French Employment Definitions: CNAM, CPAM, and CARSAT

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When a British company decides to employ people in France, they may suddenly find themselves faced with a confusing host of employment-related acronyms and jargon (as is the case in every country!)

In this article, we will define and explain the roles of three employment stakeholders in France: the CNAM, CPAM, and CARSAT. 

All three are organisations that make up the ‘general branch’ of the French social security system.  They have a united mission to offer support for life’s risks, including disability, work-related accidents, and occupational illnesses.

Caisse Nationale de l’Assurance Maladie (CNAM)

Mutuelle health insurance is mandatory for salaried employees in France.  So although most businesses will not have much direct contact with the CNAM, as the national fund for health insurance they will certainly need to be aware of it.

The role of the CNAM is to define national health insurance policy, as well as leading, advising, and co-ordinating activities among the local bodies that form its network, such as the CPAM.

Caisses Primaires d’Assurance Maladie (CPAM)

Where the CNAM is national, the CPAM is regional.  There are around one hundred CPAM offices in France (a person’s place of residence determines which they are registered with), and their responsibilities include:

  • Processing declarations of illness and accidents at work.
  • Paying healthcare-related benefits, including reimbursement of medical expenses and indemnités journalières (daily allowances).
  • Implementing risk management actions along with healthcare professionals.
  • Refining and improving accident prevention and health promotion policies.

A French employer may contact the CPAM to discuss issues related to employee compensation whilst they are off sick.  The company’s payroll provider must also contact the CPAM to arrange payment of the daily allowances.

Caisses d’Assurance Retraite et de la Santé Au Travail (CARSAT)

CARSAT (or CRAMIF in the Paris area) are powerful regional processing offices that deal with pensions and safety at work.  They have three objectives that relate to retirement and occupational health, which are:

  • Preparing and paying for retirement through fund distribution.
  • Supporting insured employees following a workplace accident.
  • Preventing occupational risk and ensuring health and safety at work.

As such, CARSAT target high-risk activities, performing relevant interventions in companies and professional branches.  They also train, document, and provide financial aid for the prevention of occupational risk.

What specific powers do CARSAT officers have?

CARSAT officers have an indisputable position of authority that gives them the right to enter any company, at any time of the day or night and without prior notice, to carry out a workplace visit or investigation.  

They may also carry out an investigation following a specific accident at work, which might include tasks like general analysis, taking samples or performing noise-level measurements.  During their work, CARSAT officers may ask for access to certain documents, including:

  • The fiche d’entreprise, which is drawn up by an occupational physician.
  • The DUERP, a document that assesses occupational risk.
  • The register of observations made by the labour inspector.

Employers are obliged to allow the CARSAT officer access to these documents, or face an offence of obstruction. 

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