The rapid implementation of these measures required the French social security institutions to be responsive, adaptable and flexible. The result demonstrated the high level of commitment from institutions to ensure the protection of the population, and how the various branches of social security could work together to implement emergency measures.

Social security measures

• Health insurance - automatic extension of benefits for vulnerable groups, including for persons with chronic conditions and those receiving state medical aid and reimbursement of telemedicine consultations with medical professionals. The health insurance systems also made a significant financial contribution to the purchase of medical equipment and protective gear for hospitals. Special payments were made to medical staff for working overtime and risk exposure during the emergency response.
   
• Work injury and occupational diseases – COVID-19 was recognized as an occupational disease for medical staff, which increased their protection levels to full income replacement and reimbursement of medical expenses.
   
• Employment promotion – special measures to compensate partial unemployment and emergency coverage for technical unemployment. By mid-May, 12 million employees - equivalent to two-thirds of salaried workers or one-third of the national labour force - benefitted from these programmes and received up to 84 per cent of net salary within the limit of 4.5 times the social security ceiling. These measures were accompanied by a simplification of requirements for employers and the extension of coverage and special regulations allowing income replacement of up to 100 per cent for certain groups.
   
• Contribution collection – deferral of contribution payments and cancellation of contributions for very small and vulnerable companies. These measures reached 830,000 companies and 460,000 self-employed workers. They complemented the partial unemployment measures as a means to further reduce business costs.
   
• Family and other social benefits – exceptional parental leave entitlements for child-care during the period of school closures, the suspension of collection activities for benefit overpayments during the crisis period, and the pre-payment of some benefits.
   
• Coverage and flexibility – targeted measures for certain groups, including the waiver of the usual social security coverage waiting period of three months for repatriated French citizens living abroad.

Operational measures

In order to implement emergency measures, meet a large increase in demand, ensure continued equal access to services for all clients while ensuring the safety of staff, social security institutions had to adapt and implement a series of special approaches.

• Continued customer service tailored to the needs of clients – establishment of flexible timetables, the use of digital channels and a significant reliance on call centres for customers not using digital tools.
  
  While the National Family Allowances Fund (Caisse nationale des allocations familiales – CNAF) leveraged existing portals, the National Sickness Insurance Fund (Caisse nationale de l'assurance maladie – CNAM) extended its chatbot service and the National Old-Age Insurance Fund (Caisse nationale d'assurance vieillesse – CNAV) launched daily video-conference programmes dedicated to seniors as well as telephone campaigns to reach out to vulnerable retirees.
  
  The contribution collection agency deployed FAQ tools and chatbot applications to provide the self-employed with information on contribution collection and social benefits.
   
• Adapting procedures and controls – prioritization was given to benefit payments over the strict enforcement of administrative requirements. Control procedures regarding delayed contribution payments and benefit overpayments were eased considerably and the renewal procedures for the extension of certain benefits for vulnerable populations were waived. The CNAM simplified a number of processes in order to ease access to sick leave and childcare leave benefits. The CNAF empowered call-centre staff to perform certain operations on behalf of customers.
   
• Implementing changes to working methods – massive adoption of teleworking for all back-office and management staff. This required ensuring remote access to business tools as well as the strengthening of IT security measures. Most call-centre staff of the CNAF and the CNAM have also been teleworking.
   
• Communication – special communication measures using radio, web portals and FAQs through various means to inform the public on the pandemic and emergency measures as well as outreach to vulnerable population groups.
   
• Inter-institutional coordination – enhanced collaboration and coordination between institutions to implement exceptional measures and new benefits. The CNAF and the Central Fund of Social Agricultural Mutual Benefit Societies (Caisse Centrale de la Mutualité Sociale Agricole – CCMSA) implemented a temporary cash benefit for four million vulnerable families. Going beyond their normal mandate, the two institutions demonstrated how important social security institutions are in the delivery of services in emergency contexts. In the coming months, the CNAM will play a key role in the control of a potential second wave of COVID-19 by coordinating the identification of new cases and their potential contacts. This involves important logistical efforts and the management of highly sensitive personal information.
   
• Solidarity initiatives – social security institutions and their staff demonstrated the value and importance of solidarity during the crisis. For example, local agencies granted leave days to front-line hospital staff, they contributed to community initiatives such as food baskets for vulnerable people and the donation of reserves of gloves and masks to caregivers.

Conclusion

The French experience once again demonstrates the value of social security as a buffer during a crisis. The capacity, flexibility and commitment of the French social security institutions enabled the government to secure the impact of its measures for individuals, the society and the economy. The investment in digital services emerged as an area of strategic importance.

Social security measures to respond to the COVID-19 crisis came at a significant cost including more than EUR 26 billion to provide partial unemployment benefits and EUR 41 billion for other social measures. These resulted in a deficit of about €52 Billion, in contrast to the global financial forecast at the beginning of this year.

As France has entered in the process of gradually lifting the restrictions related to COVID-19, the strategy to protect, test and isolate will continue to depend on the active involvement of social security institutions. At the same time, social security institutions are gradually adapting their approaches to customer services and human resources in a context of uncertainty. Undoubtedly, some of the measures implemented during the crisis will have a long-term impact on service delivery and operational processes.