The area we think of as the Gulf is a maelstrom of modernist ambition and staunch heritage, driven by aspirations to succeed and guided by desires to conform. For instance: despite its influx of oil-fuelled wealth and supercars per square mile, it may surprise you to learn that the first Apple store in Dubai wasn’t scheduled to open until October 2015.
But at the other end of a development spectrum, would you care to estimate the percentage split of female to male employees in the public sector? It is just over 65% to 35% at the moment, with empowerment ensuring that women now occupy key decision-making positions in every sector, according to the Dubai Woman Establishment and the UAE Gender Balance Council.
With such mixed approaches from an authority that is intent on moving with the times, perhaps it is not a surprise to discover that many elements of the region’s regulatory health framework are still a bundle of red-tape that keeps the rest of us on our toes.
PMI requirements
To work in Dubai, for example, employees must have compliant private medical insurance (PMI) in place before they can be issued with a visa. What is more, that insurance must adhere to regulatory measures stipulated by the Dubai Health Authority, and match mandatory benefits, including maternity provision and the non-exclusion of pre-existing conditions. Any dependents or spouses must also be covered by the employer or employee before a visa is granted, and there are some obligations that pertain specifically to employers alone.
First, the organisation must bear all the costs. Second, all policies must be fully insured; healthcare trusts and self-funded schemes are not acceptable. Finally, the employer must verify in advance that the insurance will be valid for the entire length of the employee’s tenure in the country.
Straightforward enough maybe, but that is just the tip of an iceberg: there is a prerogative to update the rules and regulations on a regular basis. Regulatory health measures do serve a specific purpose, however. As well as helping to ensure order in the region, they help to maintain a healthy workforce too (thereby reducing absenteeism costs, while at the same time promoting productivity levels). And in some cases, they can help individuals to conform with cultural and social norms for the region.
Penalties for non-compliance
The penalties for non-compliance? These may include fines, a stop on allowing other employees to work in the country, and potentially the cessation of all business practice. Time-consuming and expensive in every sense, so the need for up-to-date insights and knowledge is relatively clear.
A greater need for better insights
While very few insurers could provide this level of support or insight a few years ago, now, there are several fully compliant international PMI providers promoting policies for the region. That is good news for expatriates. For employers however, the question is how do they differentiate between those insurers objectively?
Firstly, it is about finding a provider that works with an organisation to understand what the current health needs of employees are, as well as providing for their day-to-day welfare overseas. It is also about providing easy access to prescription medication, vaccinations, dental care and eye care, as well as having a proven ability to network with local providers and offer appropriate wellbeing services in situ.
In addition to having a phone number that is easy to call 24/7, it is about having the services in place to offer translation services when and where they are needed, and liaison that is effective between employees overseas and families at home, if necessary.
It is important to find an organisation with the experience to push back on hospitals’ invoices if appropriate: analyse invoices with an informed eye, and challenge the costs if these are abnormally high.
And for employees? It is about finding an insurer that is prepared to invest heavily in access to clinical expertise, to have teams with the medical knowledge necessary, to suggest alternative treatments, drugs perhaps, or rehabilitative care pathways.
Greater involvement in building the right policy can help to reduce costs from the outset, too. But it is the cost of not having the right policy in place that should be a greater concern: the consequences of having employees on the ground who are not supported adequately could be devastating, to the employer, as well as the employee.
Martin Sellars is head of international PMI at Aviva UK Health
