Presentation of the Mutuelle Générale de l Education Nationale

Presentation of the “Mutuelle Générale de l'Education Nationale” (MGEN) 1

Origins of the MGEN The MGEN from the 19 th 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 2

The origins of the 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) “secondlevel” health and social welfare protection. 3

The mission of the MGEN Health and social welfare complementary insurance scheme MGEN Management of healthcare insurance scheme under the social security system State Social welfare insurance for public employees Optional Compulsory 4

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 5

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: 2009: 200 000 3 000 members people protected. 6

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 7

Our basic value: solidarity Contributions are proportional to income We offer a comprehensive range of services. 8

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) 9

Healthcare: Social security and MGEN services and benefits (2008) Total for services and benefits provided (Social Security + MGEN) 3. 94 billion euros BENEFITS & SERVICES Social Security (in €) MGEN (in €) SS share (as %) MGEN share (as %) 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. 4 814 281 843 274 233 806 74. 8 25. 2 161 420 118 14 545 306 91. 7 8. 3 146 930 837 159 608 624 47. 9 52. 1 51 651 995 125 133 051 29. 2 70. 8 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 2 888 184 934 1 050 724 855 73. 3 26. 7 Illness Pharmaceuticals Other Dental care Prostheses Optical healthcare Total Source: MGEN Annual Report 2008 10

Healthcare: Social security and MGEN benefits (2008) Benefits paid under the social security system: € 2. 89 billion Illness 72. 3% Hospitalisation + maternity 22. 3% Optical + dental 5. 4% Source: MGEN Annual Report 2008 Benefits paid by MGEN: € 1. 05 billion Illness 60. 8% Hospitalisation + maternity 14. 7% Optical + dental 24. 5% 11

Overview of MGEN benefits (2008) Total MGEN benefits: € 1. 2 billion Source: MGEN. Annual Report 2008 12

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”) 13

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 14

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 15

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 16

Organisation of the MGEN Group The MGEN Group MGEN co-founder “Education and Solidarity” network MGEN founder Holding MGEN Management of compulsory medical insurance MGEN (mandated by the Mutual insurance society Department of for social security) complementary health and social welfare protection MGEN Healthcare centres EGAMO Asset management subsidiary MGEN Filia Montparnasse Institute for Social Protection MGEN Public Health Foundation UMR Retirement insurance benefits 17

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