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Civility
Mister
Missus
Last name
First name
Date of birth
Nationality
Country of Residence
Marital situation
Married
Divorced
Widow(er)
Single
PACS
Concubine
Professional situation
Employee
Self-employed
Retired
Monthly salary
CFE member ?
Yes
No
Type of subscription
Individual
Duo
Family
Partner
Civility
Mister
Missus
Last name
First name
Date of birth
Professional situation
Employee
Self-employed
Retired
Monthly salary
Children
Add a child
Desired guarantees
Hospitalization
Yes
No
Current medical expenses
Yes
No
Optical
Yes
No
Dental
Yes
No
Maternity
Yes
No
Repatriation
Yes
No
Death benefit
No
10.000€
50.000€
100.000€
Daily allowance
No
50€/day with 60-day franchise
50€/day with 90-day franchise
75€/day with 60-day franchise
75€/day with 90-day franchise
Civil liability
Yes
No
Funeral allowance
No
5000€
7500€
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