Healthy People, Healthy Business

How to provide healthcare plans that matter


Businesswoman Randi Zuckerberg managed to fit this thought-provoking question in a 140-character tweet: “The entrepreneur's dilemma: Maintaining friendships.  Building a great company. Spending time with family. Staying fit. Getting sleep. Pick 3.”


It’s evident this prioritisation dilemma isn’t restricted to entrepreneurs, but something that employees across levels go through every day as well. What’s more surprising, perhaps, is that health constantly features among their top three priorities.


Mercer’s Global Talent Trends 2017 survey found that employees put their health first—60% rate it as more important than wealth or career. This was corroborated with findings from Mercer’s Thriving in the Age of Disruption, where employees want to work for an organisation that considers their needs and helps them be healthy. What is worrying, though, is that less than one-third of employees said that their employer focuses on their health and wellness.


In Singapore, expatriates, international transferees, and relocating C-suite employees make up about 804,600 of the total workforce as of 2018, yet remain the most under-covered demographic in terms of healthcare plans. Let’s look at how organisations can manage the healthcare needs of a mobile workforce.


Employee’s needs > Employer’s preferences

When selecting a benefits plan, decision makers must assess the target demographic and provide coverage options that tick four boxes: aligned with the company’s C&B objectives; fit for purpose; flexible; and meeting employees’ needs. However, what complicates this decision is the alignment of healthcare provisions in employees’ home country with the options in their host country.


The solution? Mercer Marsh Benefits’ (MMB) Singapore International Medical Plans Benchmarking Study recommends an international medical plan with a holistic approach, from healthcare to prevention and well-being. It is typically designed to meet the needs of a mobile workforce; benefits expectations of expatriates; and comprehensive coverage for high-cost treatments. If provided on an individual voluntary basis, employees can select the level of cover to suit their circumstances.


For example, an employee may opt for maternity cover if they are planning to have a family soon, or may wish to include outpatient care if they have a young family. In fact, the outpatient module is typically the highest-utilised benefit under an international plan, while accounting for 60% of the overall benefits spend, pointing to the importance of carefully considering benefits design.


What the latest healthcare data shows

MMB's 2019 Singapore International Medical Plans Benchmarking Study is derived from internal information regarding MMB clients’ benefits plans of 56 employers covering more than 4,600 employees. The data uncovers that many companies with regional offices in Singapore provide international medical plans to employees as part of their overall package. Most of them bear the full premium costs for employee coverage on a compulsory basis. Only 6% of plans are offered on a voluntary basis and are either offered as standalone options or part of a flexible benefits proposition.


The business case for healthcare for mobile workers

A 2017 research study titled Expatriate mental health: Breaking the Silence and Ending the Stigma found that between 2014 to 2016, mental health claims in Southeast Asia increased by 19%. Depression emerged as the most prevalent condition (50% increase) among expatriates, followed by anxiety (28% increase), with women between the ages of 30 and 49 being the most likely to seek treatment. Meanwhile, medical fees in the private sector have escalated rapidly. For the period 2007 to 2017, the average total inpatient bill size for Singapore citizens in the private sector grew at 9% per year, according to the Ministry of Health.


Specifically in the Lion City, Mercer’s Aging Workforce: Cost and Productivity Challenges of Ill Health in Singapore projected a 25% increase of productivity loss due to sickness absenteeism per employee based on GNI (gross national income).


With an aging workforce, this represents a cost of S$3.3 billion in 2030 at the national level – a 43% increase from 2016. The research also found that the cost of presenteesim due to ill health is estimated at 2.3 to 2.8 times the cost of absenteeism. Evidently, a more proactive approach to providing healthcare for mobile workers, be it long-term assignees or short-term business travellers, is something that employers across Asia must embrace. Not just for reasons of productivity or longterm cost savings, but simply because it is the right thing to do.



Context: Let’s take the example of Mercer’s SME client in Singapore, with 55 employees on rolls (45% of which are expats), with an average age below 35. The client found that the existing medical coverage did not quite offer enough for employees, and it was becoming critical to upgrade to an international plan from their local-plus plan.
Challenge: The challenge lay in the volume of claims. The loss ratio was more than 110% (premium versus claims), and a renewal offer at 30% increase without additional benefits. There was also an ongoing cancer case, and the local insurer imposed an annual limit cap for major conditions as well as a waiting period for pre-existing conditions.
Solution: The client opted for an international medical plan with benefits for pregnancy complications, wellness, and vision. In addition, the ongoing cancer case was covered up to the maximum annual limit. The client also opted for coverage for pre-existing conditions. Comprehensive international benefits were extended to the entire staff, not just expatriates.
Result: The client was able to provide a consistent benefits approach to all employees. For employees, the value proposition of the plan went above and beyond with benefits like concierge and online services. Though the value of the premium was higher, the company provided benefits that addresses the needs of its employees.


Neil Narale

Neil Narale is a partner and health leader at Mercer Marsh Benefits, an award-winning global health and wellness consultancy. Neil’s client responsibilities centre on helping multinational and local organisations manage their employee health and benefit offerings from a regional and local perspective.

This article was featured in Human Resources magazine, May 2019 issue. 


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