Case Study-Strategy and Products-International PMI

After an online "Request for Quotation" approach from a British client in the USA, Medibroker International considered the following criteria before suggesting specific plans. Firstly, the ages, nationality of passport, state of health and the time intended to remain as expatriates in the USA, are key elements to take into account. Mr. and Mrs Griffin were 41yrs old and 40 yrs old respectively with a young son and daughter, ages 3 yrs and 5yrs, so clearly the issue of further additions to the family should also be considered for healthcare insurance planning purposes. (A routine maternity add on option)

Mr Griffin wanted a middle of the range plan, as USA healthcare cover is notoriously expensive compared to UK domestic private medical insurance (PMI.) He did not want a Plan with "All bells and whistles" which could cost him a small fortune in premiums. However, some Outpatient cover together with full inpatient and day care cover were important to the family. We normally recommend a comprehensive plan to any family Overseas having such small children, as Outpatient visits are almost inevitable. The family additionally felt that a travel option (non medical) globally, would be helpful, as they did visit the UK from time to time. As an Importer, Mr Griffin was established in business in the USA, was green carded and unlikely to return to England to live for the foreseeable future.

Mr Griffin did keep his UK home and the address for any International Healthcare Plan would be that address. Thus the family wanted international private health cover in the USA with the option of UK and other worldwide cover included, normally called by Insurers, Area 3. The fact that all the Griffins family were in glowing health without pre existing treatment over several years meant that a "Moratorium" cover plan was possible, rather than fully underwritten. In any event we decided to offer both options to them. As the client also stipulated a budget limit of £6000 pounds to us for the premium of this plan, we restricted our suggestions to plans offered by A La Carte, Goodhealth, IHI Danmark, InterGlobal and Morgan Price International. A PPP comparison indicated premium in excess of £9,000 for this British family, based in the USA with full global cover.

Further discussion with Mr Griffin indicated that the issue of routine maternity cover was important for the next year or so. However, he preferred an add on option for this benefit, so that it could be looked at as a separate issue. He wanted an option for travel cover too (non medical). Voluntary deductibles were something for the Griffin family to look at in the future should premiums increase too much for their budget. Finally, we decided to airmail out to them the full brochures of A La Carte, InterGlobal and IHI Danmark for their perusal.

In our follow up telephone conversation the client turned down IHI Denmark, as the USA costs for Outpatient G P consultation would be higher than the capped amounts shown in the IHI benefit schedule. He liked the A La Carte inclusion of a benefit for chronic conditions, but finally chose the Ultracare Comprehensive Plan from InterGlobal. The grounds were that the optional benefits for routine maternity were higher at US$ 11,250 in the USA with only 10% co insurance, as opposed to others at 20% co- insurance.

Flexibility in future was offered with other options for Travel, Personal Accident and also Critical Illness. Organ Transplant was included to US$225,000 dollars as was personal legal liability, emergency evacuation and repatriation, plus repatriation of mortal remains. As this plan was the best priced, including additional children at no extra cost, (up to four) Mr Griffin decided to proceed.

Should the client or his family have had pre existing conditions, our approach may have differed considerably as full underwriting would have then been the best way to proceed. Furthermore, an elder or mature couple say aged 60 plus in the USA with British passports, would not have needed a comprehensive option for routine maternity, or cover for small children. Small children almost always eat up costs for Outpatient care, whilst families are living overseas. High deductibles and hospital cover and inpatient cover only without outpatient cover, can be fine for couples, mature people not having small children and young families.

This family now have a medium priced comprehensive plan, albeit with limits on Outpatient cover, to a total plan benefit level per annum, per person insured, of US$ 1,500,000 dollars, based in the USA but covering them anywhere in the World. Although the plan is moratorium based, any eligible pre existing conditions can be covered after two years. They have no limits on choice of hospitals or clinics and have a guarantee that all legitimate outpatient claims will have a cheque dispatched within 14 days, or they will receive US$ 15 a day from the Plan Provider, for any such delays. If they do decide to expand their family and use the routine maternity option, their third child will be covered by this Ultracare plan, free of charge. Providing that this Plan Provider does not radically increase the premiums of Mr Griffin over coming years, he should be able to hold such a plan for the longer term.

Should the Griffin family decide not to have more children then in the future, they can cancel the routine maternity option of this plan without penalty. In this way, their £6000 sterling ceiling budget could be kept too over time, even accounting for medical inflation. As such medical inflation is some 10% plus in the USA annually, this saving potential is an important consideration.

Article Prepared By

J Leslie Smith
Founder
Medibroker Limited