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International health insurance (or iPMI): What businesses get for their money

This article explains what organisations who invest in iPMI get for their money, from duty of care to the impact positive impact of employee well-being on productivity.

You look at the spreadsheet. ‘What’s this outgoing for the international teams? iPMI? What’s that? International Private Medical Insurance. What are we getting for our money? What is the cost going to be next year? Will it go up another

Employers also want to retain their best talent, and as the marketplace becomes increasingly competitive, so businesses must offer more attractive benefits to retain that talent. Add to this the costs of failed assignments due to ill health (whether physical or mental) and the importance a comprehensive iPMI plan becomes clear.

Insurers are rising to the challenge of meeting these demands, but as with anything of value, there is a cost attached, and this is reflected in the premiums.

What do I get for my money?

Many businesses see iPMI as ‘sick care’ — repairing broken workers. But a good health care benefits provider will provide far more value to your business. Here are some reasons to engage a reputable iPMI provider, one with each customer’s health outcomes in mind.

Helping to ensure international assignment success

40% of international assignments fail and the total hard costs of failure can be around $400,000 per year. This figure doesn’t take in to account the costs of setting up a new assignee, or any damage to revenue, relationships and the organisation’s reputation.

Why do assignments fail? According to BGRS Global Mobility Trends (2016) “factors most commonly responsible for assignments not going as planned” are:

  • 33% family-related
  • 18% poor candidate selection
  • 18% inability to adapt to the new country
  • 14% due to job expectations not being met
  • 7% due to unhappiness with compensation
  • 5% related to quality of life
  • 4% related to safety or security

A good iPMI provider can help to positively impact 60% of these (family related issues, integration, quality of life and security), reducing the chances of assignment failure. For example, Aetna International’s pre-trip planning service helps individuals and families:

  • set up the support networks they need when relocating
  • build healthy lifestyles
  • navigate health care systems abroad
  • ensure continuation of care and medication

So, by investing in iPMI, you’re investing in your own business.

Duty of care

Businesses have a duty of care to their employees and iPMI helps protect both your employees and your business.

As well as ensuring that your staff have access to quality emergency medical care, you can also provide security cover if they’re located in a ‘dangerous’ location, where war, kidnap or civil unrest is a threat.

Married older couple walking along a hiking trail Married older couple walking along a hiking trail

Staff retention

International assignees are typically your best people. They are the ones with the skills, tenacity and drive to take on big challenges and drive positive outcomes. That’s why you want to keep them. But international assignments can take a toll on the most stoic and stalwart staff, so it’s important to mitigate the risk of losing your best people.

iPMI helps support your best talent, from sick care to health care as well as providing a range of supporting services that help ensure assignment success. The insurance aspects of iPMI cover the costs of health care when people get sick/injured, or need emergency care but the cover also includes services that keep people physically and mentally healthy. This ongoing support – from stress management advice to nutritional guidance — can play a key role in helping individuals thrive in new countries.

In addition to the gratitude and appreciation that employees feel when they know their employer cares about their well-being, their family will also feel supported by the company. With family-related issues making up 33% of assignment failures, supporting a worker’s family therefore positively impacts talent retention and increases the chances of assignment success.


The key benefit of iPMI is happier, healthier, and more productive employees. Our plans aim to keep people healthy, not just step in when they’re sick. This approach means they need less treatment, fewer procedures, take less time off and help contain premium costs. A key part of this is maintaining good mental health. Expats often face increased pressure at work, home and culturally &emdash; our white paper revealed that 94% of expats were unprepared for mental health issues associated with relocating.

Our In Touch Care service has been designed to offer one-to-one clinician support to vulnerable members and provide ongoing support, ensuring that wherever they are in the world they have quick and easy access to the health care and help they need.

Since we launched In Touch Care in the Americas, we have seen a decrease in mental health claim costs per member, suggesting that our support with mental health conditions may have reduced the frequency of members’ visits to mental health treatment providers.

African-American woman using her laptop in a cafe African-American woman using her laptop in a cafe

Access to care

An Aetna International survey found that 74% of expats are worried about the quality of health care in their new country.

This concern is why Aetna International has an extensive network of quality hospitals, pharmacies and health clinics, as well as individual doctors, specialists, dentists and counsellors. In addition, we have a well-established network of partners that can provide transport and ambulance services in medical emergencies. And because our care is truly global, our relationships with agencies like national immigration and passport authorities, consulates and embassies, are crucial in ensuring that we provide the best health care solutions we can, wherever you are in the world. We are also installing as many value-based health care contracts as possible with our network providers - focusing on the quality of the health outcomes rather than the volume of individuals treated.

iPMI gives your employees access to quality care and technology has a role to play. Virtual health (including Aetna International’s vHealth solution) uses internet-connected devices and video appointments to deliver primary and other care services to patients who may have trouble accessing them in person. By improving access and reducing the time an employee spends on managing their health care (such as travelling across the country or to another country to see specialists) the technology is also helping to keep people healthier for longer and, therefore, helping to contain costs.


Aetna International iPMI

Our plans offer flexible solutions to tailor cover for groups of three or more employees. Our plans are built to provide quality, affordable access to care by:

  • Supporting the health and well-being of your workforce:

o   Access to quality health care providers for medical treatment (levels of outpatient and inpatient benefits are plan dependent).
o   Condition management and ongoing care – including medical support for chronic conditions.
o   Proactive health care – using data and ‘connected care’ to help prevent illness and conditions before they develop.
o   Medical emergency care and evacuation.
o   Pre-trip planning support programme, which includes:
        ▪  information about the health care system in the destination country, how it works
            and how to navigate the system
        ▪  guidance about the nearest medical centres and what to do in the case of an             emergency
        ▪  a health assessment prior to departure to check for potential problems
        ▪  help with shipping medications
        ▪  medical support for chronic conditions
        ▪  help arranging well-being programmes in your destination country.
o   Our Employee Assistance Program (EAP) is available to support any stress-related or mental health issues your employees may have.

  • Supporting the cultural adaptation, safety and security of your workforce:

o   Cultural briefings on destination countries or cities
o   Security alerts for health, political or natural disaster incidents (plan dependant)
o   Evacuation in the event of a crisis (plan dependent)

Aetna International has comprehensive Destination Guides that offer advice on accommodation, the cost of living, education, health and wellness in 16 key countries.


Changing health regulations, increased consumer demand and changing/differing costs of health care per country, all contribute to high iPMI premiums. But iPMI isn’t just ‘insurance’ and it isn’t just sick care. Quality international health care is also preventative, keeping your global assignees happier and healthier. These benefits help to ensure a productive workforce and a reduced risk of international assignment failure.

For information on all our health care benefits and services, feel free to speak to one of our expert sales consultants or head to our Employers homepage for more information on how you can ensure success for your international employees.

Aetna® is a trademark of Aetna Inc. and is protected throughout the world by trademark registrations and treaties.

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