As the coronavirus epidemic unfolds, what are the conditions for coverage of the epidemic’s consequences by the complementary employee benefits schemes?
In case of coronavirus-related healthcare expenditure
All healthcare expenditure of employees – and possibly those of their families – are covered under the same conditions as usual health expenses, by the Social Security and the complementary health insurance, in accordance with the coverage purchased.
In case of work stoppage
With regard to infected employees
The employee’s lost wages are covered as with any work stoppage: daily allowances from the Social Security (with a three-day waiting period) topped off where appropriate by the company as part of the salary continuance obligation and/or by the life insurance policy, following application of the contractual deductible.
With regard to employees in isolation for themselves or their children
Employees who are subject to an isolation measure without being able to keep working are covered by the Social Security as from the first day of confinement (with no waiting period) for a maximum of 20 days.
This also applies to employees unable to work owing to an isolation measure affecting a child under the age of 16. In this case, daily allowances can be paid for the duration of the closure of the educational establishment.
As with a “traditional” work stoppage, Social Security benefits are topped off as part of the salary continuance (on a monthly basis) and/or the life insurance policy:
– A decree of 31 January (amended by decree of 9 March) eliminated the three-day waiting period for Social Security benefits.
– A second decree of 4 March 2020 eliminated the seven-day timeframe for salary continuance.
– The life insurance policy comes into play following application of the contractual deductible.
These rulings have been established by the health insurance fund to which the employees concerned belong.
In case of partial activity
In the event that the coronavirus epidemic obliges the company to reduce its activity and to place certain employees on partial activity, we invite you to approach your usual contact person at Verlingue to verify the implications of this measure for your complementary employee benefits schemes.
Specific elements concerning the international mobility of employees
Life insurance policies
Point requiring special attention: Some contracts may stipulate that insured persons travelling abroad in a zone for which the Ministry of Foreign Affairs has issued a strong travel advisory lose their life insurance guarantees.
Employers’ prevention obligation (Art. L4121-1 of the Labour Code) is particularly relevant for employees required to travel abroad. Proof must be provided that employees have been trained and informed, and the company must have appropriate means of ensuring the safety of employees.
The assistance contracts implemented through Verlingue ensure access to real-time information on health developments in all countries.
Employees abroad who have been infected by the virus are covered by the insurance contract. The steps taken by the provider’s doctors in cooperation with local doctors will be submitted to the competent authorities for decisions.
Financial coverage will depend on the contractual modalities of your programme.
Confinement of expatriate employees affiliated to the Fund for French Citizens Abroad (CFE)
The protection afforded by the Social Security applies under the same conditions as for employees in France, subject to the confinement of the expatriate in France, with a work stoppage prescribed by a Regional Health Agency doctor.