How does sick leave for the self-employed work?
As a freelancer, you are wondering how a sick leave works? It is true that the status of freelance does not provide the same protections and guarantees as the salaried employee.
In case of illness, the procedures, daily allowances and waiting days are different. It is normal to want to anticipate all the modalities to face it, in case of compulsory sick leave (which we do not wish you!).
In partnership with the Mutuelle GSMC, discover how a sick leave is done as a self-employed person, the steps to follow and the reimbursements granted ! At the end of the article, you will also find some advice to optimize your health protection and anticipate all the possible cases. Enjoy your reading!
Conditions for receiving daily allowances in case of illness
Even if you take good care of your health, you are not immune to falling ill or being hospitalized. In this case, you will have to consult a doctor and have a work stoppage issued to you.
As a freelancer, you are therefore attached to the SSI (Sécurité Sociale des Indépendants), formerly the RSI. In order to receive benefits, you must respect certain conditions:
- To exercise an activity of craftsman, trader or service provider.
- Be in activity or in maintenance of right at the time of the stop.
- Be up to date on all your Health Insurance contributions (check your URSSAF online account, you must not have any contributions in “Due dates”).
- Have been affiliated to the SSI for at least 1 year.
Steps to take in case of sick leave
As a freelancer, to be able to benefit from daily allowances in case of sick leave, you must :
- Check that the medical reason written on the sick leave is correct. If not, your sick leave may be rejected.
- Send your SSI part 1 and part 2 of the sick leave within 48 hours of the consultation.
It is by following these steps that your sick leave as a self-employed person will be validated and will trigger your rights.
The duration of the payment of sick leave benefits
The duration of the payment of the daily benefits varies according to the length of the work stoppage:
- For a sick leave of less than 6 months: you are entitled to 360 days of benefits (if you work full time), and 90 days if you work part time.
- For a sick leave of more than 6 months : in case of a long term illness, you can receive daily allowances up to 3 years (and 270 days in case of therapeutic part-time work).
Good to know: there are waiting periods. The daily allowance for the self-employed is paid from 4e day in case of hospitalization, and from the 8th day in case of sick leave.
The method of calculation of daily allowances
Do you want to know how much support you will get if you are sick as a self-employed person? The SSI divides your average income over the last 3 years by 730, up to the annual social security ceiling.
- If your average income is higher than 3 806.80€, the daily allowance will be between 5.21€ and 53.74€.
- If your average income is less than 3 806.80€, you will not receive any indemnity as a micro-entrepreneur.
Please note: in the case of part-time work, the daily allowance is reduced by half.
Let’s take 2 concrete examples to know how to calculate your rights:
- Let’s say you have an average income of 10 000€ over the last 3 years. The calculation is as follows: 10 000/730 = 13.69€ of benefits per day.
- If you have an average income of 45 000€ per year over the last 3 years, the calculation is: 45 000/730 = 61.64€. The limit is 53.74€, so you will receive 53.74€ per day.
Obligations to respect during a sick leave
On your sick leave, the doctor will define your rights and hours of leave. This obviously depends on the health problem encountered.
To this end, you can:
- Be allowed to go out freely: in this case, you will not risk any control.
- Be obliged to stay at home between 9 and 11 am, then from 2 to 4 pm: you will still be able to go out during these hours in case of medical appointments (with supporting documents).
- Not be allowed to leave your home, except for medical appointments or care, because your health condition does not allow it.
In the last two cases, the Assurance Maladie can check your presence at any time and therefore the respect of your sick leave.
When you are not out, you must also respect these rules:
- Interrupt your activity for the full duration of your downtime.
- Inform ISS if you decide to return to work early.
- Avoid staying away from home without prior medical approval.
How to strengthen your social protection as a self-employed person?
As we have just seen, daily allowances as a self-employed person are quite low. They are often perceived as insufficient to maintain one’s standard of living and ensure the sustainability of one’s business. This last point is particularly crucial as a freelancer or consultant, because you work alone.
So, when it is no longer possible to carry out your missions for a more or less long period, receiving compensation that guarantees the payment of your invoices and your social contributions is essential.
The solution? Opt for a health insurance plan dedicated to the self-employed.
The advantages of a health insurance for freelancers
When you subscribe to a complementary coverage, like the one proposed by our partner GSMC, you get additional guarantees to maintain your activity:
No waiting period
Depending on the nature of the contract signed, in the event of sick leave, you may receive daily benefits as early as 1st day.
Third-party payment to avoid advance payment
In addition to having to stop working for a while, a sick leave can also result in medical expenses. When money goes out but doesn’t come back in, it can quickly put you in an uncomfortable situation.
With a mutual insurance company dedicated to TNS, you benefit from the third party payment which avoids you to advance the medical or hospitalization expenses.
Better reimbursement of specific care
You know the saying “prevention is better than cure”. Taking care of your health is essential to avoid sick leave. However, some treatments are poorly or not at all reimbursed. This is particularly true for dental, optical and hearing care.
With a health insurance for freelancers, you can boost the reimbursement levels for certain treatments and take better care of yourself in the long term.
Additional daily allowances to compensate for loss of income
A health insurance for TNS reinforces the protection of the freelancer, by compensating more for the loss of income. It is possible to obtain additional benefits to allow the self-employed person to maintain his standard of living, pay his bills and face his personal and professional expenses. Which leads us to the next point…
An indemnity guarantee for the reimbursement of professional expenses
GSMC offers a “Business Expense Reimbursement Benefit” that covers social security contributions and other expenses related to your business, such as rent and bills for your business premises.
A pension in case of disability
In case of accident or long-term illness, preventing you from resuming your activity, a health insurance for freelancers can allow you to receive an annuity. This is paid until the company is liquidated or you retire. The benefit is based on the contract taken out and the degree of disability.
It applies whether the disability is permanent, total or partial.
The tax advantages of a health insurance for self-employed
A health insurance policy for freelancers is eligible for the Madelin law. This is another good reason to subscribe to this type of protection!
This means that contributions can be deducted from professional income. This is an interesting tax advantage for self-employed people whose legal status allows this type of deduction (the micro-business is not concerned).
The deduction limit for Madelin contributions is subject to the annual Social Security ceiling (PASS), as well as to the professional income of the year. Currently, the tax deduction limit is equal to 3.75% of professional income plus 7% of the PASS. All this up to a limit of €9,872.64 in 2021.
Beyond the financial aspect, a complementary health insurance for freelancers allows you to gain peace of mind. You can plan your missions, investments and objectives on the medium and long term. In case of illness, you know that your activity will be little or not impacted.
