CNAM, CPAM, and CARSAT are separate French social security organisations that share a united mission to offer support for life’s risks, including disability, work-related accidents, and occupational illnesses.
In this article, we will define and explain the distinct role of each organisation in an employment context.
Caisse Nationale de l’Assurance Maladie (CNAM)
The CNAM is the operational lead of France’s compulsory health insurance system (mutuelle). As such, its primary role is to drive national health insurance policy. The CNAM also leads, advises, and co-ordinates activities among the local bodies that form part of its network, such as the CPAM offices.
While French businesses should be aware of the CNAM’s function and purpose, most will have no need for direct contact.
Caisses Primaires d’Assurance Maladie (CPAM)
CPAMs are regional offices that process declarations of illnesses and accidents at work, as well as implementing risk management actions in partnership with healthcare professionals. They also pay healthcare-related benefits, including reimbursement of medical expenses and indemnités journalières, ordaily allowances.
There are around 100 CPAM offices across France. A person’s place of residence determines which one they are registered with.
A French employer might contact the CPAM to discuss issues relating to employee compensation while they are off sick. Their payroll provider will also contact the CPAM to organise direct payment of the indemnités journalières.
Caisses d’Assurance Retraite et de la Santé Au Travail (CARSAT)
CARSATs (or CRAMIF in the Paris area) are regional processing offices that deal with pensions and safety at work. They have three objectives relating to retirement and occupational health, which are:
- Preparing and paying for retirement via fund distribution.
- Supporting insured employees after a workplace accident.
- Preventing occupational risk and ensuring health and safety at work.
CARSAT officers target high-risk business activities and perform relevant interventions in companies and professional branches. They also train, document, and provide financial aid for the prevention of occupational risk.
The three rights of CARSAT officers
CARSAT officers wield a lot of power, so their actions must be taken seriously and assisted by the company as far as possible. In particular, they occupy a position of indisputable authority that takes the form of three rights:
- Right of entry. A CARSAT officer has the right to enter any company, at any time of day or night without prior notice, to perform an investigation or site visit.
- Right of investigation. CARSAT officers carry out investigations following accidents that have occurred on company premises. This could include tasks like general analysis, taking samples or performing noise-level measurements.
- Right of communication. During the course of their work, CARSAT officers may ask for access to specific company documents, such as:
- The fiche d’enterprise, drawn up by the occupational physician.
- The DUERP, a single document that assesses occupational risks.
- The register of observations made by the labour inspector.
It is a criminal offence for a French employer to refuse entry to their workplace, obstruct the investigation or refuse the CARSAT officer access to the company documents requested.
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