Opting for the Employers' Mutual Insurance

For self-employed persons, the Employers' Mutual Insurance (Mutualité des employeurs - MDE) pays a replacement income while cash benefits from the National Health Fund (Caisse nationale de santé - CNS) are suspended. Entry to the MDE is voluntary.

Persons concerned

Self-employed persons along with their assisting spouse/partner, where applicable.

How to proceed

Voluntary entry to the MDE

Self-employed workers may register voluntarily with the MDE using the 'Application for voluntary entry of non-employees to the Employers' Mutual Insurance' form. Voluntary entry for self-employed workers also covers their assisting spouse, if they are affiliated as such. Assisting spouses are not able to register in the MDE solely in their own right, however.

The insurance takes effect from the start of affiliation for all social security risks, provided the application is made no later than 3 months after the affiliation starts.

For self-employed persons already affiliated with social security for more than 3 months and who submit an application during the year, entry to the scheme will take effect from 1 January the following year.

End of voluntary entry

Voluntary entry to the MDE ends:

• when the insured submits a written declaration. In this case, voluntary entry ends on the final day of the month in which the written request for cancellation is received. A new entry is only possible from the following 1 January;
• following non-payment of 2 successive contributions;
  
• if the self-employed person cancels their affiliation. In this instance, the voluntary entry automatically ends on the date of the cancellation.

Contributions for the MDE

Contributions are calculated using the same contribution base as the one used for calculating cash benefits. Contributions appear alongside the other (compulsory) social security contributions on the monthly account statement.

Contribution rate and financial absence rate

Members are divided into 4 contribution classes depending on their financial absence rate. All new members pay class 2 contributions.

The contribution classes and financial absence rate are set out in the Articles of Association of the MDE. They are determined before 1 December of the current year for the coming fiscal year.

Reimbursement

Reimbursements from the MDE are made by the Social Security Centre (Centre commun de la sécurité sociale - CCSS).

While sickness cash benefits from the National Health Fund (Caisse nationale de la santé - CNS) are suspended (the first +/- 77 days of temporary incapacity for work), the Employers' Mutual Insurance reimburses 80 % of the contribution base applied when the incapacity for work starts. During this period, the MDE also fully covers:

• leave for family reasons;
• family hospice leave.

Any period of incapacity for work must be justified by a medical certificate.

If the period for which benefits are paid is less than one month, every day of incapacity for work corresponds to one thirtieth of a month. If the period for which benefits are paid lasts an entire month, it is deemed to be 30 days. This number of days applies to all calendar months.

The amount to be reimbursed is shown as a credit on the self-employed person's monthly statement for the month in question.

Any subsequent amendment of the contribution base means the MDE reimbursement must be recalculated.

The MDE reimbursement for self-employed workers is based on their average monthly income. This average monthly income corresponds to 30 working days per month. Please find below an example of an MDE reimbursement calculation.

 

 

Example calculation:

A self-employed worker registered with the MDE with an annual income of EUR 36,000 has a 6-day incapacity for work period in January 2021. This is how the reimbursement from the MDE is calculated for this 6-day incapacity for work period:

•  Average monthly income: EUR 36,000 / 12 = EUR 3,000
• Daily base: EUR 3,000 / 30 = EUR 100.00
• Reimbursement amount: 0.80 x EUR 100.00 x 6 = EUR 480.00

Forms