On the positive side, investments in healthcare infrastructure and technology means that quality health facilities can be found in places like Dubai The World Health Organization estimates that countries spent 10.4% of GDP on health care in 2010. The US lead all countries at close to 18% of GDP. China and India spent around 4-5% of GDP on healthcare but you have this tremendous pent up demand. China now has over 300 million people classified as middle class. These people are going to want access to adequate health care facilities and providers. Like the US, the developed economies of the world all face an aging population where fewer workers support an increasing number of retirees. The retiring baby boomers. This puts a strain on the social health care systems in place in countries outside of the US. How countries respond to this issue will vary but there are a limited number of options available. These include: Reduce benefits Increase taxes Shift costs Arguably, all three options involve a cost shift. And whether there is a direct impact upon the employer like a local mandate to provide coverage in Saudi Arabia or Abu Dhabi or this is an indirect approach where longer wait times to see a physician results in the increased demand for private or company sponsored coverage – there is a cost shift. UHI – takeover of the Global Choice partnership with Bupa Met Life – Integration of Alico operations Geo Blue – new partnership between HTH and Blue Cross Blue Shield. Other non-US players and TPAs. Our hope is that with the increased competition in the marketplace that we will see improved data reporting on loss information. The median size of the international assignee population in the survey was 75 employees. Carriers have typically provided limited information to groups of this size beyond changes in age and how that change impacts the cost of the program. Now we are going to look at some of the information related to the demographics of the international assignee population.
Two thirds of those companies include their TCN employees under the same program as their US expatriate employees. For those that offer a separate TCN plan design we see a richer plan benefit at a much lower cost. Composition of the TCN population plays a significant role in the overall cost of the TCN programs. Do the TCN employees come from countries with strong social health care systems? Do they come from countries with low demands for healthcare services. Some plans may not offer certain benefits including prescription drugs. These factors will influence the cost of the programs.
Each of the responding companies identified that they would be hiring additional field personnel at the local level. 77% indicated that they would be hiring Administrative staff and more importantly over half indicated that they Management level personnel would come from the local market. This is important as these individuals could become the globally mobile employees of the future. Supplemental health remains the number ranked benefit. Again, as social health care systems seek ways to shift or contain costs there will be increasing demands placed on the employers where to provide adequate supplemental health benefits. An important note here. The rationale for offering the supplemental health coverage could be that it could be the only way that the employee has to access local health care. Keeping the employee healthy helps keep the employee engaged and productive.
Communications has been the number one ranked issue of supporting international assignees in each of the five global surveys. 70% of the participants reported that they developed customized communication materials for their international assignees 58% reported that they had a formal HR Branded communications campaign.
You will be receiving your survey booklets when you leave. There are over 300 charts, tables and exhibits in the Global Survey booklet. Please feel free to contact any member of our team if you have questions around the survey results. Again, we would like to thank you for your participation in these surveys. We have thousands of hours invested in these surveys but we need you input and feedback to make sure that the information that is being presented in meaningful. We look forward to your continued participation and input.
Employee Benefit Trends For International AssigneesBackgroundThe Global Employee Benefit Survey is sponsored by Employee Benefit Solutions, Inc. (EBS) and is one of six industry and market based surveys conducted by EBS each year.This document is intended to provide an overview of some of the key findings of in the 2012 survey. The detailed survey results are available to survey participants only.Contact information is available at the end of this overview if you are interested in gaining access to the more detailed survey results through participation in future surveys.
International Health Care TrendsInternational health care trend has been in the low double digitsfor the last several years and is likely to remain elevated in thecoming yearsKey Drivers to This Trend-Increased investment in health care infrastructure andtechnologies globally-Increased demand for health care services-Aging global population-Constrained social systems – cost shiftingChanges in the Marketplace – New Players Enter-MetLife, United Health International and Blue Cross expandtheir international capabilities-Positive trend or temporarily shuffling of the deck?
Employee Benefit Trends For International AssigneesDemographic Trends-Expatriate population is older and has longer servicecompared to domestic counterparts - Median age – 46 - Median length of service – 6.6 years-68% of the population was over the age of 40-39% of the population was over the age of 50-Significant exposure to the ‘bust’ from the baby boomgeneration. Retiring boomers as the demand for skilled labor inthe oil sector is increasing.
Employee Benefit Trends For International AssigneesExpatriate Health TrendsEmployers shoulder greater cost burden-Median employer cost increase of 7.1%-Median employee cost increase of 1.3%-Median subsidy level of 80%Limited evidence of benefit plan changes
Employee Benefit Trends For International AssigneesNon-U.S. expatriate or Third Country National (TCN) employees- Richer plan design compared to U.S. expatriates- Median net cost is $2,276 compared to expatriate median net cost of $8,816Factors Influencing Lower Overall Costs- Treatment typically secured in lower cost locations (care typically excluded or limited in the U.S.)- Dependents may remain on home country social health care system or may not be covered at all- Annual maximums put an upper limit on plan exposure
Local Programs63% of participants reported that they wereincreasing the utilization of local hires.Localization-Field Personnel 100%-Administration 77%-Management 54%Ranking of importance of local benefits-Supplemental Health-Life Insurance-Retirement/Severance-Disability
International Assignees Top Challenges Supporting International AssigneesCommunications•69% - Produce expat/TCN specific communications•58% - Formal branded HR communication strategy•54% - HR/Benefit Intranet or website
Benefit Risk AssessmentChallenges that international assignees pose todomestic benefit programs-Review eligibility language – watch for carrier limitations - Types of employees covered - Locations of coverage-Flexibility to support international mobility-Shifts in underwriting capacity for international exposureBe aware of local insurance requirements orrestrictions- One size does not fit all- Administrative issues associated with tracking internationalassignees
Thank You for your time and participationCliff Caldwell, GPHRGlobal Solutions Practice LeaderEmployee Benefit Solutions, Inc.firstname.lastname@example.org