French mutual insurer MGEN is fighting a government plan to strip the organisation of its role in managing mandatory state health insurance for 3.3 million teachers and civil servants.
The mutual provider's president, Matthias Savignac, publicly challenged the proposal on Monday, warning that transferring administration to France's national health insurance fund would fail to lower costs or improve efficiency.
Under the existing arrangement, affected public sector workers submit healthcare reimbursement claims directly through MGEN rather than dealing with the state agency. The current agreement governing this delegated service is scheduled to end on December 31, 2027.
Speaking at a press conference, Savignac said MGEN saw no economic rationale behind the proposed shift, adding that the government had not demonstrated how the move would benefit state finances or individual policyholders.
Costs and Operational Structure
MGEN receives 100 million euros annually from the state health insurance system to deliver the delegated coverage. Savignac explained that this payment is calculated based on the administrative expenses of the three best performing primary funds operating under the national health framework.
Because those top primary funds operate with high efficiency, Savignac argued that shifting 3.3 million policyholders into general state funds would not reduce public expenditure. He warned that moving members to standard primary funds would dilute them among regional offices that generally operate at higher management costs than MGEN.
MGEN, formally known as the Mutuelle Generale de l'Education Nationale, is the leading health insurance provider for French public education staff. In France, the national Social Security network provides mandatory statutory coverage, while approved mutual organisations like MGEN frequently manage state benefits alongside supplementary health policies for specific public sector groups.
Staffing and Technology Expenses
Around 1,000 MGEN employees currently handle the delegated mandatory health scheme across four operational centres in Montreuil, Lyon, Rennes, and Le Mans. Montreuil is located in the eastern suburbs of Paris, while Lyon, Rennes, and Le Mans serve as major regional centers in eastern, western, and northwestern France.
Out of the 100 million euros received for administering the service, the mutual must pay between 10 million and 15 million euros back to the state to access Cnam's new IT infrastructure, according to MGEN general director Christian Cochennec. MGEN reported total revenue of 3.1 billion euros in 2025.
Cnam, the Caisse Nationale d'Assurance Maladie, is the primary administrative agency overseeing public healthcare coverage across France. It coordinates a network of local primary health funds that process medical claims for millions of French residents.
Lack of Notification and Historical Roots
Savignac noted that MGEN and other affected mutual insurers have not yet received formal written notification of the plan from the government. MGEN was first informed of the initiative during a meeting with the Ministry of National Education held this summer, but received no further details following queries to the Ministry of Health or Matignon, the official office of the French prime minister in Paris.
The unique delegated arrangement dates back to the creation of the French Social Security system in the aftermath of World War II. When the national healthcare system was established in 1945, French teachers already possessed established mutual benefit societies and secured agreement to preserve their own dedicated health coverage structure within a single mutual provider.
