Updated by Victoria Giroud-Castiella , Tharcisse Nkanagu on 21.04.2017
The Tunisian social security system is essentially State-run. There are two funds under State supervision which manage the statutory social security schemes: the 'Caisse Nationale de Retraite et de Prévoyance Sociale' (CNRPS - National Pension and Social Contingency Fund) for the public sector and the 'Caisse Nationale de Sécurité Sociale' (CNSS - National Social Security Fund) for the private sector. The boards of administration of these funds are composed on a tripartite basis (State, employers and employees). Private sector intervention (insurance companies and mutual benefit organizations) remains very limited and takes the form of complementary and optional management of health care coverage.
Statutory social security schemes currently cover the vast majority of the working population in employment. Social development and social assistance programmes are intended for low-income categories and persons who are not covered by any social security schemes. These include of programmes of aid for needy families, programmes targeting the elderly and disabled, the granting of an allowance to families who agree to take in an elderly person and free medical assistance.
More than 80% of the Tunisian population has health coverage (in 2006) that allows access to medical care either through social health insurance or public medical assistance program. This percentage is particularly high for a middle-income country like Tunisia. The population not yet covered by social security legislation include casual and seasonal agricultural workers, workers on development sites, domestic employees, home helpers, religious officials, the unemployed. The reasons that these categories are not covered include their marginal nature, their limited ability to pay contributions and their reliance on alternative forms of social protection. In order to increase coverage measures have been taken with varying success: inspection and compulsory affiliation procedures; free medical assistance subject to verification that the applicant was not insured under a social security scheme; and schemes being adapted to the needs of injured persons. The objective is to extend and improve coverage of social security by conducting studies and adapting schemes to the needs and financial capacities of the categories of persons; modifying the conditions for determining and recovering contributions taking into account the specific characteristics of the populations concerned; and consulting the representatives of the target population and of employers at all stages during the establishment of the system.