Survey of Complementary Health Coverage Organisations (OC Survey) 2019 to 2021

The purpose of the DREES “OC” survey is to find out the activities of the organisations offering supplementary health coverage, the population they cover, the guarantees they offer, and their methods of pricing. The survey aims to describe as fully as possible the “heart” of the complementary health market, by asking organisations about their most subscribed contracts, individually and collectively. Since 2019, the scope of the contracts investigated has been extended to a representative selection of the ten largest collective and individual contracts The guarantee levels of contracts are theoretical amounts of reimbursement that each beneficiary is entitled to in case of use of care, and not actual reimbursements received by insured persons. The observed changes in the guarantees of the population may be the result of a change in the guarantees offered by the contracts but also of a change in underwriting behaviour. The published indicators are the maximum guarantees available to insured persons and not, as for the 2011-2016 and 2011-2019 (2011-2016 revised) series, guarantees associated with a given amount of expenditure.DREES"OC"调查旨在调研提供补充健康保险的机构的运营活动、服务覆盖人群、承保责任以及定价策略。 本次调查通过向相关机构问询其最受投保的个人与团体健康保险合同详情，尽可能全面地刻画补充健康保险市场的核心业态。 自2019年起，本次调查覆盖的合同范围已扩展至个人与团体健康保险市场规模前十的代表性合同样本。 合同承保责任水平指的是每位受益人在接受医疗服务时可获得的理论报销额度，而非参保人实际收到的报销金额。观测到的参保人群承保责任变化，既可能源于合同承保责任条款的调整，也可能源自承保行为的变更。本次发布的指标为参保人可享有的最高承保责任，而非2011-2016、2011-2019（2011-2016修订版）系列报告中所采用的、与特定支出额度挂钩的承保责任。