How to roll out healthcare and wellbeing benefits globally

Global healthcare

Need to know:

Employers looking to roll out healthcare and wellbeing benefits globally need to use culturally appropriate language to effectively engage employees across different locations.
Creating a global framework that allows for local tailoring is effective for supporting geographically dispersed staff while adhering to an overall vision.
Buy-in from local HR teams, as well as senior leaders, ensures that country-specific challenges and considerations are accommodated.

Health and wellbeing remains a key agenda item for the majority of employers, but those that are based across different continents and countries may experience greater trepidation when preparing to roll out initiatives.

Sharon Tebb, former compensation and benefits manager at Withers, says: “There are numerous challenges, because [we are] talking different countries and [a] diverse workforce; coordination of benefits across multiple geographical boundaries is not easy. What works very well in one location may be a complete no-no in another.”

Nevertheless, 60% of multinational employers want to create a financial wellbeing or health and wellbeing strategy, according to the Global benefits governance study 2018-2019, published by Aon in April 2019.

Challenges and considerations

A primary challenge when taking a global approach to health and wellbeing is to understand the cultural norms and expectations of individual jurisdictions; for example, perceptions around mental health support.

Patrick Watt, commercial director at Bupa Global, explains: “[While] offering mental health [support] in Western or more developed countries is quite commonplace, there’s some countries where culturally, [employees] just don’t talk about it. If [employers] impose Western views in those cultures, it can cause real conflict and defeat the purpose of having a global plan.”

Legal compliance should also be addressed in terms of minimum mandatory healthcare benefits, which differ according to location. A specialist global consultant can help in this area.

“Both the employee and the employer can incur fines if policies do not adhere to local legislation and regulation," Tebb says. "The starting point for any good global health and wellbeing strategy should be to ensure local and mandatory legislative requirements are fully met, and also that commonly offered local benefits are also considered.”

Furthermore, different locations might have varying primary health risks. For example, Chris Bailey, partner at Mercer, notes that Irish employees more commonly experience vitamin D deficiencies, while in South East Asia, smoking and lung-related diseases are a greater issue. “Having an understanding of the employee population and issues they’re likely to present with is really important," he says.

The size of the employee population in certain geographies can pose a consistency challenge, too; large head offices may be able to facilitate benefits such as group private medical insurance (PMI) schemes or group income protection arrangements, while smaller sites may not have the economy of scale to action these. This could lead to the implementation of costly individual arrangements.

Global approach, local implementation

The key to implementing a global approach to health and wellbeing lies in creating an overarching framework which clearly defines and identifies key deliverables, principles or values, as well as minimum benefit levels. This can then be used to steer local benefits packages and initiatives.

“It’s quite common to start with a global framework that then gets interpreted regionally, making sure the [regional] provision is in line with the aspiration, but made relevant to that local market,” Bailey adds.

In addition to senior support and investment, employers should seek to gain buy-in and feedback from local HR teams to help navigate legal complexities, highlight cultural nuances and challenges, and ensure local teams understand and embody the global ethos.

A diverse workforce

Adopting a culturally sensitive stance is essential, and employers must understand than no one size will fit all. Employers should also be aware that the provision and availability of benefits themselves will vary from country to country, as will the level of state benefits.

Mark Harris, consultancy leader, international at Mercer, says: “A Swiss native would be expecting a different level of benefits and certainly a more comprehensive suite than maybe a US citizen, who’d be much more used to an employee co-pay-type benefit design. Understanding the cultural nuances of the individual and how that leaks in to the global strategy is fundamentally important.”

Other considerations include exercise and nutrition advice, says Simon Ball, head of international risk and healthcare at Fidelity Workplace Consulting: “In [the Middle East], it would be highly unusual for a woman to be exercising outdoors, and in a country that is very hot for the majority of the year, it may be that during the summer months exercise outdoors is rarely done. For nutritional advice, [employers] need to align it to both the food that’s available locally and the food that is usual and customary for these individuals to eat.”

Providing content in local languages and using relevant terminology is also important; for example, 'GP' may be suitable in the UK, but Americans would refer to a doctor or physician. In Asia, 'coaching' is more frequently used than 'counselling', because it has more positive connotations. This would also apply for mental health, which is commonly termed as mental resilience or mental fitness in this part of the world.

So, how can employers get to grips with the needs of a diverse, global workforce? The answer lies in gathering employee feedback, via surveys, focus groups, local wellbeing champions and suggestion boxes, as well as collating data from sources such as benefits claims, employee health risk assessments, employee assistance programme (EAP) usage and benchmarking analysis from benefits consultants. This spectrum of information can provide insights on employees’ medical status and lifestyle, which can help inform local strategies.

Using the universals

Preventative health programmes that centre around overall wellbeing and the promotion of a healthy lifestyle can be the easiest to roll out globally, says Bailey: “Having a healthy lifestyle is relatively easy to promote; interpretation of that will depend on the market, but that aim and the vision stays consistent, which is really important.”

International EAPs are a low-cost and easily accessible support service that an employer can roll out globally to staff and their families.

Creating educational events around globally recognised events, such as World Health Day in April and World Mental Health Day in October, can also create a framework for an international approach.

Communicating to all

“One of the aims for these programmes is to create a common employee experience, wherever [staff] may be based around the world, and create that linked experience,” Bailey says.

Employers can achieve this by creating a health and wellbeing communications brand; this can articulate the advantages and aims of the approach, and ensure that even varied initiatives are communicated under the same unified umbrella, showing that all staff are included and being considered.

“Organisations that do this well will have commonality in terms of brand; a brand that resonates and promotes health and wellbeing across various geographies,” Watt adds.

Although rolling out healthcare and wellbeing benefits globally might seem intimidating, with a vast array of challenges and sensitivities to bear in mind, this type of approach can be hugely beneficial for uniting international employees and providing more ready access to support where it might currently be lacking.

Annelise Tracy Phillips: Implementing a global wellbeing strategy