Caisse Primaire d’Assurances Maladie

With the increase in life expectancy, the development of medical progress and the improvement of pensions, Social Security soon found itself faced with financial difficulties. To deal with this, a 1967 ordinance established a separation into independent branches: sickness, family and old age. Each branch is then responsible for its resources and expenditure.

The reform adopted in 2004 by the Parliament aims to safeguard the health insurance system while preserving and consolidating its fundamental principles: equal access to care, quality of care and solidarity.

• The missions of a CPAM are as follows: Affiliate the insured persons and manage their rights to health insurance Process treatment sheets and provide service insurance disease and work accidents / occupational diseases (reimbursement of care, payment of daily allowances, advance of medical costs to beneficiaries of universal health protection [PUMA], etc.)
• Apply each year, in conjunction with health professionals, a risk management action plan
• Develop a prevention and health promotion policy (screening for cancers, impairments, etc.)
• Ensure a health and social action policy through individual aid to insured persons and collective aid for the benefit of associations. Each department in mainland France has at least one CPAM, but some departments have more than one. This is, for example, the case in the Nord department which has 4 CPAM (Lille-Douai, Roubaix-Tourcoing, Flanders, Hainaut) or in Pas-de-Calais which has two funds (Artois and Côte d ‘ Opal).
• There are 102 CPAMs. Its agents are not civil servants. They are employees of private law employed by organizations of private law. They are covered by several collective agreements, in particular the National Collective Labor Agreement for staff of social security organizations.
• The primary health insurance funds (CPAM) are registered with the higher council of the mutuality. This confirms their status as private law bodies.