Expat Focus International Healthcare Update September 2017

Employers overlooking repatriates’ wellbeing


Employers are being accused of overlooking the emotional and mental wellbeing of their expat staff who are returning from overseas assignments.The warning comes from The Health Insurance Group who say that expats have to endure a lot of disruption when preparing for their return from overseas, and this can have a big impact on their mental and emotional health. Now the firm is urging employers to make as much effort for their expat employees and families who are returning from overseas as they do when they relocate an employee abroad.

The organisation points to a Canadian Employee Relocation Council survey which revealed that just 30% of employers provide repatriation support.

The Health Insurance Group’s head of international, Sarah Dennis, said: “When staff return their care cannot stop and reintegration has traditionally had little thought, but it is key and can be surprisingly problematic. We are urging employers to investigate options since support is available including specialist employee assistance programmes.” She added that employers could put their expat staff in touch with those who have had international relocation experience and encourage participation in local support networks, as well as providing counselling.

Brexit healthcare deal for pensioners

British expat retirees living in the European Union will still be able to access healthcare after Brexit, says the UK government. The announcement comes after negotiators from the UK and EU agreed to maintain their reciprocal healthcare agreements. The government says this is good news for pensioners.

The agreement will see pensioners’ healthcare being paid for by the NHS after Brexit, with the deal having recently been agreed in principle in Brussels.

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Currently, the UK spends around £650 million every year reimbursing other European Union countries for their treatment of British patients. Of that figure, around £500 million pays for the healthcare for 190,000 registered pensioners.

Brits will also still be allowed to use their European Health Insurance Card (EHIC) for urgent medical attention around the EU. Around 27 million cards have been issued to users in the UK.

Expats in same-sex relationships lose health cover

Expats and workers in the US who are in same-sex relationships are finding that employers are increasingly dropping domestic partner healthcare benefits unless the couples are married, says a report.

The findings from the International Foundation of Employee Benefit Plans (IFEBP) reveal that with the Open Enrolment period for 2018 beginning in November, small- and medium-size employers are increasingly restricting the benefit. The report says that since same-sex marriage has been legal across the US since 2015, many employers are dropping domestic partner health coverage and offering it only for couples who are married.

The IFEBP, an educational organisation, says that employers believe there’s no need for them to offer domestic partner coverage since same-sex partners can now tie the knot. The organisation’s associate VP, Julie Stich, said: “Many employers offered domestic partner benefits when same-sex marriage was not legal in all states, to provide inclusive and consistent benefits to employees.”

However, their research reveals that there were 20% fewer employers offering healthcare benefits to same-sex partners in a civil union and an 11% drop offering benefits to same-sex domestic partners. In 2016, 31% of employers were offering healthcare benefits to same-sex partners who are in civil unions and 48% offering benefits for same-sex domestic partners.

Ms Stich added: “Not offering domestic partner benefits for same-sex relationships is more common among small and medium size employers. It’s likely that larger employers and those in competitive markets, such as high-tech, will still offer the benefit to attract key talent so they remain competitive.”

The trend for larger employers to retain cover for same-sex and opposite-sex domestic partners is being underlined by the National Business Group on Health. They say there will be little change in larger employers offering coverage for domestic partners over the next year.

Demand grows for international private medical insurance

A report says that the demand from British expats living in EU countries will lead to a boom for international private medical insurance (IPMI). The findings from an insurance trade journal point to more than a million expats who may lose health benefits and will need to switch to short- and long-term IPMI policies as well as travel cover.

A spokeswoman for the journal said: “It’s possible that there could be a hybrid travel insurance and IPMI policy to emerge to help cater for frequent travellers, the corporate arena and those with second homes overseas.”

MENA needs more hospitals

A study by real estate consultants JLL has revealed that the healthcare infrastructure provision in the Middle East and North Africa (MENA) needs to be developed.

Their findings reveal that many countries need to increase their spending on healthcare and point to the UAE’s expenditure as being just 17% of Switzerland’s spend. The study also reveals that 10,500 extra beds aer needed in the region’s five major cities of Dubai, Riyadh, Abu Dhabi, Cairo and Jeddah.

With growing interest in medical tourism, the countries also need to boost other healthcare facilities, including clinics.

New short-term IPMI cover launched

In a bid to meet the growing needs for expats on short-term assignments, April International has launched a short-term IPMI cover.

The firm says that the trend for short-term assignments for expats has grown in recent years, with younger expats particularly keen to take up shorter overseas assignments. April International says this market now needs specific short-term policies that run from three months to one year.

A spokesman for the firm said: “We noticed the short-term expat placements growing in importance and launched our short-term product to meet this need. The product today is designed for multiple short trips and longer stays for any period of up to 12 months.”

British embassy campaign focuses on healthcare

British expats new to the UAE will be the focus of a British embassy campaign with healthcare top of the list.

The ‘Checking In’ campaign is aimed at recent British arrivals, since the late summer tends to attract the most UK expats to the country. There’s a big increase in demand for consular services and the new online campaign aims to smooth the path for these people.

The UK’s ambassador, Philip Parham, said: “Some expats may be unaware of the time it takes to become established and the licenses and paperwork that need to be obtained.” He added that the campaign will be highlighting the most important issues, including health insurance, residency visas and Emirates ID cards, as well as driving licences and bank accounts.

Employers warned over expat health risks

Employers with expat staff in developing countries have been warned that these workers face more health risks, with higher rates of ‘presenteeism’ than workers in developed countries, according to health insurance firm Cigna.

The insurance company has published research that reveals the health risks for employees in 12 countries and the need for employers to use wellbeing programmes for their global workforce.

Cigna’s chief medical officer, Jose Quesada, said: “Where a person lives is an indicator of their productivity. Employees in developing countries are reporting more health risks than those in developed countries – 82% of these employees have more than one health risk including existing medical conditions or smoking compared with 72% of those in developed countries.” However, the health risks from obesity are lower in developing countries.

Researchers also reveal that employees in developing countries have high levels of presenteeism – where an employee is present physically at work but is not engaged or productive due to being ill.

Meanwhile, a survey of employees in the UK has revealed that 18% have gone into work when feeling mentally unwell. The findings from Canada Life also show that only 20% of staff say they would take time off work for a stress-related illness.

A spokesman for the insurance firm said: “Employers must do more if they are serious about supporting their employees with stress-related and mental health issues.”

Singapore joint venture with International SOS

Expats are among those to benefit from a collaboration between International SOS, a travel security risk services and medical company, and Global Excel to strengthen services in Asia. The new firm will be based in Singapore and aims to leverage mutual healthcare services and capabilities across the Asia-Pacific region.

A spokesman for International SOS said: “We have extensive experience in driving successful joint partnerships to strengthen and complement our operations and we are committed to offering innovative solutions to our clients.”

In other healthcare news…

AXA Global Healthcare has announced changes to its IPMI plans. Expats will find that policy limits from October will be increased on a number of their health plans.

Pacific Prime, the worldwide insurance broker, has revealed that it is partnering with Orient insurance and Alliance Worldwide Care to deliver a fresh international insurance solution for people living in Dubai. The new offering has a long list of core plan benefits, including intensive care and surgical fees as well as medical evacuation.

Workers in the US are being shamed into not taking paid time off, according to the Alliance Travel Insurance vacation confidence index. The findings reveal that one in four American workers feel negative emotions when asking for vacations, with millennials being the most likely to feel guilty or nervous when requesting time off.

Dubai’s Health Authority has revealed that in the first six months of this year, its call centre received more than 151,000 calls, mainly from expats. Calls were made to the centre from within the UAE and from overseas, with 37% of callers asking about individual and facility licenses.

Expats signed up with Alliance Worldwide Care can now access an artificial intelligence powered symptom checker through their MyHealth app. The app enables users to ask questions to see whether their symptoms require medical treatment.

The fast-growing middle class sector, plus the growing numbers of expats, in Indonesia has led to the country’s president Joko Widodo urging more foreign investment into the country’s healthcare sector. One international banking firm says the country’s huge population and developing infrastructure is making it increasingly attractive to the world’s top healthcare insurance firms.

Health insurance premiums for people in the UAE have risen by 17% over the last six months. S&P Global Ratings says the rise is down to health insurance policies rising in price and also motoring premiums increasing.

Australian doctors are increasingly resisting moves from insurance companies requesting their patients’ health records, including those for expats, before they make a decision about life insurance. A representative from the Royal Australian College of General Practitioners has told a Parliamentary committee there that doctors do not believe that sending entire files is appropriate for insurance companies.

Expat Pakistani surgeons, doctors and health professionals are being urged by the country’s chief minister Shehbaz Sharif to invest in the country’s healthcare sector. In a speech made in London, he said the ‘time has come to return the debt’ to a country that needs their professionalism, expertise and cooperation to improve healthcare.

Expats living in Ireland without health insurance can now ‘pay as they go’ under a new scheme for private care. The offering comes from new firm Letsbuyhealthcare, for expats looking for outpatient appointments or diagnostic procedures.

Expats in Vietnam with health insurance coverage may be surprised to find that their next premium will rise substantially, after news that health insurance premiums have rocketed by 22% in just eight months.

As Asia’s most populous country, China’s economy will attract increasing numbers of health insurance providers. Insurance firm AXA says that employers sending expats on long-term contracts to China means there will be a greater demand for health insurance provision.

A new text alert service has been unveiled to help expats and mobile executives with information alerts and to give them emergency contact details when necessary. The offering comes from On Call International and is an ‘app-less’ mobile information delivery system.


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