Uncertainty over the management of social and health benefits For millions of public servants, it has become a growing concern. Currently, private entities that maintain agreements with the General Mutuality of State Civil Servants (MUFACE) expressed their dissatisfaction, saying that the current agreements generate economic losses. For this reason, they rejected the renewal of the contract for 2025. The main companies involved in this process are Adeslas, Asisa and DKVwho requested a 38% increase in coverage and premiums. However, the government only offered a 17% increase, which created a point of tension in the negotiations.
The Executive has set a deadline November 5 for private insurers to accept their offer, otherwise MUFACE coverage would be affected, a situation which could generate a crisis in several autonomous communities. Added to the concern raised by MUFACE is the fact that other mutual societies, such as Social Institute of the Armed Forces (ISFAS) and the General Judicial Mutuality (MUGEJU)also have contracts that expire in 2024. Together, these three entities manage the health care of approximately 2.14 million civil servants and their families. Although the three mutuals face a similar challenge, negotiations are being conducted independently, with MUFACE being the most advanced so far. If an agreement is not reached before December 31, the mutualists should move towards the public systemwhich would further complicate the health situation of the people concerned.
MUFACE
The government established a contingency plan which will be activated in February 2025 if an agreement is not reached with the insurers. Under the terms of the current MUFACE contract, which ends on December 31, entities must continue to provide services to participating mutualists until the first month of the new year. This measure includes the obligation to care for patients hospitalized or whose delivery is scheduled for February, guaranteeing their assistance until their discharge or until the end of the maternity process.
If a patient remains hospitalized beyond this period, insurers will cover their costs until end of March 2025. However, once this period is over, the situation of mutualists could become complicated since the agreement is only maintained if at least one supplier agrees to participate in the new MUFACE concert. Otherwise, patients would be left without coverage.
Even if insurers will receive a fixed premium for each mutualist in January, 10% of this premium will be withheld until the end of 2026. This could lead to additional losses for the entities, since in 2023 for example, Adeslas has reported a monthly deficit greater than six million euros. Regarding the renewal of the agreement, the government is proposing an increase of 17.1%, which is insufficient for companies which are demanding an increase of 40% to balance their accounts after accumulated losses of 400 million over the last three years. .
The new concert, whose economic allocation amounts to more than 2.681 million euros for 2025 and 2026, is in a urgent tender process. Interested entities must fulfill certain requirements, such as demonstrating their economic and technical solvency. In the meantime, time is running out for insurers, who must decide before November 5 whether they accept the government’s proposal, in a context where the viability of MUFACE and the medical care of 1.5 million civil servants do not hold. only by a thread.
ISFAS and MUGEJU
The agreement approved by the Council of Ministers on October 8 provides for a 17.12% increase in MUFACE premiumsstanding at 16.5% for 2025 and 0.62% for 2026. Similar figures should apply to MUGEJU and ISFAS. This increase, however, was considered insufficient by the private health sector, which emphasizes that the premium per person is 43% lower than public health spending.
The government’s offer for MUGEJU and ISFAS concertswhich will also begin in January 2025. Insurers are waiting for these conditions to decide on their participation. However, they have until November 5 to present their proposals for the years 2025-2026.
As for MUGEJU, this mutual has 91,834 people, 75.9% of whom opt for private health care. Insurers currently providing services to this group include Asisa and DKV. In the case of ISFAS, which covers a total of 546,611 people, 91.3% also prefer to seek treatment through insurers. The decrease in the number of members of this mutual is notable, with a loss of 74,689 since 2014.
The lack of renewal of these concerts could cause a health system crisisleading to collapse in several autonomous communities, according to sector experts. Pressure is increasing for quick and effective decisions to be made on this matter.
