Insurance for Expatriates residing in Europe

What type of employee benefits package do you provide expatriates in Europe?  It depends on the makeup of the expatriate population, for example, if they are American expats working in Europe, Asian expatriates working in Europe, or inter-European expats or British expats.

There are some very strong international insurance companies that are based in the EU and the UK, so the decision would be, do we use an American international insurance company for expatriate insurance in Europe, or do we go with a local EU international insurer who may have better doctor and hospital relationships on the ground?

If the group is composed of American Expatriates needing healthcare in Europe, you most certainly will want to go with an American International Health Insurer because most would consider it necessary to offer U.S. compliant policy language to American expatriates working in Europe.  (for example offering COBRA continuation to expatriates as well as, HIPAA, ADEA, and other U.S. laws.  You will not find these provisions in European expatriate insurance policies.

If your group is composed primarialy of non-U.S. expatriates or TCN employees, there are some great companies in Europe that can provide group insurance in the EU.  For example, Allianz, AXA/PPP, Gouda, and BUPA, the largest provider of expatriate insurance in the world.

Expatriate Insurance in Japan

Expatriate stationed in Japan should make sure they have an international medical insurance plan, international dental plan, and Life and Disability insurance that will perform if the claim occurs inside Japan.  Many U.S. expatriates are left under U.S. (or in the case of TCN employees, home country) life and LTD insurance plans that would not be able to honor claims once the expatriate had take up permanent residence abroad in Japan.

Local nationals in Japan have a government managed and required health insurance scheme.  Employees of private companies must be covered under a Gov't managed HI plan or a Society managed HI plan in Japan.  Unemployed and self employed persons can be covered by the National Health Insurance System.

Although expats should not want to participate in the Japanese national insurance scheme they are required to pay into the system.  Although double coverage will ensure, there is just no way around the fact that an international health insurance plan is needed for expatriates in Japan.  

Expatraites will spend quite a bit of time out of Japan, and the Japanese system can do little or nothing in the U.S. or in EU hosptials.  What's more, if the expat becomes gravely ill, he or she will want to return home to seek care and not be "stuck" in Japan for years getting treatment in the Japanese system.

Expatriate Insurance Canada for Americans

American expatriates in particular don't think about international health insurance and expatriate issues when they take an expatriate assignment in Canada.  However, they really should take the same steps planning here as they would for an expatriate assigment to China.

First, you cannot keep your U.S. domestic health insurance carrier if you are residing full time in Canada.  By residing full time, in most cases we mean three months or more.  If you have permanently relocated and moved your family to Canada for an expat assignment you should very quickly secure an expatriate health insurance program and drop the U.S. coverage before it drops you. 

The problems with relying on a U.S. medical program while working in Canada are numerous and proper expatriate insuance in Canada means avoiding these U.S. plan problems:

1. Coverage can simply be denied because the U.S. insurer is unable to provide coverage for permanent residents of Canada.
2. Canadian hospitals may not use U.S. FDA approved drugs and these would be denied by a U.S. health plan.
3. Even if coverage continues coverage under a U.S. PPO or HMO plan for an expat in Canada, it may only pay for healthcare that is emergency in nature.  An American cannot choose elective care in Canada and may only find out after it's too late and the medical claim in Canada is denied.

An American should obtain the proper expatraite insurance in Canada for other reasons beyond the medical plan.  There can be similar problems with the U.S. life insurance plan for expatriates, and the U.S. long term disability plan for expatriates.  Dental and vision will have the same problems as the medical plan.  It's not like Iraq, obtaining the proper expatriate insurance plan in Canada is easy, and should be done the week before the assignment.

Expatriate insurance U.K.

Expatriate insurance United Kingdom is not the "easy as pie" cakewalk people think it is.  Yes,  there is no expatriate medical insurance carrier that will not provide expatriate medical insurance in the U.K. but it's worth looking at other lines of insurance for a change and not just focusing on international medical for a change.

Expatriates living in the U.K. may or may not be able to get adequate renters insurance in the U.K.  International property insurance may be easy to get for an American living in the United Kingdom, but International liability insurance may be very difficult and the expat may need to look at U.S. solutions to adequately protect from liability risk and lawsuit.

An expat living in the U.K. will be able to find international life insurance, however the policy will most likely only be good in the U.K. and cannot continue once the person has returned to the host country, and certainly will not continue if the expatriate is an American citizen and plans to return to the U.S.  It is possible for expatriates working in the United Kingdom to secure both life insurance and even LTD insurance in the U.S. although they are working in London.  The advantage of doing this lies in the fact that the coverage under an individual plan can be maintained once the expat returns to the United States.

Medical evacuation insurance in the U.K. is, for the most part, unnecessary because the "nearest appropriate facility" is always ground transportation and international life flight is unnecessary.

International Insurance Broker through McKinley International

This blog is sponsored and created by McKinley International Risk Management, an international insurance broker that works with employers who have international employees in the following situations:

1. U.S. expatriates working abroad
2. Non-U.S. expatriates also called Third Country Nationals
3. Local national hires / foreign national employees
4. International global business travelers
5. Inpats, foreign nationals residing in the U.S.

The following areas of expertise are offered to clients:

1. Expatriate medical insurance (expat health insurance)
2. Expatriate ancillary benefits such as life, LTD, STD, Dental, and Vision Insurance
3. Foreign workers compensation and Defense Base Act Coverage
4. International medical evacuation and assistance
5. International security such as kidnap and ransom insurance
6. International property and liability

Expatriate Insurance in India

India is becoming the technology center of the East, and unlike the old days where Indian expatriates headed to the U.S. to work in Silicon Valley, the opposite is occurring. U.S. expatriates and expats from all over the world are heading to India to work and tap a marketplace of over 1,000,000,000 people. Expatriate insurance in India and a full expatriate insurance package needs to be considered for any foreign national working in India for over six months.

Expat insurance India needs to begin with a good international major medical insurance plan. Quality of healthcare in India has improved but there is only a small list of medical facilities where expats would be truly comfortable. Medical evacuation in India is still an essential benefit because in many parts of India, the nearest appropriate facility is not ground transportation but a lifeflight may be necessary. Expat medical insurance in India, if you surveyed the expats on the ground there is dominated by BUPA International, CIGNA International, and AETNA Global Benefits.

Expatriates in India should also be offered a separate and special international life insurance benefit and international long term disability.

Just a few years ago, not too many people made the same kind of security plans for expatriates in India that they would for say Pakistan or Lebanon, however the Mumbai incident had everyone take notice. A quality kidnap and ransom insurance plan for India is a good way to provide essential security services and a kidnap lump sum benefit at the same time.

Third Country National Insurance vs. U.S. expatriate insurance

When looking at insurance for third country nationals, should the same decision criteria be used as when looking at insurance plans for U.S. expatriates? In 2009, we think the answer is now no. For years, no one thought about TCN insurance in a different way than U.S. expat insurance. However, in most cases the two groups should no longer be lumped together in the same plan. Third Country National Insurance Schemes should be different and these are the major considerations:

1. TCNs do not need elective access to U.S. care like U.S. expatriates do, so why pay for an expensive expat medical program that allows elective care in the U.S. TCN insurance schemes should limit coverage to both the home country and host country, and restrict medical care in the United States to just emergencies while visiting the U.S. Some TCN plans can be regional, for example, coverage offered throughout the EU.
2. TCNs may have a different expectation when it comes to the benefit package they receive. For example, a U.S. style international long term disability insurance benefit is probably not what a TCN would expect or require, so why provide this expensive benefit? TCNs may be perfectly accepting of a PTD benefit that would replace salary for 3 years and after which pay a lump sum. A less expensive option for TCN insurance.
3. Regarding the international medical and dental plan, TCNs don't need international medical plans with bloated U.S. legal provisions which add to the overall cost, such as HIPAA and COBRA. There is no legal need to offer a TCN 18 months of COBRA continuation so why offer an expensive plan that has this feature at a cost.

Overall, a good rule of thumb is, if you have a group of 10 or more Third Country Nationals, when considering the proper international insurance package for Third Country Nationals, consider a separate benefit package and resist the temptation to just lump them in with the U.S. expatriates. The savings could be significant.