As we continue to monitor the current spread of coronavirus (COVID-19) and its global impact, we are also diligently monitoring carrier and policy changes. The situation is evolving daily, and many of our international partners are helping us navigate this challenging new employee benefits environment.
Whether it is a corporate travel policy, an expatriate plan or a local international benefits plan, it is very important to understand the provisions and how they may change over the next several days, weeks and months. Your broker or adviser can support you in navigating the current landscape and keep you informed of any upcoming revisions to policy specifics.
Travel Policies: AD&D, OOC, BTM and BTA
There are many types of travel policies. These include individual plans, group plans, accidental death and dismemberment (AD&D) plans, out-of-country (OOC) medical plans, travel medical plans, evacuation plans and more. It is critical to evaluate what is in place and how it applies to employers and employees.
Most of the plans mentioned above are purchased to enable the movement of and payment for an injured or sick employee. However, there are distinct differences in how they will respond, depending on the carrier and policy language. For example, an AD&D policy typically excludes viruses and does not apply to sickness or disease. Therefore, in the case of COVID-19, this type of coverage would likely not be applicable.
Most business travel medical (BTM) plans will ensure support for traveling employees. The benefit levels, evacuation and repatriation coverage, as well as any other benefits will be outlined in the plan policy. Employees should always carry their policy information in case of illness or emergency. Most international medical travel carriers offer a mobile app so that the traveler can access information regarding clinics and hospitals as well as travel advisories.
A business travel accident (BTA) plan can include medical expenses for “illness,” including infectious disease, but again the language can vary by carrier. A BTM policy will include coverage for illness, injury and accident. BTA and BTM policies are often purchased to supplement standard employee healthcare plans. An employee who has contracted the virus and sustained bodily injury as a result will likely be a covered claim. However, terms and conditions on the policy should be reviewed to ensure no specific exclusions or limitations apply in the case of a COVID-19 incident. Both types of policies may also include trip cancellation benefits if a covered person’s trip is cancelled due to an illness that renders them unable to travel. Trip delay and/or trip interruption coverage is typically included if the covered person contracts an infectious disease or illness, or is quarantined by a medical or governmental authority while already traveling because presence of the infectious disease is suspected. It is important to note that most policies exclude coverage for travel to countries after a travel advisory has been issued by a governmental authority.
Another type of policy, available usually as a rider, is the out-of-country medical or OOC policy. This type of policy covers employees traveling outside of their home country during an accident or illness. The benefit limits can vary, but this policy would apply in the case of a virus.
Policies and Evacuation
Now, consider evacuation. While medical evacuation is almost always attached to BTA, BTM, OOC and other group travel policies, if someone were to be diagnosed with COVID-19, the voluntary evacuation of employees is typically not covered.
Any covered evacuations are subject to the approval of health authorities in both the originating and receiving country. For example, if the U.S. government were to decide not to allow the medical evacuation of a patient known or suspected to have COVID-19, the insurer could be stopped from performing the services.
Another consideration is the availability of flights and possible cancellations of evacuation flights due to security concerns. This may result in evacuation carriers willing to repatriate an employee being unable to proceed due to logistics and restrictions. The evacuation benefit usually includes epidemic disease but must be warranted by a physician’s authorization. The fear of contracting the virus is not a valid reason to be evacuated and would not be a covered event.
Similarly, a security evacuation, which is available as an add-on to some BTA and/or BTM policies, covers employees if they fall ill and medical evacuation is deemed necessary. Again, voluntary evacuation or a fear of contracting the virus would not apply.
Note that some carriers and underwriters are no longer including the threat of coronavirus as a covered trigger for evacuation, cancellation and interruption benefits. Some of the “cancel for any reason” policies available in the market have begun to exclude the coronavirus from their covered triggers. These policies will only cover a traveler who actually contracts the virus. Therefore, it is imperative that you confer with your risk management team to determine the potential threat before you or your employees decide to travel.
Currently there are no special regulations in place for foreign patients who need to be medically assessed in their country of assignment or work. If expatriates have any concerning symptoms, such as fever or respiratory issues, they must follow the public health system requirements at this stage. Expats should follow the guidance of their employer. Most if not all carriers and policies have assistance services that expats can reach to receive guidance, and most carriers also have telemedicine apps.
It is important to remember that expatriates wishing to travel to and from their country of assignment need to evaluate the decision with their employers. Several governments have travel restrictions in place, and many airlines have temporarily suspended flights. If individuals travel where restrictions exist, their coverage could be in jeopardy.
Medical evacuation by air ambulance is possible for sick and contaminated people. Specialized equipment and trained staff are required. However, the evacuation must be authorized by the receiving country, which usually is the patient’s home country.
Due to the widespread travel advisories and the rise in COVID-19 cases worldwide, many countries are implementing measures to have their local nationals (who are working outside of their home country) flown back to their country of citizenship. On March 19, 2020, the U.S. Department of State urged citizens outside of the country to arrange for immediate return to the United States, unless they were prepared to remain abroad for an indefinite period.
Local In-Country Policy Changes
For employers that have an international footprint and have either operations in foreign countries or people working globally, the local plan and policy guidance will vary by country. The majority of private medical insurance providers haven’t yet issued a decisive stance on COVID-19. It is therefore impossible at this time to have exact answers regarding how claims will be handled in each country.
Many private medical insurance policies contain an epidemic or pandemic exclusion. Since the COVID-19 virus has been deemed a pandemic, treatment for the disease could encompass claim complications for some employers. Other impacts will likely also come into play in the global benefits arena, including pension schemes. Worldwide Broker Network partners continue to evaluate the situation and provide guidance to employers locally.
The U.S. Department of State is providing country-specific information as it relates to COVID-19, including information from government entities all over the world. In the following days, weeks and months, countries will continue to evaluate the situation and relay guidance as necessary.
The Department of State has issued a Global Level 4 Health Advisory, warning U.S. citizens not to travel abroad due to the global impact of COVID-19. U.S. citizens who are considering a return to the United States are urged to make travel arrangements as soon as possible, while flights are still available. Some airlines continue to operate but do so on a greatly reduced schedule. Transportation links to international destinations, including the United States, are becoming increasingly limited. Travelers should be prepared for the possibility that air carriers may further reduce or eliminate currently available commercial flight options with little advance notice.
In addition, travel advisories are continually changing as the Department of State monitors the threat of COVID-19. Some countries have instituted preventive measures for travelers who want to visit, are requiring medical clearance before the travelers are permitted to enter the country, or are instituting other measures, such as health quarantines.
A tremendous amount of information is available both through the Centers for Disease Control and Prevention website and the U.S. Department of State Department website. Resources include guidance and FAQs for international travelers and health notices by country.
Hylant is committed to keeping you informed about changes that impact employees and businesses domestically and globally. Visit the Hylant Coronavirus Resource Center at www.hylantcoronavirusinfo.com to access a wide variety of materials designed to help you navigate these unprecedented times.