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Healthcare International

New Broker Technology Platform Launches For International Private Medical Insurance (iPMI) Market

First time intermediaries and brokers can compare iPMI products for both features and pricing.

The digital Health Compass ( platform has launched today, providing intermediaries fully licensed access to the international private medical insurance (IPMI) market and the ability to match product selection more precisely with their clients cover requirements and budgets. 

The platform caters for brokers with individual clients requiring IPMI cover. The unique benefit scoring feature allows a broker to immediately compare different products and their benefits when making client recommendations. Brokers also receive an on-screen price indication for each policy being considered and can access the Health Compass ‘Solution Radar’ that maps each product according to price vs benefit.

The system enables an intermediary to go from client enquiry to sending a proposal form in less than five minutes.

David Eline, founder says, “Health Compass is a game changer for brokers as it cuts through the complexity and reduces transaction times for IPMI business. As a broker with many years’ experience in the IPMI industry myself, I know that intermediaries will find the platform to be hugely beneficial.”

David continues, “The system not only cuts transaction times compared to dealing directly with an insurer or MGA but also response times from underwriters once the application is submitted.

“The system can be used by established IPMI brokers and non-specialist intermediaries with a small number of clients needing IPMI cover each year.”

Health Compass has access to 80% of the IPMI market products, creating the potential to quickly build an IPMI book. Ownership of customers added to Health Compass remain firmly with the intermediary.

David Eline explains, “Health Compass is not an intermediary or a broker and it does not operate on a price aggregation model. The platform is an electronic master broker providing access to the IPMI market for the wider intermediary community. It does not compete with brokers or insurers but acts as an enabler and communication tool.”

The platform offers intermediaries the ability to access Health Compass’ regulatory umbrella. It is fully licensed in Europe and authorised to operate in the UK by the Financial Conduct Authority. UK intermediaries can support clients across Europe and European brokers can access the UK market, regulated brokers in the US or in the Middle East can place business in Europe/UK and UK/European brokers can place business in offshore territories.

The technology allows intermediaries to interact in two phases.

The first is to access the platform through the Health Compass website and once connected it will provide work flow capabilities through to submission of proposal to the insurer.

The second phase sees Health Compass offer API’s to enable brokers to embed all the benefits of Health Compass within their own website so that customers can interact directly with the platform to complete the selection and submission process.

David Eline concludes, “With a skill shortage in the sector Health Compass is well placed to assist intermediaries to expand their business in this market or to easily take a step into it for the first time. We are excited to be working with brokers around the world including the UK who we know will find the system of benefit to their business.”

Brokers and intermediaries interested to know more or who would like to arrange a demonstration visit here.



Worldwide Broker Network Appoints Alan Fergusson As Global EB Practice Leader

The Worldwide Broker Network™ (WBN) has announced the appointment of Alan Fergusson as Global Employee Benefits Practice Leader. Alan will report to Olga Collins, CEO. 

The appointment of Fergusson is one of the first moves to expand the WBN headquarters team. The addition of this new role demonstrates the commitment of WBN to driving forward the employee benefits proposition of the network to our brokers and clients around the world.

Fergusson brings with him over 20 years of experience in the employee benefits sector. Previously, Alan has been a consultant for WBN and has been associated with the network since 2012 evolving the EB strategy and participating on the Board of Directors from 2014-2018. He joins WBN from Beneficia where he was responsible for delivering complex projects across the EB spectrum. Alan has also held board positions at Mearns & Company, Kudos Financial Services and Mattioli Woods plc.

Alan Fergusson on his new role at WBN: “I am delighted to be given the opportunity to take on this new position at WBN. There has never been a more exciting and dynamic time for international EB clients. I look forward to working with Olga, the WBN team and members to play a leading role in WBN’s growth and development in this key sector.”

Olga Collins, CEO of WBN commented: “I am so pleased to have Alan leading our EB strategy. There’s vast growth potential in the employee benefits part of our industry and his role will be to drive that agenda and support members in further building out this area of their businesses. Alan has worked closely with us for many years and I know his global experience, combined with his dedication to delivering for clients will greatly accelerate our plans.”


Will Bupa And DNI Now Compete In Several Countries Where Generali And Generali Employee Benefits Are Both In Business, Or Just The Middle East, Or Just The UAE?

In this article, Ian Youngman, leading insurance analyst and author of the leading iPMI market report, “International Health Insurance 2021" talks about the DNI takeover of the Global Choice international medical insurance portfolio of Generali Global Health.

A few weeks ago Generali and Bupa announced a deal on IPMI.

Generali Employee Benefits (GEB) and Bupa Global announced a strategic partnership to offer “best-in-class” international private medical insurance and global employee benefits solutions to their new and existing corporate customers.

RELATED: Generali Employee Benefits And Bupa Global Announce Strategic Partnership To Offer International Private Medical Insurance

GEB customers will have access to Bupa Global’s quality, expertise, and comprehensive health and wellbeing offering, when and where they need it, across 190+ countries. Bupa Global customers will also have the ability to access global health and benefits solutions provided by GEB’s worldwide network.

What is easy to miss here is that it only refers to corporate business.

So what happens to the individual business of Generali Global Health?

The implication is that Generali Global Health would cease trading and leave the IPMI market.

I expect details to be explained on December 15th, 2021 when Generali will hold a virtual Investor Day to present its new strategic plan.

One part of the future was leaked – but it leaves gaps in knowledge.

Dubai National Insurance & Reinsurance (DNI), one of the leading insurance companies in the UAE, has partnered with Munich Re to take over some of the Global Choice medical portfolio of Generali Global Health.

Munich Re took over the reinsurance of Global Choice in July 2021.

DNI and Munich Re will maintain the existing policy benefits and terms and conditions of Global Choice.

Abdulla Al Nuaimi, CEO of DNI said, "We are delighted to officially announce the takeover of the GGH portfolio in collaboration with Munich Re. This exciting new collaboration affirms our commitment to continuously provide the same level of benefits and enhanced quality services to our clients and existing policyholders. We are dedicated to working with and strengthening our relationship with our partners to ensure seamless integration, giving customers peace of mind that they will not only continue to enjoy the benefits of GGH but take advantage of the combined expertise that DNI and Munich Re have to offer on the international medical front.”

Dr Frank Mayer, CEO, Munich Re comments, "DNI has been a trusted partner, and we are eager to work together and continue to expand our portfolio of services in the coming years. We believe that, together, we are in the best position to cultivate an even stronger and more comprehensive ecosystem that will allow us to serve our customers and partners better."

To ensure seamless operations following the takeover, DNI has continued working with Munich Re subsidiary MedNet as the third-party administrator owing to their familiarity with the scheme. The process will continue under the new partnership with Munich Re. The international network direct billing facilities previously through GGH will now be offered through the MedNet Global Network.

Although MedNet has a global network, DNI is limited to the Gulf and most of that is in the UAE.

Will Bupa and DNI now be competing in several countries where Generali and Generali Employee Benefits are both in business, or just the Middle East or just the UAE?

What will happen to the rest of the Generali Global Health portfolio?


There is a trend for even leading global insurers to decide to stop competing in PMI and IPMI in selected countries.

There is also a trend for insurers to work in partnership with local groups and TPAs.

Regional groups see gaps.

What is interesting is to look at the plans of Oman Insurance to offer PMI/IPMI in six more countries from 2022 in association with four named and two yet unknown local insurers.

Looking at other recent deals, there is a move for insurers in Africa and The Gulf to offer PMI and IPMI across borders in association with others from the region.

While this may or may not have anything to do with Afghanistan it is very clear that American and European insurers are going to have to compete with strong local rivals.

My tip for 2022 is watch for more country exits by USA and European insurers.

But it is not all one way traffic, with Zurich quietly entering in some countries and the expected IPMI launch from HDI Global - ironically bringing us full circle as they have been recruiting from Generali Global Health.

READ THE LATEST REPORT ON IPMI: International Health Insurance (IPMI) 2021





Expatriate Group Adds Free Upgrades To Corporate iPMI Plans For All New And Existing Policyholders

Expatriate Group commit to upgrade their corporate iPMI policies for all new, and existing policyholders, for free, from New Year’s Day 2022.

They will restructure their group iPMI policy cover following conversations with their corporate and broker partners.
Their feedback clarified the requirement for policies that better suited the needs of businesses seeking to meet the challenges of greater corporate responsibility to their staff and their work environments – both physically and mentally.

From 1st January 2022 all group policies will include, as standard: an Employee Assistance Programme; Business Travel insurance; and Income Replacement cover, integrated into all international healthcare policies.

“From the feedback, it was clear that HR managers want simpler and more cost-effective solutions for managing employee protection” said Amanda Giscos, Head of Business Development.

She also added “COVID-19 often led HR managers to remain with existing providers, even if there were better products on the market, to give employees the feeling of an element of security through consistency. However, with the world easing back to work, the ability to attract and retain staff is vital. Businesses who put employee wellbeing at the heart of their culture and support the transition to the new normal, and beyond, will thrive”.

“We have now reinvented our corporate policies to better meet these needs in a simple, single HR solution” said Lee Gerry, Expatriate Group Director.

“Now, if an employee is travelling on business, they’re covered; if they need immediate access to counselling, they’re covered; if they can no longer work because of their health, they’re covered. These benefits are now core to our comprehensive group iPMI policies.

“What’s more,” Gerry said “following strong underwriting results in 2019 and 2020, the improvement in benefits hasn’t resulted in any change in premium”.

“International HR managers are seeking more from their partners” Gerry continued, “Enabling employee services and risk management to be centralised under a single contract, will streamline administration, and make both time and cost savings.

There’s also the added benefit of claims being handled under the same online platform, which’ll make life easier for the employee too!”

Expatriate Group’s new corporate iPMI policies will be available from 1st January 2022. Existing customers will have the new benefits automatically added to their group policy at renewal.


Allianz Partners Announce Details Of Enhancements To International Health Plans

Allianz Partners has today announced details of significant enhancements to their international health plans, aimed at enabling members to take a more proactive approach to managing their health and addressing evolving healthcare needs following the Covid-19 pandemic. 

Designed and sold through the company’s international health brand, Allianz Care, these enhanced plans will give customers a more comprehensive and easier to understand cover, with improved ease of access to treatment and services.

From today, customers can access enhanced cancer screening, complemented by a follow-on preventative surgery benefit and comprehensive mental health cover. Inpatient treatment is fully covered up to the annual plan maximum on all plans and waiting periods have been removed. In addition, cover is now extended to include the treatment of behavioural and personality disorders such as autism spectrum and eating disorders, and a counselling service is available for short-term, solution-focused interventions through the Expat Assistance Programme (EAP).

The improved health services package also includes a Telehealth Hub, which is available to all customers with an Outpatient Plan. Which means that depending on location they can avail of video consultations and/or medical advice via telehealth. The Telehealth Hub can be accessed via the MyHealth portal or on the Allianz Care website and video consultations will be available for customers and their dependants. The improved plans also give customers access to the Olive health and wellness support program - which includes the HealthSteps app, as well as access to a Second Medical Opinion. 

Paula Covey, Chief Marketing Officer, Health at Allianz Partners, said, “The world has changed significantly since the outbreak of Covid-19 and the needs of our customers across the world have changed. We recently carried out global research which found that over one third of employees have experienced poor mental health since the pandemic began. The importance of proactively helping people to manage their health and wellness has never been more important.

“Following a global shift to remote working and the current move to a hybrid working model, many people are now more comfortable living their lives online. Our research showed that many appreciate the privacy and convenience of online mental health services, rather than accessing them in-person. It also reduces the risk of contracting Covid-19 during travel and the consultation itself.  We’ve listened to our customers, and as their health partner, we’re delighted to deliver this range of enhancements, helping them to make a positive difference to their quality of life.”

As part of Allianz Partners’ commitment to simplifying products and processes for customers, small changes to the terms and conditions will make it easier for customers to understand the full range of benefits offered. While further automation will mean an improved claims experience and faster response times.



Generali Employee Benefits And Bupa Global Announce Strategic Partnership To Offer International Private Medical Insurance

Generali Employee Benefits (GEB) and Bupa Global announce a strategic partnership to offer “best-in-class” international private medical insurance (IPMI) and global employee benefits solutions to their new and existing corporate customers.

GEB customers will have access to Bupa Global’s quality, expertise, and comprehensive health and wellbeing offering, when and where they need it, across 190+ countries. Bupa Global customers will also have the ability to access global health and benefits solutions provided by GEB’s worldwide network.

The benefits of the partnership include access to in-house healthcare experts 24/7, the ability to access a second medical opinion, a team of multilingual advisors, enhanced mental health benefits, and the ability to include these plans within international employee benefits arrangements.

This agreement builds upon GEB’s existing partnership with Bupa in the UK and reinforces GEB’s commitment to continue to provide customer-focused solutions. The partnership aligns with Bupa Global’s long-term strategy to drive growth and further strengthen its leadership position in the IPMI market, by expanding its capability to more customers globally.

Paolo Ribotta, CEO - Generali Employee Benefits, stated, “We are proud to join forces with BUPA and have the possibility to offer our clients and prospects one of the leading and world-class providers of health insurance and wellness solutions for internationally mobile employees. This is another testament to our strategy to continue to strengthen our network and ecosystem of partnerships and the result of a broader strategic plan that translates our ambition of being Lifetime Partners to our customers. Health & Wellbeing markets will continue to grow and the proposition of companies towards their employees goes in the direction of interpreting wellbeing increasingly in a broader sense. We are focusing on bringing to Internationally Mobile Employees all solutions to their needs, and having the right partners to support us on this path is key.”

Sheldon Kenton, CEO for Bupa Global, said, “Now more than ever, people are prioritising their health and wellbeing. Our own research from the Bupa Global Wellbeing Index showed that over the past year, nearly half (48%) of senior leaders spent more time focusing on their physical and mental health. We are pleased to enter this agreement with Generali Employee Benefits, which aligns to our strategy to accelerate growth in IPMI and give more customers access to premium healthcare, where and when they need it.”


How To Grow An IPMI Broker Business: Increase Profits and Value Proposition

In this article, Olivier LE FAOUDER, CEO, Think Insurtech, talks about how iPMI brokerages can become more profitable and compliant, whilst raising the value and efficiency of their business.

Let's talk about money. You are an owner, partner or senior manager in an IPMI brokerage firm.

What are the expenses of a broker? Central costs (rent, IT) are necessary, but it is mainly the cost of selling that will be important: first of all, the salaries of the sales representatives and then the marketing costs.

These salary costs vary with the level of sales. The turnover is directly generated by the sales representatives who are there to prospect, establish quotations, negotiate, close sales and provide after-sales service. All this while respecting the more drastic compliance constraints (in Europe GDPR and DDA), which are a burden on their working time.

Therefore, the issue of productivity and efficiency of sales representatives is crucial for the profitability of a broker. If your representatives are able to process their tasks four times faster, they will generate four times more revenue.  The more efficient they are, the more profitable the broker business will be and the higher its valuation.

The question is: how do you make salespeople much more efficient?

The answer lies of course in the implementation of efficient IT tools that will accelerate their productivity. For several years, structured brokers have invested in CRM software acquired from publishers at a high price.  These softwares are customised on demand with high costs.

Problem: they are not able to evolve once installed. They do not manage either technological changes (the cloud, video-conferencing, APIs) or business changes (the compliance issues that change the usual sales process).

The solution that stands out today is the implementation of SAAS software, i.e. software hosted in the cloud, which is invoiced by subscription, with low deployment costs. Today, no company pays for its IT and software in one go and SAAS is the way.

Think Insurtech has developed a SAAS software suite dedicated to the international medical insurance brokerage sales force.  This suite, interfaced with a CRM directly in the cloud (such as PipeDrive or SalesForce) can reduce the processing time of a sales lead by 80%.

So how does it work? Converting more leads into sales in a quick way is the key.

ThinkInsurtech SAAS is a part of AOC Insurance Broker, a tech comparator in international health insurance and employee benefits. The SaaS platform was built by AOC Insurance Broker to help insurance brokers, providers, insurance companies become more productive in providing quotes and to work digitally with clients to compare plans and rates in real time with full client experience. The Think Insurtech SaaS is scalable and assists intermediaries in Insurance with both GDPR and IDD Compliance.

We manage a suite of module with our SaaS platform :                             

Think Insurtech Individual: IPMI/Health Insurance Comparison regarding needs, destination, and an algorithm to analyse, recommend the best value. This module is at the heart of the system. It allows sales representatives to save 80% of the time in making quotations, selecting plans, writing recommendations and sending them digitally to the prospects. Our software compares the prices and up to 64 benefits of each plan and lays out the comparison.

Think Insurtech Corporate: Employee benefit Tender Comparison/Data & insurance needs collected online with a sign up/the system generate a proposal comparison with a recommendation                                                 

Think Insurtech Rewards: Preventive and predictive care with a reward program connected to a third party and a mobile app. platform for HR/Compensation Benefit (Our customer engagement program and the Smartcare health platform allow us to analyse, interpret, recommend, prevent and manage medical risks (blood tests, genetic tests, ADN, monitoring with Internet of Things, etc.) for the interest of the insured members and the insurers on the long term. We also engage and reward our clients if they recommend friends with Amazon coupon, wearable with Garmin and a point system)                                      

Think Community: Tribe API connected to the SaaS platform to educate and manage interactions, topics between insurer, providers & insurance brokers                                          

Think Compliance: An API connected to the SaaS to educate and to manage broker & insurer compliance with the Insurance directive distribution

We launched a marketplace at the end of December 2020 for our user formula in order to convert insurance brokers into a white label. A challenge for intermediaries globally is shifting to a digital platform. Few tools are readily available today. Going digital has many benefits, it enhances performance, productivity, profitability, and value of         the business. Assists in Regulator compliance, GDPR, IDD and KYC. Enhances the customer journey via real time side by side comparisons of benefits, premium, currency based on the clients' individual wants, needs and budget requirements. Both regulations and COVID dramatically impacted and accelerated the need to utilize digital platforms.                                      

Simply, there is a need to become digital. The alternative - leaving the market, merging, being acquired or becoming digital.                                                       

Our SaaS platform is a turnkey solution for broker, provider & insurance company with 3 formulas and a Starter Edition at €49,90/month.

We have a catalog with upsell from deployment to support, legal package, webform, API integration etc. that are added to the price of the licenses.                                              

AOC Insurance Broker (AOC) is a French insurance broker specialised in the mobility & expat insurance targeting international individuals and groups.

What sets Think Insurtech from the crowd?

We are unique in our niche market of international health insurance which is not digital and the only ones to have thought of digitizing the distribution chain within the framework of the European insurance distribution directive. We know this market perfectly well because we represent 37 insurance providers with AOC Insurance Broker and no one is yet digital and able to manage APIs. Most of them have great difficulties in managing compliance and their distribution networks in the framework of product governance.

Award Winning Insurtech:

  • Finance Innovation French Tech awarded in 2017 (AOC Insurance Broker)
  • Top Innovator - Innovator Edge Insure Thought leadership 2017 (AOC Insurance Broker)
  • Top 4 Prize of Innovation Paris Ouest la Defense (AOC Insurance Broker)
  • Nominated Insurtech of the year 2020 in France (Think Insurtech)

Get Started With Think Insurtech:

Start your free trial today, simply fill in the quick form here.




The Best And Worst Destinations For Living And Working Abroad

The Expat Insider 2021 Survey is out now, and the results reveal the best and worst destinations for living and working overseas.

Ian Youngman, Author of the International Health Insurance 2021 report comments, "Among all the doom and gloom I have heard suggestions that not only were some companies thinking of moving people away from cities into the country but also thinking of moving people abroad. The other vibe is that rather than moving back home - as the media suggests- most expats have opted to stay but perhaps move to the country or move from cities. This is the first time that I have seen any evidence that more people are thinking of moving abroad.

In the UK there is already a trend to move from cities into the country and either work remotely or commute. In my village, every week estate agents ask if I want to sell up - local house prices have shot up over 10% in a few months. So if you think this through globally, with remote work globally being possible and digital nomads becoming a new breed of expats, people are looking to move from cities- and that may mean moving abroad. Nobody can predict figures but I expect expat numbers to increase every year in the next few years - from individuals and companies.

There are now 80 million expatriates, 5 million international students, 4 million temporary foreign workers, and 18 million high net worth individuals of which 2.7 million are ultra high net worth."

RELATED READING: International Health Insurance (IPMI) 2021

The Best Destinations for Living and Working in 2021

1. Taiwan 

Taiwan ranks 1st out of 59 destinations for the third year in a row in the Expat Insider 2021 survey. It also comes first in the Quality of Life and Working Abroad Indices: Most expats are satisfied with their job security (83% vs. 61% globally) and the state of the local economy (85% vs. 62% globally). Additionally, the majority is happy with their job (75% vs. 68% globally) and their life in general (80% vs. 75% globally). Furthermore, 96% of expats rate the quality of medical care positively (vs. 71% globally), and another 94% are satisfied with its affordability (vs. 61% globally). An expat from Chile shares: “The Taiwanese healthcare system truly considers people as human beings instead of mere numbers.” Moreover, not a single expat (0%) feels personally unsafe in Taiwan (vs. 8% globally). An expat from Canada shares: “I can live independently. I feel safe wherever I go, and everything is convenient.” 

Although Taiwan places slightly lower in the Ease of Settling In Index (13th), it is the best-ranking country worldwide in the Friendliness subcategory (1st). Most expats find it easy to make friends there (62% vs. 48% globally) and describe the Taiwanese population as friendly towards foreign residents (96% vs. 67% globally).  

2. Mexico 

Mexico ranks 2nd out of 59 destinations worldwide. It is even rated the best country for expats in the Ease of Settling In Index (1st): 85% find it easy to settle down in Mexico (vs. 62% globally), and 78% say it is easy to make local friends (vs. 44% globally). A US American expat says that “the culture and friendliness of the local people” is their favorite thing about living in Mexico.  

Mexico also does well in the Personal Finance (2nd) and Cost of Living (4th) Indices. In fact, four in five expats (80%) are satisfied with their financial situation (vs. 64% globally), and 90% say their disposable household income is enough or more than enough to cover their living expenses (vs. 77% globally).  

Mexico performs slightly below average in the Quality of Life Index (31st). It comes in 42nd place in the Quality of the Environment subcategory, with 27% of expats being unhappy with the water and sanitation infrastructure (vs. 12% globally). Additionally, Mexico even ends up among the bottom 10 of the Safety & Security subcategory (51st), with 20% of expats concerned about their personal safety (vs. 8% globally). Despite that, 89% of expats in Mexico are happy with their life in general (vs. 75% globally), placing the country first worldwide for personal happiness.  

3. Costa Rica 

Costa Rica places 3rd out of 59 countries in the Expat Insider 2021 survey. It ranks among the top 5 in the Ease of Settling In Index (3rd), with 91% of expats describing the population as generally friendly (vs. 69% globally). Another 87% describe the local residents as generally friendly towards foreign ones (vs. 67% globally), and 70% find it easy to make local friends (vs. 44% globally). “I love the social life and culture,” shares a US American expat. Maybe this is why most survey respondents find it easy to get used to the local culture (82% vs. 65% globally) and feel at home in it too (80% vs. 63% globally).  

Costa Rica performs well in the Quality of Life Index (14th), coming in second place worldwide for personal happiness — just behind Mexico (1st). All things considered, 88% of expats in Costa Rica are happy with their life (vs. 75% globally). The country comes 10th in the Quality of the Environment subcategory, with the majority of expats rating the natural environment (96% vs. 84% globally) and the air quality (91% vs. 66% globally) positively. However, Costa Rica lands in the bottom 10 of the Travel & Transportation subcategory (52nd): 29% of expats are unhappy with the public transportation system (vs. 15% globally). A Canadian expat shares: “Traffic is terrible because of poor drivers, bad roads, and insufficient infrastructure.”  

On the upside, Costa Rica makes it into the top 10 of the Personal Finance Index (7th), with 84% of expats considering their disposable household income enough or more than enough to cover all expenses (vs. 77% globally).  

4. Malaysia 

Ranking 4th out of 59 countries in the Expat Insider 2021 survey, Malaysia ranks above the global average in every index. The country does particularly well in the Ease of Settling In Index (2nd) — as a US American expat puts it: “It is easy to live here, and the people are wonderful.” In fact, most expats find it easy to settle down in Malaysia (77% vs. 62% globally) and to make new friends there (66% vs. 48% globally). It might help that Malaysia ranks first in the Language subcategory: 92% of expats find it easy to live there without speaking the local language (vs. 54% globally), while 45% also consider it easy to learn (vs. 39% globally).  

The country also does exceedingly well in the Cost of Living Index (2nd), where just Vietnam (1st) performs better. In fact, 82% of expats rate the cost of living in Malaysia positively (vs. 48% globally). With the destination ranking 9th in the Personal Finance Index, 73% of expats are satisfied with their financial situation (vs. 64% globally), and 85% say their disposable household income is enough or more than enough to cover their expenses (vs. 77% globally).  

Malaysia does worst in the Working Abroad Index, but it still lands in a slightly above-average 25th place: 72% of expats are satisfied with their working hours (vs. 66% globally), and 69% are happy with their job in general (vs. 68% globally). 

5. Portugal 

Portugal ranks 5th out of 59 destinations in the Expat Insider 2021 survey, performing best in the Quality of Life Index (3rd) — just behind Taiwan (1st) and Austria (2nd). The country ranks third in the Personal Happiness subcategory of this index, with 84% of expats being happy with their life in general (vs. 75% globally). What is more, 87% of expats are satisfied with the local leisure options (vs. 72% globally), and 90% say the same about the climate and weather (vs. 66% globally). “I like the weather and the laid-back lifestyle,” says a French expat.  

Portugal also makes it into the top 10 of the Ease of Settling In Index (9th), coming sixth in the Friendliness subcategory. In fact, 87% of expats find the local residents generally friendly, compared to just 69% globally. Portugal even ranks second worldwide in the Feeling at Home subcategory, where just Mexico (1st) performs better. The majority of expats feels at home in the local culture (83% vs. 63% globally) and finds it easy to settle down in the country (84% vs. 62% globally).  

Portugal receives its worst — but still fairly average — results in the Working Abroad Index (36th). The destination places 44th in the Career Prospects & Satisfaction subcategory, though, with more than half the expats (51%) unsatisfied with the local career opportunities (vs. 33% globally). However, 70% of expats are at least happy with their work-life balance (vs. 66% globally).  

6. New Zealand 

New Zealand almost makes it into the global top 5 of the Expat Insider 2021 ranking, coming 6th out of 59 countries. It performs particularly well for working abroad (2nd): 81% of expats consider their job secure (vs. 61% globally), and 64% feel optimistic about local career options (vs. 45% globally). At the same time, expats enjoy a great work-life balance (83% satisfied vs. 66% globally).  

The country comes in 11th place in the Quality of Life Index, doing especially well in the Digital Life subcategory (5th): 98% are happy with the cashless payment options (vs. 83% globally), and 89% rate the availability of government services online favorably (vs. 63% globally). What is more, New Zealand has the best ratings worldwide for its natural environment (100% positive vs. 84% globally), coming in 6th place in the Quality of Environment subcategory. Last but not least, it is a very safe and stable country to settle down in: 95% of expats describe New Zealand as peaceful (vs. 80% globally), and not one single respondent rates its political stability negatively, compared to about one in six (16%) globally. “I love my peaceful, calm, and safe existence in New Zealand,” a US expat comments.  

The results for the ease of settling in are only slightly worse (16th). Expats find it easy to settle down in New Zealand (77% positive ratings vs. 62% globally), and 82% describe the local residents as friendly (vs. 69% globally).  

7. Australia 

In the Expat Insider 2021 survey, Australia (7th out of 59) lands among the top 10 destinations worldwide. While it ranks sixth in the Quality of Life Index overall, it comes first worldwide for its local leisure activities (87% positive ratings vs. 72% globally). An impressive 97% of respondents also praise the natural environment (vs. 84% globally). “Living in close proximity to nature — close to the beach and the rainforest — is so amazing!”, says a US expat. Lastly, it ranks very well in the Digital Life subcategory (8th) as, for instance, 89% of expats appreciate the availability of government services online (vs. 63% worldwide). However, opinions are divided on the topic of healthcare in Australia: while 88% of expats are satisfied with its quality (vs. 71% globally), just 68% consider it affordable (vs. 61% globally).  

Australia does well in the Working Abroad Index (10th). Expats are especially satisfied with their local career opportunities (60% positive ratings vs. 45% globally) and their work-life balance (76% positive responses vs. 66% globally). Even Australia’s somewhat worse results in the Ease of Settling In Index (18th) still place it in the top 20. Expats find it especially easy to get used to the local culture (76% positive responses vs. 65% globally) and to settle down in Australia (74% vs. 62% worldwide). However, only a slightly above-average 54% find it easy to make new friends there (vs. 48% globally).  

8. Ecuador  

Coming in 8th place out of 59 countries in the Expat Insider 2021 survey, Ecuador performs best in the Personal Finance Index (5th). Close to three in four expats (73%) are satisfied with their financial situation (vs. 64% globally). Moreover, 91% describe their disposable household income as enough or more than enough to cover their expenses (vs. 77% globally). This places the country third for this factor, just behind India (2nd) and Vietnam (1st). Ecuador also lands among the top 10 in the Cost of Living Index (7th), with 78% of expats rating this aspect of life abroad positively (vs. 48% globally).  

In the Ease of Settling In Index (10th), the country ranks sixth in the Feeling at Home subcategory. The majority of expats (82%) finds it easy to settle down in Ecuador (vs. 62% globally), 80% feel at home in the local culture (vs. 63% globally), and 68% find it easy to make new friends in general (vs. 48% globally).  

Ecuador shows a slightly weaker performance in the Quality of Life Index (24th). Still, nearly all expats (96%) rate the country’s natural environment positively (vs. 84% globally), and 85% are satisfied with their socializing and leisure activities (vs. 67% globally). “The nature and scenery are great,” shares a Venezuelan expat. However, in the Digital Life subcategory (45th), Ecuador comes last worldwide (59th) for cashless payment options, with 37% rating this factor negatively (vs. 9% globally).  

9. Canada 

Making it into the top 10 out of 59 destinations, Canada (9th overall) performs well in most indices of the Expat Insider 2021 survey. The country ranks best in the Quality of Life Index (5th), with the majority of expats finding it easy to get high speed internet at home (92% vs. 79% globally) and to pay without cash (96% vs. 83% globally). Additionally, 86% are happy with the availability of government services online, compared to 63% globally. Most expats are also satisfied with the affordability of healthcare in Canada (85% vs. 61% globally) and the country’s political stability (90% vs. 64% globally). “Healthcare is a basic right, and the quality of life is very good in Canada,” says a US American expat.  

Canada also performs well in the Working Abroad and Ease of Settling In Indices (12th for both). It even lands in the top 10 of the Feeling at Home subcategory (7th), with 73% of survey respondents feeling at home in the local culture (vs. 63% globally). In terms of work, close to two out of three expats (64%) rate the career opportunities positively (vs. 45% globally).  

On the other hand, Canada ends up among the bottom 10 of the Personal Finance Index (50th). Nearly a third of expats (32%) say their disposable income is not enough to cover all their living expenses (vs. 23% globally). An expat from Mexico shares that “the best cities are really expensive. It is hard to become a homeowner with an average income.”  

10. Vietnam  

Coming in 10th place out of 59 countries in the Expat Insider 2021 survey, Vietnam ranks first in both the Personal Finance and Cost of Living Indices. The majority of expats (85%) rates the cost of living positively (vs. 48% globally), and 78% are satisfied with their financial situation (vs. 64% globally).  

Vietnam also does well in the Working Abroad Index (9th), with the vast majority of expats (86%) expressing overall job satisfaction (vs. 68% globally). Placing 25th in the Ease of Settling In Index, Vietnam does especially well in the Finding Friends subcategory (9th). According to 63% of expats, making local friends is easy (vs. 44% globally), and another 67% find it easy to make new friends in general (vs. 48% globally). What is more, the majority (81%) considers the local residents generally friendly (vs. 69% globally).  

Despite its great performance in the overall ranking, Vietnam ends up among the bottom 10 in the Quality of Life Index (53rd). More than three in five expats (63%) rate the air quality in Vietnam negatively (vs. 20% globally), and 42% are unhappy with the water and sanitation infrastructure (vs. 12% globally). A Swiss expat shares: “Plastic pollution is a major problem, especially along the coast.” However, 85% of expats in Vietnam are still generally happy with their life (vs. 75% globally).  

The Worst Destinations for Living and Working in 2021 

59. Kuwait 

For the seventh time in eight years, Kuwait (59th out of 59 countries) comes in last place in the Expat Insider 2021 survey. The country ranks last in the Quality of Life Index (59th), with especially poor results in the Leisure Options, Personal Happiness, and Travel & Transportation subcategories (59th for all). In fact, 58% of expats in Kuwait are unhappy with the local leisure options (vs. 14% globally), and 50% rate the climate and weather negatively (vs. 17% globally). Additionally, 29% state that they are generally unhappy (vs. 10% globally).  

Kuwait comes last in the Ease of Settling In Index (59th), with 46% of expats not feeling at home in the local culture (vs. 20% globally) and 45% finding it difficult to settle down in this country (vs. 22% globally). Moreover, 51% have trouble finding new friends (vs. 32% globally), and 62% find it difficult to make local friends in particular (vs. 36% globally). The country ranks last for friendliness (59th) as well: 36% of expats rate the general friendliness of the population negatively (vs. 16% globally), while another 44% describe the people as unfriendly towards foreign residents (vs. 18% globally).  

Placing 56th in the Working Abroad Index, Kuwait performs poorly in both the Work & Leisure (58th) and the Career Prospects & Satisfaction (57th) subcategories. More than three in ten respondents (31%) are dissatisfied with their job in general (vs. 16% globally), and 34% are unhappy with their work-life balance (vs. 17% globally).  

58. Italy 

Coming in 58th place in the Expat Insider 2021 survey, Italy is the second-worst country for expats — ranking only ahead of Kuwait (59th). In the Personal Finance Index (59th), the Southern European country even lands in last place worldwide: 30% of expats are dissatisfied with their financial situation (vs. 19% globally), 14% even very much so, twice the share of the global average (7%). Furthermore, one in three expats (33%) says their disposable household income is not enough to cover their expenses (vs. 23% globally).  

Italy also performs poorly in the Working Abroad Index (58th), only ahead of Turkey (59th), coming last in the Career Prospects & Satisfaction subcategory (59th). More than half the expats (56%) rate their local career opportunities negatively (vs. 33% globally), and 31% are dissatisfied with their job (vs. 16% globally). An Iranian expat shares: “Finding a job is not easy for foreigners, not even for the well-educated ones.”  

Within the Quality of Life Index (42nd), Italy ranks worst in the Digital Life subcategory (51st): 23% of expats find it difficult to get high-speed internet access at home (vs. 12% globally), 18% consider it difficult to pay without cash (vs. 9% globally), and 40% are unhappy with the availability of government services online (vs. 21% globally). Overall, there are only few upsides about expat life in Italy, such as the climate and weather (71% happy vs. 66% globally) and the travel opportunities (88% happy vs. 84% globally). 

57. South Africa 

Coming in 57th place out of 59 destinations in the Expat Insider 2021 survey, South Africa ends up in the bottom 3 — only ahead of Italy (58th) and Kuwait (59th). It performs worst in the Personal Finance Index (55th): over one-third of expats in South Africa (34%) do not consider their disposable household income enough to cover all their expenses (vs. 24% globally), and just 57% of expats in South Africa are satisfied with their financial situation (vs. 64% globally).  

South Africa also ends up among the bottom 10 of the Working Abroad Index (54th), coming last worldwide in the Economy & Job Security subcategory (59th). Only 47% of expats are satisfied with their job security (vs. 61% globally), and less than a third (31%) are happy with the state of the local economy — exactly half the global average (62%).  

Ranking among the bottom 10 in the Quality of Life Index (52nd), South Africa ranks last worldwide in the Safety & Security subcategory (59th). More than one-third of expats (34%) do not consider South Africa a peaceful country (vs. 9% globally) and just about one in four (24%) feel safe there (vs. 84% globally). An Ethiopian expat even says: “You are not able to walk around safely.” However, South Africa does well in the Leisure Options subcategory (15th), with 87% of expats rating the climate and weather favorably (vs. 66% globally). The majority (95%) is also satisfied with the natural environment (vs. 84% globally). “I like the climate, the diverse coastlines, and South Africa’s natural beauty,” summarizes a German expat. 

56. Russia 

Out of 59 countries in the Expat Insider 2021 survey, Russia (56th) lands in the bottom 10. It performs worst in the Working Abroad Index (52nd): Close to one in four expats (24% each) rate the state of the local economy negatively (vs. 19% globally) and are unhappy with their job security (vs. 20% globally).  

Narrowly escaping the bottom 10 in the Quality of Life Index (49th), Russia performs especially poorly in the Quality of the Environment subcategory (49th). Expats are unhappy with the air quality (31% vs. 20% globally), the water and sanitation infrastructure (21% vs. 12% globally), and the natural environment (14% vs. 8% globally). “I do not like the lack of any meaningful efforts or policies to reduce environmental pollution and to support basic recycling,” shares a US American expat.  

With Russia coming in 48th place in the Ease of Settling In Index, 29% of respondents find it difficult to settle down in this country (vs. 22% globally). What is more, Russia ends up in the bottom 10 of the Language subcategory (58th), only ahead of Japan (59th). Nearly half the expats (48%) find it difficult to live in Russia’s cities without speaking the local language (vs. 29% globally), and two-thirds (67%) find it difficult to learn Russian (vs. 42% globally). Russia receives its best result in the Cost of Living Index (25th): 49% of expats rate the cost of living positively, which is, however, still just one percentage point above the global average (48%). 

55. Egypt  

Egypt (55th out of 59) also ranks the bottom 10 of the Expat Insider 2021 survey. The country performs worst in the Quality of Life Index (57th), where only India (58th) and Kuwait (59th) do worse. In fact, 39% of expats in Egypt rate the water and sanitation infrastructure negatively (vs. 12% globally), and 48% give the air quality a negative rating (vs. 20% globally). “The air quality is bad, and there are only few green spaces,” shares an Afghan expat. Landing at the very bottom, Egypt performs even worse in the Digital Life subcategory (59th). Exactly three in five expats (60%) rate the availability of government services online negatively (vs. 21% globally), 34% find it difficult to get high-speed internet access at home (vs. 12% globally), and 32% consider it hard to pay without cash (% vs. 9% globally).  

Also ending up among the bottom 10 of the Working Abroad Index (53rd), Egypt receives extremely poor results in the Career Prospects & Satisfaction (55th) and Economy & Job Security (53rd) subcategories. A quarter of expats (25%) are dissatisfied with their job in general (vs. 16% globally), and 46% rate the local career opportunities negatively (vs. 33% globally).  

The country performs better in the Cost of Living (19th) and Ease of Settling In (30th) Indices: 61% of expats rate the cost of living positively (vs. 48% globally) and 57% find it easy to make local friends (vs. 44% globally).  

54. Japan 

Japan ranks 54th out of 59 countries featured in the Expat Insider 2021 survey. Performing particularly poorly in the Ease of Settling In Index (58th), Japan only ranks better than Kuwait (59th). Just 36% of expats find it easy to settle down in Japan (vs. 62% globally), and a mere 45% feel at home in the local culture (vs. 63% globally).  

In the Working Abroad Index (50th), 30% of expats are unhappy with their work-life balance (vs. 17% globally). A US American expat living in Hashimoto even says that “the work-life balance here is atrocious”. Japan also receives poor results in the Personal Finance Index (54th), with 26% of expats dissatisfied with their financial situation (vs. 19% globally).  

On the upside, Japan has an above-average performance in the Quality of Life Index (21st). With the country coming 12th for the quality of the environment, 94% of expats rank the water and sanitation infrastructure positively, compared to 77% globally. Additionally, nearly all expats rate Japan positively for personal safety (97% vs. 84% globally) and peacefulness (95% vs. 80% globally). A Brazilian expat shares: “In Japan, there is a low crime rate throughout the country. It is very safe to walk on the streets at any time.” And a South African expat says: “Japan offers a safe environment, and most things are done properly with respect for others in mind.”  

53. Cyprus 

Cyprus lands in the bottom 10 overall, coming 53rd out of 59 destinations in the Expat Insider 2021 survey. It places 57th in the Working Abroad Index — just ahead of Turkey (59th) and Italy (58th). Close to half the expats (49%) are dissatisfied with the local career opportunities (vs. 33% globally), and more than a third (34%) rate the job security negatively (vs. 20% globally). A Nepalese expat shares: “It is difficult to find work, so I cannot afford college or my living expenses.” In fact, Cyprus also places in the bottom 10 of the Personal Finance Index (57th) and comes last for the disposable household income (59th). Close to two in five expats (39%) say their disposable household income is not enough to cover their expenses abroad (vs. 23% globally).  

Cyprus performs best in the Ease of Settling In Index (28th), with 66% feeling at home in the local culture (vs. 63% globally) and 70% describing the local population as generally friendly towards foreign residents (vs. 67% globally). Furthermore, 80% of expats find it easy to get around without knowing the local language(s) (vs. 54% globally).  

With Cyprus placing 34th in the Quality of Life Index, the majority of expats (89%) is happy with the local climate and weather (vs. 66% globally) — ranking the destination 5th worldwide for this factor. However, while 70% of respondents are happy with the air quality in Cyprus (vs. 66% globally), 14% rate the water and sanitation negatively (vs. 12% globally).  

52. Turkey 

Overall, Turkey (52nd out of 59) lands among the bottom 10 destinations in the Expat Insider 2021 survey. Ranking last worldwide in the Working Abroad Index (59th), Turkey ends up in the bottom 10 for every single subcategory: Career Prospects & Satisfaction (56th), Economy & Job Security (58th), and Work & Leisure (59th). In fact, expats in Turkey are dissatisfied with their working hours (32% vs. 16% globally), their job in general (29% vs. 16% globally), and their job security (30% vs. 20% globally). A British expat shares that “for expats, it is extremely difficult to get a work permit”.  

Turkey places 32nd in the Ease of Settling In Index, with more than half the expats (53%) finding it easy to make local friends (vs. 44% globally). Most expats consider the local residents to be friendly towards foreign ones (72% vs. 67% globally), and they are happy with the general friendliness of the population too (72% vs. 69% globally). “There is a general warmth and hospitality among the people around me,” shares a Russian expat.  

Coming in 35th place in the Quality of Life Index, Turkey ranks among the bottom 10 in the Digital Life subcategory (50th), though: 16% of expats find it difficult to get a local mobile phone number (vs. 7% globally), and 21% have trouble getting high-speed internet at home (vs. 12% globally). The country also lands in the bottom 10 for political stability (54th), with more than a third of expats (35%) rating this factor negatively (vs. 16% globally).  

51. India 

Coming in 51st place out of 59 countries, India also ranks among the bottom 10 of the Expat Insider 2021 survey. Despite the poor result overall, the country ranks fourth worldwide in the Personal Finance Index: 82% of expats in India are satisfied with their financial situation (vs. 64% globally), and 89% say their disposable household income is enough or more than enough to cover their expenses (vs. 77% globally). Additionally, India places 13th in the Cost of Living Index (69% positive ratings vs. 48% globally).  

India performs slightly below average in the Ease of Settling In Index (34th). More than three in five expats (62%) feel at home in the local culture (vs. 63% globally), and 79% say the local population is generally friendly towards foreign residents (vs. 67% globally). However, over half the expats (51%) find it difficult to settle down in India, compared to 22% globally.  

India receives the second-worst results worldwide in the Quality of Life Index (58th) — only ahead of Kuwait (59th) — and performs worst in the Quality of Environment subcategory (59th): 67% of expats rate the air quality negatively (vs. 20% globally), and more than half (54%) are unhappy with the water and sanitation infrastructure (vs. 12% globally). The overall quality of life is also lowered by India’s poor performance in the Safety & Security subcategory (56th). Just 29% are satisfied with the country’s political stability (vs. 64% globally) and just 72% feel safe in India’s cities (vs. 84% globally). 

50. Malta 

Malta comes in 50th place out of 59 countries in the Expat Insider 2021 survey, performing worst in the Quality of Life Index (54th). It ends up among the bottom 10 in the Quality of the Environment and Travel & Transportation subcategories (56th for both). More than half the expats in Malta (51%) are unhappy with the transportation infrastructure (vs. 15% globally), and 11% rate their travel opportunities negatively (vs. 7% globally). “There is no nature at all, no green spaces, poor infrastructure for children, and too much traffic and pollution,” shares an Italian expat. In fact, 38% of expats in Malta are unhappy with the natural environment (vs. 8% globally). Moreover, 35% rate the air quality negatively (vs. 20% globally), and 25% are dissatisfied with the water and sanitation infrastructure (vs. 12% globally). On the upside, Malta ranks 7th worldwide for its local climate and weather (92% positive ratings vs. 66% globally).  

Malta receives below-average results in the Cost of Living and Ease of Settling In Indices (35th for both). In fact, 20% of expats rate the friendliness of the local population towards foreign residents negatively (vs. 18% globally). Additionally, 37% of expats find it difficult to make local friends in Malta (vs. 36% globally).  

Expat Life during the COVID-19 Pandemic 

On a global scale, 45% of survey respondents say that COVID-19 had an impact on their current stay abroad or their relocation plans: the share of expats who say so (37%) either decided to not move back home in the near future (18%), planned to move to another country but had to change these plans (8%), will move to another country due to the pandemic (6%), or will move back home sooner than originally planned (5%).  

The share of local respondents whose relocation plans were affected by COVID-19 (61%) is a lot higher: some of them were living abroad but moved home sooner than planned (18%), others were planning to move abroad but had to change their plans (35%), and about one in ten have now decided to move abroad because of the pandemic (9%).  

The Pandemic’s Impact on Everyday Life 

Of course, COVID-19 has not only disrupted the relocation plans of expats worldwide. When asked where they see the biggest impact of the pandemic on their personal life right now, the survey respondents point out its effects on personal travel (25%), social life (23%), and their work or business (16%) in particular. In the long run, respondents are still concerned about the impact of COVID-19 on their social life (17% of all respondents), and there are also considerable worries regarding personal travel (22%).   

How Expats Stay Informed on COVID-19 

Expats across the world mostly rely on official government channels (48%), local news (47%), and social media (40%) for news on the COVID-19 situation and the related regulations in their country of residence. Considering the importance of government channels, just how satisfied are expats with the official communication regarding COVID-19 and related regulations? Worldwide, not quite two-thirds (66%) rate this factor positively, with close to a quarter (24%) saying they are completely satisfied. The main complaint among expats who are not satisfied with the official communication on the pandemic is that the information is unclear, confusing, and/or contradictory (67%).  

For further information on the global impact of COVID-19 on expat life, please take a look at the full press release in the download center of our e-mail.  

About the InterNations Expat Insider 2021 Survey  

For its annual Expat Insider survey, InterNations asked 12,420 expats representing 174 nationalities and living in 59 countries or territories to provide information on various aspects of expat life, as well as their gender, age, and nationality. Participants were asked to rate up to 37 different aspects of life abroad on a scale of one to seven. The rating process emphasized the respondents’ personal satisfaction with these aspects, considering both emotional topics and more factual aspects with equal weight. The respondents’ ratings of the individual factors were then bundled in various combinations for a total of 13 subcategories, and their mean values were used to draw up five topical indices: Quality of Life, Ease of Settling In, Working Abroad, Personal Finance, and Cost of Living. The first four of these indices were further averaged together with expats' general satisfaction with their life in order to rank 59 expat destinations around the world. In 2021, the top 10 are Taiwan, Mexico, Costa Rica, Malaysia, Portugal, New Zealand, Australia, Ecuador, Canada, and Vietnam. Moreover, expats were asked about how COVID-19 has impacted their life abroad; however, these responses did not influence the overall ranking.  

For a country to be featured in the indices and consequently in the overall ranking, a sample size of at least 50 survey participants per destination was necessary. 


iPMI Magazine Speaks with Antony Brown MBE, Head of Africa, Aetna International

In this exclusive iPMI Magazine interview, Christopher Knight, CEO, iPMI Magazine, met with Antony Brown MBE, Head of Africa at Aetna International. They discussed in detail the international private medical insurance market in Africa, and the Sanlam Pan Africa and Aetna International Global Health Plan.

Please introduce yourself and background in the international private medical insurance (IPMI) market:

After 10 years with Her Majesty’s UK Foreign Office, I started the African subsidiary of InterGlobal Private Medical Insurance in 2008, as a member of the Executive Management team, and with overall responsibility for the Africa region as Regional General Manager, I later accepted the role of Head of Business in Africa for Aetna International following the acquisition of Interglobal by Aetna.

I have traveled extensively across the continent and I have a thorough understanding of the key insurance services required in local markets. I am also very well-versed in the regulatory requirements needed by insurers looking to operate stand-alone insurance businesses or partner with local insurance entities, in the region.

Sanlam Pan Africa and Aetna International have joined forces to deliver Africa’s “most comprehensive health care solution”. Can you walk us through the features and benefits of the new IPMI plan for Africa?

This offering has been created in partnership with Sanlam Pan Africa to address the healthcare needs of both local and expatriate nationals, on an international basis, across all market segments in 20 countries in Africa. Global Health offers a broad range of benefits, an extensive direct billing medical network and an enhanced member experience with local in-country service. The Global Health Plan reflects the needs and concerns of our clients and members across Africa, by giving them access to quality health care in a cost-effective way.

Through this partnership, we bring together the Africa-specific experience of Sanlam Pan Africa with the global expertise of Aetna International to deliver Africa’s most comprehensive and locally compliant health care solution with broad international access.

The Global Health proposition provides four plan levels — Value, Essential, Plus and Premium — with coverage ranging from US$100,000 to US$5,000,000. Depending on the tiers, the plans offer a host of health and well-being benefits, including cancer care, inpatient psychiatric treatment or psychotherapy, HIV or AIDS, terminal care, dental, optical and emergency treatment outside the area of cover.

With pre-authorised inpatient care across all of Africa and outpatient direct billing across the 20 Africa markets, Global Health offers members access to one of the widest medical networks locally and globally, as well as a 24/7 multilingual call centre for emergency and evacuation immediate assistance.

Who is the target market for the Global Health plan and why?

The Global Health Plan addresses the needs of the local market in 20 countries across Africa, for all employee levels: administrative, management and executive. Depending on the choice of cover, it offers access to health care in the country of residence but also abroad, for cases where medical expertise is not available locally or where the member is travelling. 

Geographically speaking, which countries does the new Global Health Plan cover?

Global Health is sold in 20 countries across the continent including Angola, Benin, Burkina Faso, Cameroon, Congo Brazzaville*, Gabon, Guinea Conakry*, Ivory Coast, Mali, Madagascar, Morocco, Niger, Nigeria, Senegal, Togo, Kenya, Rwanda, Uganda, Zambia and Tanzania. Members in these countries can choose one of four variants of area coverage:

Area 1: Worldwide Inc. US

Area 2: Worldwide Excl. US

Area 3: Europe Inc. Africa, India, Pakistan, Sri Lanka, Lebanon & Bangladesh

Area 4: Africa, India, Pakistan, Sri Lanka, Lebanon & Bangladesh

* Subject to OFAC regulations

Regarding access to healthcare across Africa, and the medical network, what are the options?

Members have access to an extensive direct billing medical network across the continent and beyond with more than 8,000 directly contracted providers in Africa and over 1.3 million health care professionals globally.

Emergency and non-emergency evacuation remain a critical feature of any IPMI plan. What options are available?

All four variants of the plan — Value, Essential, Plus and Premium — offer medical evacuation and in-patient cover as standard, but the coverage limits vary depending on the plan tier. For members under the Platinum plan, the cover is 100% of the medical evacuation costs.

What currency and billing options are available for insureds seeking access to healthcare under the Global Health plan?

Whether it is choice of medical provider or level of benefits, flexibility is a key value proposition of the plan and the same is true for billing.

For plan sponsors, premiums can be invoiced centrally in USD, or in the local currency of each respective country, subject to local laws and regulations.  

For members, Global Health offers outpatient treatment from within the available network on a direct billing basis in each of the 20 countries — the medical provider invoices us, as the insurer, directly without the need for the member to pay at the point of service. Inpatient treatment is required to be pre-authorised beforehand, and arrangements will be made by us, as the insurer, for the medical provider to bill us directly without the member having to pay. 

Can you please give us some more background on Sanlam Pan Africa?

Sanlam Pan Africa is the Sanlam Group’s business cluster that manages financial services in the emerging markets in Africa (excluding South Africa). Africa is a fundamental component of the Sanlam Group’s vision, which is the strategic mission of Sanlam Pan Africa — to build a leading pan-African financial services group.

Founded in 1918 as a life insurance company, Sanlam has become the largest non-banking financial services group in Africa, through its global diversification strategy and an unmatched

Pan-African footprint in more than 30 countries. Over the years, Sanlam has established itself as a financial services leader in the emerging markets in Africa and Asia.

What opportunities exist in the African market for international private medical insurance? Africa is a challenging geography – what issues on the ground, are expats and travelers facing when it comes to accessing high quality healthcare?

Africa is certainly challenging; its sheer size and diversity means that it is impossible to make broad generalisations on healthcare across the continent. Each country has its own strengths and weaknesses when it comes to accessing healthcare in any situation. For example, while coverage of healthcare can be patchy in rural areas, the quality of service in urban areas is certainly improving and often the challenge can be in arranging and funding care. In this respect, many parts of Africa are leading the way technologically when it comes to seamlessly booking appointments and minimising the use of cash, and Kenya is a great example of this.  We expect this capability to expand and, as the use of technology becomes a norm, insurance companies and medical providers will have to be ready with digital offerings, like telehealth services, to meet the demands of their members. 

The diversity of the countries in terms of language, currencies, cultures, and service expectation is also a challenge. We believe we have managed to address these aspects by making our plans as locally relevant as possible — the plans offer cover to local nationals, all documentation is available in the primary language of the country, we offer local invoicing and currency payment options, access to primary care on a direct billing basis, and local in-country representation. 

In 5 years’ time how will the international private medical insurance market look in Africa?

In recent years we have seen employers across Africa pivot from traditional offshore international medical insurance providers to local ones. However, few local providers have the capacity to offer international cover, which in Africa, where certain forms of treatment are not always available locally, is essential. Combining the expertise and capabilities of Aetna and Sanlam not only solves for such issues but offers access to a world-class comprehensive healthcare service. 

Furthermore, as a result of the global pandemic, we are seeing employers across the globe re-think their strategies when it comes to sending their staff on expat assignments, meaning that we expect a pivot towards more local hiring. Africa is no exception, particularly as the local workforce becomes more skilled and self-sufficient. What this means is potentially less demand for the traditional, high-cost fully international plans, which are the norm today, and an uptick in demand for plans that are more focused on regional cover, with comprehensive yet affordable benefits. This is exactly where we position Global Health; fit for today’s market and yet future-proofed for the changes ahead.



iPMI Magazine Speaks With Janette Hiscock, CEO of Global Solutions Europe, UnitedHealthcare Global

In this exclusive iPMI Magazine interview, Christopher Knight, CEO, iPMI Magazine, met with Janette Hiscock, CEO of Global Solutions Europe, UnitedHealthcare Global. They discussed in detail the COVID-19 global pandemic and how UnitedHealthcare Global has managed the public healthcare crisis, internally and externally. 

COVID-19 has had a huge impact on the healthcare industry. How has your organisation managed?

As a leading global healthcare company, we have been impacted like everyone else. We’ve been able to help support our employees, our customers, and communities around the world to aid the global fight against this disease. 

Since the outbreak, we’ve had to work quickly to make sure that we’re doing everything possible to continue treating patients and supporting our members. In the U.S., UnitedHealth Group has worked to develop accurate tests which aren’t as invasive as those which have been used more widely. These tests were made available to patients with a doctor’s order at hospitals, clinics and testing facilities across the U.S. We’ve also completed a *study with the Yale School of Medicine that suggests older COVID-19 patients with hypertension, who were taking angiotensin-converting enzyme (ACE) inhibitors, may have a lower risk of COVID-19 hospitalisation. A clinical trial will follow as a next step.1 The study is still under peer review.2

At UnitedHealthcare Global specifically, we have waived member cost sharing, including copayments and deductibles, for COVID-19 diagnostic testing provided this is medically necessary and is carried out at an approved location and in accordance with applicable governmental or public health advice.

This was made available on top of existing access to Virtual Visits, our telehealth solution, our Optum Employee Assistance Programme (EAP) and our unique health management programme. All these features continue to be a source of significant support for our members during this unprecedented time..

More widely, we looked to help other businesses in need across the world. For example, in the UK, our Medical Services team has been globally supplying vital PPE to protect healthcare workers across other essential businesses around the world.

Not only have we supported the scientific and clinical aspect of COVID-19 but since April we’ve committed over $60 million, via the UnitedHealth Foundation, to support homelessness, food insecurities and the health and safety of the frontline workforce. This funding has been used across the U.S. and other regions including, Brazil, Chile, Columbia, India, Ireland, Peru, the Philippines and Portugal.  It’s been a real privilege to be part of an organisation working actively to address the virus and its effects and serve the needs of our members and customers. We are fortunate that as a global organisation we’re skilled at working seamlessly across countries, time zones and home offices. As the pandemic evolves, I’m confident that we’ll continue to adapt and support our customers effectively, with a focus on compassion, relationships and performance. 

How has your role changed during the pandemic and what are your priorities for your own people?

This year has been challenging in so many ways, both personal and professional. However, it has shown me the importance of understanding our markets and the people we serve. We must offer comprehensive, yet affordable solutions to meet their changing needs. I’ve been working closely with my team to navigate our response to the changing healthcare landscape, and I am confident we have delivered a high standard of support and care throughout this time. 

A crucial aspect of my role this year has been to find the best route to minimise the impact of the pandemic on the business, both in terms of our continued growth and, more importantly, on our employees. The safety and wellbeing of our employees is my absolute priority and I have been in close communication with all our teams to ensure we support each other. We’ve also made it a top priority to reinforce the importance of taking annual leave, using the EAP and supporting flexible working. We commissioned a 12 Steps to Personal Resilience programme for all our European-based teams and encouraged them to adopt the practical hints and tips on a weekly basis.

I am very proud to lead our team in Europe and whilst I have reverted to working at home full time, this has been the only real change for me in my role: We have maintained our strong engagement with our brokers and partners, supported our clients and their members at every step, and have ensured the health, safety and wellbeing of our people are protected at all times.

The pandemic has raised lots of questions about the world of work. How do you imagine the future of the workplace?

Prior to the COVID-19 outbreak, I would imagine that only a small portion of the population had experienced working from home. Some companies may have previously doubted the efficiency and productivity of working from home, preferring to keep their workforce in the office. Personally, I’ve been so impressed by the professionalism and productivity of my colleagues continuing to go above and beyond during this crisis, whilst working from home. Despite the upheaval of this year, we have remained collaborative across the organization, working with our colleagues around the globe.

It is likely that working from home will continue to be an ever-present feature of our working life for the foreseeable future. Homeworking is a new reality for all of us. This may be individual employee preference or simply continuing to ensure social/physical distancing. Whatever the reason, organisations will need to be able to foster a sense of community despite the increased physical distance between their staff. Leaders will need to trust their people and empower them to manage their working day in a way that suits them. This can be a difficult pivot to make as a leader, but I encourage any leader to make this transition sooner rather than later. It takes time to build new working patterns and nurture trust and self-management, but in my opinion, it is worth the investment.

What can organisations do to support employees working from home for long periods, and manage the eventual return to the office?

Boosting and maintaining morale will be critical for employee wellbeing during this extended period of working from home. Never has it been so important to have that virtual coffee with a colleague and to provide virtual events such as quizzes or team activities. In addition, employees should be encouraged to frame their day as if they were in the office and work within their agreed working hours. Although the traditional 9-5 ‘clock in clock out’ approach has been turned on its head, it’s key that employees maintain a balance and don’t fall into the trap of always being available. And yes, I need to take my own advice!

I encourage all employees to take frequent breaks for their physical and mental wellbeing. This is especially important as the days get shorter and its harder to get outside in the evening. Employees should also be encouraged to block an hour in their diary each day to ensure they are taking a lunch break, which will only serve to benefit their productivity for the remainder of the day. 

Depending on where you are in the world and how the pandemic changes, some companies have already started to head back to the office. Employers have a duty of care to make sure that workers feel safe. There are various ways to create a safe, clean, socially distanced environment, such as visible signs and instructions, one-way systems, and plenty of handwashing stations. Ensuring staff are aware of the measures in place to protect their wellbeing is a critical step in implementing social distancing and creating a safe working environment. Communication is key.

To help navigate our customers through these unfamiliar times, we’ve developed a new product, our ‘Return to Workplace Screening Tool.’ This is an online health screening service for clients to monitor the health and wellness of their global workforce. Using a simple online pre-deployment medical screening questionnaire, we can identify responses which may require further intervention and alert HR teams to decide whether further action is required. It has been designed to highlight COVID-19 exposure and any changes in their employees’ health and wellbeing that may have developed since last in their workplace.

We’re also pleased to offer an extension to our Global Medical Arrangement (GMA) service by now facilitating COVID-19 testing across our network of providers. All testing is conducted at vetted and approved facilities by certified and accredited healthcare professionals either through a nasal/throat swab or an antibody test. Our offering is unique in that it is managed in-house, creating a continuum of care for all our members.

Have you managed to keep building your business despite the challenges of COVID-19?

Despite the challenges we have faced from COVID-19, we’re still committed to growing our team. In April we added to our senior leadership team with the appointment of John Kaye as Market Development Director for the EMEA region. John’s hire further strengthens our commitment to this market, with his extensive experience in the international healthcare industry. We have also had new hires in sales support, policy enrolment and client management, all signs of an ever-growing business.

Looking ahead to 2021, we are very optimistic about UnitedHealthcare Global’s continued evolution across the European market. Despite the continued challenges from COVID-19, I feel positive about what lies ahead. We have exciting new plans lined up, including entering the Netherlands market, and I know that we have the people and resources to deal with whatever challenges COVID-19 has in store for us.



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