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Supporting globally mobile employees through the COVID-19 pandemic

Global benefits and related programs

Health and Benefits
COVID 19 Coronavirus

May 12, 2020

We discuss key insurance programs and support services that can help to support globally mobile employees during the pandemic.

Since January 7 when the novel coronavirus was identified in Wuhan, China, COVID-19 has rapidly spread to all continents but Antarctica, escalating to pandemic status on March 11. The numbers have grown exponentially, with global mobility as the most significant factor in how the disease has spread from city to city, country to country.

The initial concern about outbound travelers from China resulted in the first travel restrictions related to COVID-19. With the quick spread of the virus, there has been cause for travel restrictions all over the world. In a matter of weeks during February and March, travel came to a near standstill, and now we can all expect that business travel – particularly global travel – is not going to pick up anytime soon. While the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have issued upgraded travel advisories for affected countries, many governments and businesses reacted quickly to ban or limit travel – both domestic and international – to stem the spread of the disease and protect their citizens and employees, respectively.

The combination of travel restrictions and stay-at-home guidelines has had a tremendous impact on the usual pattern of business travel and face-to-face meetings. While there is an obvious, immediate and devastating financial impact within the travel industry, the financial impact on global companies that rely on travel and international assignees (expats) to conduct their corporate business is still unknown. Based on the surveys we have conducted in the past three months specific to how employers are reacting to COVID-19, here are some consistent responses:

  • All business travel suspended (viable essential travel must be approved)
  • Requirement for employees who have traveled to affected areas to self-quarantine for 14 days
  • Restrict visitors to sites of business
  • Work-from-home mandate for those employees who can do so
  • Leverage video conferencing platforms as a replacement to face-to-face meetings

Expatriates around the world are likely managing the same or similar work restrictions regardless of their location. Depending on the work they are undertaking, work from home (WFH) arrangements have become standard practice, and with a growing number of governments enacting “Stay-at-Home” or “Shelter in Place” guidelines, virtual business is the new normal for a many of us. In the early stages of the COVID-19 outbreak, multinational employers may have received requests from their expatriates for extended home leaves or possibly abbreviated assignments. Some employers may have granted these requests depending upon the specific locations of assignment. However, for those still on assignment and given the quick spread of the virus and resulting healthcare crises in an escalating number of countries, some expatriates asking to repatriate may have had to extend their assignments until travel is practical. At present, based on our most recent COVID-19 survey and related data points from the market, the majority of expatriates are still on assignment in their host locations, and most employers are delaying deploying any new expatriates.

From an employee benefits viewpoint, there are three key insurance programs and two supportive services that can help globally mobile employees during this incredibly difficult time. For multinational employers, we believe all five are important at any time, and are especially valuable today given the impact of the COVID-19 global pandemic.

  • Global Business Travel Accident
  • Global Business Travel Medical
  • Expatriate Healthcare
  • Telehealth services
  • International Employee Assistance Program services

Global Business Travel Accident (BTA) plans

A majority of multinational employers maintain a Global Business Travel Accident (BTA) insurance plan. These plans are often implemented as a risk management tool, primarily designed to provide 24-hour non-occupational injury protection for employees who are exposed to additional risk by traveling on behalf of the company. The purpose of a business travel accident insurance policy is to: (a) supplement the current benefit structure, (b) enforce the company’s commitment to the care of their employees and their families, (c) provide high limit benefits for a comparable low cost and (d) reduce the risk against potential litigation. The benefit(s) included under the travel accident insurance plan are payable in addition to any other group or individual plan (double indemnity). Eligibility is usually extended to include all employees or specifically designated classes of employees. Coverage may also be extended to Non-Employee Directors, Consultants and Guests of the Policyholder.

Global BTA insurance plans can be instrumental in meeting an employer’s Duty of Care obligation for their employees. After the unimaginable events of 9/11 the critical value of BTA policies and specific provisions including On-Premises Terrorism, On-Premises Felonious Assault, War Risk, and Travel Assistance Services including Political and Security Evacuation, were implemented to protect and meet the needs of employees. Today, COVID-19 has highlighted additional essential benefits that are often extended under a Global BTA program, including Out-of-Country Medical coverage for accident and sickness, Travel Assistance services including medical evacuation and repatriation of mortal remains and Travel Inconvenience cover for Trip Cancellation/Interruption/Delay. Furthermore, in the quickly changing arena of Business Travel, clients are now looking at broadening their programs to also include commutation (to/from work) as employees alter their daily commute from trains/buses/subways to cars, mopeds, bicycles, etc. In addition, as a result of the broadened commuting exposure, accident medical (domestic) can also be extended under a BTA Policy.

  • If an employee has travelled for business outside their country of residence and become infected with COVID-19, an Out-of-Country Medical provision should cover these emergency healthcare expenses until they return home. The provisions within BTA plans can vary, of course and not all plans include this medical provision. Additionally, some plans have a maximum medical benefit, others have an unlimited benefit. Also, while not typical in the U.S. market, in some countries pandemic claims may be excluded and it’s important to check the policy provisions and update as necessary.
  • If evacuation is deemed medically necessary, the cost would be covered under the BTA policy. If there is an unfortunate loss of life, the cost of repatriation of mortal remains may be covered if the provision is included in the policy.

It’s important to note that the core AD&D benefit of a BTA plan would not be applicable, as a death due to COVID-19 would not be deemed an accidental death.

Global Business Travel Medical (BTM) plans

Many multinational employers also maintain a Business Travel Medical (BTM) plan, sometimes in addition to a BTA plan. BTM policies are most common in the U.S. market, often implemented as an employee protection program, and specifically intended to provide urgent and emergency healthcare coverage for business travelers who are outside of their home countries.  These plans are often procured and managed alongside an Expatriate Healthcare plan, to support both international travelers and short-term international assignees.

Some BTM plans may also include an AD&D benefit, just as some BTA plans may include the Out-of-Country Medical benefit. Overlaps like this are not uncommon when these policies are managed separately by Risk Management and Human Resources, and the most important consideration today should be filling any gaps that exist, to ensure suitable coverage for employees and any dependents who are traveling with them on approved company business.

Also, it’s common for these plans to include Travel Assistance services, including Medical Evacuation and Repatriation of Remains, similar to BTA plans.

Expatriate Healthcare plans

A top concern regarding COVID-19 for expatriate employees is essentially the same as for local employees: access to testing and healthcare. While availability of testing varies by location, there are ways that employers can help these employees access healthcare, most specifically through telehealth options to help triage patient care. While not commonplace in all markets, in growing number of countries there are insurance plans that provide options for virtual healthcare. Notably, most leading expatriate healthcare insurers offer some version of telehealth, although access may vary by location. With the WHO and CDC promoting telehealth during the COVID-19 pandemic, there is a greater level of awareness and appreciation for virtual doctor visits during this extraordinary global health crisis. Most expatriate insurers are providing specific communications to ensure expats and their families know how to access this service.

Additionally, some insurers are extending telehealth access to business travelers covered by BTM plans during the COVID-19 pandemic. Check with your broker or consultant, or directly with your insurer, to find out if this is available to your business travelers.

Another major concern for expatriates and their families is managing the increased levels of anxiety and stress that this situation adds to their time abroad. For employers who do not have an international Employee Assistance Program (EAP) in place as part of a wellbeing strategy for all employees (locals and expatriate employees), there are several providers who can offer such coverage either regionally or globally, and therefore can fill gaps that may exist across countries of operation. Similar to the inclusion of telehealth services, most of the leading expatriate insurers already offer international EAP services as part of the overall expatriate healthcare plans.

Click here for additional insight into ways employers can address emotional wellbeing amid COVID-19.

Recommended evaluation of insurance plan provisions

Employers should be reviewing insurance policies that are specific to their globally mobile workforce, and the following aspects of those plans should be confirmed immediately to ensure there is appropriate coverage in place:

BTA and BTM plans:

  • If the plan covers emergency Out-of-Country Medical expenses, confirm that COVID-19 claims will be covered “same as any other illness”.
  • These plans do not include a benefit for death by natural causes, so there is no life insurance coverage. Accidental Death coverage that is typical in BTA and optional in most BTM plans will not cover death due to illness, so COVID-19 deaths would not be covered under these policies. However, many plans include a repatriation of mortal remains benefit, and this should be confirmed.

Expatriate Healthcare plans:

  • Leading Expatriate Healthcare insurers in the U.S. (and most outside of the U.S.) have confirmed that COVID-19 health claims will be covered “same as any other illness”. If an employer has not received any information already from Willis Towers Watson or directly from their expat insurer, they should confirm if COVID-19 will be covered.
  • Many expatriate health plans provide EAP access and telehealth services to the covered employees and dependents.  For employers who already have EAP and telehealth included in their plans, we recommend coordination with the insurer to send out additional communications on these services right away. If EAP and/or telehealth are not included in the plan but are available from the insurer, we recommend immediate implementation of these services right away to expand the support provided to the expatriates and their families.

Communication

It is essential for employers to maintain frequent communication with their globally mobile employees regarding any new travel restrictions and corporate policy changes, and to have regular touchpoints with expatriate employees and their families while they are still on assignment. This will continue to be a very fluid and changing situation as the virus continues to spread quickly, with many countries limiting inbound travel and some closing their borders to non-citizens/residents. Employers should monitor the WHO and CDC websites for escalating or revised travel advisories or bans. Corporate policies during the COVID-19 pandemic should now also address domestic travel as it has been limited in many countries. There are mixed messages coming from various sources in relation to lifting restrictions, and therefore employers should consider whether travel restrictions apply equally in all locations, or if there will be flexibility for certain operations. We recommend close collaboration between Human Resources, Risk Management and Security throughout the pandemic, with joint messaging for the globally mobile workforce.

Disclaimer

Each applicable policy of insurance must be reviewed to determine the extent, if any, of coverage for COVID-19. Coverage may vary depending on the jurisdiction and circumstances. For global client programs it is critical to consider all local operations and how policies may or may not include COVID-19 coverage. The information contained herein is not intended to constitute legal or other professional advice and should not be relied upon in lieu of consultation with your own legal and/or other professional advisors. Some of the information in this publication may be compiled by third party sources we consider to be reliable, however we do not guarantee and are not responsible for the accuracy of such information. We assume no duty in contract, tort, or otherwise in connection with this publication and expressly disclaim, to the fullest extent permitted by law, any liability in connection with this publication. Willis Towers Watson offers insurance-related services through its appropriately licensed entities in each jurisdiction in which it operates. COVID-19 is a rapidly evolving situation and changes are occurring frequently. Willis Towers Watson does not undertake to update the information included herein after the date of publication. Accordingly, readers should be aware that certain content may have changed since the date of this publication. Please reach out to the author or your Willis Towers Watson contact for more information.

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