Research shows inadequate health and wellbeing support for global employees

According to new research, companies are putting themselves – and their overseas employees – at risk by not offering the right health and wellbeing support. Sarah Dennis, head of international at Towergate Health & Protection, shares the latest findings from the independent adviser’s research and the pitfalls employers need to avoid.


This article is taken from the Summer 2024 issue of

Think Global People magazine

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When a company has overseas employees, it may seem ‘fair’ to offer everyone the same health and wellbeing support, wherever they are based in the world. This is rarely the case. Not only is it often an ineffective approach, but it could also lead to major non-compliance issues.  Towergate Health & Protection’s latest research based on the response of 500 HR professionals in January 2024 into health and wellbeing support reveals 57% of companies with overseas employees are open to this risk. This is because they offer the same health and wellbeing support to those working abroad as those based in the UK.Employees working abroad generally need, and are entitled to, different support compared to those working in the UK. And, as much as it may be an issue if specific benefits are not provided in some countries, it may also cause unintended issues if they are provided.

Differences by country

Employers need to know about, and comply with, any mandatory legislation regarding the health and wellbeing support they offer in the countries their employees are based. Local governing bodies will often stipulate what health and wellbeing support needs to be offered.What is provided in the UK may therefore not be fit-for-purpose in other countries and regions. Rules in some countries may also bear no resemblance to those in the UK, so it is important for employers to take expert advice.People from the UK going to work in other countries may also require different health and wellbeing support from those who originate from that particular country. This may be because local nationals are offered additional benefits by virtue of being born in the country, and those from the UK may not automatically have access to these benefits, so employers need to make them available.

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Implications of non-compliance

Not offering the right level of health and wellbeing support can have legal consequences. Working visas may be reliant on particular health cover and can be revoked if it is not provided, so it is vital that employers get this right.As well as legal implications, there can also be tax implications when overseas employees are over-compensated with benefits. In some countries, such as Germany, employees are taxed to cover their medical care, so they may just need top-up benefits. Overcompensating an employee can lead to additional and unnecessary tax. 

Fit for purpose

The good news is that 41% of companies with overseas employees offer different benefits from those offered in the UK. However, they still need to ensure that the health and wellbeing support they offer is fit-for-purpose, and the right level for globally mobile employees and in-country nationals accordingly. It is important for companies with employees abroad to benchmark their offering. This should not only be by country or region, but also by sector, as it will help companies be genuinely competitive in attracting and retaining the right talent.Health and wellbeing support should not be just blanket cover for all employees abroad. It should be carefully tailored to meet employees’ needs based on the countries in which they are working. Employers must make use of in-county expertise to help ensure that they are fully meeting their responsibilities.
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Offering cash lump sums

Many employers simply offer their employees a lump sum and leave them to buy their own health and wellbeing cover, giving them the freedom to choose what they think is right. Indeed, Towergate Health & Protection’s research shows that 83% of employers with overseas staff give their employees a cash lump sum for them to choose their own benefits. This is, however, rarely the best option.Providing a cash lump sum, rather than offering specific benefits, leaves both the employer and the employee open to the unknown, which can prove risky. Employee benefits are a specialist area and it is best to take expert advice to ensure both the employer and the employee are properly protected.

Employer impact

It can be more expensive for an individual to purchase their own healthcare than for an employer via a group scheme. Employers will benefit from economies of scale when they purchase cover for a number of employees; providing individuals with lump sums is likely to work out to be more expensive. Employers have a duty of care to all employees. It could be argued, especially for employees working abroad, that this is not fulfilled by offering a lump sum rather than specific health and wellbeing support from an approved and expert source.Health and wellbeing support and the surrounding employee benefits are a crucial part of attracting and retaining the right talent, especially for overseas posts. If the employer is purely providing a cash lump sum, then this does not reflect well on their care for employees and may impact the recruitment process and mean that staff are less likely to want to work for them.

Employee impact

In some countries, certain employee benefits are mandatory in order for the employee to be eligible for a working visa, such as having PMI in Dubai. If the employee selects their own benefits, then they are at risk of not knowing which are compulsory and leave themselves, and their employer, open to non-compliance issues, such as working visas not being given, or being revoked.There is also a risk of poor, uninformed choices being made. An employee is unlikely to know the best ways to spend the money available and they may not buy the cover they need. If they fail to buy dental insurance, for example, costs for treatment abroad can be astronomical. Individuals are not experts in health and wellbeing support.Many of the employee benefits available are technical and benefit from a high level of understanding to find the right cover, such as international PMI, life assurance and income protection. This is particularly true of benefits being purchased abroad or to cover international employees. This can be an onerous task for individuals to take on in addition to their day job.Furthermore, if an overseas employee purchases their own benefits, then they will not receive employer communications regarding health and wellbeing support, what is available and how to access it. This communication is vital to benefit take-up and, as a result, utilisation is likely to be lower. 

Equity not equality: advice over choice  

When it comes to overseas staff and their health and wellbeing support, offering the same benefits to all rarely benefits all. This approach can put overseas employees at a distinct disadvantage as they have different requirements to those based in the UK.Allowing employees to choose their own benefits, such as providing a cash lump sum, is also not as considerate as it may sound. Providing expertise and guidance is far more important. The employee benefits selected by a professional with experience in overseas markets are likely to offer far better support than those chosen by the individual employee. 

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