Intermediaries are well-placed to offer both big and small companies valuable advice when it comes to the important task of organising private medical cover for employees being sent abroad to work
Despite the failings of the NHS, anyone working in the UK will take the provision of family doctor appointments, dental work and emergency hospital treatment almost for granted. But once they move, or are sent abroad by their company, they can find that even the simplest health problems become nightmares.
In a climate of political instability on a global scale, the expat workforce remains undeterred. Figures from the UK's Office of National Statistics show that over 91,000 Britons left the UK in 2002, adding to the estimated 1.1 million working expats that Axa PPP Healthcare has identified already scattered across the globe.
Counting the cost
Be it a large multinational or a small business, any company sending employees on an overseas assignment - be it for a few weeks, months or years - holds an additional responsibility for the welfare of expat employees and their families. Employers must be well equipped to prepare their staff about their impending destination, from accommodation and food hygiene to schooling options and healthcare. Large multinationals supporting a network of offices across the world will tend to have their own in-house functions to deal with expat services. They may even employ their own doctor to carry out pre-travel health checks. Smaller enterprises are more likely to outsource their occupational health requirements.
Clearly, international assignments incur substantial costs in relation to relocation. Consequently, the costs of failure are also high. Choosing the right health insurance package is a key factor in the remuneration package, and intermediaries can play a key role in ensuring the expat assignment remains a healthy one.
THE HEALTH ISSUES
Understanding the diversity of the expatriate profile - and the types of companies that are sending them - is essential in order for intermediaries to recommend the most appropriate type of medical insurance. The location of their destination will have a direct impact on the healthcare needs of the working expatriate and their family.
For some expats, their destination may not even provide basic medical amenities locally. In parts of South-east Asia or West Africa, for example, a local clinic may be considered a luxury and the nearest doctor could be an hour's plane ride away. In other locations, the standard of healthcare may be exceptional, indeed far superior than what they may be used to back in the UK. In this scenario, it is likely that the corresponding cost of healthcare is substantial, as the table below demonstrates. Neither the employee nor the employer would be comfortable with shouldering the cost of medical treatment in this instance.
In countries where quality healthcare does exist and the state provides reputable medical facilities, there is an increasing amount of legislation that impacts both the extent to which the expat is eligible to receive state healthcare and the corresponding cost.
Intermediaries can guide companies through the minefield of healthcare legislation that exists globally. A number of countries are tightening their healthcare regulations for foreign nationals. In Switzerland, for example, expats must produce a certificate of insurance, signed by their PMI provider, confirming that they have adequate health insurance. In France, the introduction of 'CMU' to the state health system in 2000 has impacted residents.
Saudi Arabia is due to introduce legislation making it compulsory for all expatriate residents to purchase PMI cover, to avoid an excessive burden on its state health system. Intermediaries who are well read on these varying laws are a valuable tool for any individual or employer who is considering international PMI.
Medical insurance is a fundamental part of the expatriate benefit package. With it, the expat is reassured that they have access to quality healthcare at an affordable price. Being ill abroad can be unnerving, but quick access to private healthcare facilities will increase their chances of avoiding a prolonged period of sick leave or, even worse, returning home prematurely.
The demands of a corporate client are wide and varied and health insurers are continuing to enhance their corporate medical insurance packages in the changing international marketing. Intermediaries are well placed to help their corporate clients find the best healthcare solution for their employees.
On top of the usual cover for inpatient, day-patient and outpatient medical treatment, corporate clients are placing increasing value on a variety of options, including:
• Evacuation and repatriation. Should an expat employee become seriously ill, this service provides crucial emergency help and advice, to evacuate the patient to the nearest centre of medical excellence.
• Chronic conditions. Conditions such as asthma, diabetes and high blood pressure should not have a significant effect on employee ability to take on overseas work provided they are kept well under control.
• Pregnancy and childbirth. With extortionate medical costs, this is considered by many employees as a crucial benefit.
• Dental and optical. These benefits are valuable outside the UK, where the costs of treatment can soon stack up.
• Health checks. Provides reassurance that the employee remains fit and healthy throughout their time abroad.
• Vaccinations, drugs and dressings. Providing support to the expat employee who may be faced with higher costs for items such as prescription drugs or travel vaccinations.
In addition to the product offering, corporate clients understandably demand high service levels to ensure their expat employees are well provided for. Equally, they want to minimise their involvement in administration or claims queries. Intermediaries can identify providers who can provide the following added-value services to their core product:
• Global expertise. A medical provider that backs up product proposition with real international experience, with an understanding of the diversity of a market.
• Local knowledge. A provider who has invested the time to build relationships globally, ensuring networks of hospitals and third-party administrators are there on the ground.
• Around-the-clock health support. Ensuring that whatever their healthcare query, members can speak to a healthcare professional, whatever the day or time zone.
• Dedicated helplines. Enabling the corporate expat to phone their customer service team directly to get help and advice that is relevant to their medical policy.
• Claims help desk. A dedicated team of claims assessors experienced in paying international claims, whatever the currency or condition.
• Direct settlement of bills. Ensuring that wherever possible, inpatient bills are settled by the medical insurer directly with the hospital, to avoid the patient being out of pocket and having to seek reimbursement for costly medical treatment.
• Online services. Providing additional support by enabling expats to view policy details online.
Whether commission or fee-based, the increased premiums that are incurred by intermediaries from international products will generate healthy commission levels, to compensate the effort made. While the international PMI market demands an in-depth knowledge of the environments, health concerns and circumstances of an expat client and their employers, advisers bold enough to take on this challenge will discover a diverse and rewarding market.
Choosing the right health insurance package is a key factor in an expatriate's remuneration package, and intermediaries can play a key role in ensuring the expat assignment remains a healthy one.
With more countries tightening healthcare regulations for foreign nationals, advisers can guide firms through the minefield of legislation.
Intermediaries can identify providers who can provide added-value services to their core product.
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