Inpat Insurance and Expatriate Insurance for Foreign Nationals in the U.S.

Global employers should not treat foreign nationals coming into the United States on assignment the same as expatriates leaving the U.S. for insurance issues.  Here is an overview of the major areas why inpat insurance is a different animal and why foreign nationals coming to the U.S. need different treatment.

First, almost all foreign nationals needing insurance in the United States are coming from a country that has national health insurance in some form or another.  They just don't understand the medical insurance system in the U.S.  Medical plans offered to foreign nationals in the U.S. have to be very easy to understand.  If a form of managed care is used like an HMO, the specifics of our system need to be explained in detail.  A massive uncovered claim may fall back on the employer.

Also, these local nationals in the United States need to know that they may have very little or limited coverage if they leave the U.S. or return home for a period of time, and may be considered "out of network."

Other than the big one, medical, here is the rest of the list:

1. Auto insurance:  They should be told to apply for a State drivers license as soon as possible without delay.  You can't keep driving here with an international license and can't get insured properly.
2. Property insurance:  They need to understand where to get personal property insurance and more importantly, international liability insurance to protect their net worth in case of lawsuit.
3. Vacant Home Insurance:  Do they still have a house back in the home country that is unoccupied?
4. Life Insurance:  Is the U.S. 2 x salary standard adequate?
5. Disability insurance:  A personal plan may be necessary because the U.S. plan will not be able to pay foreign nationals LTD money if they return to their home country if disabled.

International Employee Benefits 7 Step Process

For any global employer with more than just a handful of expatriates and global business travelers, international employee benefits has to be a 6 step process in order for the organization to complete it's goals and remove risk and unfuned liability.

1. Know your exact international exposures exposures.  For example, many university HR managers tell us "we have no idea when professors from the college of business are travelling overseas."  This is completely unacceptable.  Do you really know where your people are and where they go?
2. Understand what home country benefits cover and what they do not.  There are 100 examples here.  If you are leaving people that spend time abroad under a U.S. medical plan, is it a PPO or an HMO.  Will treatment received overseas need to be an emergency before it's covered.  What about out of network issues?  What about non US. FDA approved drugs prescribe abroad?
3. What international insurance is required to fill gaps and liabillities?  Is an international medical insurance plan needed.  Will the U.S. LTD plan honor disability that occurrs abroad?  Again, there are 100 questions to ask.
4. What international insurance would be nice to offer for maximum employee retention, but not absolutely required.  A wish list for better times.  What is the rest of the industry offering?
5. What international service programs are needed, or would be nice to offer.  Two buckets.  For example, for expats working in Almaty Kazakhstan, an international medical evacuation plan is essential.
6. Work closely with the risk manager to avoid gaps and overlap.  In one organization we met a benefits manager that did NOT KNOW the risk manager!  I can assure you there was both overlap in coverage and gaps in coverage at this company. 
7. Document everything to both the employees and internally.  Do you have a good international expatriate handbook and when was the last time it was updated?