International Group Insurance Products with Full Description:

Who helps you today to navigate international risk management and global benefits for expatriates, TCNs, foreign nationals and global travelers?

The 3 most important reasons to team with us for international group insurance needs are outlined below:

There is no cost to have McKinley International on "retainer" and we share advice with clients every day with no consulting fees.

If you employ expatriates and other international assignees, you never know what may cross your desk and you need a partner that can navigate ANY issue that may come your way.

Your current broker or consultant may lack international experience (99% do), and there is no conflict because we do NO U.S. domestic benefits.

For an in depth review of these international group insurance topics, please review each of the 4 white papers below:

International group insurance reference encylopedia; Know these terms and convince anyone you have been in the business 20 years! A fun reference page


24 Hour Coverage (n) 24 hour coverage is used to describe coverage that pays claims despite whether an injury or illness was caused by an occupational or non-occupational cause. (Use) "Most U.S. international health insurance plans for expatriates are non-occupational while many EU and Canadian plans are 24 hour in nature meaning there is no separate need to buy a workers compensation policy. Many U.S. benefit managers need assistance securing 24 hour coverage for third country national groups or local country hires."
Alphabet House (n) Insurance slang used to represent a number of large "old school" insurance brokers and consultants referenced by the initials derived in their names. Although the term is still used in the industry to speak of the "large fee based consultants that charge enormous fees," most of the companies that created the term are now gone or have been gobbled up by other large firms. For example, Alexander & Alexander became AON and A. Foster Higgins became part of Marsh, as did "J&H" (Johnson & Higgins.)
CAD (n) Abbreviation for the Canadian Dollar symbol $. (Note) The one dollar in Canada is a coin and not a bill, called the "loonie" while the two dollar coin is called a "toonie." Queen Elizabeth II is depicted on the $20 bill. (Use) "Anyone that has traveled to Canada over the past 3 years has seen the U.S. Greenback buy less and less loonies. Today the value is much closer to equal today."
Continuity of Coverage (n) A term used to describe a situation where an expatriate (or employee in general) is switching from an expat insurance plan to another medical program with no break in coverage, and generally there are no penalties for switching plans, like a new pre-existing condition limitation, are imposed. (Use) "Australian expats need to maintain a locally admitted medical plan in Australia so they do not have continuity of coverage problems upon their repatriation back to Australia."
Cradle to Grave System (adj) A derogatory way of referring to most local national health insurance plans, and particularly the social security systems of the European Union. These systems essentially offer "free" healthcare from birth until death as well as provide other benefits such as pension and retirement income. (Use) "Third Country National hires come from Cradle to Grave systems and are not used to North American insurance standards "
DBA (adj) Stands for Defense Base Act Insurance coverage and is used to describe a type of foreign workers compensation insurance where most U.S. government contractors must secure a certain type of workers compensation policy in order to receive U.S. Federal Funds. (Use) "Generally, international medical insurers discount their rates when they are asked to insure an expatriate group that has DBA workers comp coverage in place"
Donkey's Years (adj) A term used by Britons to describe all things old. Lineage comes from a Donkey's ears being very long; later became "donkey's years." (Use) "I haven't seen that chap in donkey's years, said the Lloyd's broker as he anticipated meeting an old friend in Balls Brothers that afternoon"
Excess (n) Generally used to describe a deductible in many "foreign" plan designs relative to foreign national insurance. (Use) "When buying an Australian hospital plan you can choose a plan with no excess or an excess of $250 where the patient must contribute to costs before the insurance pays."
GBP (n) Abbreviation for the British Pound symbol . The pound is divided into 100 "pence" (vs. cents) and the official name is Pound Sterling. (Note) It would be acceptable to reference the price of something in the U.K. has 100 Pounds, 100 Sterling, or after a few pints, 100 "quid," the slang term. Of course, the abbreviation comes from Great Britain Pound. (Use). "The GBP has been extremely strong in the past 5 years and even surpassed 2 U.S. dollars at one point. In 2007 Britons thought shopping on 5th Avenue in NYC is a fire sale, as everything seems cheap. It's not uncommon for Brits visiting the U.S. to check an empty suitcase at the airport, on their way to the U.S." 2009 update.. the GBP has come back the other way vs. the USD.
FSA (n) Related to foreign national insurance in the U.K. it stands for the Financial Services Authority, an independent non-departmental public body and quasi-judicial body that regulates the financial services industry. (Notes) FSA is often criticized in the U.K. like Sarbanes-Oxley is in the U.S., cited for endless paperwork and over regulation. The FSA has imposed new and stricter rules on licensing of agents, and insurance company regulation especially affecting the Lloyd's market. Although there is additional paperwork it did create more standardization in the market. (Use) "In order for an American agent to sell products in the U.K. one must be FSA licensed and hold a functioning office in the U.K."
Home Country (n) Related to the underwriting standards of expat medical insurance; refers to one's country of citizenship. (Use) "A factor in international medical plan rating is the home country of the expatriates. For example, Americans that may return home for expensive U.S. care would be rated much higher than Canadian nationals who may return home to a government paid, national healthcare system, shielding the insurer from large claims."
Host Country (n) Relating to expat insurance, refers to one's country of assignment. (Use) "If the host country of an expatriate is similar to the home country, that does not mean an assignment will be easier. Many studies show very high degrees of failed assignments between the U.S. and the U.K. for example, because expectations are not set correctly and an expat (and family) does not understand how difficult the integration will be. It is assumed that "like" culture and language will lead to an easy integration and this is a fallacy. Expats going to China (see topic Expat Insurance China) for example, may actually be more successful because they understand upfront how difficult it will be, and are emotionally prepared when they begin the assignment."
IEAP (n) Abbreviation for International Employee Assistance Program. (Notes) Growing in popularity over the past 5 years, IEAP plans are considered vital to aid in the success of expatriate assignments in many industries. An EAP provider can be even more important to a spouse that is not adapting well to the new surroundings. An expat's spouse that is not happy in the host country can very quickly lead to a failed assignment. (Use) "An IEAP provider like Shepell-FGI or Compsych, in additional to traditional EAP services catering to an international assignment, can provide emergency crisis intervention and support for terrorism attacks like the Bali bombing in Indonesia (2002)."
Inpat (n) Inpat stands for inpatriate which outside the international insurance industry is not even a real word. In most instances where it is used, it refers to a foreign national coming into the United States to work for 6 months or longer. (Notes) The legal status of inpatriates is a gray area in most States. For example, at what point does a foreign national in the U.S. need to be offered a U.S. compliant medical plan like his or her coworkers in the U.S? At what point does the inpat need to be offered similar benefits to their coworkers relating to pension or 401K? (Use) "An organization bringing inpats to work in the U.S. for a year or more should consider personal liability protection for them. If they are found negligent of a tort and a court awards damages, in most cases they will not be insured, and the suit will find its way to your door."
Imputed Income (n) A term used to describe an employee benefit that falls outside of what is considered "tax deductible" and therefore, is taxed as regular income to the detriment of the employee. In international benefits, it most commonly describes a situation where a host country treats claim payments made from a home country self insured (ASO) medical plan as income payments.
International Rotator (n) International rotator, a term used to describe a certain classification of expatriate that may work several weeks in the foreign jurisdiction and then return home for several weeks before again, going abroad. A host country situation does not really exist with a rotator and a permanent overseas address is not established. A typical rotation assignment would be 6 weeks abroad and 2 weeks home. (Use) "To oversee the construction of the new drilling platforms outside Almaty Kazakhstan, PetroChina has 40 engineers rotating in and out, on a 8 week on, 4 week off cycle."
Line Slip (n) In the Lloyd's of London marketplace, describes a document that outlines the type of insurance, limits, terms, conditions, and binding authority granted to the coverholder. A coverholder is like a managing general agent (MGA) responsible for the marketing of certain Lloyd's products, and in many instances holds expressed binding authority or claim payment authority. (Use) "A Lloyd's coverholder, Special Contingency Risks Limited, has authority laid out in their line slip, to enable them to quote and bind Kidnap & Ransom coverage."
Local National (n) 1. A person living and working inside their country of citizenship. 2. Not an expat. 3. Key local national generally describes a local national of a more senior level where, for equity purposes, may need to be offered similar benefits to those being offered expatriates at a similar job grade. (Use) "International organizations must be very careful with local national insurance plans to ensure local laws are not being violated that could jeopardize local country operations."
International Medical Evacuation and Repatriation(n) International Medical Evacuation and Assistance is the name to describe companies such as International SOS, Worldwide Assistance, MEDEX, On-Call International, and Mondial, that are hired to fly patients (usually expatriates) out of the host country in a medical emergency. Flights generally go to the "nearest appropriate facility" to where proper care can be administered for the condition causing injury or illness. An Access Plan refers to contracting with a medical evacuation and assistance company on a self insured basis with no insurance component. (Use) "Medical Evacuation and Assistance companies almost never own their own aircraft and instead contract with "medivac" providers on a regional basis. It's very common for competing companies to be using the same contracted vendors in many countries and there is quite a bit of overlap in the use of providers"
Multinational Pooling (n)

Multinational pooling insurance is a term used to describe a way large employers pool, combine, or experience rate local national insurance groups around the world to form one large experience rated group. The claim experience for each local national insurance group in each particular country is not as important as the overall collective loss ratio of the entire group. Good experience generates a surplus which can return premium to the parent organization after a plan year during something called second stage accounting.

Multinational Pooling Defined; A global insurance mechanism that combines local national insurance groups into one large experience rated group for life insurance, long term disability insurance, and possibly international medical insurance.

NHS (n) Stands for National Health Service of the U.K., the system most North Americans think of when they hear "nationalized healthcare." Every Brit is covered by the NHS at birth and the system is supported by general tax revenues. Because of problems with the system, private medical insurance in the U.K. is becoming more popular in order to bypass waiting lines and delays.
No loss No Gain (adj.) A term that is similar to "continuity of coverage" presented above. Meaning, at the time a group switches from one insurer to be replaced by another insurer, the new insurance company promises no better or worse terms. For example, a deductible satisfied under the old carrier will be honored by the new carrier. Amounts of life insurance secured under the old carrier will be honored by the new carrier without new medical evidence of insurability for example. In many cases it refers to, "no new waiting periods" under the new carrier for things like Class III dental or maternity.
Non-Admitted (adj.) Generally, an excess and surplus lines term that refers to an insurer that is not licensed or not authorized to conduct business in a particular U.S. State in the admitted market. In international benefits, it generally means a foreign insurer trying to cover local nationals in a country in which they are not licensed to do business. (Use) "Blue Cross of California would not be able to cover Chinese nationals in China because they are seen as a non-admitted company by the Chinese authorities."
Offshore Pension (n) Describes a product to fill a particular need to provide pension benefits to employees that leave behind their home country, and can no longer contribute to their pension plan at "home" on a tax privileged basis. In some cases, government contributions toward one's home country pension are no longer applicable so employers often need to make up for this retirement savings shortfall.
Offshore Plan (n) A term used to describe any employee benefits program provided, where the insurer is not admitted (not licensed) in the country of the policyholder or the member receiving benefits. The phrased was coined many years ago to refer to plans sitused in the Isle of Mann or Guernsey for legal or tax reasons. When looking at a map, the Isle of Man is "just off" the British coast while Guernsey is just off the French coast. Thus these areas were, in fact, "offshore." Today, plans that are used to escape tax or legal legislations are still actually offshore, but islands like Bermuda or Barbados have become more popular. Either way, if Algeria (Africa) became a new center for non-admitted financial or insurance plans, they would still be called "offshore" plans. The word has evolved to a point where the presence of a real "island" is not necessary.
PA (n) Stands for a Personal Accident program. A "PA" is the European version of the North American Accidental Death & Dismemberment (AD&D) program with some minor differences. One difference is more additional insurance add-ons are available though a PA. For example, it's quite common for a PA to include not only a death benefits but a lump sum payout for total disability.
Paramedical Services (n) A "catchall" phrase very common in Canadian policies, to encompass a basket of benefits that in the past, have not been payable under most medical policies. These services are considered on the fringe of medical necessity and generally lumped together, often capped on a per member per year aggregate basis. Common treatments classified as paramedical included chiropractic, podiatry, acupuncture, homeopathy, and osteopathy.
Persona Non-Grata (n) Literally meaning "unwelcome person." A "diplomatic term" often used in security evacuation policies or in relation to the war risk clause in policies as a trigger for claim payment. A foreign government may declare U.S. citizens in the country "persona non-grata" and provide instructions relating to when these expatriates must exit the country. Many policies will not pay claims that happen "in country" after this has been declared. (Use) "An expat in Venezuela asked, what is the plan of action if we are declared persona non-grata by Hugo Chavez, and we need to get out of the country in 72 hours?"
PMI (n) Stands for "Private Medical Insurance" and is the term used in the U.K. (Refer to private plans outside the NHS as "PMI.")
Provincial Plan (n) In most instances, refers to the health insurance plans provided to Canadian nationals inside each of the major Canadian provinces: Quebec, Ontario, Alberta, and British Columbia. The system of each province is unique. For example, the Ontario plan is called O.H.I.P. and there are differences in benefits between what is provided by O.H.I.P. and the neighboring provincial medical plan in Quebec (Montreal).
PTD (n) Stands for Permanent & Total Disability, a common EU and Lloyd's program for disability insurance. Under most PTD plans, benefits are paid as a percentage of salary for up to 24 months similar to a U.S. short term disability plan (this is called the TTD benefit or temporary total disability). At the end of the TTD period, if the insured can still be considered permanently and totally disabled by definition and after examination, the policy will pay a lump sum amount.
Repatriation (v) 1. Refers to a standard benefit in a medical evacuation & assistance plan where, in the event of death, mortal remains will be returned by the assistance company to the insured's home country. 2. The process of bringing an expatriate back to the home country at the end of an assignment. (Note) The fact that the same term is used in the international market to describe the return of an assignee and death itself, may not be a coincidence. The repatriation process is often the biggest complaint of an expatriate citing poor integration back to the "home office" and a continued feeling of isolation. Numerous studies show that a very high number of expats don't last more than 2 years with the company after the repatriation home.
"The Box"(n) A Lloyd's of London term to describe where a Lloyd's underwriter takes a risk at Lloyd's to seek approval. (Use) "I have to takes these risks to the box and get them approved by underwriters by the end of the week at latest" (Note:) The box is a very busy and chaotic place at Lloyd's with brokers presenting risks for approval (or declination) by Lloyd's syndicates. An associate here has seen an underwriter in the box stand up and yell out "I reject the risk" while clearing, with one swipe of his hand, all the papers the broker was presenting, onto the floor!
Socialized Medicine (n) Another way of referring to government healthcare for foreign national insurance, cradle to grave systems, or foreign social security systems. These are generally all synonyms. This is not a European specific term and governments in Latin America and Asia also provide their citizens with a form of "socialized medicine." There are only a handful of countries in the world, with the U.S. being one, where citizens are not afforded healthcare by birthright.
Tax Equalization (v) The practice of making taxes a "neutral factor" for an expatriate employee on assignment. The tax burden of the employee should be no better or worse than the tax burden the employee had back in the home country. (Use) "Because of higher tax rates in the EU, most Americans working in Europe need to pay higher income taxes, and tax equalization causes the employer to pay the incremental difference."

Third Country
National (n)

Third country national is used to describe an employee that is working outside of their country of citizenship (an expatriate) but neither the host country or the home country is the same as the parent company's. In other words, a Mexican national working in Japan for General Motors (a U.S. company) is a considered a TCN. TCN is considered an "old school" term and somewhat politically incorrect. However, it's so common and such a good descriptor, it's still used today.
War Risk (adj. n) An exclusion in almost all insurance policies, domestic and international; property & casualty and employee benefits. There are some misunderstandings related to this exclusion. When one talks about an international policy "with war risk" (an enhancement) what they really mean is that the war risk exclusion on the policy has been removed, thus the coverage is more comprehensive and now includes perils related to war. When insurers use this exclusion in a policy it's generally far more of a broad brush than what most consider "war" or a battle between two governments with a clash of troops. It can include all of the following: riot, civil commotion, terrorism, coup d'etat, and police action. On the other hand, benefit manager often assume events that involve a "bullet" or a bomb will not be covered because of the presence of this exclusion. An expatriate that is shot in Cape Town South Africa certainly should not have his medical claim denied because of a war risk exclusion. On the other hand, a land mine explosion in Siere Leone from one buried 8 years ago that causes injury, could possibly be denied by an insurance company because a land mine is an instrument of war, and nothing in a war risk exclusion references "current war."
Zone Rating (n) Typically, a European term whereby expatriate medical insurance plans are rated by the zone where coverage is allowed. Coverage for those traveling to the United States should never be assumed as part of the standard program and an expatriate would need to select the zone associated with worldwide coverage that would include care in the United States. Of course, this zone is always the most expensive option.