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The cost of keeping an an employee and their family oversees can run as high as________for an average 3 year assignment
1.3 million dollars of which 2% is typically Healthcare
Expatriate (Expat)
Any employee residing and working outside of their home country
Third Country National (TCN)
AKA "Non US expat"
Employee of country A (ex: American) working in country B (ex: Brazil) for a company who is headquartered in country C (ex: France)
Key Local National (KLN)
Executive, partner or high level manager working in his/her own country for a foreign company
Inpatriate (Inpat)
A non-US Citizen working and residing in the US
Leaving employees on domestic plan avoids certain laws ie. ERISA, HIPAA, AND COBRA
Using a foreign insurer enables employer to avoid certain laws ie. ERISA, HIPAA, AND COBRA
Is a benefit plan maintained outside of the US for 25,000 employees, of which only 1,900 are US residents, subject to US laws?
Is a benefit plan maintained outside the US for 110 participants, of which <50 are US residents and citizens, subject to US laws?
Can brokers be liable for benefit plan designs determinations?
Is a plan, maintained outside the US primarily for persons who are non resident aliens, subject to ERISA?
HIPAA privacy rules apply to healthplans with >50 employees or administered by third party;
HIPAA portability rules apply to health plans with >2 employees;
ERISA applies to Welfare Benefit Plans with >2 employees;
COBRA continuation requirements apply to Group Health Plans >20 employees;
Products available through International Benefits
Medical, Dental, Vision, Life, AD&D, Travel, EAP, Evacuation, and LTD
Who are the major player is International Benefits?
CIGNA, Aetna, Allianz, AXA PPP Healthcare & BUPA International
International SOS
1. Network (SOSNET)
- 15,000 providers in more than 200 countries
- Credentialed network
- 300+ site visits per year
2. International name recognition
3. Unparalleled name recognition
4. Medical/Security evacuations - 12,000 in 2000
5. 2,800 employees with 750 medical professionals
6. 24/7 customer service
International SOS Alarm Centers: Crisis Response
Each Alarm Center's multilingual coordinators, physicians and support personnel assist with everything from pre-travel health recommendations, to the coordination of medical care, to emergency evacuations
International SOS: International Clinics
In places where international standards in medical care are not locally available, International SOS owns and operates clinics to give our members international standards of care
International S0S - Services
- 24 HR Access to Medical Help
- 24 HR Access to Medical Emergency Travel Related Services
- Arrangement of Outpatient and In-Patient Medical Care
- Care of Members' Next of Kin
- SOS Online Information
- 24 HR Access to Security Services
Legislative Compliance for Saudi Arabia
Must use local company
# of International SOS Clinics and # of Remote Site Medical Centers:
- 21 International clinics
- 150 Remote Site Operations
CIGNA International Expatriate Benefits
- US Federal and state compliant plans
- 24/7/365 access to multilingual customer service
- Advanced Technology(ie., integrated processing system, imaging, web)
- Experienced, globally focused staff with over 25 year track record
**110 of the Fortune 500 use CIGNA
Key Advantages of the partnership - CIEB/International SOS
1. An integrated, physician-managed system for the global delivery of quality healthcare services
2. The two premier organizations providing services to expats
3. Long-term contract
4. Enriched CIEB member website
5. More visible, committed relationship
In research commisioned by CIGNA, the 3 top concerns of employees considering an international assignment are:
1. 76% referenced the adequacy of the total benefits package
2. 64% cited the adequacy of health plan arrangments
3. 61% referenced the quality of healthcare as important

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