Need to know:
- Prior to assignment, an employer can tailor its private medical insurance (PMI) plan to suit budgets or local markets.
- Employers need to make sure that they work with a provider, or broker, that has knowledge of global markets.
- Employers should make sure that the provider offers expats access to a good medical care network.
Prior to sending employees abroad for expatriate assignment, employers must first ensure that their private medical insurance (PMI) policies are sufficient to protect the health and wellbeing of their mobile staff. So what are the key things employers should consider before an employee embarks on assignment?
Understand global rules
When providing insurance for expats, an employer must ensure that it chooses a PMI provider that has an understanding of the local rules and regulations that can affect cover. While employers may want all expatriates to have the same cover wherever they are in the world, this simply is not possible due to complex legislation that sits behind PMI in different locations.
Paul Winstanley, head of business development at Generali Global Health, says: “If [employers] want to provide insurance that is more locally based, they need to consider things like international sanctions. [For example], UK-based insurers would have to adhere to the EU sanctions list; countries on there [include] Sudan, Somalia, the Congo, Ukraine and Russia.”
This means that while the insurer will insure employees, it will probably not be allowed to pay claims directly in that country because it will not be permitted to take money in or out of the country. In these cases, the employee would have to pay for the treatment, which can be very expensive in some instances, and claim it back. This can be done either in their home country or through the insurer’s e-claims portal, as long as the employee’s bank account is outside of the sanctioned country in which they are based.
The insurer must also be able to advise the employer on how legislation impacting coverage differs across countries. For example, in Abu Dhabi, insurers must cover maternity costs in full; in Germany, the law states that expats must have cover for long-term nursing care; and in Switzerland, insurance is not necessarily legally compliant across all cantons, or federal states.
Tailor the plan
As with UK plans, PMI for expatriates can be a costly benefit, but there are steps employers can take to counter this. Working with their insurer they can determine the best product or model for their expatriates; this could, for example, include introducing co-insurance or an excess so that employees can claim what they want but have to pay for a certain amount themselves. “For the employer, it means their expats have some ‘skin in the game’, [so] they are on the side of the employer knowing that this benefit costs quite a lot,” says Winstanley.
Employers might also want to consider offering expats certain products tailored to the location they are going to. Rebecca White, head of proposition, accident and health at insurer Collinson Group, says: “For example, if the employee’s assignment is in Singapore where there are very good medical facilities, it may be in that case the employer decides to put that assignee on a local product, but then also buys them evacuation and repatriation cover just in case they have a medical emergency for which they’d rather be treated at home.”
Ensure access to good medical networks
Wherever they are sending an employee, employers need to ensure that individual has access to a good network of hospitals, clinics and doctors. If an insurer has a good network, typically it will have negotiated good rates with hospitals, which will then make the insurance cheaper for the employer.
Joe Barber, senior consultant at Willis Towers Watson, says: “It comes down to access to care and the prime locations that employees will expect to go to receive care, whether that be a medical clinic, a hospital, [or] pharmacies. Through engagement with their PMI insurer they’ll have a programme where [they] can download information about quality of care, access to care and then be provided with a list of facilities, maybe some with English-speaking doctors and nurses, and what to expect from that experience.”
Consider wellbeing add-ons
The expat PMI market has seen a change in demand for additional services that are available through insurance policies and look after employees’ wellbeing. “For example, a product that provides expat assistance, like an [employee assistance programme] EAP but specifically with expats in mind [covering] issues such as leaving family and friends behind, is often [included] in a package with financial and legal advice tailored specifically for expats,” says White.
Other pre-assignment services are also in demand, such as knowing where an employee can get a prescription fulfilled, or the ability, through virtual health services, to have a consultation with a GP over Skype, says Damian Lenihan, executive director of distribution at Aetna. “Employers can demonstrate the duty of care they are taking for their employees,” he adds.