share treated as fully exempt. Yet it is partly reintegrated into the social and tax base. This is a point to check against the URSSAF contribution base and brackets.

The third is late deregistration: the employee has left, but the contribution keeps running on the insurer's side, creating an overpayment to adjust.

The fourth is unflagged portability, already mentioned, which deprives the employee of a right and exposes the employer.

Our reading is simple: company health cover is not a contribution problem, it is a traceability problem. The amount appears on the payslip almost automatically once the setup is in place. What goes wrong is the tracking of documents: the missing waiver record, the delayed enrolment, the forgotten deregistration.

Recently, one file illustrated this well. An employee had been waived at hiring on the basis of their spouse's cover, without a supporting document being kept. When that spouse lost their job, the employee wanted to be enrolled in the company scheme. With no trace of the initial waiver and no clear date, the payroll team no longer knew since when they should have been covered. The adjustment was manageable, but it would have been avoided by a simple written request filed on day one.

In practice, we recommend keeping a log of enrolments, waivers and deregistrations reconciled with the insurer's list at each payroll close. It is the same reflex as for the whole social chain: a regular checkpoint costs a few minutes, a catch-up costs hours. The firm, registered with the Ordre des experts-comptables, supports this tracking as part of the payroll engagement, in liaison with the insurer.

Hayot Expertise tip. Document each entry and each exit as it happens, and reconcile your payroll with the insurer's list at each close. If you manage several establishments or short contracts, frame the handling of waivers from hiring. Our payroll and HR team secures this flow, and our outsourced CFO service for startups and SMEs steers it in growing structures.