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The cost of social regime in France since the universal health protection (PUMA)

universal health protection

A certain number of people who settle in France and do not exercise a professional activity there or exercise an insignificant activity there wonder what will be their social cover.

Two social regimes are most often likely to be applied to them in their case :

  • The social security scheme for the self-employed when the annual net professional income exceeds around € 8,000 ;
  • Universal health protection (PUMA) when professional income is below the above threshold and the taxpayer has other French or foreign income.

We will briefly present these two regimes.

I – Condition to be fulfilled by an “auto-entrepreneur” to benefit from the social regime 

  1. Reimbursement of medical expenses

In 2018, the Social Regime for the Self-Employed (RSI) was replaced by the Social Security for the Self-Employed (SSI), which is itself attached to the general system.

Thus, when a person become a self-entrepreneur in 2020, he depends on the Primary Health Insurance Fund of his place of residence for his health protection. If he was previously an employee or job seeker, his membership organization therefore remains the same. His health insurance has no interruption.

The amount of the contributions of the “auto-entrepreneurs” varies according to the turnover. Those who have very low contributions, or even zero, can then be penalized for their retirement or their daily allowances but apparently not for reimbursement of medical expenses.

Since January 2016, universal health protection (Puma) provides sickness and maternity cover to anyone exercising a professional activity in France or residing in France on a stable and regular basis. Adult members of the worker’s family (spouse, children) can now be affiliated on a personal basis. The spouse without professional activity who was, before the entry into force of the Puma, attached to Social Security for the self-employed as a beneficiary can no longer maintain this status since 2019.

Self-employed workers benefit from healthcare costs under the same conditions and according to the same reimbursement rates as employees of the general scheme.

  1. Daily benefits in the event of illness or accident

Merchants or craftsmen can benefit from daily allowances in the event of illness or accident provided that :

  • Be registered with the Social Security of the Self-Employed for at least a year ;
  • Be update in the payment of social contributions ;
  • Being in activity at the time of work stoppage ;
  • Have an annual professional income greater than or equal to € 3,919.20.

Only unregulated liberal professionals affiliated to the SSI are entitled to this scheme.

They must also fulfill the same conditions as traders.

  1. Maternity leave

The maximum duration of maternity leave for self-employed women is 6 weeks before the expected date of delivery and 10 weeks after.

To benefit from it, an “auto-entrepreneuse” must fulfill two conditions :

  • Be update with compulsory health and maternity insurance contributions ;
  • Justify ten months of affiliation for a self-employed activity (or other activity or unemployment, as long as there has been no interruption between these affiliations).
  1. Basic retirement and supplementary retirement for “auto-entrepreneurs”

The craftsmen or traders are affiliated to the Social Security of the Self-Employed (formerly RSI) which validates the pension rights according to your turnover.

Liberal professionals registered since 2019 no longer depend on the CIPAV for their old age insurance. Their social protection (sickness, maternity and retirement) is managed by the Social Security of the Self-Employed, like artisans and traders.

The others always depend on CIPAV unless expressly requested to be affiliated to the SSI.

However, to validate the quarters for basic retirement, it is necessary to achieve a minimum turnover which depends on the activity carried out. Pension rights depend of course on the social contributions paid.

Pension fund


Standard abatement

Turnover to be carried out to validate










Commercial activities (sells)

71 %

€ 3,670

€ 6,490

€ 9,340

€ 20,430

Services BIC

50 %

€ 2,135

€ 3,775

€ 5,440

€ 11,850

Services BNC and non-regulated liberal activities

34 %

€ 2,425

€ 4,320

€ 6,265

€ 8,980


Regulated liberal activities

34 %

€ 2,246

€ 4,491

€ 6,737

€ 8,892

  1. Contribution rate

“Auto-entrepreneurs” benefit from a simplified system for calculating and paying compulsory social security contributions.

Each month or each quarter, according to their choice, they must calculate and pay all of their personal social charges according to their gross turnover achieved during this period according to the following rates :

  • 12.8% for a purchase/resale activity, the sale of foodstuffs to be consumed on site and accommodation services, with the exception of the rental of furnished accommodation premises, the rate of which is 22% ;
  • 22% for the provision of services and the liberal professions.

The social package includes all contributions relating to compulsory social protection :

  • Illness-maternity leave ;
  • Daily allowances (only for craftsmen and traders as well as unregulated liberal professions) ;
  • Disability-death ;
  • Base and complementary retirement ;
  • Family allowances ;

II – Contributors of subsidiary sickness contribution (C.S.M.)

  1. Rules of coverage

Persons who are liable for the subsidiary sickness contribution (C.S.M.) for a given year meet the following cumulative conditions :

  • Exercise a professional activity in France or have a stable and regular residence in France for the benefit of the assumption of their health costs ;
  • Have income from professional activities carried out in France of less than € 8,104 for 2019 or € 8,227 for 2020 (i.e. 20% of the annual Social Security ceiling (Pass)) ;
  • Have income from assets and capital greater than € 20,262 in 2019 or € 20,568 for 2020 (i.e. 50% of the annual Social Security ceiling).

In the case of a couple, if each of the two members meets the conditions, both members of the couple are liable for a C.S.M.

If either member of the couple has a higher working income (around € 8,227 for 2020), both members of the couple are exempt from the CSM.

On the other hand, the receipt of a retirement pension in annuity or in capital over all or part of a year totally exempts the person, as well as the other member of the couple, from the C.S.M. due for the same year.

  1. Calculation of C.S.M.

The base of the C.S.M. consists of the following income categories :

  • Property incomes ;
  • Income from movable capital ;
  • Capital gains from the sale of goods or rights of any kind ;
  • Non-professional industrial and commercial profits and profits from non-professional non-commercial professions.

The calculation of the C.S.M. is the next :

Contribution amount = 6.5% × (Non-professional income – 0.5 × ASSC) × [1 – Professional income / (0.2 × ASSC)].

ASSC corresponds to the Annual Social Security Ceiling.

III – An example of calculation 

Suppose a person whose professional BIC turnover (service provider) is € 8,000, his taxable profit will therefore be set at € 4,000 after application of the standard abatement of 50%.
Also assume that he has property income of a net amount of € 30,000 for the year 2019.

  • Social charges on professional activity : 8,000 X 22% = € 1,760
  • C.S.M. 6.5% x (30,000 – 20,568) x (1 – 4,000 / 8,227) =  €    315
  • Total contributions for the year :   …………………….…..  € 2,075

Suppose now that the amount of BIC professional turnover for the same year amounted to € 20,000, his taxable profit will be set at € 10,000.

Total contribution for the same year would be : 20,000 x 22%  4,400.

The results could of course be very different depending on each case. You can contact us so that we can examine your personal situation.

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