Issue and expected outcomes

10 MNEs engagement in extending social security examples of practices A questionnaire was sent to the HR services of each of the 56 subsidiaries so they could perform a self-assessment. Danone also contracted a consulting company in order to go through the responses, challenge them exchange back and forth with the subsidiaries in order to obtain the most objective assessment possible and analyse them. Few elements of benchmark regarding market practices i.e. collection of the levels of protection offered by other companies in the same country were collected and taken into account since at the time, the objective was to get a picture of the position of each subsidiary against the ambitions of the Dan‘Cares programme that were already set and not against competing companies. Definition of internal minimum levels of protection The Dan‘Cares programme provides guidelines that set an internally defined minimum level of medical care protection covering all employees permanent and temporary meeting the following criteria: – the composition of the minimum health care package is: inpatient, outpatient and maternity care as well as basic medicine; – the minimum accessibility criteria are: provide accessible, quality care at an affordable price the out-of-pocket payment borne by the worker should not be over 20 percent of the total cost of care. In other words, the Dan‘Cares programme guidelines define the provided coverage as follows 6 : – scope: complementary medical care; – extent: all employees permanent and temporary; – level: at least 80percent of the cost of inpatient, outpatient and maternity care in geographically accessible facilities as well as basic medicine are covered the out-of- pocket payment borne by the worker should not be over 20 percent of the total cost of care. International commitment The Dan‘Cares programme was one of the topics developed through the social dialogue led between Danone and UITA. In 2011, Danone and UITA signed an IFA, which i ncluded both the commitment in terms of invalidity and survivor‘s benefits and the provisions of the Dan‘Cares programme as regards medical care. This allowed for an institutionalization of the programme, and was the only time to date a multinational enterprise and a global union agreed on a detailed health insurance minimum package for all employees. 6 See the International Labour Organisation definition of coverage in ILO: World Social Security Report 201011 Geneva, 2010, p. 22. MNEs engagement in extending social security examples of practices 11 Figure 3. Extract of the Danone-IUF international framework agreement on health, safety, working conditions and stress, 2011 “Danone considers that its health mission must be reflected primarily in actions for the benefit of its employees. To this end, Danone has taken a number of initiatives HealthWork, Dan’Cares. HealthWork actions are designed to inform and make Danone employees aware of better health through dietary habits and physical activity, etc.. Similarly the Dan’Cares action plan is intended to provide minimum medical cover for all employees, primarily by ensuring that fundamental needs hospitalization, maternity, medical consultations are covered by local schemes andor insurance cofinanced by Danone companies and its employees, at a cost and of a quality and accessibility above or at least equal to those offered by other locally established international groups. The application of the D an’Cares action plan could be the subject of dialogue between the trade unions andor staff representative bodies. Subject to local legislation, where staffs are asked to contribute, the introduction of medical care cover shall be the subject of negotiation. Employees of all Danone companies shall be covered under a disabilitylife insurance scheme.” Source: Danone-IUF international framework agreement on health, safety, working conditions and stress, 2011. As regards disability and survivor‘s 7 benefits, the internally set minimum level is equal to one year growth salary in the form of a lump sum. The rest of this case study focuses on the Dan‘Cares programme which relates to medical care benefits since the process for defining the minimum level of protection and implementing it was far more complex 8 . Implementation mechanisms The implementation was progressive. The process undertaken by each subsidiary when joining the Dan‘Cares programme is the following: conduct the assessment, undertake a gap analys is where are we in comparison to Dan‘Cares guidelines and elaborate and implement an action plan by the end of which the level of protection enjoyed by workers complies with Dan‘Cares guidelines. After the assessment and gap analysis, each subsidiary has to provide a yearly action plan that it has to follow and report on to headquarters. In this plan, the subsidiary has to detail the local needs the new medical care benefits will respond to what is already covered by the national health insurance, if any, what is already covered by a complementary plan, if any, and what will be covered through the new plan. The action plan also details how the medical care insurance will be financed, including if the subsidiary will need financial support from headquarters to start the implementation. The programme is result-oriented; each subsidiary is free to choose its own implementation mechanism. The new medical care insurance can be made available through a private insurer, a pooling of insurers, a mutual health fund, etc. Each subsidiary is also free to go beyond the minimum medical care package and accessibility criteria set by Dan‘Cares guidelines. Still, harmonization between the subsidiaries of the same country is encouraged with a view to reduce costs and facilitate staff mobility. For instance, in 7 Though the International Framework Agreement mentions ―life insurance‖, the international terminology as defined by International Labour Organisation Convention No. 102 for the guarantee covered is ―survivor‘s benefit‖. 8 According to our interlocutors at Danone, many countries of operation already had statutory obligations and or many subsidiaries already had complementary benefits in place that met this internally set minimal level when the International Framework Agreement was signed. Also, put in place such benefit is easier for the subsidiaries than medical care benefits it is easy to see whether or not they meet the requirement and subsequently renegociate their insurance policy accordingly.