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Home
About
I am an individual
Car Insurance
Motorcycle Insurance
Home Insurance
Complementary Health
Insurance and health solutions
Loan insurance
I am a professional
Collective mutual insurance
Professional civil liability
Vehicle fleets
Ten-year guarantee
I am an expat
International health insurance and Schengen Visa
Blog
Français
Home
About
I am an individual
Car Insurance
Motorcycle Insurance
Home Insurance
Complementary Health
Insurance and health solutions
Loan insurance
I am a professional
Collective mutual insurance
Professional civil liability
Vehicle fleets
Ten-year guarantee
I am an expat
International health insurance and Schengen Visa
Blog
Français
Collective Mutual
Quote
sheet
Name of representative
*
Representative’s first name
*
Representative phone
*
E-mail address
*
Number Siret
Company Name
*
Postal code
City
*
Are you affiliated to a collective agreement?
No
Yes
If yes, indicate your IDCC number
Enter your NACE code
( le code NACE est indiquée sur la fiche de salaire )
Is there a unilateral decision by the health and welfare employer?
No
Yes
If yes, check (if modification or implementation.)
Modification
Set up
Indicate the date of entry into force of the decision
Indicate the share of distribution of the contribution in %:
Employer's contribution
Salary Share
Who will be insured?
Choose...
1 - All staff
2 - The executives
3 - Non-executives
Would you also like to subscribe to a pension plan?
No
Yes
Number of executives
Average age of executives
Number of non-executives
Average age of non-executives
Number of children dependent on staff
Common medicine consultation
Base level
Average level
High level
Hospitalization
Base level
Average level
High level
Optical
Base level
Average level
High level
Dental
Base level
Average level
High level
Do you currently have health coverage?
No
Yes
Si oui est ce que vous l’avez depuis plus de 12 mois ?
No
Yes
Indicate the anniversary date of your contract.
Enter additional information if necessary
Send me a quote
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