Spot the trend

CIGNA International Expatriate Benefits’ Mark Coleman outlines the latest take on expatriate postings.

Decisions are easy with the benefit of hindsight. The greatest skill, of course, is identifying new trends as they emerge. Maximising the benefits of technology, and creating strategic alliances ahead of legislative decisions – those are the skills that differentiate excellent healthcare providers from the merely ordinary. Cultural preparation and the health of expatriates and their families has always been key to the success of international assignments, and there was a time when a posting to Paris or Brussels would have made locating the whole family an automatic decision – with the added costs of re-location, international PMI for the whole family, and independent school fees. But the new trend is to remove the unknown quantity of families from the equation. Affordable flights and Eurostar trains have shrunk parts of Europe to a weekly commute. Re-locating a whole family is no longer the automatic decision it once was.

Married couples and families make six or seven times more claims on an international PMI plan than single people. Being able to select employees for assignment gives companies an element of screening in the process, and assignees tend to be healthier. When it comes to the family, they have no influence or control. Expatriate healthcare also tends to be assurance, as well as insurance. 12- 15% of insureds will claim on their domestic PMI plan, but around 60% claim on international PMI. Deprived of free primary healthcare available in the UK, it is not a question of whether assignees and their families will use benefits such as dental and vision, included in a comprehensive International PMI plan, but when.

Call in the night
Customers need to test and research insurers’ service provision and global reach when selecting the most appropriate insurer for their expatriate workforce. After all, no HR Director wants a call in the night from a stranded expatriate nursing a sick child, with no idea where to seek appropriate healthcare or treatment. But service isn’t simply answering a phone. It’s the ‘back office’ functions that provide a complete operation – efficient claims settlement, clear information, and communication material.

For as little as 3-5 per cent of the premium on a standard international healthcare plan, the cost implications of providing a family with international medical ‘assurance’ can also be mitigated. Low-cost benefits to maintain ‘wellness’ include routine physical examinations, cervical smears, mammograms and prostate cancer screening.

The most innovative PMI providers have also developed strategic alliances with the best local or national health insurer. They achieve the cost benefits of local network agreements and compliance with local healthcare legislation in countries such as The Netherlands, Australia and the Middle East, where legislative changes dictate that all employees must be covered by a local healthcare provider. In return, their members have costeffective access to the highest quality national care, supported by the safety net of comprehensive global healthcare. That is particularly important in handling of large claims – £15,000 and above.

The ability to manage and co-ordinate the members’ clinical needs while ensuring cases are not exploited financially, is imperative. With medical inflation varying from one country to another, and an increase in the number of large cases, the need for a reliable, robust infrastructure to accommodate and manage cases efficiently and sympathetically is an essential element in their overall service proposition.

Safe and secure
Then there is security. With a global increase in kidnapping for ransom and extortion, expatriate workers are frequently viewed as easy targets. For many years Colombia has been acknowledged as the kidnap capital of the world, but new hot-spots are constantly emerging, and there has been a shift in the nature of this dangerous crime.

Ultimately, the decision to locate a whole family depends on the length and location of an assignment, but families no longer need to be uprooted and added to the employer’s international plan for a commutable posting in Europe. For those assignees, international PMI is as essential as it ever was. Adding their families to the equation can simply multiply potential exposure to claims. Employers, it seems, are simply recognising that fact.