If you're already a micro-entrepreneur, or if you're thinking of becoming one, it's quite legitimate to wonder about your social security coverage. Every month or quarter, you'll have to pay social security contributions, depending on the nature of your business: craft, commercial or liberal. These contributions, intended for the various funds, guarantee your social protection, particularly in the event of illness, maternity, retirement and invalidity.
However, it's important to note that you won't automatically be covered for accidents at work (AT) or occupational diseases (MP). That's why you might ask yourself: is it necessary to take out voluntary accident and occupational disease insurance as a micro-entrepreneur?
What are workplace accidents and occupational illnesses?
As a micro-entrepreneur, your basic social security cover is limited to partial reimbursement of medical expenses and the payment of daily allowances in the event of absence from work due to illness (professional or otherwise).
If you decide to take out additional insurance to cover you against the risk of work-related accidents and illnesses, you'll benefit from extended coverage in the following situations:
- Accidents at work: Accidents at work are defined as all events resulting in physical and/or mental injury occurring in the course of your work at your place of work. Commuting accidents, such as going to and from work, or to and from lunch, also fall into this category.
- Occupational diseases: to be recognized as an occupational disease, it must be included in an official list drawn up by the French Social Security Code. It can also be classified as work-related if it results directly from your professional activity (exposure to toxic products, exposure to constant noise, handling of heavy loads, exposure to lead, etc.) and causes a permanent disability of at least 25%.
Individual voluntary insurance against accidents and occupational diseases is not compulsory, but it can prove invaluable, if not essential, for certain high-risk manual occupations, such as many professions in the construction, industry and transport sectors. Many accidents are linked to the use of machinery, and the agricultural sector is not exempt from risk. So it's up to you to make your own decisions, depending on your personal and professional situation.
Benefits covered by occupational injury insurance
In the event of a problem, you and your spouse (if they work regularly for your company) can take advantage of a number of significant benefits:
- In the event of permanent disability of less than 10%, a lump sum will be paid.
- If the permanent disability is equal to or greater than 10%, an annuity will be paid.
- In the event of death, funeral expenses will be covered and an annuity will be paid to the heirs.
What's more, the insurance provides full coverage (based on Social Security rates) for all general and special medical care, pharmacy, hospitalization, surgery, appliances, functional rehabilitation and re-education. Dental prostheses are reimbursed up to 150%.
Of course, these rights are only granted in the event of a proven work-related accident or illness.
How do I take out voluntary insurance against accidents and occupational diseases?
To benefit from this coverage, you need to apply to your Caisse primaire d'assurance maladie (CPAM). They will provide you with the cerfa 11227*03 form to complete.
A variable contribution must be paid to Urssaf, in advance and every quarter. This is calculated on the basis of your professional income and field of activity. You will therefore need to provide your annual salary as a basis for calculating contributions. The rate applied will be that of policyholders in the same line of business, less 45%. The average rate is currently 2.24%, but higher rates apply to occupations exposed to greater risks, such as construction. The applicable contribution rate is determined by the regional fund (Carsat, Cramif or CGSS).
It is important to note that there are ceilings to be respected. Your annual income must not be less than €20,049.09, nor exceed the social security ceiling (€43,992 in 2023).
In the event of a workplace or commuting accident, you must report it within 48 hours to your local Cpam, using the cerfa 14463*03 form.