Choosing medical insurance for globally mobile employees

Appropriate international private medical insurance cover is an essential component of employers’ provision for their international assignees, business travellers, and expatriate employees.

Global Health - medical insurance and iPMI
International private medical insurance, or iPMI, is essential to protect the health of employees working overseas. Employers who rely on reciprocal agreements or the local healthcare system may find their assignees cannot access the treatment they need.In some countries, high-quality healthcare is available but very expensive. In others, healthcare provision and medical facilities are not of the standard found in the home country.Employers should note that the European Health Insurance Card (EHIC, previously the E111) and/or travel insurance do not provide sufficient protection for employees working or travelling in Europe, says Adam Harding, of employee benefits company Jelf International
European Health Insurance Card (EHIC)
European Heath Insurance Card
“If you are relocating staff abroad, then part of that process is agreeing effective health cover for them,” says Mr Harding. “It’s a common misconception that the EHIC will allow anyone access to healthcare across Europe; the card is primarily aimed at short-term holidaymakers.”He continues, “The simple message is that international PMI is a vital consideration for expats. Travel insurance may also be required by overseas staff, particularly if travelling outside their base location. Policy wording will include clear guidelines about how often employees can travel, and how long they can be overseas.

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“However, there is likely to be an element of duplicate cover. A professional adviser can ensure an employer is not paying more than they need to in such scenarios, but will ensure they have adequate cover – the most important thing.”When selecting a medical insurance policy, it’s important to work with a provider which can demonstrate its understanding of the local area, from both risk and regulatory viewpoints, by developing products that reflect any specific health risks and are fully compliant with local regulations.In regions where medical insurance is mandatory for expats – Abu Dhabi, for example – a work visa will not be provided unless there is proof that the product has been authorised by the appropriate authorities.

Choosing a medical insurance policy

When choosing expatriate medical insurance or a corporate medical plan, remember that health insurance policies vary enormously, so it’s vital to compare health insurance plans. Types of International private medical insurance policy include group health plans and individual health insurance.Different levels of cover, suitable for employees of differing levels of seniority, are usually offered. Industry-specific schemes – covering, for example, the oil and gas sector – are also available.When it comes to deciding what elements of cover are required, risk assessment and planning are essential. These should consider not only the assignee and his or her family’s health history but also the risks endemic to the destination country, area or city. Pre-assignment assessments and health screening can be invaluable.
Among the health and security risk factors to consider are:
  • Whether the assignee has any pre-existing medical conditions, and, if so, whether there are facilities in the destination location to manage them – for example, access to the necessary prescription drugs
  • Any infectious diseases prevalent in the destination location. In many cases, these can be dealt with through vaccinations, immunisations, medication and/or health advice. Vaccines are available for diarrhoeal diseases such as cholera, typhoid and hepatitis A, and for respiratory diseases like influenza (or flu), pneumonia and tuberculosis. The World Health Organization publishes details of the latest vaccination recommendations for countries around the world on its website
  • Risks that may arise from trauma, such as road-traffic accidents
In cases of sudden serious illness or serious injury, medical evacuation, usually to the nearest location offering the necessary facilities and care, or even repatriation to the home country, may be the only option.It’s essential to check whether medical evacuation and/or repatriation are included in the private medical insurance policy you choose, as not all insurers cover them as standard.Be aware, also, that international health policies vary in what they pay out for. Some cover evacuation but not repatriation, while others cover outward transport from the country of residence but not return transport.If the assignee has accompanying family, it’s important that the policy also covers their repatriation. It’s also wise to check for any excluded health conditions.

Mixing business with pleasure

Don’t forget to include cover for any leisure days employees on business trips may take. According to research by Collinson Group, 72 per cent of corporate travellers bolt leisure days on to business trips, and 89 per cent of companies allow this type of 'bleisure' travel. Despite this, 31 per cent of firms say that employees aren't protected by their company's travel risk policy during these additional days.The findings raise concerns that employers may not be fulfilling their duty of care to employees. Collinson Group believes that employers should look to address the 'grey area' of bleisure days within their corporate travel policies, particularly in the absence of a set legal precedent over the question of employer accountability.Enhancements such as international employee assistance programmes, or EAPs, provided as add-ons by some insurers, are now increasingly being offered as part of the International private medical insurance package. By addressing wider wellbeing issues than the purely physical, international employee assistance programmes are a logical next step in supporting globally mobile employees.As well as choosing an expatriate health insurance plan that meets the needs of their staff, employers should make use of the technology add-ons which many insurers offer as part of the package.

For more news and features about health and wellness, visit our Global Health and Wellness section.


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