Home and away

Treatment in the world’s best hospitals and cover when you are abroad is certainly attractive. But will AWC’s combined international and domestic offering set a new benchmark for top end group PMI? Sam Barrett investigates

Cedars Sinai Hospital, Los Angeles

For years, international medical insurance has enabled employees to access healthcare while away from home. But, as it becomes increasingly common for people to travel, either on business or pleasure, there is arguably a growing need for plans that combine domestic and international cover.
It’s a need identified by Allianz Worldwide Care, which launched its healthcare plan, Signature, in the UK this June, claiming a groundbreaking development in the delivery of healthcare in the workplace. But will employers, employees and indeed intermediaries embrace the idea of a single, merged scheme, or is it best of breed in each domain a preferable solution? And how new is it?
The AWC plan, which is available as two core plans, Signature Prime and Signature Plus, covers a range of in-patient and day care treatments plus other benefits such as comprehensive cancer treatment and cover for pre-existing and chronic conditions. It can be upgraded with a number of optional add-ons such as out-patient treatment, GP visits, dental and optical treatment and maternity cover but most importantly, whatever the level of cover, it can be accessed both inside and outside the UK.
“There’s a growing trend for global mobility,” says Ron Buchan, chief executive of Allianz Worldwide Care. “It doesn’t make sense that someone leaves one country and they’re not covered in the next. This plan means they can be treated wherever they like, whether for convenience or because they want to access the best treatment available.”
For those travelling abroad this can be a significant benefit. Although travel insurance might pick up the tab for any emergency medical treatment an employee requires while on business or holidaying overseas, it doesn’t offer any cover if they feel unwell and want the reassurance of seeing a doctor. Conversely Signature will give them access to benefits such as a GP consultation in exactly the same way as if they were in the UK.
UK competition
But, although Allianz’s plan brings together a unique set of benefits, combining international and domestic cover is not a new concept. Similar coverage can be obtained from both the international and domestic insurers.
As an example, at Axa PPP healthcare it is possible to add international cover as an option to some of its UK corporate schemes. “We’ve been offering this for several years and have a number of large corporates that do this for their employees,” says Paul Moulton, sales and client relationship director at Axa PPP healthcare, who adds that it tends to be popular with the highly paid foreign nationals working in the UK. “They’re happy to access day-to-day healthcare in the UK but if they’re having an operation or being treated for something more serious they like to have the option to return to their home country,” he says.
Another option for those happy to travel for treatment is recent entrant Passport2Health. This offers its corporate and individual policyholders access to private UK diagnostics with any treatment provided by medical facilities in Europe. As well as the treatment, it also covers the cost of door-to-door travel and accommodation for the patient and a companion. Importantly, because treatment in Europe is often cheaper than in the UK, premiums can be as much as 50 per cent lower than on traditional UK medical insurance.
Chris Beardshall, global account executive at PMI Health Group, says Passport2Health is a great concept but believes it’s more suited to the individual market than the corporate one. “Medical insurance is an employee benefit but it’s also important for the employer that you’re fixed and back to work quickly. If treatment is being provided abroad, an employer might be concerned about how long the employee would be off and what might happen if there were any complications afterwards,” he says. “An individual might be more comfortable with this, perhaps tagging a holiday on after their treatment to enable them to recuperate.”
International offerings. The option to combine domestic and overseas cover is also available from many of the international insurers. For instance, icommon with some of the other international insurers, Aviva allows policyholders on its international plan to have treatment in the UK, providing they have chosen an appropriate region of cover.
As an example, if someone is based in Malta, which is a lower level region than the UK, they would need to buy a higher level of cover to be able to access healthcare when they’re back in the UK.
ALC Health’s plans also cover both markets. Andrew Apps, director at ALC Health, says that as well as appealing to people who want the reassurance that can have treatment anywhere in the world, this can also be popular with some who never set foot outside the UK. “The cover on an international plan can be more extensive than on a domestic plan, including things like private GP consultations and health screening. Policyholders like the ability to access these benefits even if they don’t leave the country,” he says.
As well as covering benefits that aren’t commonly included on domestic plans, cover can be more generous. Gerry Mould, international sales adviser at April Medibroker, says that cover for areas such as chronic and pre-existing conditions can make an international policy more attractive than its domestic equivalent.
But while cover may be more extensive on an international policy, Mould says price tends to be too. “Cost can be a major stumbling block,” he says. “People like the cover but when they look at the cost they tend to stick with the domestic product. Premiums can be significantly more expensive.”
As an example he says that someone aged 30 to 34 would pay £155 a month for Interglobal’s comprehensive plan, which gives cover in the UK as well as overseas. “This could then be loaded by as much as 75 per cent depending on the underwriting,” he adds. “If someone’s living overseas it can be an option but we find the price difference means people in the UK prefer to stick with a domestic plan.”
The pricing differential is something that Allianz Worldwide Care has looked to address with its Signature product. Buchan says its price point is roughly the same as a top end domestic plan. “In reality offering international cover on a domestic plan shouldn’t be much of an issue,” he explains. “People aren’t going to make additional claims because they can have treatment anywhere in the world. Further, although there are places such as the US, Hong Kong and Switzerland where treatment is more expensive, I’d defy you to find many hospitals that are more expensive than the top ones in the UK. The UK market is very commercial so when you go overseas you see that costs are much more controlled and therefore often lower.”
As well as balancing treatment costs in this way, Allianz Worldwide Care also points to its international claims infrastructure as a means of controlling costs. This enables it to have direct settlement arrangements in place with hospitals in the UK but also gives it more control over billing from treatment centres around the world.
Further, the insurer has a good reputation for managing claims costs and delivering value for money. Beardshall says he has experienced this on Allianz Worldwide Care’s international plans. “It’s very effective at controlling claims costs and if it’s able to translate this into the Signature product that will be a real bonus,” he says.
Market potential
Although there have been options available for people wishing to combine UK and international cover for some time, questions remain over what the market will be for Allianz Worldwide Care’s new product. While Beardshall says he hasn’t seen demand for this type of cover, adding that this may be because this product has only been available for a short time, Mould says he does receive enquiries from clients who want to be able to combine international and domestic cover. “Cost is often a deterrent,” he says. “How successful this product is may depend on how the economy shapes up,” he adds. “If budgets remain squeezed, people will look to save money with a domestic plan.”
But, given the breadth of cover and the top-end price, Allianz’s plan is not designed to be a mass market product. Signature is aimed firmly at the senior executive, where it can potentially help to win the war to attract and retain talent. These employees are more likely to travel overseas on business or spend more time abroad on holiday or because they own a home abroad.
Buchan also believes that global mobility is set to become a major theme in the healthcare arena, driving more demand for this truly global product. “We’re already seeing examples of countries where it’s becoming the norm to travel abroad for treatment and this trend will continue as the focus on outcomes increases,” he says. For example, in the US it’s common to travel between states to access better quality healthcare. US healthcare is also favoured by people in Latin America who can afford to access it and in China people will travel to Hong Kong or the US for treatment.
“The next big thing will be a comparison website that lets you input your diagnosis and it will give you a list of the top treatment centres and surgeons for it,” Buchan adds. “It will happen and when it does people will want medical insurance that enables them to access the best healthcare, wherever it may be.”