The August-2004 reform Law has reformed the CNAMTS Council's role by entrusting it with a steering, monitoring and assessing role of the Health Insurance Policy.
As a result, the CNAMTS Council determines guidelines concerning:
- The Health Insurance contribution to the application of the healthcare policy and the organisation of the healthcare system, including healthcare establishments, and the right use of prevention and treatment.
- The risk management policy and objectives set for its application.
- The draft budget, in expenditures and revenues, for the coming year.
- The COG concluded for a minimum of 3 years with the State, signed by the Council President and the Managing Director.
- The principles governing measures of control, prevention, and abuse and fraud prevention.
- The improvement of the quality of services provided to users.
- The communication policy for policyholders and healthcare professionals.
- The organisation of the network of regional and local bodies, and their groups or unions.
- The national management and intervention budgets.
The CNAMTS Council is made up of 35 members :
- 13 representatives of policyholders, named by salaried-trade union organizations at a national level (CGT, CFDT, CGT-FO, CFTC, CFE-CGC).
- 13 employers' representatives, named by national employer professional organizations (MEDEF, CGPME, UPA).
- 3 representatives named by the French National Federation of Mutual Health Insurance Companies (Fédération nationale de la mutualité française / FNMF).
- 4 representatives of institutions involved in the health insurance sector, named by the Minister responsible for Social Security (FNATH, UNAPL, UNAF, Collectif inter-associatif sur la santé).
- 2 qualified individuals in the activities of health insurance organisations, named by the Minister responsible for Social Security.
3 staff representatives (respectively representing the employees and the like, medical advisers and managers) sit at Council meetings and have a consultative role.
The Managing Director, the national finance and accounting director, the economic and financial controller and the national medical adviser also attend the Council. Government commissioners represent Ministers responsible for Social security and for Budget.
The Council is appointed for a five-year period.
It elects its President and Vice-President by secret ballot.