International health cover news from IHC’s David Heppard

It’s been an interesting time for international health cover. But, perhaps surprisingly in a market which is global by nature, one of the areas that have been attracting attention has been the way international players operate in local markets.

AXA PPP International, in particular, has been demonstrating its desire to be an international and a local player in the private medical insurance space. With regional offices in more than 30 countries, the firm has been taking steps to forge greater links between regions to become truly global – while increasing their offering on a local level.

There have always been restrictions on international markets when it comes to covering local clients, but AXA PPP International, and others, are beginning to make inroads into this area. By tying its global offices together, AXA PPP International can gain local licensing, giving them the ability to sell their products to the local market, and potentially opening up a world of opportunities.

Dubai developments

Meanwhile, some local markets have been keeping the sector busier than others. The Dubai Health Authority, for example, will only grant visas to people who have health insurance. The decision to introduce mandatory health insurance means employers must ensure their staff are covered while providers must ensure their products are fully compliant. The programme has been phased, with the largest firms having to ensure their employees are covered first, cascading down to the smallest companies in the last phase.

Movements at the top

There has been plenty of activity at the top tiers of the main players. Reuters reported in July 2015 that Bupa had named Sheldon Kenton, formerly of Cigna Corp, as its new global commercial director. And at broker level, there have been interesting acquisitions happening, with the likes of Aon and Mercer acquiring international brokers Jelf and PMI, and IHC remains one of the few players left – perhaps the last at the top tier.

Bupa International, too, is busy as it continues with its restructuring and regionalising programmes, and looks at a far more global picture, in line with other top tier providers.

And a move by Anthem looks set to change the face of the US health insurance industry. Anthem has bought out Cigna at a price of around $50bn. According to the Wall Street Journal, the move will bring more than 53 million people under the cover of the group, and around $115bn in annual revenue.

Underwriting improvements

While on the macro level there has been a lot of activity, things are changing at provider level too. One of the themes that is becoming more common is a change to the Medical History Disregarded (MHD) approach. Historically, MHD was reserved for groups of 20 or more. This minimum was eventually reduced to groups of 10 people. Now, though, there are a handful of providers who will offer MHD cover to groups of five or more employees – a real turning point, a much better deal for smaller groups, and something that is pretty much unheard of in the domestic PMI market.