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This article simultaneously examines the rationality, legitimacy and equity of socio-fiscal expenditure aimed at implementing collective top-up health insurance schemes within businesses. This type of spending is fairly well-established, but changed fundamentally from the 1 January 2016, from which date businesses are required to finance at least 50% of supplementary health cover for their employees. The system of incentives which dominated previously has therefore given way to one of subsidisation of private insurance purchasing. Though numerous questions and criticisms have been raised in relation to the inconsistent and unequal nature of such subsidisation as well as the inefficient coexistence of “AMO” (assurance maladie obligatoire = compulsory health insurance) and “AMC” (assurance maladie complémentaire = supplementary or top-up health insurance), private insurance does nevertheless seem to be the inevitable destination of reforms to health insurance.