Summary of our market study

The French supplementary health insurance market has been growing steadily, with total consumption of healthcare and medical goods reaching 206.5 billion euros in 2020. This growth reflects structural factors such as an aging population and a greater focus on health, as well as regulatory reforms such as compulsory group supplementary insurance for private-sector employees in 2016. Insurtechs like Alan disrupted the market, posting rapid growth with 140,000 users by January 2021.

Costs continued to rise, in part due to government measures such as the 100% health law implemented in 2021, aimed at reducing out-of-pocket expenses for glasses, dentures and hearing prostheses and hearing aids, which were added to a COVID tax imposed on healthcare organizations, resulting in higher costs for the consumer with a median annual increase of €79. Despite this, the satisfaction rate of French consumers with their supplementary cover is high (81%). The COVID-19 pandemic has had a significant impact on the sector, leading to a 31% drop in healthcare spending in the first 13 weeks of 2020 compared with 2019, with optical care seeing the biggest decline at 55%.

Trends and figures

In recent years, the French supplementary health insurance market has undergone a significant transformation, driven by structural and regulatory changes. Today, some 95% of French households benefit from some form of supplementary coverage. This broad coverage reflects an upward trajectory in the consumption of healthcare and medical goods. This growing demand is fuelled by demographic changes, medical advances and the increased importance attached to health and well-being. From over 600 organizations a few years ago, the sector is now characterized by consolidation, with two-thirds fewer players than in 2010.

Mutuals, non-profit entities, and pension institutions, regulated private partnerships, currently dominate the market, accounting for over 70% of organizations. However, private insurers such as AXA and Groupama are gaining ground, accounting for around 24% of market players. Adaptation to digital transformation is evident, as new entrants such as Alan, an insurtech company offering digital health plans, have rapidly acquired a membership of almost 140,000 users. Traditional players are not to be outdone, presenting digital solutions to stay competitive. As a result, the cost structure between mutuals, private insurers and pension funds varies, with private insurers bearing the highest acquisition costs of around 18%.

The French government's efforts to extend coverage led to the ANI reform, which obliged employers to provide health insurance for their employees, and the 100% health law ensures that cover such as optical and dental care is fully reimbursed. The introduction of the Complémentaire Santé Solidaire (CSS) has further rationalized the supplementary insurance system, while Solvency 2 has imposed stricter financial health checks on organizations.

From a financial point of view, complementary health organizations contributed 28 billion euros to healthcare costs, with significant coverage in sectors such as optical and dental care. However, prices for complementary healthcare are on the rise: median inflation for health insurance has reached 4.3% in 2021, triple the increase in French purchasing power. This soaring cost is seen as a consequence of the 100% Santé law and the additional COVID tax imposed on these organizations.

The French market is characterized by a mix of individual and group contracts. Individual contracts, mainly represented by mutual groups, account for 52% of premiums, showing a preference for this type of insurance. The COVID-19 pandemic has also left its mark.

Profiles of the main players in the French supplementary health insurance market

In the French supplementary health insurance landscape, several major players are emerging from different categories, each with their own unique characteristics and positioning. Here's an overview of the key players shaping the sector:

private insurance companies

  • Covéa: Comprising MMA, GMF and MAAF, Covéa represents a significant force in the private insurance market, offering comprehensive health insurance solutions to a broad customer base. Thanks to its sense of innovation and customer service, Covéa maintains a strong position in the sector.
  • - Groupama: Known for its cooperative roots, Groupama offers a range of insurance products, including complementary healthcare. Groupama's local presence and community-oriented approach reinforce its unique market position.
  • - Axa: A world leader in insurance, Axa is well established in the French market, offering a wide range of health insurance policies. Its strength lies in the international recognition of its brand and its ability to harness global knowledge for the local market.
  • - MAIF: Initially focused on teachers and civil servants, MAIF has broadened its scope to offer mutual insurance, including healthcare, positioning itself on the basis of strong values of solidarity and responsibility.

Mutual insurance companies

  • - Harmonie Mutuelle: As a mutual health insurance company, Harmonie Mutuelle emphasizes solidarity and mutual aid. It serves a broad membership base by offering inclusive health insurance plans tailored to diverse needs.
  • - Groupe MGEN: Focusing primarily on the education and civil service sectors, Groupe MGEN has built its reputation by offering health insurance solutions with a strong emphasis on social protection and member support.
  • - La Mutuelle Générale: This entity focuses on offering health insurance on a human scale, aiming to facilitate access to healthcare for individuals and families throughout France.
  • - L'AG2R La Mondiale: With a large number of members, AG2R La Mondiale is another major player offering a range of insurance products, including health insurance, with an emphasis on personalization and specific solutions for every stage of life.

provident institutions

  • - Malakoff Humanis: Merging the expertise of Malakoff and Humanis, this provident institution plays a crucial role in the market thanks to its commitment to social protection and comprehensive coverage, aimed at a broad public, including retirees.
  • The market is also experiencing the dynamism brought by new entrants such as Alan, which represents the digital wave transforming the sector.
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  • Number of pages : ~ 40 pages
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  • Last update : 02/07/2021
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Summary and extracts

1 Market overview

1.1 Introduction

A complementary healthcare is a guarantee offered by a insurance company to supplement the benefits provided by social security for health care costs. There are three families of complementary healthcare the mutuals s, the private insurers and the pension institutions These guarantees cover all health expenses partially reimbursed by social security, including: medical consultations, prescribed medicines, medical analyses, hospitalisation, optical and dental expenses.

In 2017, 95% of French households benefited from supplementary health insurance coverage . There are currently more than 600 complementary health organisations, two-thirds fewer than in 2010, and the number of provident institutions has been halved. Supplementary health insurance accounts for 91% of the turnover of mutual insurance companies and almost half of that of pension funds.

The market is in the midst concentration The market has become more fragmented: many players have grouped together, resulting in a decrease in the number of organizations on the market. Mutual health insurance companies are governed by the Mutual Code: they are non-profit legal entities under private law. Provident institutions such as Radiance Groupe Humanis are covered by the Social Security Code. They are partnerships under private law subject to strict regulations. Finally, health insurance companies are subject to the Insurance Code. They have the status of private companies and are increasingly present on the health market. They include AXA and Groupama

In addition, new players riding the wave of digitalisation of the economy are establishing themselves on the market and offering more flexible and competitive coverage. Thus, the Alan insurtech, which offers complementary health insurance for companies, had more than 140,000 users in January 2021.

The current issue is the reform of complementary health care . Indeed, the government is seeking to address the difficulties of companies, especially SMEs, in finding an insurer for their employees. To this end, it had provided for the introduction of appointment clauses, a measure denounced by insurers and invalidated by the Constitutional Council.

The cOVID-19 health crisis has had a major impact on the complementary health products market. Indeed, the various players in the sector are on the front line in the face of the pandemic, and their economic patterns and their actions are put to the test by it. For example, players positioned primarily in the personal insurance sector were able to take advantage of the drop in claims to finance commercial actions for the benefit of their customers while at the same time carrying out promotional actions aimed at self-employed workers and small businesses, which were hard hit by the crisis but have little insurance cover at home. Conversely, players exposed to professionals were unable to finance this type of commercial gesture and saw the controversy over their clients' operating losses increase their legal risk, not to mention the potential commercial impact on their image and customer relations.

List of charts presented in this market study

  • Les dépenses liées à la santé
  • Consumption of medical care and goods
  • Chiffre d'affaires en assurance des organismes de complémentaire de santé
  • Evolution de la part de marché de chaque OC
  • Répartition des OCAM par catégorie
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Latest news

AXA: an extremely balanced business model - 22/02/2024
  • - The business model is split equally between companies and individuals, with 50% each
  • - 17,000 people to be hired worldwide by 2021, including 6,000 in France
How France's Havea is capitalizing on the dietary supplements boom - 27/12/2023
  • 59% of French people have consumed dietary supplements in the last two years, according to a survey conducted by Harris Interractive for Synadiet, the industry's trade association.
  • Estimated at 2.6 billion euros in France and 15 billion euros in Europe, the dietary supplements market has been growing at an average annual rate of 5% over the past ten years.
  • French company Havea, number one in Europe with sales of almost 300 million euros in 2023, 40% of which are exported, has been recording annual growth of 10% to 20% for the past five years.
  • Group sold in 2022 by 3i fund to BC Partner
  • The site has already doubled its production in three years with 12 million euros of investment Havea consolidates its industrial base in Vendée
  • Havea acquires Biocyte's nutricosmetics business

  • Aragan, the group's flagship brand along with Biolane, Densmore, Vitavea, Dermovitamina and Bears with benefits.
  • The Aragan brand, distributed in pharmacies, accounts for a quarter of the Group's sales, and is growing by over 25% a year.
  • This success is linked to the waves of delisting that affect around twenty drugs a year.
  • 54% of sales of supplements are made in pharmacies
  • Non-reimbursed business represents less than 15% of sales
  • Havea acquired Germany's Bears for Benefits in 2022. Thanks to its gums, the beauty supplements specialist has doubled its sales in one year to 30 million euros in 2023
Vitavea, Havea's factory of 1,000 natural health products in Vendée, France - 11/08/2023
  • The Havea site covers 25 hectares near Montaigu, in the Vendée region
  • The company employs 900 people, half of whom are based in Montaigu.
  • Havea produces 1,200 products a year, 1,000 of which are manufactured in its Vendée plant
  • The group estimates the natural health market in Europe at around 15 billion euros, including 2 billion in France.
  • Havea achieved sales of 232 million euros in 2022 and forecasts total sales of 290 million euros in 2023.
  • The Vitavea and Biolane brands account for over 30% and 22% respectively of Havea's sales.
  • 60% of Havea sales are centered in France, and 90% in Europe.
  • The Group is also present in markets outside Europe, such as China and Canada.
Havea consolidates its manufacturing base in Vendée - 05/07/2023
  • The French Havea Group has taken over the German company Bears with Benefits.
  • Havea plans to invest 5 million euros in a chewing gum line.
  • The gum line will have a capacity of 4 million boxes a year.
  • The Vendée-based company recently completed its seventh acquisition in six years.
  • The Montaigu plant is home to half of the group's 450-strong workforce.
  • A project to increase capsule production from 400 million to 600 or 700 million is scheduled for the second half of 2024.
  • Havea, taken over in October 2022 by the BC Partners fund, will achieve sales of 290 million euros this year.
  • The group has gained 104 million euros in sales through acquisitions since 2017.
  • Havea aims to gain a further 200 million euros in sales through acquisitions by 2027.
Havea Group: Natural health specialist - 30/06/2023
  • Sales target for Havea Group in 2021 is around 300 million euros, an increase of 20%.
  • The sales target for Havea Group in 2027 is one billion euros.
  • 60% of Havea Group sales are generated in France.
  • The growing "natural health" market in Europe is worth around 15 billion euros.
  • Havea Group's product portfolio comprises some 1,200 products.
  • Havea Group was acquired by the British investment fund BC Partners for 1.16 billion euros.
  • 950 employees, including 450 at its Montaigu plant and 250 in Paris.
Health insurance: hospital mutuals to work with MGEN and Groupama - 23/06/2023
  • Three leading players (MNH, MGEN and Groupama) have joined forces to bid for future health insurance contracts for hospital civil servants.
  • MGEN is the leading mutual insurer for civil servants, with 4.2 million active and retired policyholders.
  • MNH intends to position itself in certain government ministries.

Companies quoted in this study

This study contains a complete overview of the companies in the market, with the latest figures and news for each company. :

Mutuaide (Groupama)
Axa groupe
Malakoff Humanis
VYV Groupe
Havea Group
Mutuelle interprofessionnelle de prévoyance (MIP)
Mutame & Plus
Mutuelle autonome générale éducation (MAGE)
MNT - La mutuelle nationale territoriale
Mutuelle UNEO

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