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Presentation of the “Mutuelle Générale de l'Education Nationale” (MGEN). Origins of the MGEN. The MGEN from the 19 th century to 1946 : - PowerPoint PPT Presentation
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Presentation of the “Mutuelle Générale de l'Education Nationale” (MGEN)
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Origins of the MGEN
The MGEN from the 19th century to 1946:
Schoolteachers created 132 friendly societies or “mutual aid societies”, with a limited geographical scope (1 or 2 districts or “départements”), to cover a range of specific risks relating to:
Death
Incapacity
Illness
Orphanhood
Retirement
Saving
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The origins of the MGEN MGEN
From 1946:
At the proposal of the national schoolteachers’ union, the 132 friendly societies merged into a single national mutual insurance society, the MGEN.
A social security system was set up for all wage-earners in France. The law entrusts the MGEN with the management of the social security of all public
employees of the national public education system (“Education Nationale”) The MGEN manages social security and provides additional (complementary) “second-
level” health and social welfare protection.
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The mission of the MGEN
MGENManagement of healthcare insurance scheme under
the social security system
StateSocial welfare insurance
for public employees
MGEN Health and social welfare complementary
insurance scheme
Compulsory
Optional
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Tasks entrusted to the MGEN
Public-service tasks
Management of social security: 83 million treatment forms (“feuilles de soins”)
2.89 billion euros worth of healthcare services provided under the compulsory regime (“Régime obligatoire” – RO)
Management of the State’s participation in covering social risks
Participation in ministerial welfare policies
Management of the services provided by the mutual insurance society
Health
Social welfare, assistance for dependants and other supplementary social protection services and benefits
Healthcare: 1.5 million days of care, visits or consultations in our 33 healthcare and social welfare centres
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The MGEN population
1946 – 2009:
The MGEN has developed on the basis of solidarity principles and is today one of the largest mutual insurance societies in France.
1946: 200 000 members
2009: 3 000 000 people protected.
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Basic mutual insurance principles of the MGEN:
Membership is on an individual, voluntary basis
Members have responsibility : all decisions are discussed and voted on by the General Assembly.
Non-profit-making
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Our basic value: solidarity
Contributions are proportional to income
We offer a comprehensive range of services.
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The MGEN: Healthcare based on a service-oriented approach
Assistance and support provided to MGEN members:
1.05 billion euros worth of healthcare services provided under the complementary health insurance scheme (Régime complémentaire” – RC)
Annual turnover in 2008: 1.6 billion euros, including contributions and the turnover of our healthcare centres
A policy based on national agreements governing hospital- and dental-care service contracts (“conventionnement”)
An innovative approach to the provision of optical healthcare under national agreements (closed network)
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Healthcare: Social security and MGEN services and benefits (2008)
BENEFITS & SERVICES
Social Security
(in €)
MGEN
(in €)
SS share
(as %)
MGEN share
(as %)
Illness 2 087 506 288 638 823 676 76.6 23.4
Medical fees 596 603 915 194 782 309 75.4 24.6
Prescriptions 1 329 482 255 429 496 061 75.6 24.4
Pharmaceuticals 814 281 843 274 233 806 74.8 25.2
Other 161 420 118 14 545 306 91.7 8.3
Dental care 146 930 837 159 608 624 47.9 52.1
Prostheses 51 651 995 125 133 051 29.2 70.8
Optical healthcare 8 796 488 98 013 334 8.2 91.8
Hospitalisation 606 314 067 151 270 049 80.0 20.0
Maternity care 38 637 254 3 009 172 92.8 7.2
Total 2 888 184 934 1 050 724 855 73.3 26.7
Total for services and benefits provided (Social Security + MGEN) 3.94 billion euros
Source: MGEN Annual Report 2008
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Healthcare: Social security and MGEN benefits (2008)
Benefits paid under the social security system: €2.89 billion Benefits paid by MGEN: €1.05 billion
Source: MGEN Annual Report 2008
Illness 72.3% Hospitalisation + maternity 22.3% Optical + dental 5.4%
Illness 60.8% Hospitalisation + maternity 14.7% Optical + dental 24.5%
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Overview of MGEN benefits (2008)
Total MGEN benefits: €1.2 billion
Source: MGEN.Annual Report 2008
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The MGEN also provides….
Other products and services:
A range of products and services to help members meet their housing needs: Loan to set up or move to a new home (“Prêt installation”) Deposit guarantee to rent or buy accommodation Loan insurance
A comprehensive range of personal services, particularly for persons with diminished autonomy
A supplementary retirement scheme: COREM (“Complément de retraite mutualiste”)
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The MGEN also provides….
Subsidies to finance medical research : “Institut national de la santé et de la recherche médicale” (National Institute for Health and Medical Research – INSERM), Institut Pasteur, “Centre national de la recherche scientifique” (National Centre for Scientific Research – CNRS), etc.
A partnership with the French Ministry of National Education to develop and implement social welfare policies
The organisation and funding of preventive-healthcare and health-education actions
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The MGEN comprises….
9 319 employees
Including 4 607 in healthcare centres
More than 91 000 hours of training provided every year
1 national headquarters
1 information technology production centre
1 information technology research centre
101 district branches (“sections départementales”) throughout France
8 specialised treatment centres
1 management unit for specific services
4 call centres
33 hospitals
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The MGEN relies on a team of…
Active members:
- 13 members of the national headquarters
- 60 national administrators
- 473 membership delegates to the General Assembly(2010)
- 266 branch directors and managers
- 2524 active members elected to the branch committees
-15 000 correspondents of the association
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“Education and Solidarity” network
Montparnasse Institutefor Social Protection
MGEN co-founder
MGEN founder
Organisation of the MGEN Group
MGEN
Holding
MGENHealthcare centres
EGAMOAsset management
subsidiary
MGEN Filia MGENPublic Health
Foundation
UMRRetirement insurance
benefits
MGENManagement of compulsory
medical insurance(mandated by the
Department of social security)
The MGEN Group
MGENMutual insurance society
for complementary health
and social welfare protection
The international development of MGEN
MGEN action to ensure the durability of the mutual model
Manage the social protection of our mutual members when they live and work abroad: the SEM
Develop the provision of MGEN services in other countries: Europamut in Portugal
Mobilise to defend the interests of MGEN and its members at the European level
Take action to develop the mutual model worldwide and ensure its durability: the Education and Solidarity Network.
« Mutual insurance system, transmitter of movement, humanism and solidarity is our
difference »
Thierry BEAUDET, President
Rapport moral 2009