It’s not just high profile footballers choosing to leave for Saudi Arabia; international private medical insurance (IPMI) advisers too have noticed a large uptake of workers moving to the Kingdom.
While IPMI assignments in general are tending to be more short term than before the pandemic, there are also reports of more virgin schemes entering the market and employers using the product for more reasons.
But this is a sector that also faces challenges: increasing regulation from individual governments across the globe, continued inflationary pressures and meeting demands from different populations who may need more tailored coverage.
Rich investment in Saudi Arabia
Undoubtedly one of the main global trends as been people moving into the Middle East, and one location in particular.
“There has been a large uptake from workers moving to the Kingdom of Saudi Arabia (KSA) as a result of the rich investment the region has seen in recent years, which is drawing large multinationals to the region,” Joseph Barnes, senior consultant for global benefits at Lockton People Solutions, tells Health & Protection.
But Barnes has also witnessed an increase in virgin schemes in the last year as businesses reignite assignments and secondee programs post-pandemic.
“We have noticed an uptick in clients taking IPMI products as cross-border solutions to provide a consistent level of benefits across Europe,” Barnes continues.
“There has been an increase in demand from UK domestic clients utilising IPMI plans for senior management or C-suite employees as a gold level of cover and a wider application of IPMI plans to support new remote working patterns, including digital nomads.”
Digital nomads and shorter assignments
This emergence of the digital nomad is symptomatic of a trend towards fewer traditional assignments.
And Linda Beavis, senior consultant for global benefits at Aon, reveals the global consultancy firm is seeing more requests for short-term IPMI products.
“The market has developed some short-term insurance products or made extensions to existing business travel policies with the same goal,” Beavis says.
“At Aon we continue to work with our trusted insurance partners to co-create products fit for our clients and this evolving market.”
Meanwhile, in order to respond to increased demand for its services, Barnes explains Lockton has created four expat centres of excellence (COE) in the UK, US, Singapore, and Dubai to ensure clients’ needs are met effectively globally and provide local support where required as its operation grows.
“Regular COE meetings allow for knowledge sharing and local market updates to ensure all teams are aware of key regulatory changes, carrier updates, and product enhancements,” he continues.
“Our Middle East North Africa (MENA) office is looking to expand into KSA to service clients locally and, in the UK, Lockton is expanding into Europe via Lockton Europe Brokers Limited (Malta) to support clients throughout the EEA.
“Appointing Selene Wong as regional employee benefit specialist in Singapore will support expat growth in the region,” he adds
Telehealth providing cost effective solutions
While firms across the globe are not immune to adverse impacts from the cost of living crisis, it also presents opportunities for the growth of some services.
Andy Edwards, managing director of Axa Global Healthcare, notes cost-effective services like telehealth in particular are in demand to help contain premium increases related to inflation – particularly medical inflation.
But monitoring how customers actually use these services has also played a key role.
“To support looking after mental wellbeing, we removed the need to get a referral from our virtual doctor service first,” Edwards says.
“After we made this change in April, we saw utilisation of our mind health service more than double.
“We also monitor anonymised data to detect trends and measure the impact of our services. This includes member ratings on our speed, helpfulness and overall satisfaction.”
Expanding on increased demand for remote solutions, John McQuillan, leader of UK and global divisions at Teladoc Health UK, tells Health & Protection the provider has witnessed growing appetite for its wellbeing services in hotspot locations including the UAE, UK and US.
“We have seen higher demand for wellbeing solutions. Team wellness is seen as mutually beneficial to business goals,” McQuillan continues.
“And further capabilities are trending – virtual physio, additional mental health services, and nutrition.”
Splintered compliance landscape
But each destination brings its own set of regulatory challenges.
According to Barnes, this is because each country has a different healthcare infrastructure and he maintains while the growth of insurance legislation across the globe is necessary, it is adding additional complications.
“A splintered compliance landscape also creates further issues in keeping track of requirements for expats and managing a global workforce,” Barnes continues.
“This is not aided by the fact that compliance developments often come with short notification periods in some regions, meaning providers must act quickly.
“And moreover, this makes it harder for organisations and their HR functions to provide a one-stop solution to cover all their employees as products need to be adapted to different markets. So having advisers on board to help businesses navigate this ever-evolving landscape should be considered.”
Compulsory cover in Qatar
One particular area that has created several challenges within the market has been the introduction of minimum benefit requirements in Qatar in May 2022, Barnes says.
“The compulsory health insurance scheme applies to all expats in Qatar and means employers are required to provide their foreign workers in Qatar, as well as the dependents living with them, spouses and up to three children under the age of 18, with private health insurance,” he continues.
“The private health insurance cost must be covered by the employer and failure to comply is subject to penalties and denial to obtain or renew their foreign worker’s visa.
“The penalties are doubled for repeat violations. In addition, employers will be liable for the cost of healthcare services provided if they fail to maintain compulsory insurance coverage.”
Europe and Brexit
Perhaps surprisingly, Barnes notes there is also one country in Europe causing particular issues.
“A further challenge is the rising number of expats in Germany as there are very few IPMI carriers that offer compliant coverage,” he adds.
And although it is seven years since the UK vote to leave the European Union, Brexit continues to bring its own set of challenges for firms operating the sector.
Kevin Bürchler, head of key accounts at the SIP Medical Family Office, tells Health & Protection Brexit has become a significant issue for many brokers, as it has made it more difficult to pursue incoming new business requests or continue existing business in markets where they are no longer regulated.
For SIP, Brexit has meant setting up operations and achieving FCA authorisation along with its licenses in Switzerland and the European Economic Area (EEA).
Opportunities for growth
Trends towards talent localisation and international remote working represent an evolving challenge and an opportunity for product evolution, Aon’s Beavis says.
“Traditional international healthcare providers, may not always have the risk appetite or may operate a maximum threshold when providing insurance to individuals in their home country,” she continues.
“As organisations look to leverage remote working technologies and take advantage of local talent, a market capable of providing the insurance does not always exist and particularly when total headcount is small.
“This is an opportunity for us as we do have insurance partners who can operate in a global local market. Our intention is to develop solutions with these partners and bring them to our clients to support their needs in these scenarios.”