Product Specification#
Status: Draft, 2026-08-26 (all cited sources accessed 2026-08-26).
Scope note. This is a standardized composite specification assembled for reference
liability cash-flow modeling. It describes no single insurer’s product. Facts carrying a
source tag — [S#] (primary product documents) and [R#] (product-specific
regulatory/actuarial references), both numbered per _research/dependance.md — resolve
against sources.md in this directory; that numbering is carried over verbatim and is
never renumbered. [REG-R#] tags resolve against the cross-product reference library
references/regulatory-and-actuarial-references.md, whose own R-numbering is frozen
separately. Values marked std are standardizations introduced for the reference
implementation; every std row in a parameter table carries a numbered footnote giving
the rationale and, where the research file recorded one, the observed range across
insurers. Claims the research file could not confirm against a retrieved document are
flagged unverified here too. French terms of art are kept in French and glossed on first
use; the model built from this specification is Dep_FR_S, on a monthly grid, and its
cells, columns and CSV headers are English lower_snake_case throughout.
Product overview and market role#
French individual long-term-care insurance — assurance dépendance — pays a rente mensuelle viagère (a lifetime monthly annuity) once the insured is recognised in a contractual state of dépendance (loss of autonomy), usually alongside an optional capital d’équipement (an equipment and home-adaptation lump sum) and a package of prestations d’assistance (care-coordination services) R8 §2.2 [S1] [S2] [S3] [S4] [S8] [S10]. Three structural facts shape everything below.
It is written as a group contract that individuals join. Almost every retrieved “individual” product is a contrat d’assurance de groupe à adhésion facultative — a policy subscribed by an association or a distributor, which the customer joins by signing a bulletin d’adhésion. Confirmed subscribers: ANPERE for AXA [S1 §1.1.1], the Fédérations Régionales de Crédit Mutuel and APCAS for Suravenir [S7 p2], the Banque de France for CNP 0658 Q [S5 art. 1], the MSPP for CNP A063 F [S6 art. 1.1]; Antarius, BPCE Prévoyance and Sogecap are described the same way [S2] [S3] R12 §1.2.1. The customer therefore holds a notice d’information, not conditions générales, and the notice is the contractual document REG-R30. The wrapper is annual and tacitly renewed; the membership inside it is viagère — lifelong — and survives termination of the wrapper as long as premiums are paid [S1 §8.2] [S5 art. 25].
It is a non-life risk carrying a lifelong guarantee. Cover sits in branches 1 (Accidents) and 2 (Maladie) of art. R. 321-1 of the Code des assurances [S1 §1.1.1] [S3] [S6 art. 1.1]; optional death benefits sold alongside sit in branch 20 (Vie-Décès) [S1 §1.1.1]. There is no LTC-specific regime in the Code des assurances, the branch agrément is at the insurer’s discretion, and on R12’s reading the participation aux bénéfices obligation does not bite because the risk covered is not human life R12 §1.1.2.2. That reading is one actuarial dissertation’s, not a settled position: art. L. 331-3 states the obligation in general terms, and the reference entry for it records that case law and parliamentary answers hold no category of contract to be carved out of the obligation a priori REG-R14. Under Solvabilité II the business falls in the Health-SLT underwriting module, life techniques applying because of the long-term commitment R12 §1.1.2.1 REG-R4.
It is fonds perdu. There is no surrender value at any time — “Votre adhésion ne comporte pas de valeur de rachat” [S1 §7.3] — and if the insured stays autonomous until death, nothing is paid and the premiums are lost [S11]. What replaces surrender is a mise en réduction: after a qualifying number of years of premiums a lapsing member keeps a reduced rente determined by a barème [S1 §1.3] [S2] [S5 art. 24.2] [S7 §4.6] R12 §1.2.1. The Code des assurances requires the contract to state how that valeur de réduction is computed REG-R31; the CCSF’s standing criticism is that it is not highlighted clearly enough at the point of sale R8 §4.2.
Market scale, 2024. Insurance undertakings covered 2.4 million people, down 6.9% on the year, individual memberships (two thirds of the portfolio) falling 9.9%; 28,400 new subscribers, down 13.7%; premiums 618.1 M€, down 3.0%; benefits paid 357.3 M€, up 6.3%; provisions 6.4 Md€, falling for a third consecutive year; 44,200 rentes in payment on sole-and-principal-guarantee contracts, 41,900 of them individual, at a mean monthly rente of 583 € and a mean age at onset of 80; typical subscription age 64 R10 §2.3 R13 p6 REG-R28. Across mutuelles, insurance undertakings and institutions de prévoyance together, 6.0 million people were insured — 56% / 40% / 4% R13 p6 REG-R28. DREES puts dependence cover at about 1% of the premiums private insurers collect for social risks R14; the CCSF’s aggregate is 814 M€ of premiums for 2.64 million people, 28% collective R9 §1.
The representative design below is the individual rente viagère design of AXA Entour’Age [S1], which the research file identifies as the cleanest representative of the retrieved individual market: group contract with facultative membership, entry 40–75, a chosen rente mensuelle viagère, a dépendance totale trigger on an AVQ count with cognitive alternatives, an optional dépendance partielle at 50%, an optional capital d’équipement, waiting periods of nil / 1 year / 3 years by cause, a three-month absolute franchise, monthly payment in arrears, discretionary annual revalorisation of both the guarantee and the rente in service, a premium level for the entry age but revisable for the portfolio, no surrender value and a paid-up reduction after eight years. The purely GIR-triggered designs [S3] [S7], the severity-ladder design [S5] and the points-based collective design R13 pp. 17–21 are documented as variations.
Representative specification#
Product identity and issue rules#
Parameter |
Representative value |
Basis |
|---|---|---|
Design type |
Individual assurance dépendance, rente mensuelle viagère form, written as a contrat de groupe à adhésion facultative, branches 1 and 2 of art. R. 321-1 |
[S1 §1.1.1] [S3] [S6 art. 1.1] |
Cover duration |
Viagère from the effective date; no age limit — “L’Assuré reste garanti quels que soient son âge et l’évolution de son état de santé” |
[S5 art. 8] [S1 §1.1.5] |
Entry ages |
40–75 inclusive at signature, age by différence de millésimes |
[S1 §1.1.2.1]; band std (1) |
Underwriting |
Two-stage: short déclaration d’état de santé, then a full questionnaire de santé assessed by the médecin-conseil, who sets acceptance terms; a majoration tarifaire pour risque aggravé may be applied |
[S5 art. 3] [S7 §2.2] [S3] [S4] [S1 §1.2.1] |
Territorial scope |
Residence in metropolitan France, Monaco or a DOM; stays outside of no more than three continuous months |
[S1 §1.1.6] [S3]; composite std (3) |
Renunciation |
30 days from signature |
[S1 §7.6] [S5 art. 8] [S7 §2.5] — the window only; no retrieved document states what becomes of premiums already paid |
Resiliation by the member |
Annually, 60 days’ notice |
[S1 §1.1.4.2a]; window pick std (4) |
Surrender value |
None at any duration |
[S1 §7.3] [S11] |
Base model cell |
Female, entry age 70, formule Dépendance Totale et Partielle, rente totale 1,000 €/month, rente partielle 500 €/month, capital d’équipement 3,500 €, |
Footnotes to std rows:
Observed entry-age bands: 40–75 inclusive [S1 §1.1.2.1]; 50 to under 75 [S2] R12 §1.2.1; under 75 [S5 art. 2] [S7 §2.1]; recommended from 40, generally not available after 77 [S8]. The compulsory group variant runs cover only to 65 for members joining after inception [S6 IPID]; two IPIDs state nothing [S3] [S4] — a silence of the retrieved document, which by construction summarises and omits, and not a finding that there is no limit. 40–75 is the widest band in a retrieved notice.
Pure modeling cell, except the price point. Entry at 70 sits inside every retrieved band and above the market mean subscription age of 64 R10 §2.3 R13 p6 REG-R28. The 1,000 €/month total plus 500 €/month partial cover at 75 €/month is not std: it is the CCSF’s indicative market price for exactly that cover at entry age 70, published in 2013 R8 §2.2 — the only age-graded price point for a two-tier individual contract in any retrieved source, the CNP Banque de France scale [S5 annexe 1] being for a group product on a four-rung severity ladder (2, 3, 4 and 5-or-6 AVQ of 6) sold across five subscribed coverage levels [S5 arts. 13, 16, 17, annexe 1]. It is dated and indicative; it is used because inventing a premium would be worse. For scale, the 2024 mean individual premium on a sole-and-principal-guarantee contract was 472 €/year (39 €/month) at a mean subscription age of 64, and the mean rente in payment 583 €/month R10 §2.3 R13 p6 — so the base cell is a larger-than-average cover bought later than average, and its premium is correspondingly above the market mean. Sex is female because 70% of APA beneficiaries are women and the female prevalence rate is nearly double the male one (9.1% against 4.8% of the 60-and-over population) R7, which is where the decrement basis of
technical-notes.mdis anchored; the premium is unisex, compulsory since the 2004 EU directive R12 §3.2.1.Observed clauses run from metropolitan France, Monaco or a DOM with the carer resident too [S1 §1.1.6], through principal residence in metropolitan France or DOM/TOM [S4] and recognition performed in France or an EU country [S7 §3.6], to worldwide cover with stays outside France capped at three continuous months [S2] [S3], and at most 90 days a year outside the EU with benefit paid only from return to France so that medical control can be exercised [S6 IPID]. No cash-flow effect in the reference model.
Observed notice: 60 days [S1 §1.1.4.2a]; one month [S7 §4.5]; before 1 November for a 1 January effect [S5 art. 9a]. No cash-flow effect on a monthly grid.
The two assessment grids and the trigger definitions#
There is no single French definition of dependence in insurance. Two referentials coexist and contracts use one, the other, or both R8 §3.2 R12 §1.1.1.
(a) AGGIR — the public grid. Autonomie Gérontologie Groupes Iso-Ressources. Statutory, annexed to the Code de l’action sociale et des familles as annexe 2-1 in the version created by décret n° 2017-882 du 9 mai 2017 art. 5 R1; referenced by CASF art. R. 232-3 and used by départements to award the allocation personnalisée d’autonomie (APA), which is restricted to GIR 1 to 4 R2 arts. R. 232-3, R. 232-4 R3. Ten variables discriminantes (cohérence, orientation, toilette, habillage, alimentation, élimination urinaire et fécale, transferts, déplacements à l’intérieur, déplacements à l’extérieur, alerter) and seven variables illustratives (gestion, cuisine, ménage, transports, achats, suivi du traitement, activités du temps libre), each scored A (does it alone, spontaneously, totally, habitually and correctly), B (alone but not spontaneously and/or partially and/or not habitually and/or incorrectly) or C (does not do it alone) R1. The six bands R1 R3 R7 [S1 §2.1.2] [S7 defs]:
GIR |
Profile |
|---|---|
1 |
Confined to bed or chair, mental functions gravely impaired, continuous attendance required; or a person at end of life |
2 |
Confined to bed or chair with mental functions not wholly impaired, care needed for most everyday activities; or mentally impaired but mobile, requiring permanent supervision |
3 |
Mental autonomy retained, locomotor autonomy partly retained, help with bodily care several times a day |
4 |
Cannot transfer alone but moves about indoors once up, needs help washing and dressing; or no locomotor problem but needs help with bodily care and meals |
5 |
Needs only occasional help with washing, meal preparation and housework |
6 |
Still autonomous for the essential acts of everyday life |
(b) AVQ — the insurer-built grids. Grids of 4 to 6 actes de la vie quotidienne (activities of daily living), built by insurers precisely because AGGIR is applied by départements the insurer does not control — an uncertainty that complicates rating and reserving R8 §3.2. The five acts of the GAD common definition are transfert, déplacement, toilette, habillage, alimentation R11 R12 §1.1.1.1 [S1 §2.1.1]; six-act grids add continence [S4] [S5 art. 12] [S6] [S9]. AIVQ grids (transport, telephone, medication, budget) exist in the market but no retrieved contract used them R8 §3.2.
(c) The cognitive overlay. The Mini Mental State Examination (Folstein / MMSE) is the standard route to psychic dependence. Thresholds observed: below 15 certified by a psychiatrist or neurologist [S5 art. 11] [S6 art. 21.1] [S7 defs]; ≤ 10 for AXA’s psychic route to totale, ≤ 15 for its mixed route, < 15 for partielle, < 18 for its light tier [S1 §2.2]; ≤ 15 and ≤ 10 in the Sogecap tiers R12 §1.2.1. The Blessed test also appears R8 §3.2.
State |
Representative trigger |
Basis |
|---|---|---|
Dépendance totale |
Definitive need of a third person and (≥ 4 of 5 AVQ; or dementia with Folstein ≤ 10 and prompting needed for ≥ 2 of 5 AVQ; or dementia with Folstein ≤ 15 and ≥ 3 of 5 AVQ) |
[S1 §2.2]; corroborated R12 §1.2.1 |
Dépendance partielle |
AGGIR group 1, 2 or 3 and (≥ 3 of 5 AVQ; or dementia with Folstein < 15) |
[S1 §2.2] |
Consolidation |
The state must be consolidé — permanent, irreversible, “non susceptible d’amélioration” — before it is indemnifiable |
[S1 §2.2] [S2] [S4] [S6 art. 20] |
Independence from the public decision |
“L’Assureur n’est pas lié par les éventuelles décisions des services publics pour déterminer l’état et le degré de dépendance de l’assuré” |
[S5 art. 13] [S6 art. 21.1] |
Recognition process |
Claim form (CNP: attestation médicale d’état de dépendance, AMED) completed with the treating doctor, sent under confidential cover to the médecin-conseil, who fixes the date the state reached an indemnifiable level; that date cannot precede the date the insurer received the claim; decision within 45 working days of a complete file |
[S5 art. 19] [S6 arts. 23–24] |
Model trigger grid |
|
std (5) |
The three grids are alternative definitions of the same two states, and the reference model has to price all three: the CCSF’s 30-contract sample found AGGIR-only and AVQ-only about equally frequent, with a significant share combining both R8 §3.2. What no retrieved document states is the equivalence between them — and the model needs one, because its decrement basis is built from public GIR-graded APA data. Two retrieved contracts require both grids at once and are the only direct evidence of how an insurer equates them: AXA’s partielle requires AGGIR 1–3 and ≥ 3 of 5 AVQ [S1 §2.2]; BPCE’s requires GIR 3–4 and constant third-party help for ≥ 2 of 4 AVQ [S3]. Everything else is inference, so the mapping used by
technical-notes.mdis std:Contract state
5-act AVQ
6-act AVQ
AGGIR
Direct evidence
Dépendance totale
≥ 4 of 5 [S1] R12 §1.2.1
≥ 5 of 6 [S4] [S6 art. 21]
GIR 1–2 [S3] [S7 defs]
none equates the three; equivalence std
Dépendance partielle
≥ 3 of 5 [S1] R12 §1.2.1
≥ 4 of 6 [S4] [S6 art. 21]
GIR 3–4 [S3] [S7 defs]
AXA: GIR 1–3 and ≥ 3/5 [S1 §2.2]; BPCE: GIR 3–4 and ≥ 2/4 [S3]
There is no observed range for the equivalence itself, but the direction of the residual uncertainty is known: the CCSF records greater variability for partielle than for totale, and dépendance lourde variously defined as GIR 1–2, as GIR 1–2–3 subject to a cognitive score, as 3 AVQ of 4, as 5 AVQ of 6, or as 3 AVQ of 4 with 2 AIVQ of 4 R8 §3.2. A 6-act grid is stricter than a 5-act grid at the same count, and a GIR trigger is looser than either because it borrows a public classification the insurer would not have made itself.
Benefit amounts#
Parameter |
Representative value |
Basis |
|---|---|---|
Rente form |
Rente mensuelle viagère, paid monthly à terme échu (in arrears) while the insured state persists, at the latest until death |
[S1 §4.3.1.2] [S5 art. 16] [S6 art. 26] [S7 §4.2.1] [S11] |
Rente totale — chosen range |
500–3,000 €/month; base cell 1,000 |
[S1 §1.1.2.2a]; cell pick std (2) |
Rente partielle |
50% of the chosen total amount |
[S1] [S2] [S7] [S8] R12 §1.2.1; ratio std (6) |
Capital d’équipement |
3,500 €, optional, paid once per membership on first entry into a covered state; the guarantee is extinguished on payment regardless of later deterioration |
[S1 §1.1.2.2c, §4.3.2.1] [S2] [S5 art. 17]; amount std (7) |
Cessation of the rente |
On death, or when improvement takes the insured out of a covered state |
[S1 §4.3.1.2] [S6 art. 26] [S7 §4.2.1] |
Mutual exclusivity |
Total and partial rentes are mutually exclusive; recognition of totale never opens partial rights |
[S1 §4.3.1.2] |
Continued entitlement |
Annual proof of life and of the persisting state; non-return suspends payment with retroactive settlement on receipt; the insurer may re-examine at any time and stop payment on refusal of medical control |
[S1 §4.3.1.2] [S6 arts. 23–24] [S7 §4.2.1] |
Taxation of the rente |
Not subject to income tax outside the loi Madelin framework |
[S1 §1.1.1] [S8] |
GAD-label minimum rente |
500 €/month for dépendance lourde |
Observed partial/total ratios: 50% at five providers [S1] [S2] [S7] [S8] R12 §1.2.1 and at OCIRP R13 p19; 60% at CNP Ecureuil, which also offers a légère tier at 30% [S4]; a doubling of the base rente at the top rung of the CNP Banque de France ladder [S5 arts. 13, 16]. 50% is modal. Observed rente ranges: 500–3,000 [S1] [S10] R12 §1.2.1; 400–3,000 in steps of 100 [S4]; 300–2,100 [S2]; 200–2,000 [S8]; 300–4,000 “selon les contrats” [S11]; five fixed levels of 158.61 to 951.66 €/month at rung 3 [S5 annexe 1]; 200 €/month flat in the compulsory group variant [S6 annexe 2].
Observed capital amounts: 3,500 € [S1]; 3,000 € [S2] [S4], with 900 € on the light tier deducted from any later payment [S4]; at most 3,200 € on total and 2,400 € on partial, net of earlier payments [S3]; up to 5,000 € of adaptation costs reimbursed [S8]; 5,000 € or 10,000 €, paid with no franchise [S10]; 5,000 € R12 §1.2.1; 1,586.10 € to 9,516.60 € by coverage level [S5 annexe 1].
Waiting period (délai de carence) and elimination period (délai de franchise)#
These are two different things and the reference implementation keeps them apart. The carence (also délai d’attente) runs from inception and decides whether a state is covered at all. The franchise runs from recognition and decides when payment starts on a state that is covered.
Parameter |
Representative value |
Basis |
|---|---|---|
Carence — accident |
None |
[S1 §1.1.5] [S2] [S3] [S4] [S5 art. 7] [S7 §3.2] R12 §1.2.1 |
Carence — illness other than neurological or psychiatric |
1 year |
[S1 §1.1.5] [S2] [S3] [S4] [S5 art. 7] R12 §1.2.1 |
Carence — neurological, neurodegenerative or psychiatric illness |
3 years |
[S1 §1.1.5] [S2] [S3] [S4] [S5 art. 7] [S7 §3.2] R12 §1.2.1 |
Consequence of dependence arising inside the carence |
No benefit is ever payable for that state and the membership is terminated, premiums refunded in full |
[S1 §1.1.4.2c] [S3] [S5 art. 7] [S7 §3.2] |
Extension |
AXA extends termination to a dependence-causing condition merely diagnosed during the carence |
[S1 §1.1.4.2c] |
Restart |
Any increase in cover restarts the carence on the additional cover |
[S1 §1.1.3] [S7 §3.3] |
Cause mix weighting the three carences |
accident 10% / other illness 55% / neurological or psychiatric 35% |
std (8) |
Franchise |
Absolute, 3 months; the rente starts on the 91st day after recognition |
[S1 §4.3.1.2] [S7 §4.2.1] [S8]; three months / 90 days [S4] [S5 art. 14] [S6 arts. 24, 26] |
Franchise on the capital d’équipement |
None — paid at recognition |
[S10]; composite std (9) |
No retrieved document states a cause mix. The three-way split is close to universal in structure — six of the eight contracts in the research file’s table — and France Assureurs states the market range as one to three years R11, the CCSF as nil or very short for accident, about one year for illness, up to three years for neurological disease R8 §2.2. What is missing is the weight of each cause, which is what a projection needs. The 10 / 55 / 35 split has no observed range; it carries a large neurological share because every retrieved contract puts an MMSE overlay on exactly that cause [S1 §2.2] [S5 art. 11] [S6 art. 21.1] [S7 defs] and singles it out for the longest carence, which is what an insurer does when a cause is both frequent and adversely selected. Its sensitivity is reported in
technical-notes.md.Only Generali states in terms that its capital d’équipement is paid with no franchise delay [S10]; AXA, Antarius, CNP and Suravenir do not state a franchise for the capital separately from the rente [S1] [S2] [S4] [S5] [S7]. Because the capital is a one-off, the choice moves its timing by three months and nothing else.
Absence of surrender value; mise en réduction#
Parameter |
Representative value |
Basis |
|---|---|---|
Valeur de rachat |
None, at any duration |
[S1 §7.3] [S11] |
Qualifying period |
8 full consecutive years of premiums |
[S1 §1.3] [S2] [S7 §4.6] R12 §1.2.1 |
Effect |
The membership is maintained with a reduced rente, set by a barème whose coefficients depend on the years of premiums already paid |
[S1 §1.3] [S2] [S7 §4.6] |
Scope of the reduced cover |
Dépendance totale only; the capital d’équipement option is lost |
[S7 §4.6] R12 §1.2.1; composite std (12) |
Revalorisation of the reduced guarantee |
None — reduced guarantees are no longer revalued |
[S7 §4.6] |
Assistance |
Prestations d’assistance end on mise en réduction |
[S1 §1.3] [S5 art. 24.2] |
Reduction scale |
The published CNP Banque de France barème de maintien des garanties, applied from year 8 |
[S5 annexe 2]; re-basing std (13) |
Disclosure obligation |
The contract must state how the valeur de réduction is computed |
Observed scope: reduced guarantee on dépendance totale [S7 §4.6], and the same at Sogecap, which also removes the capital d’équipement option R12 §1.2.1; partial maintenance of both the rente and the Capital Premiers Frais at AXA [S1 §1.3]; partial maintenance of the rente with capital and assistance lost at CNP Banque de France [S5 art. 24.2]. The composite takes the majority on both points, against the AXA chassis it otherwise follows — a deliberate departure, recorded so it is not mistaken for the AXA rule.
The only published French LTC reduction scale found is CNP Banque de France annexe 2, in force 1 January 2012, whose qualifying period is 5 years, not 8 [S5 annexe 2]:
Years of premiums
5
6
7
8
9
10
15
20
25
≥ 30
Coefficient
16%
18%
21%
25%
28%
30%
40%
50%
60%
70%
The full scale is stated for every integer year from 5 to 29, rising at about 2 percentage points a year from year 10 and capped at 70% [S5 annexe 2]. The composite adopts it verbatim but applies it from the 8-year qualifying period of the AXA/Antarius/Suravenir/Sogecap chassis [S1 §1.3] [S2] [S7 §4.6] R12 §1.2.1, so the coefficient at first qualification is 25% and the rows for 5, 6 and 7 years are unreachable. No retrieved 8-year contract publishes its own scale.
Revalorisation#
Two distinct indexations exist and both are discretionary in every retrieved contract.
Parameter |
Representative value |
Basis |
|---|---|---|
Revalorisation des garanties (guaranteed rente and capital before claim) |
Annual, on the insurer’s declaration; the premium rises in the same proportion; modeled at 1.0% per year |
mechanics [S1 §1.2.3] [S5 art. 21] [S7 §3.4]; rate std (14) |
Revalorisation des rentes en service (the rente in payment) |
Annual; modeled at 1.5% per year |
mechanics [S1 §4.3.1.3] [S5 art. 15] [S6 art. 16] [S7 §4.2.3]; rate std (14) |
Reference index for rentes en service |
AXA: joint ANPERE/AXA management committee, at the latest 1 April. CNP Banque de France: 1 January, by reference to the rate applied to French civil and military retirement pensions, subject to the fonds de revalorisation; the AGIRC point if the group contract is resiliated. Suravenir: 1 January, by reference to the annual change in the AGIRC point value, within a fund fed by 36% of any surplus on the result account. CNP MSPP: only by agreement between insurer and subscriber, subject to results |
[S1 §4.3.1.3, §8.1] [S5 arts. 15, 25] [S6 art. 16] [S7 §4.2.3] |
Reduced (paid-up) guarantees |
Not revalued |
[S7 §4.6] |
Neither rate is contractual and neither is published. The mechanics are fully sourced — the two indexations exist, they are separately governed, the premium follows the first and not the second, and the reduced guarantee follows neither — but every retrieved clause makes the rate a discretionary decision taken “en fonction des résultats techniques et financiers” or by reference to an external pension index whose future path is unknown [S1 §4.3.1.3] [S5 art. 15] [S6 art. 16] [S7 §4.2.3]. The CCSF flags this as the market’s weakest disclosure and warns that a rente promised fifteen or twenty years ahead can be substantially eroded at 2% average inflation R8 §3.3. The two rates are set different on purpose: setting them equal collapses two ledgers into one and hides a capability the contract requires. There is no observed range.
Contractual mechanics#
The amount payable at recognition#
The cleanest statement in any retrieved document is AXA’s three-factor formula
[S1 §4.3.1.1]: the amount paid equals the guaranteed amount, times the revalorisation
factor accumulated between adhesion and recognition, times — if the membership had been
resiliated after at least eight full consecutive years — the reduction coefficient in force
at recognition. With G0 the guaranteed rente totale, g_G the revalorisation des
garanties rate, n completed policy years at recognition and c the reduction
coefficient (1 for a membership still in force):
rente totale at recognition = G0 x (1 + g_G)^n x c
rente partielle at recognition = 0.50 x rente totale at recognition
Thereafter the amount in payment grows at the revalorisation des rentes en service rate
g_S, a different rate under a different clause [S1 §4.3.1.3] [S5 art. 15] [S7 §4.2.3].
For a reduced membership c freezes the guarantee, so (1 + g_G)^n stops accruing at the
reduction date [S7 §4.6].
Carence: what it blocks, and what it terminates#
The carence runs from the effective date of cover and is cause-specific (table above). Its consequence is not simply “no benefit”: a state of dependence arising inside the carence for a cause not yet covered ends the membership, and the premiums paid are refunded in full [S1 §1.1.4.2c] [S3] [S5 art. 7] [S7 §3.2]; AXA extends this to a dependence-causing condition merely diagnosed during the carence [S1 §1.1.4.2c]. Two consequences for a projection. First, the carence is a decrement with a cash outflow attached — the refunded premiums, which R12 §3.2.1 prices as a contre-assurance term. Second, the incidence rate is scaled, not switched: inside the three-year window some causes are covered and others are not, so the model needs a carence factor between 0 and
R12 §3.2.1 models exactly this, as coefficients S1 ≤ S2 ≤ S3 applied to incidence over the first three contract years with S4 = 100%; the composite’s cause mix (footnote 8) produces that shape.
Franchise: when the rente starts#
Three months, absolute, from recognition: “un délai de franchise absolue de 3 mois, soit à
compter du 91e jour qui suit la date de reconnaissance” [S1 §4.3.1.2]; “à partir du 91e
jour” [S8]; “Le point de départ de la rente est fixé au 91ème jour” [S7 §4.2.1]; three
months at CNP [S4] [S5 art. 14] [S6 art. 24], described as 90 days in the A063 F notice and
IPID [S6 arts. 24, 26]; three months at Sogecap R12 §1.2.1. Market range 30 to 90 days
R8 §2.2; France Assureurs states “généralement 90 jours” R11; GAD-labelled products
carry fr = 3 in the pricing formulae R12 §3.2.1.
Because the rente is paid monthly in arrears [S1 §4.3.1.2] [S5 art. 16] [S6 art. 26] [S7 §4.2.1], a three-month franchise removes three monthly instalments. The proof that this is the right reading is Antarius, which carries the same three-month franchise but pays a first instalment equal to three monthly rentes [S2] — economically neutral precisely because it restores the three instalments the standard design drops. Two carve-outs are not in the composite: CNP A063 F pays from the recognition date itself where the cause is an accident [S6 art. 24], and Generali pays its capital with no franchise [S10] (which the composite does adopt, footnote 9). Recognition has its own lead time on top: the médecin-conseil rules within 45 working days of a complete file, and the recognition date cannot precede the date the insurer received the claim [S6 arts. 23–24].
Deterioration from partielle to totale, and the capital d’équipement#
A new claim file is required; the new amount takes effect from the first day of the month
following the opening of the right, and the two rentes are mutually exclusive —
recognition of totale never opens partial rights [S1 §4.3.1.2]. CNP allows the level to
move in either direction on a fresh medical file [S5 art. 13], so improvement out of a
covered state is contractually possible and stops the rente [S1 §4.3.1.2] [S6 art. 26]
[S7 §4.2.1]. The actuarial literature retrieved does not model this transition:
R12 §3.1.2 sets it to zero for want of a transition law and prices two separate guarantees
instead. The reference implementation does model it; the consequences are in
technical-notes.md.
The capital d’équipement is paid once and extinguished on payment, so a life that took it on entering partielle takes nothing further on becoming totale [S1 §4.3.2.1] [S2] [S4] [S5 art. 17]; Suravenir instead pays half on partielle and the balance on deterioration [S7 tableau des garanties]. Its trigger sometimes sits below the rente trigger: on dépendance légère [S1 §4.3.2.1], at severity level 2, two rungs below the rente [S5 art. 17], or on a “Dépendance sensible” [S2]. The composite pays it on first entry into either covered state and carries no light tier.
Revalorisation of the guarantee and of the rente in service#
Before a claim the guaranteed amounts grow at the declared revalorisation des garanties rate and the premium rises in the same proportion [S1 §1.2.3] [S5 art. 21] [S7 §3.4]. In payment the rente grows at a separately declared rate, on a calendar date (1 January at CNP and Suravenir, at the latest 1 April at AXA) applied to all rentes en service regardless of how long each has been in payment [S1 §4.3.1.3] [S5 art. 15] [S7 §4.2.3].
Riders and options#
In scope (modeled):
Formule Dépendance Totale et Partielle — the partial tier at 50% of the chosen rente, on in the base cell [S1] [S2] [S7] [S8] R12 §1.2.1; the total-only formule is the alternative model-point value [S1] [S7 Contrat Essentiel].
Capital d’équipement (AXA: Capital Premiers Frais) — 3,500 €, paid once, on in the base cell [S1 §1.1.2.2c].
Premium exonération on claim — zero premium income from lives in a recognised state [S1 §1.2.4] [S4] [S5 art. 21] [S6 art. 18].
Mise en réduction — a paid-up state carrying a reduced rente totale, entered on lapse from eight years [S1 §1.3] [S2] [S7 §4.6] R12 §1.2.1.
Out of scope (listed for completeness; no charges or benefits projected): the dépendance légère tier and its 900 € capital [S1 §2.2] [S4]; Antarius’s “Dépendance sensible” capital trigger [S2]; the optional Capital décès and Capital décès remboursement des cotisations, which end at the end of the insurance year in which the insured turns 85 [S1 §1.1.4.1, §1.1.5] and are branch-20 business [S1 §1.1.1]; Generali’s death option requiring death before 85 [S10]; the Garantie Fracture paying 300 € [S4]; the prestations d’assistance themselves — 24/7 line, teleassistance, meal and medicine delivery, home help, sitting and respite services, memory assessment and training, an ergotherapist’s home-adaptation assessment, help finding an establishment, legal and social support R8 annexe 2 [S1 ch. 3–5] [S8] [S10] R13 p24, which are a prestation en nature subject to an obligation of means, not of result [S1 §7.2.2], and are carried only as an expense line; the loi Madelin framework, which makes premiums deductible and the rente taxable [S1 §1.1.1]; the 10% couple discount [S1 §1.2.6] [S5 art. 21] [S8]; increases and decreases in cover [S1 §1.1.3] [S7 §3.3] R12 §1.2.1; and the exclusion set — intentional acts and attempted suicide, narcotics and non-prescribed medicines, blood alcohol above the criminal threshold and the complications of chronic alcohol abuse, war, riot and terrorism where the insured takes an active part, nuclear transmutation, motorised competitions, unapproved air sports [S1 §7.1] [S3] [S4] [S6 art. 22] [S7 §3.5], with BPCE’s disease-specific exclusions of fibromyalgia, chronic fatigue syndrome, Ehlers-Danlos and fasciitis [S3].
Variations across insurers#
Trigger grid. Purely AVQ: AXA on 5 acts with a Folstein overlay [S1 §2.2], CNP Ecureuil [S4] and CNP MSPP [S6 art. 21] on 6 acts, Sogecap on 5 acts R12 §1.2.1. Purely AGGIR: BPCE, GIR 1–2 for totale and GIR 3–4 plus 2 of 4 AVQ for partielle [S3]; Suravenir, “L’état de dépendance est évalué selon la grille de référence AGGIR du décret 97-427 du 28 avril 1997”, GIR 1–2 and GIR 3–4, with MMSE below 15 for neuro-degenerative conditions [S7 defs]. Mixed: AXA requires AGGIR 1–3 and an AVQ count for partielle only, AGGIR playing no part in its totale definition [S1 §2.2]. Groupama documents AGGIR with a four-rung 6-act ladder as “un complément ou une alternative” without publishing the contractual trigger [S8] [S9]. Representative: the AXA 5-act definitions, with
trigger_grida model-point column.Partial/total ratio. 50% at five providers [S1] [S2] [S7] [S8] R12 §1.2.1; 60% at CNP Ecureuil, which adds a 30% light tier [S4]; the CNP Banque de France ladder monetises severity differently, paying nothing at 2 or 3 AVQ of 6 except the equipment capital, the base rente at 4 of 6 and double it at 5 or 6 of 6, across five subscribed coverage levels [S5 arts. 13, 16, 17, annexe 1]. Representative: 50%.
Reduction. Qualifying period eight full years [S1 §1.3] [S2] [S7 §4.6] R12 §1.2.1, five at CNP Banque de France, the only contract publishing its scale [S5 arts. 23–24.2, annexe 2]; the two IPIDs state nothing [S3] [S4]. What survives differs too: rente and capital both partially maintained [S1 §1.3]; rente only, capital and assistance lost [S5 art. 24.2]; rente on totale only [S7 §4.6], with the capital option removed as well R12 §1.2.1.
Cap on tariff revision. Only Suravenir states one — 10% per year excluding revalorisation, the member then free to ask for a reduction of the guaranteed rente or resiliate on one month’s notice [S7 §4.4]. AXA, CNP and Sogecap state the right with no numerical cap [S1 §1.2.3] [S5 art. 22] R12 §1.2.1.
Indexation. For the rente in service: joint-committee decision by 1 April [S1 §4.3.1.3]; the rate applied to French civil and military retirement pensions, and the AGIRC point on resiliation of the group contract [S5 arts. 15, 25]; the AGIRC point in a fund fed by 36% of surplus [S7 §4.2.3]; agreement between insurer and subscriber subject to results [S6 art. 16]; the contract’s technical and financial results R12 §1.2.1. For the premium: in the same proportion as the guarantees [S5 art. 21] [S7 §3.4], or on the growth of the PASS R12 §1.2.1.
Structural outliers. (a) The severity-ladder design: CNP’s Banque de France contract 0658 Q, four rungs on 6 AVQ (2/6, 3/6, 4/6, 5-or-6/6), the rente starting at rung 3 and doubling at rung 4, plus a placement condition — residence in a section de cure médicale or an establishment for the elderly, long-stay hospitalisation, or the combination of home nursing care and third-person assistance [S5 arts. 12, 13, 16, 17]. The same ladder is what Groupama documents [S9]. (b) The points-based collective design: OCIRP, where contributions of 0.40%–1.50% of the PMSS buy points de rente dépendance at an age-dependent or mutualised valeur d’acquisition and the rente equals points × valeur de service; the guaranteed minimum is 200–750 €/month for GIR 1–2 and half of it for GIR 3; recognition is automatic on receipt of APA at GIR 1–2, otherwise requiring a state lasting more than three months and inability to perform 2 or 3 of 4 everyday acts; there is no reduction value at all; and the final rente is unknown at inception R13 pp. 17–21, 31 REG-R28. Neither is the representative chassis: a severity-ladder model needs a rung index in place of a two-state machine, and a points model needs an accumulation account and a valeur de service the insurer sets each year.
Compulsory group cover, for scale. CNP MSPP A063 F pays 200 €/month on totale and 100 €/month on partielle for 20.40 €/year (1.70 €/month) per insured person [S6 annexe 2] — an order of magnitude below individual pricing, which is the mutualisation effect the CCSF’s 2024 recommendation argues for R9 §1.
Regulatory context#
Contract law and classification. Cover sits in branches 1 and 2 of art. R. 321-1 of the Code des assurances [S1 §1.1.1] [S3] [S6 art. 1.1]; the group-contract machinery of arts. L. 141-1 ff. governs the notice d’information, the member’s rights and the non-payment procedure of art. L. 141-3 [S1 §1.1.1, §1.2.5] [S5 art. 23]. Art. A. 132-4 and its annexe prescribe what a note d’information must disclose — the guarantees, the premium arrangements, the délai et modalités de renonciation, the claims procedure, and reduction, surrender and transfer values — and art. A. 132-8 the one-page encadré REG-R30. Art. L. 132-21 requires the contract to state how the valeur de réduction is computed REG-R31, the statutory hook under the mise en réduction clauses above. There is no LTC-specific regime: LTC is best read as a non-life risk carrying a lifelong guarantee, the branch agrément is at the insurer’s discretion, and R12 reads the participation aux bénéfices obligation as not applying because the risk covered is not human life R12 §1.1.2.2. That proposition rests on the dissertation alone. Art. L. 331-3 imposes the obligation in general terms and carves out no category on its face; the reference entry for it records case law and parliamentary answers holding that none is carved out a priori, and warns that the served version ends 1 January 2016, so it is cited here for the substance of the obligation and no current article number is asserted REG-R14. Nothing in this library’s cash flows turns on the point — no participation aux bénéfices is projected on this product either way. Mis-statement falls under arts. L. 113-8 (intentional — nullity, premiums retained) and L. 113-9 (non-intentional — proportional reduction, or resiliation after ten days) [S1 §1.1.2.2] [S7 §2.4].
Prudential. Under Solvabilité II technical provisions are a best estimate — the probability-weighted average of future cash flows discounted at the relevant risk-free term structure — plus a risk margin, in a three-pillar regime transposed into the Code des assurances rather than applied directly REG-R4 REG-R1 REG-R2. EIOPA publishes the risk-free term structures monthly REG-R5; this library produces undiscounted cash flows and stops short of the discounting. LTC sits in the Health-SLT underwriting module R12 §1.1.2.1. On the French statutory balance sheet art. R. 343-3 enumerates the eleven technical provisions, item 1 being the provision mathématique, computed including future management costs REG-R6. This product generates two: the provision pour risques croissants for autonomous insureds (present value of future commitments less present value of future premiums, allowing for the waiting-period incidence reduction and for the counter-insurance of refunded premiums) and the provision mathématique des rentes for rentes in payment R12 §3.2.2. The code article governing the PRC was not retrieved — the partie législative table of contents was retrieved and the code identity and version confirmed R18, but the partie réglementaire is not exposed on that page — so everything said about the PRC rests on R12, an actuarial dissertation, not on the code. Reinsurance is usually quota-share; the Sogecap product cedes 70% R12 §1.2.1.
Mortality tables. A French tariff must use a taux d’intérêt technique fixed under
art. A. 132-1 and one of exactly two permitted kinds of mortality table: homologated tables
by sex, or the undertaking’s own tables certified by an independent actuary approved by a
recognised actuarial association REG-R23. For a rente viagère the homologated tables are
the generational TGH05 / TGF05 REG-R21; for everything that is not an annuity,
TH 00-02 / TF 00-02 REG-R22. Neither family is reproduced here — they are cited by
name and arrêté, and the decrement CSV shipped for this product is a std proxy that
takes no value from any retrieved source: a two-parameter Gompertz force fixed entirely by
the two unsourced anchors mort_rate(60) = 0.00400 and mort_rate(90) = 0.10500
(technical-notes.md (c)), shaped like a French female population table. INSEE publishes the
only freely redistributable French mortality series and is what a production implementation
would fit here REG-R24; this one does not read it, and the shipped provenance column says
so on every row. The technical-rate ceiling for a contract with
periodic premiums is the lower of 3.5% and 60% of the semi-annual average rate of French
State borrowings REG-R17; no technical rate is disclosed in any retrieved product
document.
The public benefit this rente tops up. The APA is paid to people aged 60 or over classified in GIR 1 to 4 R2 arts. R. 232-1, R. 232-4 R3. Assessment is by the département’s équipe médico-sociale APA during a home visit, and the plan d’aide states the GIR, the aids financed and the beneficiary’s participation rate; GIR 5–6 are redirected to pension-fund assistance R5. At home the GIR is set by a departmental professional, in an establishment by the establishment’s physician, usually within a month of admission R6 — so the same insured can be re-graded by a different assessor on entering an EHPAD. Monthly plan d’aide ceilings from 1 January 2026: GIR 1 2,080.33 €, GIR 2 1,682.30 €, GIR 3 1,215.99 €, GIR 4 811.52 €, the beneficiary contributing nothing up to a monthly income of 933.89 €, between 0% and 90% up to 3,439.31 €, and 90% above R4; the 2024 ceilings were 1,955.60 / 1,581.44 / 1,143.09 / 762.87 € REG-R26. Against those, the reste à charge in an EHPAD was about 1,957 €/month per a DREES study of July 2022, roughly 120% of the average gross pension R9 §2 — the gap a 1,000 €/month private rente is sold to close.
Consumer protection and the label. The GAD ASSURANCE DÉPENDANCE® label sets nine criteria, published verbatim by France Assureurs R11 and reproduced by the CCSF R8 §4.3 — among them a minimum rente of 500 €/month for dépendance lourde, a common definition of dépendance lourde on the five actes élémentaires, and conditions for maintaining rights on interruption of premium payment. GAD-labelled contracts covered 194,900 people at end 2024 at an average annual premium of 584 €, 14% of insureds on sole-and-principal-guarantee contracts but 38% of new business in that category R10 §2.3. The label’s rule book was not retrieved, and whether any contract cited here carries the label is unverified — no retrieved notice claims it; the label’s prohibition on medical selection before age 50 R8 §4.3 point 6 R11 is likewise unverified as applied to any contract above. The CCSF’s January 2024 recommendation would replace the individual market with a compulsory Contrat Dépendance Solidaire covering GIR 1–2 only, with a single lifelong tariff grid, no waiting period, a reduction mechanism for interrupted payment, portability through a single insurance pool, and automatic payment on receipt of APA at GIR 1 or 2 R9 §I.C — a recommendation, not law: nothing here should be read as saying that a compulsory French LTC contract exists.
A supervisory gap this library cannot close. No ACPR material on assurance dépendance
could be retrieved: the ACPR news page on the lessons of its LTC supervisory inspections and
the September 2023 Revue de l’ACPR article both return HTTP 403, as does the DGCCRF
consumer fiche pratique, and the ACPR host returns an HTML error page rather than the PDF
even to a request carrying a browser User-Agent. Those three references are omitted from
sources.md rather than cited, and nothing here rests on them. The supervisor’s own view
of pricing adequacy, provisioning practice and claims handling on this product is missing
from this library.
Standards and accounting. Institut des actuaires NPA 2, Modèles actuariels, is a category-3 pratique recommandée adopted 15 June 2015 with effect from 1 January 2016, applying “à tout modèle actuariel, qu’il soit basé sur des logiciels externes ou des développements internes”, read under a principle of proportionality and covering pricing and the technical studies attached to new products REG-R44 — the standard against which a published model documentation, worked example and test suite are judged. IFRS 17, effective for annual reporting periods beginning on or after 1 January 2023, measures a group of contracts as risk-adjusted fulfilment cash flows plus a contractual service margin REG-R45; French listed insurers report on that basis, with no French carve-out.