Alléger le coût des arrêts maladie : le gouvernement augmente la période de carence de 3 à 7 jours

The French government is undertaking a major reform concerning the management of sick leaves in 2025 by increasing the waiting period before daily allowances from Health Insurance are paid, changing this delay from three to seven days for private sector employees. This measure is part of a health economy approach aimed at containing the rising costs of work stoppages that significantly burden public finances. The initiative also involves a redistribution of responsibilities among the Health Insurance, companies, and their insurers, who may bear the economic consequences. Experts highlight the significant challenge this reform presents, both for the insurance system and for traditional protections, notably considering a strengthened reliance on supplementary health insurance and mutual health insurance to compensate for the loss of direct compensation through the public scheme. Moreover, debates raise the need for a balance between expense control and social protection, especially regarding social justice for the most vulnerable workers.

Many stakeholders, like the CFDT, have already expressed their reservations about a measure that risks leading to paradoxical consequences, potentially even worsening certain patterns of absenteeism. The reform also draws attention to occupational health and health prevention, key sectors where better coordinated actions could reduce the current dynamics of sick leave. This article will analyze in depth the content and expected impacts of this reform, confronting data, testimonials, and alternative proposals in 2025.

The stakes of increasing the waiting period from 3 to 7 days in sick leave

The proposed reform by the government extends the waiting period for sick leave compensation in the private sector, primarily aiming to reduce public expenditure related to Health Insurance. Currently, social security only pays daily allowances starting from the fourth day of sick leave, leaving the first three days unpaid. Extending this period to seven days means shifting the responsibility between the fourth and the seventh day, which could fall on employers and their private insurers.

This measure has several key implications:

• 💼 Strengthening companies’ responsibilities: They would be required to provide longer financial compensation, which could impact their operating costs.
• 👥 Possible increase in costs for employees: Employees without a favorable company agreement would face a greater income loss at the start of their sick leave, creating a risk of incentivizing private insurance coverage.
• 🏥 Impact on supplementary and mutual health insurance: The need for additional coverage would become crucial to cover days not paid by the Health Insurance.
• ⚖️ Balancing social control and protection: The debate centers on the appropriate balance between reducing public expenditure and ensuring social protection for active workers.

It is also noted that in the civil service, the current waiting period is one day, making the reform more significant for the private sector. The financial burden on companies is even greater considering many collective agreements provide for partial salary continuation after one week of absence, but through negotiated arrangements. A detailed analysis outlines the economic implications of this project in 2025.

📅 Waiting period	Currently in the private sector	Projected in 2025	Civil service	Key implications
Number of days	3 days	7 days	1 day	Delayed compensation period, transfer of costs
Indemnity coverage	Starting from the 4th day	Starting from the 8th day	Starting from the 2nd day	Reduction of costs for health insurance
Financial responsibility	Health insurance	Employers + private insurers	Health insurance / employer	Increased charges for companies and employees

Concrete examples of impacts on employees and companies

A large industrial company in Lyon has already prepared for this measure in 2025. They note that the new waiting period requires an additional financial effort equivalent to about 15% of their initial provident budget. Employees without supplementary health insurance risk a net loss that can reach several hundred euros per simple sick leave. Conversely, employees with a good mutual insurance and provident contract continue to receive almost complete compensation.

This change also encourages increased use of teleconsultation to shorten the duration and frequency of sick leaves. By facilitating access to medical services remotely, many companies consider this channel an essential lever to mitigate the financial impact of the reform.

Union and association reactions to the increase in waiting period

The increase of the waiting period from 3 to 7 days quickly drew reactions from several social actors. The French Democratic Confederation of Labour (CFDT) strongly opposed this project, highlighting social and human risks associated with the measure. Marylise Léon, head of the CFDT, stated on RMC that “being ill is not a choice,” reminding that extending the delay could lead to longer sick leaves and health complications.

Furthermore, accepting a heavier burden on employees seems complex in an already tense context where professional life and health intersect in an uncertain environment. Unions particularly fear:

• ⚠️ Worsening the financial situations of vulnerable workers without adequate health coverage.
• 📉 A risk of decreased quality of life at work and potential disengagement from occupational health.
• 🔄 A possible increase in long-term sick leave, contrary to the expected economic savings.

These debates revolve around the balance between strict social expenditure management and the right to protection: an enhanced health insurance or a more comprehensive mutual health insurance is often viewed as a mitigation tool but entails additional costs for the insured. CFDT calls for in-depth reflection and for health prevention measures alongside, rather than strictening, indemnification rules.

💼 Actor	Position	Key arguments
CFDT	Opposed	Illness is not chosen, risk of longer leaves, social injustice
Employers	Mixed	Additional cost but desire to reduce absenteeism
Government	In favor	Cost control, necessary cost transfer

Hausse du nombre de jours de carence des #fonctionnaires : "il faut cibler l’abus d’arrêts maladie et non les arrêts maladie eux-mêmes", estime @EmilieCChalas, ancienne députée LREM et rapporteure de la loi de réforme de la #FonctionPublique de 2019 https://t.co/vcR66TeTGf

— Bastien Scordia (@Bas_scordia) October 31, 2024

Economic consequences for companies and insurers

Delaying the payment of daily allowances from the eighth day of sick leave poses a major economic challenge. All companies, whether large or SMEs, potentially face increased costs related to their insurance contracts and the allowances to be paid to employees during this extended, public coverage-free period. The risk of rising contributions in this area is a particular concern for employers.

Here is an overview of the main economic issues:

• 🏢 Increase in provident costs: Private insurers must now cover an average of 4 additional days. This extra cost can be passed on to employer contributions.
• 💰 Increased pressure on companies’ cash flow: The need for financing longer sick leaves at their expense can deteriorate financial stability.
• 🔄 Changes in collective bargaining negotiations: Sector agreements and company conventions will need to be renegotiated to incorporate this new reality.
• 📉 Potential impact on employment: In certain sectors, additional costs could hinder local hiring or encourage optimizing occupational health to reduce absenteeism.

According to several analysts, the measure might in some cases curb abusive absenteeism practices but also carries the risk of weakening already vulnerable employees without adequate coverage.

💼 Category	Situation in 2024	Projected in 2025	Financial impact
Large company	Provident limited to 3 days	Responsibility extension to 7 days	Additional cost of 10-15%
SMEs	Variable company agreement	Necessity to renegotiate contracts	Increased administrative and financial costs
Private insurers	Standard management	Revisions to coverage and premiums	Increase in contributions

The enhanced role of supplementary health insurance and mutual health insurance

The extension of the waiting period highlights the crucial importance of supplementary schemes, especially health insurance and mutual health insurance, within the current social protection landscape. For employees, subscribing to an appropriate mutual health plan or a more comprehensive coverage becomes an essential lever in face of public coverage now being delayed.

The consequences are manifold, including:

• 🔑 Increased financial protection: Mutual health insurances play a central role in providing supplementary compensation during sick leave, thus reducing salary losses.
• 💡 Diversification of offerings: There is a move towards higher-end contracts, with integrated services like teleconsultation or wellness and health prevention programs.
• ⚖️ Balance between cost and coverage: The challenge for insured individuals is choosing adequate coverage without excessively increasing contributions.
• 📈 Increase in coverage options: Some mutual insurances immediately affected by this reform are improving their offers to meet growing insured expectations.

This increased focus on mutual health and health insurance fuels a trend toward telemedicine, with teleconsultation emerging as a strategic tool for effective and accessible medical follow-up.

🛡️ Coverage	Advantages	Challenges	Associated services
Mutual health insurance	Complete coverage, access to care	Cost of contributions	Teleconsultation, health prevention, wellness
Provident insurance	Guarantees income during long-term absence	Sometimes high premiums	Personalized support

Example of integrating teleconsultation into care management

A Parisian SME has integrated a teleconsultation service for its employees to optimize sick leave management. This service has enabled faster assessment of symptoms, appropriate medical guidance, and often a reduction in leave durations. Thus, employees benefit from easier access to the medical service, strengthening their engagement in an effective health prevention process.

The implications for occupational health and health prevention

The reform of the waiting period revives the discussion on the need to deepen actions in occupational health and health prevention. While the government aims to mechanically reduce the cost of sick leaves, professionals believe that prevention-focused strategies could truly limit the frequency and duration of absences.

Among the preferred avenues are:

• 🩺 Well-being programs at work: Integrating wellness and regular workshops to promote psychological and physical health.
• ⚙️ Improvement of working conditions: Reducing risks of accidents and occupational diseases.
• 📋 Close monitoring by medical services: Better coordination between employers, employees, and health professionals.
• 🔄 Increased use of technological innovations: Teleconsultation, absence tracking software, and personalized support.

A recent review highlights that companies investing in these areas see a significant decrease in absenteeism, contributing to cost control and improved social climate.

🔍 Action	Objective	Observed result	Economic impact
Wellness workshops	Improve overall health	Absence reduction by 15%	Lower sick leave costs
Medical monitoring	Detect risks	Reduction of long-term absences	Cost savings
Teleconsultation	Quick access to care	Optimization of leave durations	Better expense management

Impact on public expenditures and Social Security accounts

The government aims, through this reform, to lighten the heavy financial burden on Social Security, estimated at several billion euros annually due to sick leaves. The increase in expenses, around 16 billion euros in 2022, is seen as a critical issue requiring action on the indemnity schemes.

The extension of the waiting period could, according to the Ministry of Public Accounts, save up to one billion euros in savings—a short-term goal to support public finances. However, this measure should not be considered in isolation. Indeed:

• ⚠️ It alters the division of costs among health insurance, companies, and employees.
• 🛠️ It requires the immediate implementation of additional health prevention actions.
• 🔍 It must be accompanied by strengthened medical control and monitoring to prevent abuse.

In a context of rapidly rising healthcare costs, the reform nevertheless raises questions about its ability to reconcile economic efficiency with social equity, and it opens the way to other proposals for labor law and unemployment insurance reforms, some of which are recent and controversial. A detailed analysis outlines the economic implications for the health system.

The reform compared to other solutions considered to combat absenteeism

Beyond extending the waiting period, several other avenues are discussed to address the complex issue of absenteeism in companies and the rising costs of sick leaves:

• 📅 Limiting the maximum duration of prescribed sick leaves.
• 📊 Establishing a mandatory public order waiting day, unpaid by both Health Insurance and employers.
• 🤝 Strengthening monitoring and medical control mechanisms.
• 🏢 Implementing targeted occupational health measures to promote employment retention.
• 🏥 Developing teleconsultation for better management of prescriptions and absences.

These options are already under consideration within the government, while unions and associations are calling for prioritizing health prevention and establishing a Bayou plan to address the growing deficit of Health Insurance. The question of a broader reform thus arises, particularly in 2025. A thorough reflection on these alternative solutions emphasizes their stakes and limits.

✅ Proposed solution	Main objective	Advantages	Potential limitations
Limiting leave duration	Reduce costs of long sick leaves	Control over indemnities	Risks of medical subcontracting
Public order waiting day	Cost transfer	Targeted savings	Impact on vulnerable workers
Strengthened medical monitoring	Limit abuse	Better control	Administrative costs
Occupational health actions	Prevent diseases	Decrease in absences	Initial investment

Ethical and social issues of the sick leave reform

The reform raises a fundamental debate on solidarity and social protection. The approach of increasing the waiting period, while aiming for economic balance, questions the collective responsibility towards workers in difficulty.

Several key points stand out in this context:

• 🤔 The risk of penalizing the most financially fragile, especially those who lack appropriate health coverage.
• ⚖️ A possible widening of social divides among worker categories based on access to provident coverage.
• 👨‍⚕️ The importance of an impartial and accessible medical service to guarantee fair diagnosis and safeguard rights.
• 💬 The need to promote general health prevention as a foundation for a sustainable and equitable system.

Trade associations call for avoiding a decision that would place the financial burden of absence solely on the employee. Others suggest strengthening risk mutualization through cooperative mechanisms to ensure a more solidaric health economy.

FAQ – Frequently Asked Questions about the sick leave waiting period reform

• ❓ What is the sick leave waiting period?
  The waiting period is the time between the start of the sick leave and the payment of daily benefits by Health Insurance.
• ❓ What is the impact of increasing from 3 to 7 days?
  This increase postpones the date from which employees can receive compensation, shifting part of the costs to employers or employees via their mutual insurance.
• ❓ Who is affected by this reform?
  Mainly private sector employees; civil service retains a distinct regime with a one-day delay.
• ❓ How should companies adapt?
  They will often need to renegotiate their provident agreements and anticipate higher costs in their health budget.
• ❓ Can teleconsultation help to limit sick leaves?
  Yes, by facilitating quick access to medical services, it contributes to better monitoring and potentially shorter sick leaves.

Source: www.midilibre.fr