Assessing expatriate risk and identifying the right private healthcare cover to provide for employees creates major challenges for employers, says Alison Coleman
In today’s global economy, employers are increasingly competing for the best people to look after their growing international business activities. Inevitably, this involves deploying key personnel overseas, often in far-flung destinations.
Topping the list of benefits that should be provided to this group of employees is health insurance. But as the foreign destinations become more widespread, raising the prospect of potential health threats, assessing the risks and providing the right cover is creating major challenges for employers.
David Heppard, head of international business at employee wellbeing specialists IHC, says the worst thing an employer can do is to send someone overseas without being sure that the health cover they are providing is suitable for the employee and any travelling dependants who accompany them. “Some employers still insist on their staff simply going into existing schemes, but depending on where in the world they are being sent, these may not be adequate,” he explains.
When purchasing international healthcare cover for expatriates, there are a number of factors employers must take into account. As well as the various risk factors associated with each particular destination, standards of medical care also vary from country to country, and even between cities and towns within a country. So knowing exactly what is available in each location is crucial, says Adam Thomson, head of expatriate and international benefit programmes at Mercer.”This is one of the biggest challenges for the expatriate market. Information is often disparate, and identifying what facilities exist, particularly in remote areas, is hugely difficult, yet it is a critical factor in proper expatriate healthcare provision,” he explains.
Some countries, such as China, India and Russia, are now making the approval of visas conditional upon proof of employees’ inclusion in an approved medical insurance scheme.
Employers should also extend medical cover to worst-case scenarios as in the event of a life-threatening illness or accident, for example, expatriates may need to be evacuated to the nearest country where appropriate care can be given, or repatriated.
Facing lengthy assignments of a year or more, many expatriates decide to take their families with them, and want to ensure they also have appropriate health cover. Although such cover adds to the value of the package as an incentive, Martin Banks, head of international at Norwich Union Life, says this is not always popular with clients. “We find that some employers are reluctant to provide this additional cover because it does add to the cost,” he explains.
But IHC’s Heppard believes that forward-thinking employers see this move as an investment, and many now include cover for maternity and dental expenses, and for both emergency and routine treatment and care, as standard.
Some policies will also cover chronic medical conditions that require long-term treatment, although most require an assessment of any pre-existing health conditions. James Cooper, sales director at William Russell, a provider of expatriate health insurance plans, explains: “We normally offer cover on a moratorium basis, excluding treatment for conditions that existed during the 24-month period prior to commencement of cover. After an insured person has been symptom and treatment-free for a continuous period of 24 months, pre-existing conditions may be eligible for cover.” Alternatively, he explains, cover can be provided on a full medical history underwriting basis and a ‘continued personal medical exclusions’ basis.
Aside from ensuring employers meet their duty-of-care obligations to employees, providing healthcare perks to expatriates can be beneficial for organisations. Health insurance is one of the primary determining factors for people in accepting an overseas assignment, says Mercer’s Thomson. “Increasingly, employers see these assignments as a key part of the personal development and career enhancement for their most valuable members of staff, so the benefits package has to be right, from pre-assignment issues, to the assignment itself, and finally to the post-assignment stage, where individuals are reintegrated back into the [domestic] benefits and healthcare schemes on their return,” he explains.
If you read nothing else read this…
- Identifying potential health risks, plus the standards of healthcare and medical facilities in the destination country is crucial.
- Health insurance policies should be robust enough to provide for all eventualities.
- The inclusion of cover for routine health screening, dental and maternity treatments turns a market standard benefits package into a top-of-the-range offering and a highly-effective retention tool.
- Some policies will cover chronic medical conditions that require long-term treatment, but most providers would insist on an assessment of any pre-existing health conditions.