As businesses navigate an increasingly globalised world, the demand for comprehensive and adaptable healthcare benefits for their diverse workforce has been increasing.
As a result the group IPMI sector is a market in flux, driven by pressures of rising medical costs combined with the evolving needs of internationally mobile employees.
Demand for flexible, cost-effective, and digitally-enabled plans that prioritise employee wellbeing and cater to the complexities of a globally mobile workforce are increasing.
To meet that demand, insurers are responding with modular products, enhanced digital tools, and a greater focus on mental health and inclusive benefits, while grappling with the challenge of medical cost inflation and the need for sustainable premium models.
With the surge in medical inflation, corporates are more open to reviewing plan design to ensure right and sustainable medical protection coverage is provided to their employees.
But overall mobility has not appeared to change much; as working one to two days from home doesn’t impact the benefits or benefits design much.
Medical cost inflation
Xavier Lestrade, CEO of Axa Global Healthcare highlights the continuing issue of medical and premium inflation as a particularly pressing matter for the IPMI market.
“One of the biggest challenges in the healthcare industry is managing medical cost inflation, which has been significantly increasing for years and shows no signs of slowing down,“ Lestrade says.
“For providers of global healthcare insurance, this creates a critical tension: how do we keep health insurance affordable while dealing with these rising costs?
“If premiums increase by, say, 10% annually, many clients could find health insurance out of reach over time. This balancing act is essential to ensuring sustainable access to healthcare.
“Modular insurance plans allow organisations to tailor coverage levels, ensuring they pay only for what they need.
“Part of the future of sustainable IPMI lies in a preventative, wellbeing-first approach – one that actively enhances the health, productivity, and mental wellbeing of globally mobile employees,” he concludes.
Health & Protection reported in January that the cost of employee medical plans had been soaring around the globe, with a global projected average increase for 2025 of 10%, according to a report from Aon.
The 2025 Global Medical Trend Rates Report showed that the highest forecasted increases were in the Middle East and Africa at around 15.5%.
Asia Pacific followed with a projected increase of 11.1%, up from 9.7% last year, and representing the highest increase forecasted in 10 years.
Corporates taking stock
With the surge in medical inflation, corporates are more open to reviewing plan design to ensure correct and sustainable medical coverage is provided to their employees.
Andrew Blomberg, vice president of global benefits at US-based International Citizens Insurance (ICI) agrees that with the cost of healthcare continuing to rise globally, insurers are facing mounting pressure on premiums.
“Across the industry, renewal increases have averaged between 8% and 10%,“ he said.
“However, through strong partnerships and strategic plan management, we’ve been able to keep renewal increases for our clients closer to 5%, ensuring long-term sustainability without compromising coverage.”
Aniz Sirajudin, an IPMI professional based in Singapore points out that medical inflation is a result of the wider use of health benefits.
“Medical inflation is driven by higher utilisation, costlier diagnostics and treatments, more chronic conditions and mental health claims – therefore expanding the scope of benefits.”
Catherine Farrell, head of proposition management, health at Allianz Partners notes that with the global focus on inflation, there is a resurgence in the value of control measures as employers strive for a sustainable solution between cost pressures and the health and wellbeing of their workforce.
“As well as shaping the benefits available to employees, flexibility also provides opportunities to alter critical components such as co-payments, deductibles, network access and areas of cover,“ she adds.
Currency fluctuations worsen inflation
But medical inflation is even worse in some developing economies such as Zimbabwe, according to Allan Sixpence, managing partner at Risk Experts Underwriting in Zimbabwe.
“We don’t have a strong currency so have to use foreign currencies such as the US dollar. So the issue of medical insurance inflation is worsened by the devaluation of the Zimbabwean dollar against foreign currencies,” Sixpence explains.
“Medical equipment and medications have to be paid for in foreign currency, that makes medical insurance costs very expensive resulting in low demand and uptake.
“The penetration rate of medical insurance is very low, around 5%. And that is also because there is a very high unemployment rate of over 90%. Our economy is based on informal trade, and those people can’t afford to pay for medical insurance.
“As a result more people turn to micro-medical aid.”
Meanwhile, with escalating medical costs there is a new trend developing in Zimbabwe.
“Due to the high cost of medical aid, medical insurers are opening up their own medical centres to better manage their medical costs,” Sixpence says.
Scalability
Scalability is also key, according to ICI’s Blomberg who believes the future of corporate health insurance lies in adaptability with plans that can scale with changing teams, offering real value to employees, and remaining cost-effective.
He said ICI clients want “access to benefits that not only meet today’s expectations but anticipate tomorrow’s needs.”
Building on this proactive and wellbeing-focused direction, another significant aspect gaining traction within group IPMI is the active promotion of healthy living among employees.
Megan Lewis, commercial lead at William Russell says: “On group plans, employee newsletters such as healthy living tips and articles are apparently gaining support.
“There definitely seems to be a real focus on ways to make plans more affordable as well; groups are more interested in seeing costs with and without an excess or looking at other ways to save money, such as with different zones or lower benefits.
“But they are still balancing that with looking to make benefits attractive to help retain good staff.“
Mental health
Another aspect driving corporate IPMI utilisation and consideration, particularly since the pandemic, has been a greater emphasis on mental health.
Health & Protection reported last month that mental health support tops the list of expected employee demands for 2025 in the UK, according to research released by Towergate Employee Benefits.
Nearly a third (31%) of UK employers surveyed said they believed there would be an increased demand for mental health support.
Sirajudin points out that demand for mental health, stress management, and burnout prevention benefits has increased post-Covid.
Blomberg adds: “From virtual therapy to expanded employee assistance programmes (EAPs), mental wellness is no longer a nice to have – it’s a must-have in competitive benefit plans.
“Companies want solutions beyond reactive care, including fitness support, health coaching, and stress management.”
This onus on mental health is being witnessed by insurers as well who are seeing demands on services grow steeply.
Axa Global Health’s Lestrade says: “We’ve seen through our annual market research that mental health challenges affect both local and international employees, but international employees, in particular, are twice as likely to face mental health issues.
“The reasons for this are varied but may be due to the stress of adapting to new cultures, feeling isolated from familiar support systems, and navigating unfamiliar healthcare and work environments in a new country. “
William Russell’s Lewis notes that as a result digital services are gaining traction, especially virtual advice for things like anxiety, stress and mental health.
“Mental health support generally has become big over the last few years especially since Covid-19, but not necessarily in terms of medical treatment, although this does get asked about,“ she continues.
“It is more in terms of providing access to counselling remotely, particularly with secondary services such as mindfulness highlights.“
Flexibility in product design
Flexibility is also critical as Blomberg tells Health & Protection: “As the global workforce adapts to a post-pandemic landscape, corporate and SME health insurance products are evolving to reflect changing priorities, mobility patterns, and employee expectations.
“Companies are no longer just looking for standard medical benefits, they’re seeking comprehensive, flexible plans that reflect a modern approach to health and wellbeing benefits.”
Sirajudin agrees and points out the rise of a more regional approach along with other elements of flexibility.
Health & Protection reported in November on the development of a hybrid IPMI product that was more regional in scope coming out of Hong Kong, and spreading to Singapore and even to the Middle East – with plans to expand to other countries in Asia.
“Large multinationals are seeking customisable, modular plans tailored by region, seniority and or mobility tier,“ Sirajudin says.
He notes that IPMI is seen as a vital tool for keeping and attracting talent.
“Companies see IPMI as a key differentiator for global talent attraction and retention, especially for senior or critical talent – dependents’ coverage and maternity benefits are often expected,“ he continues.
“With fewer full expatriates and more hybrid or global hires, companies need portable, flexible plans rather than location-based cover.
“Instead of full expat packages, many firms offer local plans with enhanced benefits, requiring IPMI products that bridge local and international care.”
Flexibility is also an important factor for SMEs, according to Amelie Dionne-Charest co-founder and managing director of Alea Insurance in Hong Kong.
Dionne-Charest says: “There are definitely competing interests at play in the SME sector. On one hand, employers recognise the importance of offering robust health benefits to attract and retain talent, especially with increasing focus on employee wellbeing.
“On the other hand, there is significant pressure to control costs and lower premiums, particularly in an environment where budgets are tight.
“As a result, SMEs are looking for solutions that strike the right balance – comprehensive enough to meet employee expectations but flexible and modular enough to manage costs.
“Many are also open to introducing cost-sharing elements, like deductibles or co-pays, and leveraging wellness initiatives to help reduce claims and stabilise premiums over time.”
Flexibility in coverage is also needed for employees who are more flexible in their hours.
William Russell’s Lewis notes: “Over the last 12-18 months, I’ve had brokers ask about things like covering staff who only work part-time as flexible hours have become more acceptable, and also I’ve had questions around our position on disabilities and how they might impact cover, which reflects the broader change and focus on inclusivity and non-discrimination.”
DEI still high priority
Another factor is a greater focus on diversity, equity and inclusion (DE&I), according to Allianz Partners’ Farrell who notes employers are increasingly prioritising comprehensive benefits that address these needs.
And it seems this has not been hampered, at least not yet, by agenda changes from the US.
“While demand for these solutions is rising across the group sector, SMEs are particularly gathering pace in this area,“ she explains.
“This trend signals increasing recognition of the value such benefits provide in supporting, retaining and attracting talent.
“In addition to growing interest in newer solutions such as gender-affirming care, customers are also seeking enhanced limits for more traditional benefits such as fertility treatment and hormone replacement therapy; underscoring their commitment to these needs.
“Similarly, with the continued and necessary focus on mental health, there’s a sustained drive for meaningful psychiatry and psychotherapy benefits.“
Farrell also highlights that the ability to respond to the wide-ranging needs and circumstances of different populations is more significant than ever.
“So as employers endeavour to meet the evolving requirements of their workforce, flexibility of product design is essential,” she adds.
The end result is a rapidly evolving global IPMI sector, pressured by rising medical costs and the changing needs of a more international workforce.
Demand for flexible, digital, and wellbeing-focused plans is driving innovation in modular products and enhanced services.
The future of sustainable IPMI appears to hinge on balancing comprehensive benefits with cost-effectiveness to meet the diverse needs of a global employee base.