Plan séquence - Prévoyance : Mutuelles et IP s’accrochent aux branches

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Alors que les accords de branche de 2015 arrivent à échéance, de nombreuses branches professionnelles n’ont pas rouvert les négociations sur leurs régimes santé et prévoyance. Pour autant, les branches se sont professionnalisées et les exigences des partenaires sociaux vis-à-vis des mutuelles et institutions de prévoyance sont plus fortes.

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2020 n’est pas comme 2015

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Suite à l’accord national interprofessionnel et la généralisation de la complémentaire santé, 2015 avait été une année propice à la négociation de branche. Cinq ans plus tard, ces accords arrivant à échéance, on aurait pu s’attendre à revivre la même frénésie. Or, 2020 s’est soldée avec uniquement 70 négociations de branche (30 lots d’appels d’offres pour 21 branches). La moitié des branches ne se sont pas manifestées.

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Par Mariona Vivar

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Dans un contexte de crise sanitaire, 2020 n’était pas propice à renégociation. Certaines branches ont préféré contractualiser directement avec certains organismes, de gré à gré, au lieu de lancer des appels d’offres publics avec les coûts d’actuariat associés. Par exemple, les branches de l’esthétique, du commerce de détail non alimentaire, ont contractualisé directement avec Apicil, Malakoff Médéric et Klesia.

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D’autres branches comme l’enseignement privé catholique ou l’animation (Éclat), ont décidé de reporter la négociation à 2021...

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- D’autres, ont décidé de ne rien faire, laissant ainsi la recommandation caduque, tout en préservant un pilotage du régime de branche par les partenaires sociaux. C’est exactement ce qui s’est passé en 2013 à la fin des clauses de désignation, lorsque la majorité des branches a décidé de laisser courir l’accord tel qu’il était à l’origine, sans mettre en place une recommandation. C’est le cas par exemple de la branche de la coiffure, qui connaît une certaine vitalité, avec beaucoup d’opérateurs qui proposent des offres de riposte, voire des offres améliorées. Pour autant, les anciens organismes désignés ont réussi à maintenir leurs parts de marché. La branche des hôtels, cafés et restaurants a également joué la stabilité et n’est pas entrée dans le mécanisme de la recommandation. Pour autant, elle a laissé la concurrence s’exercer, selon le courtier April.

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Dans un contexte de fusion de branches, le gouvernement veut atteindre rapidement 200 branches professionnelles et à terme arriver à 100 branches. Moins nombreuses, elles seront plus robustes, leur pouvoir de négociation est également plus fort face à l’organisme assureur. Elles vont devoir harmoniser leurs régimes santé et prévoyance et les garanties dont bénéficient les salariés.

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Les branches ont choisi différents chemins :

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Les partenaires sociaux choisissent une ou plusieurs offres assurantielles, sans aucune contrainte pour l’organisme assureur. Celui-ci peut appliquer des tarifs différents et sélectionner ses entreprises adhérentes.

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Contrat de gré à gré entre la branche et l’organisme, qui n’est pas intégré dans l’accord de branche. Les organismes assureurs s’engagent à couvrir certaines garanties, à proposer certains services et à respecter un niveau de cotisations. Le régime est mutualisé et piloté par les partenaires sociaux.  En revanche, l’organisme n’est pas obligé de couvrir toutes les entreprises ni de mettre en place des actions de prévention dans le cadre du degré élevé de solidarité.

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La branche publie un appel d’offres et toutes les données relatives au régime de branche. Les organismes retenus sont obligés d’appliquer les mêmes tarifs à toutes les entreprises de la branche et ne peuvent pas sélectionner le risque. Ils sont également obligés de mettre en place des actions de prévention dans le cadre du degré élevé de solidarité. Lorsque l’équilibre technique du régime se dégrade, les partenaires sociaux peuvent faire un avenant au contrat afin d’augmenter la cotisation.

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Aésio est recommandé dans 32 branches en santé et dans 19 en prévoyance, majoritairement dans l’économie sociale et solidaire. Le groupe mutualiste distribuait jusqu’à 2018 les offres de Mutex. Lorsque Mutex est devenue une filiale du groupe Vyv, Aésio a décidé de produire ses propres offres, dans le cadre de Prévoyance Aésio Macif.

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AG2R La Mondiale accompagne 110 branches professionnelles, à travers 80 accords en prévoyance et 50 en santé. 80% de ses accords sont des anciennes désignations. Les 20% restant sont divisés entre la recommandation et la labellisation à parts égales.

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Selon Malakoff Humanis, présent dans 78 branches nationales et 88 branches régionales, « pour une branche majoritairement constituée de TPE, la recommandation constitue sans doute la meilleure solution en termes de mutualisation. C’est généralement la solution préconisée par les experts comptables, selon Nicolas Desormière, directeur des branches de Malakoff Humanis. Le risque principal de cette forme de mutualisation est le risque d’anti-sélection avec l’entrée en portefeuille de dossiers fortement sinistrés ».

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Les branches se professionnalisent

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Le tout n’est pas de remporter l’appel d’offres. Le véritable enjeu est le remplissage des régimes de branche car 90% des entreprises françaises ont moins de 10 salariés. Dans les branches où il y avait une désignation, les organismes recommandés couvrent environ 75% des entreprises de la branche. En revanche, pour les nouveaux régimes créés de toutes pièces, l’organisme retenu ne couvre qu’entre 15 et 25% des entreprises, selon un assureur de régime de branche.

Les branches qui fonctionnent sont celles où les employeurs et les salariés sont impliqués et prêts à faire des avenants pour augmenter les tarifs en cas de résultats techniques dégradés. La nouvelle génération d’accords de 2016 peine parfois à installer une mutualisation.

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« Par rapport aux négociations menées en 2015, nous constatons globalement que les partenaires sociaux ont davantage pris en compte dans les renouvellements le coût nécessaire pour distribuer les offres auprès des entreprises de la branche. Nos accords prévoient aujourd’hui des taux de chargement totaux de 11% à 15%, là où ils étaient jusqu’en 2020 dans une fourchette de 8-12% selon les risques prévoyance ou santé. Dans la réalité, nos chargements (frais d’acquisition, frais d’assurance, gestion des contrats…) s‘établissent en moyenne autour de 15% à 17% en collectif selon les risques et tous segments confondus, avec un niveau encore plus élevé si on se positionne sur le segment TPE qui constitue l’essentiel des mutualisations de branche. Nous avons donc réussi à équilibrer davantage le modèle en réduisant le déficit des ratios de gestion, mais cela nécessite toujours d’avoir des ratios techniques assez excédentaires pour viabiliser l’ensemble. Les partenaires sociaux et les actuaires conseil de branche ont intégré qu’il fallait consacrer davantage de moyens pour développer, défendre les régimes et préserver ainsi leur mutualisation », commente Jérôme Bonizec, directeur grands comptes directs, branches et partenariats de développement d’Apicil.

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« Les appels d’offres sont de plus en plus complexes et demandent de plus en plus d’investissement de nos équipes pour y répondre. Les branches sont également plus exigeantes en matière de qualité de données de pilotage, de simplicité dans la gestion, et d’investissement des forces commerciales en mode multicanal afin d’avoir le maximum d’entreprises qui entrent dans le régime de branche. En matière de distribution, avoir à la fois un réseau débout, un réseau d’agences et un dispositif de vente en ligne c’est un atout », indique Aude Viney.

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Une autre tendance récente, « Les branches s’autonomisent par rapport à leurs assureurs. Elles cherchent notamment à mieux maitriser leurs données. Cela peut passer par une distinction formelle entre l’opération d’assurance et la gestion. Les branches s’entourent également d’experts indépendants afin d’améliorer leur capacité de négociation vis-à-vis des assureurs », analyse Xavier Pignaud, avocat associé de Rigaud Avocats.

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Dans cette recherche d’autonomie, des branches ont mis en place des outils de pilotage. Par exemple, la branche de l’intérim a signé une convention de gestion avec S2H Consulting, filiale de Siaci Saint Honoré et gestionnaire de la branche, afin de calculer le nombre d’heures travaillées par les intérimaires auprès des différents entreprises de la branche. Dès lors qu’un salarié atteint les 414 heures, l’intérimaire accède au régime de frais de santé de la branche."Depuis 2015, avec l'arrivée de la recommandation, certaines branches préfèrent dissocier le portage du risque de la gestion. Cela permet de chercher de la performance sur le plan assurantiel et du service. En plus, cela donne de la pérennité du dispositif, car les branches peuvent changer d'assureur sans tout remettre en cause", affirme un courtier gestionnaire.

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« Notre choix c’est de construire des accords de branche intégrant des dispositifs de prévention sophistiqués et efficaces. Via le programme ‘Branchez-vous santé’, financé à hauteur de 2 millions d’euros par le Groupe sur 3 ans, nous proposons aux branches d’intégrer dans leurs accords des dispositifs de prévention autour de la prévention bucco-dentaire, de la récidive du cancer et de l’épuisement du chef d’entreprise », indique David Giovannuzzi. La moitié de nos entreprises clientes se sont déjà équipées de ce programme de prévention santé, soit 170.000 entreprises et 1,5 million de salariés. Et une vingtaine de branches ont écrit le programme de prévention dans l’accord de branche.

Dès lors que ces actions de prévention sont inscrites dans le marbre d’un accord de branche disposant d’un degré élevé de solidarité le rendant prioritaire sur l’accord d’entreprise, tous les organismes qui assurent les entreprises de la branche sont obligés de les proposer. À défaut, ils encourent, ainsi que les entreprises, « un réel risque juridique », selon David Giovannuzzi.

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« Certains opérateurs peuvent avoir tendance à complexifier beaucoup les garanties pour les rendre difficilement opérables part d’autres. L’excès de cette pratique pourrait être accusée de désignation déguisée. Le cas de la ‘carie du boulanger’ est connu de tout le secteur », signale un consultant du secteur.

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AG2R La Mondiale rétorque : « Notre motivation n’est pas d’empêcher la concurrence mais de réellement participer à l’amélioration de la couverture de protection sociale. Nous faisons de la prévention dans le champ de la santé publique et professionnelle ». AG2R La Mondiale a prévu d’enrichir son programme de prévention d’ici 2022, à commencer par un meilleur accompagnement des maladies chroniques.

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« La fin des clauses de désignation n’a pas conduit à une baisse significative de la mutualisation des régimes issues de ces clauses dans nos portefeuilles, elle a par contre handicapé fortement la constitution de nouveaux régimes lancés depuis. Nos régimes sont globalement en croissance, mais avec des taux de mutualisations très hétérogènes, de 15% à plus de 80% selon leur génération (régimes créés post-désignation ou ex-désignation). Concernant la crise économique et sanitaire actuelle, nous n’avons pas encore constaté massivement ses effets, notamment sur la portabilité en lien avec les défaillances d’entreprises, mais les branches ont su mobiliser les entreprises dans cette période sur l’intérêt de rester dans les régimes mutualisés bien plus solidaires que de simples contrats d’assurance ! », signale Jérôme Bonizec.

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April, acteur historique de l’assurance des professionnels, a bénéficié de l’ouverture à la concurrence sur le marché des branches. L'ANI a augmenté significativement le nombre d'accords de branches en santé (de 20 à 80). En revanche, en prévoyance, le nombre est resté stable, autour de 200 accords. « Nous avons observé un double phénomène : une montée en puissance de la recommandation grâce à la signature de nombreux accords accompagnée d’une ouverture à la concurrence avec la fin des désignations très contraignantes. Chaque branche présente des opportunités et il n’y a plus de branche où la concurrence ne puisse pas s’exercer », considère Catherine Charrier-Leflaive, directrice générale d’April Santé Prévoyance.

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« Le respect de la convention collective pèse sur les épaules du chef d’entreprise mais aussi de l’expert-comptable qui le conseille », selon David Giovannuzzi. Selon plusieurs observateurs, les prochains contentieux viendront du non-respect de la convention collective. Par exemple, en cas de décès du salarié, les ayants-droits pourraient se retourner contre l’employeur si celui-ci avait insuffisamment couvert le risque décès.

Les assureurs et courtiers prennent sérieusement ce risque juridique. « Une de nos principales forces est notre capacité à mettre en conformité, de façon très réactive, nos contrats par rapport à l'évolution de la réglementation et des accords de branche. Nous disposons d’offres modulaires et d’un parcours digital qui garantit la conformité des propositions qui sont faites aux entreprises par nos 15.000 courtiers partenaires. Nous avons également une vingtaine de gammes sectorielles dédiées qui complètent notre offre. D’ici la fin de l’année, nous avons prévu de nous lancer dans deux nouvelles conventions collectives : le transport routier et l’Afflec (Association des Fédérations des Détaillants en Fruits et Légumes, des Épiciers et Crémiers) », signale Catherine Charrier-Leflaive.

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En cette période de crise, les branches pourraient mettre en place, via le degré élevé de solidarité (DES), un système pour gérer la portabilité des droits des salariés en cas de liquidation judiciaire. L’arrêt 5 novembre 2020 de la Cour de cassation oblige l’assureur Groupama à prendre en charge le coût de la portabilité des salariés de la société Déménagement Transports Pupier en liquidation judiciaire dès lors que le contrat n’était pas résilié. « Cet arrêt est encore récent mais, dans les prochains mois, certaines branches pourraient se positionner car elles sont légitimes pour mettre en place un système mutualisé au bénéfice des salariés de la branche en cas de liquidation judiciaire », indique Xavier Pignaud.

Les partenaires sociaux peuvent également définir les catégories de salariés cadres et personnes assimilées pour venir mettre en place les couvertures prévoyance différenciés. Un décret est attendu au printemps prochain afin de donner ce nouveau rôle aux branches professionnelles.

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Les derniers mouvements dans les régimes de branche

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Sur quel critère une branche va changer de prestataire ? « Soit parce que la qualité de service n’est pas satisfaisante ; soit parce que le niveau de remplissage est insuffisant. La moitié des branches qui ont un contrat en 2015 affichent un taux de remplissage inférieur à 50% en santé », indique David Giovannuzzi.

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La branche Convention collective 66 regroupe des établissements pour accueil d’adultes et enfants handicapés. En 2020, cette branche de l'économie sociale et solidaire qui emploie 200.000 salariés, a renouvelé la recommandation après de Mutex, AG2R La Mondiale et Apicil en prévoyance. Malakoff Humanis, en partenariat avec Aésio, n’a pas accepté les conditions tarifaires de renégociation et est donc sorti de la recommandation. « Concernant la CCN 66, nous avons estimé que les conditions n’étaient plus réunies pour piloter le régime de façon pérenne. Constituer des réserves est essentiel pour permettre aux entrepreneurs de faire face aux aléas à venir. La crise que nous traversons en est une bonne illustration. Le régime doit être piloté de façon attractive, sécurisée et pérenne », indique Nicolas Desormière, de Malakoff Humanis.

Suite à cet appel d’offres, la fédération patronale Nexem a fortement communiqué auprès des entreprises de la branche pour les inciter à choisir un des organismes recommandés. « Nous avons accepté les conséquences de ce renoncement. La moitié des entreprises a suivi les recommandations de la branche et nous a quittés », admet Nicolas Desormière, directeur commercial de Malakoff Médéric. En sortant de la recommandation, l’organisme peut avoir une stratégie plus sélective et appliquer des prix plus avantageux pour les entreprises qui présentent une bonne sinistralité. « Sortir d’une recommandation ce n’est pas sans risque, notamment dans les branches avec une fédération patronale forte », souligne un observateur. Malakoff Humanis aurait perdu de l’ordre de 35 millions d’euros par an », selon ses calculs.

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L’appel d’offres de l’enseignement privé catholique

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La branche de l’enseignement privé catholique réunit 100.000 salariés en santé et 240.000 en prévoyance (les enseignants agents publics bénéficient en effet d’un régime spécifique). La branche a recommandé en 2015 quatre organismes en santé : Uniprévoyance, Mutex, AG2R la Mondiale, Humanis prévoyance . En prévoyance, la branche a décidé de laisser courir une ancienne désignation auprès d’Uniprévoyance, AG2R La Mondiale, Humanis prévoyance, APICIL, Arpège, Agrica.

Près de 90% des établissements ont adhéré au régime de branche en santé et 100% en prévoyance, selon la Confédération de l'enseignement privé non lucratif.

Un appel d’offres a été publié en 2021 pour renouveler la recommandation en santé et en 2022 ce sera le tour de la prévoyance.

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Interrogé sur les critères de choix dans l’appel d’offres en cours, il répond : « Nous ne souhaitons pas une protection sociale au rabais et voir les tarifs augmenter dans deux ans. Ce qui fera la différence ce sera la qualité de gestion et la qualité du reporting, car pour pouvoir co-piloter un régime, il faut qu’on ait les chiffres tous les trois mois. Certains organismes rencontrent des difficultés techniques pour nous faire remonter les statistiques. Ceux qui ne seront pas capables de nous fournir les chiffres dans les délais, on leur demandera de passer par un gestionnaire indépendant ou d’accepter des pénalités financières, car dans ce cas-là nous devons payer un actuaire conseil pour faire les calculs », indique Michel Quesnot, ancien président de Mercer France.

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La branche est en train de fusionner les 8 conventions collectives des différents types d'établissements privés catholiques. Cette fusion s’est passée sans encombre ni conséquences majeures pour les régimes santé et prévoyance. Le plus délicat sera la prochaine étape, qui consiste à réunir au sein d’un même régime les établissements associés à l’Etat par contrat avec les établissements privés non associés à l’Etat. Les tailles de structure sont totalement différentes, les populations à couvrir ont des spécificités différentes (âge, sexe, cumul d’emplois). A titre d’exemple les établissements de l’enseignement supérieur rémunèrent entièrement leurs enseignants alors que dans les premiers, les enseignants sont rémunérés par l’Education nationale. Difficile donc de mettre en place un régime unique.

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la branche, véhicule de solidarité

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Les branches ont mobilisé leurs réserves et leurs fonds de solidarité pour venir en aide des entreprises les plus touchées par la crise sanitaire. Cette période de crise a permis de montrer l’intérêt du régime de branche. Pour mettre en avant les actions de solidarité, les institutions de prévoyance ont créé même un événement « Campus des branches », initialement prévu en octobre 2020, et qui a été reporté au 2 juillet 2021.

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