Which employees can benefit from the Alsace-Moselle scheme? (2023)

​Conditions modified by the law of March 14, 2012

As we indicated in a publication of October 14, 2012 (and which you can find inclick here), the conditions for affiliation to the local scheme of Alsace-Moselle have been modified, following the publication of law 2012-355 of 03/14/2012 and ACOSS circular n° 2012-81 of 07/23/ 2012.

​Affiliation to the Alsace-Moselle scheme

Are affiliated to the local scheme of Alsace-Moselle, employees who meet the following criteria:

Situation 1: the employee's activity is carried out in the Alsace-Moselle departments, regardless of the head office

Those who carry out an activity in the departments of Bas-Rhin, Haut-Rhin and Moselle are concerned, regardless of where the company's head office is located.

• Example: employee who works in Strasbourg for a company whose head office is in Paris.

Situation 2: establishment located in Alsace-Moselle and itinerant activity

Employees who carry out an itinerant activity in other departments, for an establishment located in the departments of Bas-Rhin, Haut-Rhin and Moselle.

• Example: employee who works in Paris attached to the head office or to an establishment located in Strasbourg.

​Exclusion from the Alsace-Moselle scheme

Conversely, employees who work outside Alsace-Moselle for a company whose head office is located in the departments of Bas-Rhin, Haut-Rhin and of the Mosel.

• Example: An employee who works in Paris for a company whose head office is in Strasbourg.

​Case of employees who had the old legislation

According to the law of 14/04/1998, employees who work outside the 3 departments making up the Alsace-Moselle region are affiliated to the local scheme when the companies had a head office located in Alsace-Moselle.

These employees are now excluded since 1^isavril 2012.

In a publication of 09/27/2012, on the URSSAF website, it is confirmed that:

Insured persons who benefited from this old legislation on March 31, 2012 and who would not fall within the scope of the new regulations retain the benefit of affiliation to the local scheme as long as they meet the conditions for entitlement to rights provided for by the old legislation.

Extract from circular 2012-81 of 07/23/2012 concerning the regime applicable until March 31, 2012:

1. Background

Law No. 98278 of April 14, 1998 was intended to consolidate the rules relating to the local health insurance scheme of the departments of Bas-Rhin, Haut-Rhin and Moselle.

Under the terms of article 4II1° of this law (art. L. 3251 II 1°) CSS), the following fell under the local system:

Employees who work in one of the three departments of Alsace Moselle for companies whose head office is outside of Alsace Moselle.

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Employees who work outside the three departments of Alsace Moselle for companies having their headquarters in Alsace Moselle.

The affiliation of employees working outside these three departments for a company whose head office was in Alsace Moselle appeared contrary to the rules according to which the applicable rate of contributions is determined according to the place of work of the person concerned (except for the itinerant personnel who must be attached to the company's headquarters).

Extract from the URSSAF website:

Since April 1, 2012, the conditions for affiliation of employees to the local scheme of Alsace-Moselle have been modified.

Are now affiliated:

Employees carrying out an activity in the departments of Bas-Rhin, Haut-Rhin and Moselle, regardless of where the company's head office is located.
Example: an employee who works in Strasbourg for a company whose head office is in Paris.

Employees of an establishment located in these departments who carry out an itinerant activity in other departments.
Example: an itinerant employee in Paris attached to the head office or to a secondary establishment located in Strasbourg.

On the other hand, employees who work outside Alsace Moselle for a company whose head office is located in the department of Haut-Rhin, Bas-Rhin or of the Moselle (old legislation).
Example: an employee who works in Paris for a company whose head office is in Strasbourg.

However, those insured persons who benefited from this old legislation on March 31, 2012 and who would not fall within the scope of the new regulations retain the benefit of affiliation to the local scheme as long as they fulfill the conditions for opening the rights provided for by the old legislation.

Extract from the URSSAF website:

Alsace Moselle local scheme: affiliated employees

27/09/2012

In which situations is an employee affiliated to the local Alsace Moselle supplementary health insurance scheme?

The mandatory supplementary health insurance scheme for the departments of Haut-Rhin, Bas-Rhin and Moselle provides its beneficiaries with benefits paid in addition to those of the general scheme, in return for an additional contribution payable exclusively by employees.
The employee contribution has been set at 1.50% since January 1, 2012.
The deduction of this contribution is made by the employer and is collected by Urssaf.
In the general case, the employee contribution is declared on the summary contribution slip (BRC) under the personnel type code 101 which includes the social insurance contributions and the additional employee contribution to the local Alsace-Moselle scheme.

​Publication on the website of the local health insurance scheme

We end this practical sheet with a reproduction of the information available on the website of the “Régime local d’assurance maladie d’Alsace-Moselle”(site: http://regime-local.fr/)which tells us that:

• Affiliation to the Local Scheme isOBLIGATORYas soon as the conditions laid down by article L325-1-II of the Social Security Code are met;
• Elles’imposeemployers, insured persons and social organizations.

Employer consequence:

Specifically, the employer:

• Sets up the 1.5% contribution on the salary, which he will pay to his usual URSSAF;

Assured consequence:

The CPAMs have exclusive competence in the attribution of the right to the Local Regime of Alsace Moselle when this right results from a professional activity.

It will be up to the insured to produce to his CPAM of affiliation (in principle that of the place of residence):

• A copy of the payslip attesting to the deduction of the contribution;
• The CPAM will then open the rights to the Local Health Insurance Scheme and will pay the reimbursements (an update of the Carte Vitale will be necessary).

Complementary health consequence:

Additional information, the contribution to the complementary health (mutual) is in principlelowerfor those insured under the Local Scheme.

To benefit from a lower rate, the insured must contact their complementary health organization, the latter may ask the insured for their certificate of entitlement provided by the CPAM (downloadable in your personal account on the ameli.fr site and which mention the “right to the local system”.

Article L325-1

Modified by LAW n°2016-1827 of December 23, 2016 - art. 64 (V)

I.-The local compulsory supplementary health insurance scheme of the departments of Haut-Rhin, Bas-Rhin and Moselle provides its beneficiaries with benefits paid in addition to those of the general scheme for employees provided for in 1°, 2° and 4° of article L. 160-8, to cover all or part of the participation payable by the insured pursuant to article L. 160-13 with the exception of those mentioned in II and III of this article. He can cover all or part of the daily fixed price established in article L. 174-4. These benefits are determined by the board of directors of the local scheme's management body under conditions defined by decree.

II.-The local scheme is applicable to the categories of insured persons of the general scheme for employees mentioned below:

1° Employees exercising an activity in the departments of Bas-Rhin, Haut-Rhin and Moselle, regardless of the location of the company's headquarters, and employees of an establishment located in these departments who exercise an itinerant activity in other departments;

2° Contractual and approved teachers of private education establishments under contract, non-tenured agents of the State and its public administrative establishments, contractual agents of La Poste and France Télécom, non-tenured agents of the local authorities and establishments referred to in Article 2 of Law No. 86-33 of 9 January 1986 laying down statutory provisions relating to the public hospital service, who exercise their activity in the departments of Haut-Rhin, Bas-Rhin or Moselle;

3° Employees of the Autonomous Port of Strasbourg;

4° Persons referred to in Articles L. 161-8andL. 161-9 of this code and 1° to 7° of article L. 5141-1 of the labor code, regardless of their place of residence in metropolitan France or in the overseas departments, who have been beneficiaries of the local scheme as insured persons or beneficiaries of the general scheme and who continue to benefit from it for the duration of the maintenance of entitlement to the general scheme;

5° Holders of replacement income, indemnities and unemployment allowances mentioned in Article L. 311-5, regardless of their place of residence in mainland France or in the overseas departments, who either have benefited from the local scheme as employees, or have fulfilled, as cross-border workers according to the regulation (EC ) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems, the conditions for benefiting from the local health insurance scheme at the time of their registration with associations for employment in the industry and commerce;

6° Holders of early retirement allowances pursuant to company agreements and holders of a replacement income under end-of-service leave, regardless of their place of residence in metropolitan France or in the departments overseas, who benefited from the local scheme as employees at the time of their early retirement or at the end of their activity;

7° Holders of an invalidity pension or a survivor's pension mentioned in Articles L. 341-1andL. 342-1, regardless of their place of residence in mainland France or in the overseas departments, who, prior to their disability, benefited from the local scheme as employees or beneficiaries, as well as the holders of a work accident pension or a survivor's pension mentioned in article L. 371-1, regardless of their place of residence in metropolitan France or in the overseas departments, who, prior to receiving this pension or disability pension, benefited from the local scheme as employees or 'assigns ;

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8° Holders of an old-age benefit who reside in France or in another State of the European Union and who benefit from the local health insurance scheme on 1 July 1998;

9° Holders of an old-age benefit, residing in France or in another State of the European Union, who have come under the local health insurance scheme either during the five years preceding their retirement or their cessation of activity , or for ten years during the fifteen preceding this retirement or this cessation of activity, provided that they justify the longest period of affiliation to the general old-age insurance scheme or to the scheme defined in 2° of l article L. 181-1;

10° Holders of an old-age benefit who do not meet the conditions set out in the preceding paragraph, residing in France or in another State of the European Union, who have been covered by the local health insurance scheme for at least sixty quarters insurance within the meaning of the legislation applicable to the general old-age insurance scheme and who request the benefit thereof within a period and according to the terms determined by decree, provided that they justify the longest duration of affiliation to the general scheme old-age insurance or the scheme defined in 2° of Article L. 181-1;

11° Holders of an old-age benefit under French legislation or under French legislation and the legislation of one or more other Member States of the European Union or parties to the agreement on the European Economic Area, residing in France or in another State of the European Union, who have benefited, as a frontier worker according to Council Regulation (EEC) No. 1408/71 of 14 June 1971 mentioned above, from equivalent benefits to those served by the general scheme and the local health insurance scheme either during the five years preceding their retirement or cessation of activity, or for ten years during the fifteen preceding this retirement or cessation of activity , provided that they provide proof of the longest period of affiliation to a compulsory old-age insurance scheme for salaried workers, taking into account the periods of insurance under the legislation of other Member States of the European Union or parties to it. the agreement on the European Economic Area.

The local scheme is applicable to holders of an old-age benefit falling under 8°, 9°, 10° and 11° who reside in another Member State of the European Union, provided that they request it within a period of two years from the liquidation of their pension or the publication of law n° 2016-1827 of December 23, 2016 on the financing of social security for 2017.

The provisions of 9° and 10° are applicable under the same conditions to retired former employees of the Autonomous Port of Strasbourg mentioned in 3°.

The local scheme is also applicable to the persons mentioned in Article L. 161-1 who are effectively and permanently dependent on the socially insured persons listed above.

III.-Benefit from the local health insurance scheme is subject to the specific conditions of entitlement determined in II of this article as well as to the conditions of contribution and minimum number of hours of salaried or assimilated work to be entitled. and open the right to the benefits provided for in I of this article, under the conditions provided for by decree.

Extract from http://regime-local.fr/

Affiliation of employees

The local scheme is applicable to employees insured under the general scheme, as well as to their dependents (children and dependent spouse), listed below:

Employees carrying out an activity in the departments of Bas-Rhin, Haut-Rhin and Moselle, regardless of where the company's head office is located.

Employees of an establishment located in these departments who carry out an itinerant activity in other departments. By nature, the itinerant activity is that of employees who have to move constantly, to travel on a daily basis such as delivery drivers, repairmen, sales representatives, account managers, airline flight personnel, etc.

Traveling employees attached to an establishment located outside Alsace-Moselle who exercise their activity in Alsace-Moselle, when their employment contract specifies that they exercise their activity in Alsace-Moselle (Decision of the Board of Directors of October 16, 2012).

Employees benefiting from the local scheme of Alsace-Moselle on March 31, 2012 under the legislation prior to this date. They retain the benefit as long as their situation remains unchanged and they meet the conditions for entitlement to rights provided for by the legislation in force on the same date.

Holders of replacement income, allowances and unemployment benefits who have benefited from the local scheme in respect of their previous status as employee.

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Reference text: Article L325-1-II-1° to 7° of the Social Security Code.

In practice :

Affiliation to the Local Scheme is compulsory when the conditions laid down by Article L325-1-II of the Social Security Code are met: it is binding on employers, insured persons and social organisations.

Your employer sets up the 1.5% contribution on your salary, which he will pay back to his usual URSSAF.

The Caisses Primaires d’Assurance Maladie (CPAM) have exclusive competence in granting the right to the Local Regime of Alsace Moselle when this right results from a professional activity. It is your responsibility to produce to your CPAM of affiliation (in principle that of your place of residence) a copy of your first payslip attesting to the deduction of the contribution. Your CPAM will then give you rights to the local health insurance scheme and will pay you refunds (remember to update your Carte Vitale).

The complementary health contribution is in principle lower for those insured under the Local Scheme. To benefit from a lower rate, contact your complementary health organization. He may ask you for your certificate of entitlement provided by the CPAM (downloadable from your personal Ameli account on www.ameli.fr), which mentions your entitlement to the local scheme.

​

​Confirmation by the Ministry of Social Affairs and Health

In response to a written question submitted by a parliamentarian, question published in the JO Senate of 24/01/2013 and answer in that of 8/08/2013, it is confirmed that:

• The employee of a company having its head office in Alsace-Moselle;
• And who leaves to exercise his professional activity outside Alsace-Moselle;
• Loses the benefit of affiliation to the local scheme for this activity regardless of the duration since which he ceased to work in this territory.

Conditions for benefiting from the Alsace-Moselle social security system

14th legislature

Written question no. 04190 by Mr. Jean Louis Masson(Moselle - NI)

published in the JO Senate of 01/24/2013 - page 238

Mr. Jean Louis Masson asks the Minister of Social Affairs and Health if an employee employed by a company having its registered office in Alsace-Moselle but working for more than three months outside Alsace-Moselle can continue to benefit from the local scheme of social security.

Response from the Ministry of Social Affairs and Health

published in the JO Senate of 08/08/2013 - page 2333

The local compulsory supplementary health insurance scheme in the departments of Haut-Rhin, Bas-Rhin and Moselle provides its beneficiaries with benefits paid in addition to some of the benefits of the general scheme for employees. It applies to employees carrying out an activity in the departments of Bas-Rhin, Haut-Rhin and Moselle, regardless of where the company's head office is located, and to employees of an establishment located in those departments which carry out an itinerant activity in other departments (article L. 325-1 of the social security code). Thus, the employee of a company having its head office in Alsace-Moselle who leaves to exercise his professional activity outside Alsace-Moselle loses the benefit of affiliation to the local scheme for this activity regardless of the duration since which he ceased to work in this area.

​References

LAW n° 2012-355 of March 14, 2012 relating to the governance of social security and mutuality

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CIRCULAR LETTER n° 20120000081 GREAT DISTRIBUTION on 07/23/2012

Extract from the URSSAF website, information dated 09/27/2012