The Rising Cost of Global Healthcare

iPMIM

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POWERED BY iPMI MAGAZINE | NOVEMBER 2015

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THE RI$ING COST OF GLOBAL HEALTHCARE EXCLUSIVE C-SUITE EXECUTIVE COMMENTARY FROM GLOBALITY HEALTH, BELLWOOD PRESTBURY, CIGNA GLOBAL IPMI AND WELLAWAY.

Global coverage, reliablity and service.

Seeking out new life and new civilisations. No matter how undiscovered and

Globality Health is the international health insurer with a special focus on expatriates. As part of Munich alien your new country may feel, DKV Globality provides you with outstanding healthcare wherever you go.

Health, we give you the strength and security of a leading global primary insurer and reinsurer. Under 速 速

With Globality CoGenio and Globality YouGenio we offer internationally operating companies and their

the Munich Health brand, Munich Re pools its primary insurance and reinsurance operations, as well as expatriate staff as well as individuals and their families flexible underwriting solutions, high-level products

related services in international healthcare business.

with comprehensive outpatient, inpatient and dental insurance cover and market leading services around the

Munich Re as a group stands for exceptional solution-based expertise, consistent risk management, globe. Plus the advantage of covering pre-existing diseases in the insurance policy. Trust in our expertise.

financial stability and client proximity. Some 40 million clients in over 30 countries place their trust in the services and security Munich Re provides.

www.globality-health.com

Globality Health means … … feeling at home wherever you are.

Outstanding care for outstanding people. DKV Globality is the international

With Globality CoGenio® and Globality YouGenio® we offer international companies and their expatriate health insurer with a special focus on expatriates. As a member of Munich Health with more than 5,000

staff and individuals and their families, flexible underwriting solutions, high-level products with

experts at 26 locations worldwide we offer innovative healthcare solutions for clients and partners all over

comprehensive outpatient, inpatient and dental cover and market leading services around the globe. the world. As an integral part of the Munich Re Group, we give you the financial strength and security of one of the world’s leading insurers and reinsurers.

Call our experienced consultants at +352 270 444 2201 or visit www.globality-health.com to find out more.

Call our consultants at +352 270 444 2201 or visit www.dkv-globality.com to find out more.

THERE FOR YOUR EXPATRIATE CUSTOMERS. EVEN WHILE YOU SLEEP. Be there for potential customers 24/7 with the new online AppLink quote portal from Cigna. Putting AppLink on your website lets your customers get a price and get the information they need quickly and easily. AppLink. So you can be there for your expatriate customers, all the way.

Learn more at cignaglobal.com/brokers/applink

“Cigna” and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, and not by Cigna Corporation. Such operating subsidiaries include Cigna Global Insurance Company Limited, Cigna Life Insurance Company of Europe S.A.–N.V, Cigna Europe Insurance Company S.A.-N.V. and Cigna Worldwide Life Insurance Company Limited.

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WELCOME

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ARRIVALS RBI PREMIUM Card Memberships for Expatriates

iPMI MAGAZINE SPEAKS WITH KENNETH HUNT OF RBI PREMIUM Rbi Premium is specialist provider of specially designed pre paid card memberships and in this exclusive interview we speak with Mr. Kenneth Hunt.

P15 The only alternative...

Members recieve a Multi Currency Prepaid Card with the following complimentary benefits:

www.rbipremium.com +44 207 859 4228 info@rbipremium.com Kemp House, 152 City Road, London EC1V 2NX United Kingdom

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ROUND TABLE FORUM: THE RI$ING COST OF GLOBAL HEALTHCARE In the most recent iPMI Magazine Round Table we speak with leading executives from the world of iPMI about the rising cost of healthcare.

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Our expatriate couple travelling the world for business, battle with the rising cost of worldwide healthcare access and medical inflation. Faced with increasing premium cost’s medical inflation remains a key risk for the global citizen.

To get in touch with International Private Medical Insurance Magazine (iPMIM)simply send us an email. You can write to the team on: ipmi@ipmimagazine.com and we will get back in touch right away.

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RBI PREMIUM Card Memberships for Expatriates

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The top three reasons for expatriate relocation are as follows: 01 Education 02 Employment 03 Relationship

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WellAway is a managing general underwriter specialized in worldwide expatriate healthcare.

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There are approximately 40 million high-income expats across the globe

The expected number of expatriates by 2017 is 56.8 Million (0.77% of the world)

The average person lives as an expatriate between three and five years

The country with the highest percentage of top-income expatraties is Nigeria

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WellAway offers multi-lingual, 24/7 concierge care services and e-Consultations

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INTERVIEW

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iPMI MAGAZINE SPEAKS WITH KENNETH HUNT OF RBI PREMIUM Rbi Premium is specialist provider of specially designed pre paid card memberships.

Rbi have designed and introduced a revolutionary new prepaid card membership program specifically for expatriates and overseas travellers. This is a marketfirst and world-first speciality card membership that provides card members with complementary worldwide medical and overseas travel insurance.

created by financial service industry experts with more than 60 years combined experience in medical, travel, general and life insurance sectors across the world.

How does it work?

both insurance related expenses and personal expenses. It can be loaded with up to US$160,000 in any one or combination of 12 different currencies that can be purchased at spread free money market rates.

What are the key features Instead of paying a premium and benefits of the Rbi for international medical P r e m i u m E l i t e C a r d insurance cover consumers membership? pay an annual card membership fee and they receive a unique l Complementary multi currency prepaid card worldwide medical and complementary worldwide insurance cover; medical and overseas travel insurance and a selection of l Complementary Rbi Premium is a new valued added benefits. The worldwide travel insurance industry-relevant company prepaid card can be used for cover;

Interview

Please introduce Rbi:

INTERVIEW

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l Affordable annual membership fees; l Immediate access to cash for payment of outpatient expenses; l Up to US$10,000 in available cash on the prepaid card; l No reporting claims or completing claims forms for outpatient needs;

l Complementary income replacement cover; l Complementary critical illness cover; l Complementary dental health cover.

Fo r g l o b a l b r o ke r s , intermediaries and independent financial advisors who are seeking to expand their product portfolio what can Rbi Premium offer?

Brokers and intermediaries do not need to be licensed to sell or promote our membership programs.

It provides brokers and Premium act as a top-up to intermediaries with a highly existing employee and innovative and more equitable lifestyle benefits? alternative to traditional iPMI. Rbi pre paid card memberships RBi also provides fixed rate are already proving popular introduction fees that are in the individual and corporate paid in perpetuity together group sector to supplement with flexible bonus payment locally issued mandatory packages. medical insurance schemes.

It is much more equitable Individuals and expatriate alternative to using traditional groups are seeking cost- IPMI coverage for those who effective insurance solutions. want a more affordable backup.

How can Rbi Premium assist the group market?

Rbi Premium provides an option for pre loaded credit Rbi can provide individuals cards. That sounds exciting. and groups of expatriate Can you walk us through medical insurance consumers this option? with access to a more affordable and equitable alternative to Multi currency cards are traditional international an incredibly convenient and medical insurance. versatile payment utility. The prepaid cards can be loaded Rbi provides complete in virtual real-time to pay for coverage of claimable costs insurance related expenses. and or annual cash savings This means that in most cases and tax-free interest. The card holders will not be advantage of this unique confronted with unexpected combination is that the majority bills that they may not be of card members will not face financially prepared for. end of year price increases at the end of each year as they It also provides the freedom do with traditional international to choose virtually any medical medical insurance. facility (the most convenient or best able to meet the In expat markets where immediate their needs rather visa regulations mandate being restricted to a particular local insurance, can Rbi network of hospitals or clinics).

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Interview

l Multi currency prepaid card that can hold up to US$160,000;

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iPMIM

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FLEET CAPABILITIES | TECHNOLOGY | GLOBAL ACCREDITATION

MEDICATION | PAYOR - PROVIDER RELATIONS

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INTERVIEW

IPT will increase to 9.5% in November 2015. What role will healthcare trusts play in combating this rise?

insurance premium tax liabilities. Rbi prepaid card members can leave such concerns about insurance premium tax and ever increasing insurance premium prices behind them.

Our card program is specifically geared towards helping our card members to protect themselves and save money. In most cases the majority of our card members will end the year with real cash savings and tax-free interest.

added benefits will Rbi Premium provide expats and travellers?

Rbi provides the only real alternative to the current range of international medical insurance policy products. It provides consumers with a better value proposition, the benefit of real worldwide coverage, annual cash savings and tax-free interest that makes if more affordable to stay insured from year to year.

For more information about the Rbi Premium card Rbi Premium card memberships In 2015 insurance is a given. membership program visit are an alternative and as such Consumers want options www.rbipremium.com there is no exposure to and choice. What value-

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Interview

The cards can also be pre loaded with cash to pay for out patient expenses without having to go through the typical drawn out claims processes. It puts the consumer in charge and rewards them financially with year-end cash savings and tax-free interest.

The card members are also not restricted as with traditional iPMI cover.

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ROUND TABLE

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Although global risks have changed dramatically, medical inflation and the cost of employee benefits continues to cause concern. In the most recent iPMI Magazine C-Suite Executive Round Table Business Forum we speak with leading executives from the world of International Private Medical Insurance about the rising cost of healthcare and medical inflation.

Questions

THE RI$ING COST OF GLOBAL HEALTHCARE

Š

Globality Health means … … feeling at home wherever you are.

Outstanding care for outstanding people. DKV Globality is the international

With Globality CoGenio® and Globality YouGenio® we offer international companies and their expatriate health insurer with a special focus on expatriates. As a member of Munich Health with more than 5,000

staff and individuals and their families, flexible underwriting solutions, high-level products with

experts at 26 locations worldwide we offer innovative healthcare solutions for clients and partners all over

comprehensive outpatient, inpatient and dental cover and market leading services around the globe. the world. As an integral part of the Munich Re Group, we give you the financial strength and security of one of the world’s leading insurers and reinsurers.

Call our experienced consultants at +352 270 444 2201 or visit www.globality-health.com to find out more.

Call our consultants at +352 270 444 2201 or visit www.dkv-globality.com to find out more.

EXECUTIVES

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Executives

ROMAN BEILHACK GLOBALITY HEALTH

EXECUTIVES

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Executives

ANDREW APPS BELLWOOD PRESTBURY

THERE FOR YOUR EXPATRIATE CUSTOMERS. EVEN WHILE YOU SLEEP. Be there for potential customers 24/7 with the new online AppLink quote portal from Cigna. Putting AppLink on your website lets your customers get a price and get the information they need quickly and easily. AppLink. So you can be there for your expatriate customers, all the way.

Learn more at cignaglobal.com/brokers/applink

“Cigna” and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, and not by Cigna Corporation. Such operating subsidiaries include Cigna Global Insurance Company Limited, Cigna Life Insurance Company of Europe S.A.–N.V, Cigna Europe Insurance Company S.A.-N.V. and Cigna Worldwide Life Insurance Company Limited.

EXECUTIVES

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Executives

ARJAN TOOR CIGNA GLOBAL iPMI

BROAD STATS SHOULD MEAN BROAD COVERAGE

JOIN US TO EXPAND YOUR COVERAGE TODAY

FACT

NO.

438

The top three reasons for expatriate relocation are as follows: 01 Education 02 Employment 03 Relationship

Keeping You Well, While You’re Away.®

WellAway®

Keeping You Well, While You’re Away.®

 +1 441 296 0651  info@wellaway.com  www.wellaway.com

WellAway is a managing general underwriter specialized in worldwide expatriate healthcare.

WellAway is proud to underwrite the only ACA compliant expat solution offered in the international market.

EXECUTIVES

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Executives

GRISELLE CHERNYS WELLAWAY

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ROUND TABLE

Q1

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ALTHOUGH GLOBAL RISKS HAVE CHANGED DRAMATICALLY, MEDICAL INFLATION AND THE COST OF EMPLOYEE BENEFITS CONTINUES TO CAUSE CONCERN. HOW WILL THE COST OF INTERNATIONAL PRIVATE MEDICAL INSURANCE PREMIUMS RISE IN THE NEXT 5 YEARS?

ARJAN TOOR: Medical inflation is driven by unit cost, i.e. the price of each service; and utilization, that is how many and what type of services are used. As the world’s health care standards continue to rise and the range of treatment facilities and breadth of treatment options available continues to increase, it is without doubt that both unit cost and utilisation will also continue to increase.

It’s our job as the insurer to understand these risks and continually evolve our proposition to protect our customers from the impacts of medical inflation as far as possible. We’re continually working on initiatives to help minimize the impact of inflationary volatilities including investments in expanding our medical network and claims teams globally, meaning we can counteract

medical inflation spikes to a certain extent as we build long-term relationships with hospital groups. It’s a lot about experience as well - it’s imperative that our claims advisors know the expected cost of a hip operation in Singapore, for example, and can ask the right questions to ensure the costs are appropriate.

Ultimately, it’s impossible to say exactly how premium costs will rise over a 5 year period, but our focus will continue to be on driving forward our mission of helping the people we serve improve their health, wellbeing and sense of security.

ANDREW APPS: If I had a crystal ball, it would be easy to answer this; however, the reality is that no one really knows to what extent iPMI premiums are going to rise over the next few years. What is certain is that premiums will continue to increase due to the rising cost of medical treatment along with the ever popular demand for private medical treatment.

That said, increased competition amongst the iPMI providers has, to some degree, helped to keep premiums palatable for most policyholders (putting to one side the notion that nobody likes to see their premiums increase), with average year on year increases running between 5-10% depending upon where a person is living and working. How long this will continue is anyone’s guess, but the market is hotting up with yet more new

Roundtable

ROMAN BEILHACK: Costs are expected to continue to rise at levels above general price inflation. There are continual advances in medical science with new treatments and medicines being developed all the time. It is normal that insured members will demand the best treatments and services available, particularly for expatriates. In order for insurers to offer these new treatments then there will inevitably be premium increases.

However, insurers should not use this as an excuse to increase premiums beyond what is necessary. As can be seen recently, Globality is holding 2016 rates at 2015 levels for many categories of its business.

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provider entrants trying their hand.

and technology. Longevity is also playing a role in the inflation and utilization of medical GRISELLE CHERNYS: The cost of international services which creates more demand and private medical insurance will rise dramatically demand will drive costs. and this will be driven by the development and demand for new treatments, pharmaceuticals

Q2

CAN WE QUANTIFY LEVELS OF MEDICAL INFLATION GLOBALLY?

ARJAN TOOR: A global approach is impossible: medical inflation just like inflation of any other kind is country- and sometimes even city specific. It’s therefore very important that insurers invest in staying on top of the trends emerging in each market and understand what the impact will be. Equally, short-termism is unhelpful as sometimes there are anomalies driven by one-time events in specific markets.

It’s far more appropriate to take a long-term approach and use independent economic data as a measure of where key trends might emerge.

ANDREW APPS: For many years, iPMI providers tried to convince the world that there was an average inflation rate and simply used this to increase their premiums wholesale from one year to the next. The market has changed and with it the way in which data that is being captured by underwriters, allowing them to better understand what is really happening out there on the ground Underwriters now capture detailed information of where claims are being made, for what, by whom and for how much. In addition, underwriters are becoming more regional, even country specific, in the way they set terms and how they look at inflation levels.

The data being captured allows underwriters to both identify and isolate potential danger areas, so they can plan counter measures that will hopefully bring costs under control before disaster happens. High cost and high utilisation markets, such those found in the

Roundtable

ROMAN BEILHACK: This is an objective of insurers when pricing their business. It is not an exact science but there are several sources of information which can lead to an understanding of medical inflation. There are very different circumstances in every country/region around the world so although a single average rate of global inflation can be calculated, this hides the real view that inflation varies considerably from one region to another.

For example, consider the macroeconomic indicators of general price inflation: there are currently much higher rates of general price inflation in parts of the world like China when compared to others such as Western Europe.

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ROUNDTABLE SESSIONS 2012

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ROUND TABLE

Gulf and China, are seeing higher than average premium increases. This reflects the local rather than global market, and, as the industry develops, there is every chance that products and services will become more country and even city specific.

GRISELLE CHERNYS: Because the access to medicine, the delivery of medical services and the timing in which new technologies

Q3

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reach different parts of the world, it is impossible to quantify inflation globally, I think we can quantify it by region, type of healthcare delivery systems and how the access to healthcare is provided. I believe it can be anticipated by looked at by world regions.

WHAT FACTORS WILL DRIVE MEDICAL COST INFLATION IN THE FUTURE?

ARJAN TOOR: It’s impossible to predict the future, but there are a few constants which we expect will continue to drive rising medical cost inflation. The global ageing population is a key one, after all we all must assume that as we become more aged we naturally rely more on health services to keep us going.

The growing ‘middle class’ in emerging counties is helping to push up the demands on health care, and as a result is driving up costs. There is also the broader topic of increased utilisation of medical care in emerging markets driven by improvements

in the quality and accessibility of care.

Undoubtedly this will drive up global costs.

ANDREW APPS: The main drivers are more usage per person (utilisation), the greater cover awareness by policyholders (as to what can and cannot be claimed and the increasing treatment charges from the medical profession as a whole.

Whilst the industry is continuing to see dramatic growth (at least in terms of the number of lives being insured), at the end of the day, providers and insurers are in it to make a profit and few will want to see their margins reduced, so consequently the policyholder will have to pay through increased premiums.

GRISELLE CHERNYS: As more wonder drugs and treatments arise, it will drive the costs up. Extended life expectancy will also make the cost of certain treatments high. The shortage of physicians and medical personnel will also influence costs.

Roundtable

ROMAN BEILHACK: There are many factors: the development of new treatments, new drugs and medicines, medical technologies, the salaries of doctors, nurses and other healthcare professionals plus general price inflation. Again these are very specific to the country/region involved.

Expatriates, the people who use iPMI, gravitate to the regions of the world with high economic growth, and this is where inflation is generally highest.

ROUND TABLE

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Q4

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DOES THE PROBLEM OF MEDICAL INFLATION GO FAR BEYOND THE FINANCIALS OF MEDICAL INSURANCE PLANS?

ARJAN TOOR: It goes far beyond the financials. What we are talking about here are trends which are affecting people’s lives, a lot of the time in a positive way. Globally, health care standards are improving, treatment is becoming more accessible, and that has to be a positive as the health / wealth gap narrows.

As we said though, rising health care costs are also a symptom of increases in chronic conditions such as high blood pressure, cancer and stress.

GRISELLE CHERNYS: Medical insurance will have to change from what we know today to a different method and approach. Medical insurance policies will not look the same.

Roundtable

ROMAN BEILHACK: It should not necessarily be considered a problem.

If new treatments and medicines are developed then that is progress which should be welcomed by all. Part of the objective of an insurer is to enable healthcare providers to deliver the best possible services to the insured members.

The cost of the best treatments can increase so it is normal that insurers should have to increase the insurance premiums to meet the increase in claims arising due to better treatments.

ROUND TABLE

Q5

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HOW CAN iPMI PLANS COMBAT MEDICAL INFLATION AND PROTECT FUTURE COSTS? situation and provide disease management coaching in the case of chronic conditions such as diabetes. Ultimately, this is about helping customers and delivering a service, but one of the benefits is that it can help to control treatment costs.

ARJAN TOOR: There is quite a bit international health insurers can do to mitigate against rising costs. Building stronger partnerships with health care provider networks is one.

Cigna has invested heavily in this in recent years. Of course, Cigna benefits from this in that we benefit from cost containment; but there are far more wide-reaching benefits for our customers who receive access to the very best doctors and hospitals available, but also benefit from the fact many of our providers are incentivised on health-outcomes, rather than treatment itself.

Secondly, health and wellness engagement is essential to continue to drive up health improvement outcomes and keep people healthier. All Cigna Global Health Options customers can choose to add the Health & Wellbeing module to their plan which provides access to health checks and online health risk assessments which help to keep customers healthier.

Lastly, across many of Cigna’s international businesses, we are increasingly seeing more Nurse Case Managers being appointed. This brings a fresh medical perspective to the customer conversation, and can help the customer reach a decision in a complex

ANDREW APPS: In a perfect world, insurers and medical providers will be working together to keep overall costs down, but the reality is somewhat different and despite all good intentions, the policyholder will be forced to either pay up or accept lower cover.

The days of nil excess and nil co-insurance cover being the ‘standard’ at least within the corporate sector are fast disappearing, as more companies are starting to look closely at introducing some form of ‘employee contribution’ to help reduce premiums.

Removing the low value, high utilisation treatment costs is a good way to achieve this bearing in mind that for the insurer, the actual cost of these small claims is often less than the cost of administrating the claim. After all, we’re used to paying an excess against our motor and home insurance policies, so it’s not exactly a major move to do the same with medical insurance.

GRISELLE CHERNYS: Changing the model of insurance from the form in which policies exist today to a more progressive model with prevention monitoring and wellness.

Roundtable

ROMAN BEILHACK: International PMI plans should be tailored to the requirements of the policyholders. This means finding the right balance between the level of benefits covered by the policy and the affordability of the plan.

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ROUND TABLE

Q6

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WHAT BENEFITS MAY FMU PROVIDE AN EXPATRIATE SEEKING TO PROTECT THEMSELVES AND THE RISING COST OF HEALTHCARE? been that FMU plans give the policyholder a clear understanding of what will and will not be covered before they make a final purchase decision. This, of course, is only true where a full declaration of the applicant’s health is given and the insurer provides a clear, unambiguous statement as to what will be covered.

With FMU underwriting in the main applying to individuals and small groups rather than large groups, premiums tend to be community rated and therefore reliant on a pool of individuals rather than personal usage. This ensures greater premium stability, which is good news for the policyholder, but does inevitably have the down side of penalising the older member.

ARJAN TOOR: In short, Full Medical Underwriting (FMU) has a number of advantages for customers.

By allowing the insurer some insight into their medical history, customers receive full transparency on what treatment is covered and what may not be covered so that they avoid any unexpected surprises later. This also helps to minimize the cost to the customer as the insurer can effectively manage the risk profile of their book which means that savings are passed on to the expatriate.

Cigna Global Health Options customers who have completed medical underwriting always benefit from our lowest rate.

GRISELLE CHERNYS: It permits them to verify that they are in a risk pool that is sound and priced accordingly but the ratings need to always take into account higher risks and combined rating within a group or a population within an insurance company, but there have to be a new ways of looking at the entire process of insurance.

ANDREW APPS: The justification has always

Roundtable

ROMAN BEILHACK: Opting for FMU provides the expat with full and clear expectations of what (if anything) is excluded from the start.

This can be particularly appealing to applicants who are looking to cover mild ailments for a small premium increase and those who are looking to exclude those ailments completely.

Healthy individuals can also benefit from the FMU approach as they will usually have lower premiums as no loadings would apply.

From the insurer’s point of view, FMU can reduce admin costs and may even reduce claims turnaround time, as the insurer does not have to investigate every claim as preexisting as they would with a moratorium approach.

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ROUND TABLE

Q7

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WHY IS CLAIMS HISTORY AND MEDICAL INFLATION CONNECTED?

ROMAN BEILHACK: The claims history is a relevant tool to manage our business. This data allows us to evaluate the development of a specific contract and monitor the performance of specific markets as well as medical providers. It supports us to predict future changes in their behaviour and react accordingly.

ANDREW APPS: The two are inter-connected as treatment costs and utilisation are two out of a number of key components of how risks are measured.

GRISELLE CHERNYS: It is not the medical claims that cause the inflation, is the pricing from the providers, the way in which medical conditions are treated and the use of best medical practices and Evidence Based Medicine to treat the insurance holder. The over utilisation of services, the mistreatment and misdiagnoses of conditions and the high price is what drives the medical inflation.

Utilization of medical benefits defines the future premiums.

Roundtable

ARJAN TOOR: The key to this question is really recognition that previous claims behaviour is usually a good indicator of future claims behaviour. Ultimately, if Cigna has the opportunity to profile the customer through building a picture of that customer’s claims history, we can assess the risk much more accurately and price the policy accordingly.

This helps healthy customers benefit from our very best rate, and helps otherwise healthy customers with a couple of preexisting conditions opt to exclude these conditions or pay a little bit extra to have them covered on the policy. We feel that this

provides the greatest level of flexibility for customers and brokers alike.

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WHAT RESPONSIBILITIES DO INTERNATIONAL HEALTHCARE PROVIDERS HAVE IN MINIMISING THE COST OF HEALTHCARE?

ARJAN TOOR: Provider network is key. We work with hospital groups and individual treatment centres all over the world, and we’ve invested heavily in developing regionally located provider network teams to help us

build an understanding of the treatment landscape in each region. This helps us do two things. First, we can continually offer our customers an ever-expanding range of treatment centres to choose from and ensure that they receive the very best treatment regardless of where they are in the world.

Second, this allows us to monitor claims trends in specific regions, countries and from specific providers, and identify any adverse trend data very quickly. We can then work with providers to understand whether this is a symptom of medical inflation in the market, and of course identify any behaviours which we believe are being driven by the provider at a local level, for example overutilisation. This benefits customers at the local level as our providers continue to provide the best treatment, but also helps us and the industry at a macro level as cost escalations are minimised.

ANDREW APPS: It is in everyone’s interest to better manage the cost of healthcare, not just the providers. Too often it seems that providers and insurers are at loggerheads when it comes to the cost of medical treatment (and how it is delivered) with the ultimate loser being the policyholder (patient) when it comes to paying the bill. If healthcare costs are allowed to continue to run largely unmanaged, then the industry will lose out as policyholders will start to look for less expensive ways to fund their healthcare needs.

Roundtable

ROMAN BEILHACK: As an insurer we have the responsibility to get the best possible treatment at the lowest cost in order to have a sustainable level of premium which allows us to provide the best level of coverage to our clients. It is important to create awareness within our clients and business partners about the impact of cost containment. This is being reached by closely monitoring the medical treatments received by our clients and by avoiding the coverage of any over treatment or the charge of expenses which are not customary or standard in the relevant region. A united effort gives us the opportunity to influence the cost of health care.

One important part of our cost containment management is our de-centralized set-up, which gives us direct access to local knowledge, optimising the processes of issuing guarantees of payments, reimbursements, or direct billing agreements which enable us to obtain additional discounts. We also provide 24/7 availability which enables us to provide service to our client whenever needed, especially due to the fact that this service is provided within the local time zones. This also supports us in coordinating with our partners the steering of clients to our network preferred medical providers.

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How this might happen is anyone’s guess.

Whilst the larger insurers have made a valiant attempt to work with hospitals and specialists to control costs, successes have been few and far between. On the upside, the growth of third-party claims management networks with bulk purchasing power is helping to make inroads as investment in technology and systems offer more efficient claims processing and greater cost savings than would otherwise be available, particularly to the smaller iPMI insurer.

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GRISELLE CHERNYS: Developing better coverage that is consistent with the population needs-- more prevention, more counselling and education to consumer, also to employers and to members as to how to use the medical policies presented but employers need to buy products that keep employees healthy and give access to prevention. The present insurance products put emphasis only on the catastrophic conditions, and limits prevention and life events such as maternity.

UNNECESSARY TREATMENT AND FRAUD CAN ACCELERATE MEDICAL INSURANCE INFLATION. HOW DO YOU MANAGE SUCH RISK? development of our corporate and individual business to recognize any changes in the trends of their behaviour and to be able to react immediately.

ARJAN TOOR: This again stems from our responsibilities as a provider. Our claims and network provider teams are all highly trained in spotting errant behaviour from both customers and providers and are quick to challenge where appropriate. I recently visited our global claims hub in Greenock, Scotland, and was amazed by the ‘sixth sense’ members of our highly experienced claims team have when reviewing claims. This is not about being suspicious of our customers’ and providers’ behaviour - after all we are here to pay claims - instead it is about knowing the expected benchmarks for treatment costs in the country of treatment and identifying anything which seems out of the ordinary.

Roundtable

ROMAN BEILHACK: Unnecessary treatments and fraud are one of the biggest concerns within our industry. In order to manage this risk it is important to have a solid knowledge of the different markets and medical developments. Therefore, we put a special emphasis on choosing the best partners worldwide. We want to ensure seamless global assistance services and to give our clients access to a wide range of high quality providers with local knowledge. This allows us to achieve an efficient steering of clients to our preferred medical providers. The development of our internal resources also plays an important role in this. We have built a strong medical team who assess in detail the medical necessity of the different services received by the client. This detailed review avoids the coverage of any unnecessary treatment which is also in the best interests of the insured members.

Furthermore, we monitor very closely the

Roundtable

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We ensure that our claims handlers are given the time and flexibility to find out all the facts to help us deliver a superior service to our customers.

Q10

HOW DOES YOUR BUSINESS MODEL MANAGE MEDICAL INFLATION RISK?

ROMAN BEILHACK: We manage this from several angles. Firstly, we use the ability to increase premiums at the annual renewal date. The increase will be based on our expectation of future medical inflation.

Secondly, there is regular monitoring of the claims incurred on the portfolio to see if the actual experience matches the expected performance. Thirdly, there is the underwriting at the claims handling stage to decline

unnecessary treatments and fraudulent claims. Finally, developing efficient provider networks helps to keep costs low.

ARJAN TOOR: Medical inflation risk is obviously high on our agenda. As I mentioned, one element is about continuing to build on our global hospital network and improving cost containment. We also see this as a big opportunity to help our customers improve

Roundtable

But the problem of fraud is a worrying trend none the less, with major criminal gangs starting to get in on the act. One case has seen multiple policies being bought with a number of iPMI insurers over periods of ANDREW APPS: Over utilisation is one of months, which were then sat on for a year the great annoyances with unchecked medical before a series of claims were made using a providers using insurance as a cash generator. fictitious medical provider.

The two tier pricing structure in some hospitals remains prevalent with patients often being GRISELLE CHERNYS: Fraud and abuse are asked whether they are paying cash or have both causes of inflation and one that can insurance, with substantial discounts being only be controlled with education of the offered for the former. Some medical providers consumer, their participation in preventing seem to think it is fine to overcharge insurers and not accepting unnecessary services, because in their words ‘everyone does it’ abuse of medical tests and fraudulent billing and if a fee structure has been agreed, will practices. Without the conception by the often over treat the patient or keep them in consumer that the claim today is the premium hospital for an extra day or two for observation tomorrow, it can’t be controlled. An insurance to plump up the bill. Improved claims policy is not an annuity. management systems are helping to identify those medical providers who are guilty of such practices and improved communication between insurers, particularly through fraud monitoring are beginning to pay dividends.

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their health which is why we’ve invested in building our health and wellbeing proposition, and have launched a health engagement programme including healthy life tips and a quarterly customer wellness magazine.

Going forward, you can expect to see more initiatives that are directly focused on helping our customers improve their health

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and well-being.

GRISELLE CHERNYS: By creating progressive models that engage the consumer via education and participation in the impact of the over utilization and unnecessary costs and false claims.

IS USING HISTORICAL DATA A RELAXED APPROACH TO MANAGING MEDICAL INFLATION RISK?

ARJAN TOOR: In our view, historical data is one element of managing future medical inflation risk. For example, there are some markets we know that medical inflation has historically been high and will continue to be high. However, only using historical data is a hazardous approach. We need to continue to work closely with economists and actuaries to help us understand where there may be threat of increased medical trend driven from political action, trends in health care management etc. Ultimately, medical inflation can be volatile so we will never always be able to predict this accurately, but we can take steps to ensure we are as aware as possible.

GRISELLE CHERNYS: Definitely the use of medical data is indicative of the inflation and why it is happening, predictive modelling is also a wise way of determining where they costs would be but working with providers in the best delivery system in models where both parties win.

Roundtable

ROMAN BEILHACK: Using historical data is an important method to measure medical inflation risk. However, it is not the only method that we use. As stated earlier, we consider a range of sources including historical data but also referring to industry surveys, macroeconomic indicators and national statistics.

©

ROUND TABLE SESSIONS | OCTOBER 2014

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Q12

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HOW CAN EXPATRIATES AND EMPLOYERS BUDGET FOR FUTURE PREMIUM COST INCREASES FOR INTERNATIONAL MEDICAL INSURANCE PLANS? GRISELLE CHERNYS: By developing health plans for their employees and not simply insurance policies.

ANDREW APPS: The obvious answer is to add a percentage to each year’s budget (10% seems to be figure most insurers suggest) but for individual expatriates it would be advisable to increase this by a few more percentage points, particularly as they move into their 50’s and 60’s.

Alternatively, it may be worth looking at the cover provided and whether it remains relevant. Is maternity cover needed? Do you need emergency medical evacuation cover?

(Perhaps not if you are living in a major city where there are good local medical treatment facilities) Would it be better to pay for some of the low cost treatment yourself?

It is all too easy to simply renew cover each year without looking at what you are actually getting for your money and whether all the benefits you are paying for are relevant.

CAN IPMI POLICY ENHANCEMENTS OFFSET, IN PART, THE EFFECTS OF PREMIUM INCREASE?

ARJAN TOOR: To a certain extent, yes.

We are continually working on enhancing our product to deliver richer value for our customers. In part, we try to match rate increases with bringing additional value for

our customers. For example, we recently launched the SafeTravel by Cigna app, a new health and wellness tool giving expats up to the minute travel security advice depending on where they are. These sorts of enhancements

Roundtable

ARJAN TOOR: This is a tough question as ultimately none of us know how medical inflation will impact the cost of treatment in each market in the future. One thing we do know for certain is that it exists and it will continue to put pressure on costs for insurers and expatriates alike.

As mentioned previously, taking a policy on a Full Medical Underwriting (FMU) basis can help to keep initial costs low and ensure absolutely clarity around what is covered.

We also have a number of flexible options on our product which helps expatriates to keep costs low, including variable deductibles and cost shares to help customers strike the right balance between the premium cost and the charges they might incur when seeking treatment.

Of course, Cigna takes the impact of any rate increase seriously, so we are doing everything we can to minimise rate increases for our customers. Where we are forced to pass on increases, we aim to be as transparent as possible around why we are making the increase.

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1087 MILLION

TOTAL NUMBER OF TOURIST ARRIVALS 2013

52 MILLION

MORE TOURIST ARRIVALS IN 2013 THAN 2012

56.8 MILLION

TOTAL NUMBER OF EXPATRIATES WORLDWIDE BY 2017

50.5 MILLION

TOTAL NUMBER OF EXPATRIATES WORLDWIDE IN 2013

46 MILLION

TOTAL NUMBER OF EXPATRIATES WORLDWIDE IN 2009 SOURCE: IPMIM

"...THE MOST COMPLETE FACT FILLED BUSINESS REPORT ON INTERNATIONAL AND EXPATRIATE HEALTH INSURANCE IS BACK AND BETTER THAN EVER..."

INTERNATIONAL AND EXPATRIATE HEALTHCARE AND INSURANCE 2014

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ANDREW APPS: Product enhancements are often used as a bit of a smoke screen to offset overall premium increases. What may seem like a great new benefit on paper has, in reality, little intrinsic value, so it is important to look carefully at what is actually being GRISELLE CHERNYS: They cannot without offered and whether it works for the the proper programs that involve the employee. policyholder.

are fed entirely by customer and broker feedback, and help us to deliver both enhanced value for customers, but also add another tool in the armour to help our customers stay well in the first place.

Q14

WELLNESS AND COST-CONTAINMENT INITIATIVES MAY ASSIST EMPLOYERS AND EMPLOYEES RESPOND TO THE CHALLENGES OF MEDICAL INFLATION. WHAT ELSE MAY BE DONE? overcome this, new concepts are required in the way decisions for treatment are carried out. Thus, reducing health care costs and reducing the effect of inflation involves a wide variety of factors where significant changes on the demand and supply side may be needed.

Medical inflation due to general rise in cost of goods and services has to be accepted and accordingly budgeted. There is little one can do to influence the general inflation.

ARJAN TOOR: Much of the response is about cost-containment and wellness – yes – but there is of course a more objective approach which says that both government and science have a greater role to play in driving up general health outcomes globally.

If we take the top 3 leading causes of death as defined by the World Health Organisation (ischaemic heart disease, stroke and chronic obstructive pulmonary disease (COPD)), there is an argument to say that greater investment in finding responses for each of these killers would help drive up health outcomes around the world and keep people healthier for longer.

Roundtable

ROMAN BEILHACK: To tackle medical inflation the underlying cause is to be identified, if it is the utilisation or the unit costs which is driving the inflation.

Medical inflation is bad if the rise in health care costs are due to increases in activity (unnecessary utilisation), instead of better or high quality medical treatment outcomes.

It is even worse if increases in per unit costs are due to economic in-efficiencies like monopolisation on the supplier side. Usual methods of changing benefit design, limits, stricter screening and underwriting might be helpful. However, disease management with referral controls can be effective in producing quality outcomes.

In today’s economic situation over supply and moral hazards are also supporting the rising medical treatment costs.

Active network management and control with a combination of medical necessity pre-authorisation and concurrent review of cases are proven methods of real cost suppression.

There are also traditional misaligned incentives prevailing in the medical industry where the entity being paid for treatment, decides whether it is required or not. To

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ANDREW APPS: Educating employers (and employees) about the affect of medical inflation needs to have greater importance, as it is the policyholder who will ultimately pay the price. Understanding this and what makes up the cost of each claim (it’s not just the treatment fee) helps to put things into perspective. Management reports are usually available to most group schemes covering 50 or more employees, and provide

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the employer with a useful insight as to where their money (and it is their money) is being spent, on what and by whom.

Trends can be identified early before they become a problem.

GRISELLE CHERNYS: Evidence based medicine, prevention; education partnerships with providers to best provide the needed processes via integrated healthcare systems.

sponsored plans then the specific features of those plans should be considered. This means considering the locations of the insured members, the benefit levels, the treatment providers and network access.

Referring to a single global average can be misleading for many employers.

ANDREW APPS: Competition between iPMI insurers is intensifying and will continue to do so as new entrants dip their toe into the market and dream of taking a slice of the ever expanding market. Price cutting particularly amongst the employer-sponsored plans is inevitable as the larger players jockey for position and greater market share, all of which is good for the employer in the short term at least. As the saying goes, there is always someone out there who will take the risk. But there has to come a point where underwriters have to make a return on their

Roundtable

AN AON HEWITT REPORT ESTIMATES THAT THE AVERAGE COST INCREASE FOR EMPLOYER-SPONSORED MEDICAL PLANS Q15 GLOBALLY WILL DIP SLIGHTLY IN 2015. THE REPORT SHOWS THAT IN 2015 MEDICAL COSTS ARE EXPECTED TO INCREASE BY 10.15 PERCENT BEFORE PLAN DESIGN CHANGES AND VENDOR NEGOTIATIONS, 6% POINTS HIGHER THAN THE AVERAGE INFLATION RATE. IN 2014, THE GLOBAL AVERAGE MEDICAL TREND WAS 10.34 PERCENT. WHAT DO YOU THINK? ROMAN BEILHACK: Employers are operating in an environment where they need to provide high levels of healthcare for their employees, sometimes due to statutory requirements and other times due to the natural tendency of employers to look after the wellbeing of their workforce. Employers are typically under pressure to keep their operating costs low and when they review their budgets during their annual business planning cycles they will aim to minimise the cost of employee benefits. Due to these cost pressures, there may be situations where employers will downgrade the insurance coverage so that they can afford a plan rather than removing the plan altogether. Globality seeks to find solutions for their clients in these situations.

The global average inflation rate is interesting for comparing one year to the next. However, when it comes to employer-

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Architect of international mobility solutions

International companies & organisations

NGOs

International schools

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International students in Switzerland

ROUND TABLE

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Roundtable

investment. At this point premiums have to rise and with the relationship between insurers and medical service providers becoming all the more strained as medical treatment fees increase, that day is not too far away. This makes the job of the adviser /broker all the more important.

GRISELLE CHERNYS: I think that the data is pertinent and probably correct. Healthcare is a commodity that providers will control and deliver as they want, especially in the private sector with IPMI coverage. Hospitals and physicians have the upper hand in the delivery and pricing, thus the need for integrated services. As I heard a physician

administrator in a hospital say once, during some insurance pricing negotiation “this is our price and if you do not like it, I would like to see you admit and deliver the medical care the member needs�. As long as the relationship of providers and insurance is antagonistic, a solution will not be able to achieved. More and more hospitals and physicians will develop and deliver health plans via their medical facilities and I predict that the multi-hospital system will develop internationally as it has happened in the USA or as we see with Hospiten and the like.

Insurance companies and products as we know them today will have to evolve.

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WELCOME TO THE NETWORK

V1.3 of the iPMI Magazine Provider Network Directory puts a firm focus on the major players from the world of iPMI. Underwriters and providers are represented and Team iPMIM would like to take this opportunity to say a warm thank you to all of our network sponsors including ALC Health,

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To get in touch with and contact International Private Medical Insurance Magazine (iPMIM) simply send us an email. You can write to the team on: ipmi@ipmimagazine.com and we will get back in touch right away.

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ABOUT THE iPMI PROVIDER GUIDE

Delivering pertinent company information to worldwide insurance brokers, intermediaries and agents the International Private Medical Insurance Magazine iPMI Provider Network Directory is the definitive global resource featuring international medical insurance underwriters and providers.

Identify, select and source the most appropriate insurance partners that may assist you expand your product portfolio range and coverage. Designed by iPMI providers for iPMI brokers, the directory works hand-in-hand with iPMI Magazine company micro web sites. Follow the interactive links throughout the directory for more company intelligence and content.

ALC HEALTH

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For over 10 years, ALC Health has been looking after and protecting the health of individuals, their families and international companies from across the world with a range of flexible and innovative international health insurance plans that reflect the lifestyle of today’s expatriate international traveller and global citizen.

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PROVIDERS

ANTAÉ

Antaé

Architect of international mobility solutions

International companies & organisations

NGOs

International schools

International students in Switzerland

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Antaé is a leading employee benefits specialist based in Switzerland. We specialize in advising, designing and managing corporate employee benefit programs – including medical insurance, life & disability insurance, assistance and security, pension/saving programs, kidnap & ransom. Antaé works with

first-rate partners only including Allianz Worldwide Care, Cigna, Swiss Life, Zurich International Life, Hiscox, International SOS.

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CIGNA GLOBAL

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Cigna Global specialise in providing expatriate health plans that are designed to give comprehensive overseas medical cover for people who are living and working abroad. Our core International Medical Insurance plans give you and your family cover for essential hospital stays and treatment, cancer and psychiatric care.

JOIN CIGNA GLOBAL AT THE SINGAPORE GRAND PRIX The Cigna Global Individual Private Medical Insurance Broker & Partner Conference takes place in Singapore from the 17th - 21st of September 2015. Throughout the year, we will issue invites to 15 partners who are aligned with Cigna’s customer centric vision to support expatriates through their journey.

You could be one of them.

Learn more at cignaglobal.com/brokers/singapore2015

“Cigna” and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, and not by Cigna Corporation. Such operating subsidiaries include Cigna Global Insurance Company Limited, Cigna Life Insurance Company of Europe S.A.–N.V, Cigna Europe Insurance Company S.A.-N.V. and Cigna Worldwide Life Insurance Company Limited.

International Insurance Specialists

EXPATRIATE GROUP

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International

For over a decade Expatriate Group have been underwriting, administering and providing claims services for its customers from its City of London headquarters. With a philosophy of providing comprehensive cover and 1st class service, Expatriate Group have a dedicated team of international insurance professionals looking after the whole customer journey.

Healthcare

Travel Insurance

Life Insurance

Income Protection

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At the top of every company page you will find 2 blue tabs. The 1st tab will open the company micro website on iPMIM, where you may gather more info and company news. The 2nd tab will open a simple contact form that you may complete if you wish to contact the provider.

EST: Established Date GEOGRAPHY: Market HQ: Office HQ

Every company page provides key company information including establishment date, operating geography, head quarter location and sector of business.

SECTOR: Area of Business

Phone

Email

Web Site

Postal Address

Every company page provides key company contact information including phone, email, web site address and postal address.

Both the email address and web site address are interactive links and on clicking them will either open your email program, or open their website.

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GEOBLUE

Sometimes it’s good to have a lot on your plate.

With a wide range of international health plans providing coverage for expats, travelers, students, missionaries and more; GeoBlue keeps your plate full of options.

Our network of elite physicians in over 180 countries extends an all-access pass to an exclusive level of care worldwide. And because each GeoBlue policy is U.S. licensed and offers the most complete set of benefits and services in the industry, you can feel confident that your clients expectations will be exceeded.

For more information: Visit: www.geobluetravelinsurance.com Call: 1 (855) 481-6647 or 1 (610) 254-5850 Email: sales@geo-blue.com

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Setting the industry standard, GeoBlue’s mission is to provide peace of mind to long-and short-term global travellers by offering competitive insurance protection and technology-powered assistance, including an elite community of thousands of carefully selected, contracted doctors and hospitals in almost every country in the world as well as its signature destination databases, mobile tools and concierge-level services.

©2014 GeoBlue. All Rights Reserved. GeoBlue is a trade name of Worldwide Insurance Services, LLC, an independent licensee of the Blue Cross and Blue Shield Association.

GLOBALITY HEALTH Globality Health means … … feeling at home wherever you are.

Global coverage, reliablity and service.

Seeking out new life and new civilisations. No matter how undiscovered and

Outstanding care for outstanding people. DKV Globality is the international

Globality Health is the international health insurer with a special focus on expatriates. As part of Munich

With Globality CoGenio® and Globality YouGenio® we offer international companies and their expatriate

Health, we give you the strength and security of a leading global primary insurer and reinsurer. Under ® ®

staff and individuals and their families, flexible underwriting solutions, high-level products with

the Munich Health brand, Munich Re pools its primary insurance and reinsurance operations, as well as

comprehensive outpatient, inpatient and dental cover and market leading services around the globe.

alien your new country may feel, DKV Globality provides you with outstanding healthcare wherever you go.

With Globality CoGenio and Globality YouGenio we offer internationally operating companies and their expatriate staff as well as individuals and their families flexible underwriting solutions, high-level products

related services in international healthcare business.

with comprehensive outpatient, inpatient and dental insurance cover and market leading services around the

health insurer with a special focus on expatriates. As a member of Munich Health with more than 5,000

experts at 26 locations worldwide we offer innovative healthcare solutions for clients and partners all over

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Globality Health is the international health insurer with a special focus on expatriates. Our approach is based on sound client portfolio management based on a long-term perspective, solid data and market expertise. The growing success of our individual and corporate plans clearly indicates that this approach is on track.

one of the world’s leading insurers and reinsurers.

Call our experienced consultants at +352 270 444 2201 or visit www.globality-health.com

financial stability and client proximity. Some 40 million clients in over 30 countries place their trust in

to find out more.

the services and security Munich Re provides.

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the world. As an integral part of the Munich Re Group, we give you the financial strength and security of

Munich Re as a group stands for exceptional solution-based expertise, consistent risk management, globe. Plus the advantage of covering pre-existing diseases in the insurance policy. Trust in our expertise.

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Call our consultants at +352 270 444 2201 or visit www.dkv-globality.com to find out more.

www.globality-health.com

HEALTHCARE INTERNATIONAL

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At HealthCare International, we recognise that individuals and families are becoming increasingly mobile internationally, whether because of a temporary relocation through work or a permanent lifestyle change. These expats may find that public health services in their new location are basic and limited.

The foreign health care that is available may not be of the same quality as the services they have been used to.

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The left hand page opposite every company page presents a Single Page Full Colour Advertisement for the company.

Communicate further brand values whilst expanding and protecting your position in the market.

Create and maintain mind and market share.

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INTERNATIONAL MEDICAL INSURANCE INTERNATIONAL HEALTHCARE INSURANCE INTERNATIONAL EXPATRIATE INSURANCE INTERNATIONAL TRAVEL INSURANCE

LEARN MORE ABOUT ALC. VISIT THEIR MICRO SITE ON iPMIM, CLICK HERE.

Every company page provides a corporate company bio that outlines the vision, mission and goals of the business, plus a quick overview of plans, products and service capability.

Every company page provides key information about the plans and products the company has on offer. For more detailed information visit the company micro site or contact us directly using one of the various tabs.

Every company page provides a simple and easy way to access the company micro web site.

Simply click the blue button at the bottom of each company page.

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INTEGRA GLOBAL

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We specialise in providing health plans to organisations and individuals with unique health protection needs, such as expatriates, marine professionals and specialised risks. Our speciality is the uncommon. And we like to apply our understanding and experience to such unique groups rather than trying to put a round peg in a square hole.

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WellAway specializes in health and travel insurance for expatriates including unique health programs for foreign nationals living throughout the world.

Each of our products offer an extensive set of benefits coupled with the highest standard of customer service to provide unquestionable peace-ofmind for expatriates, employers, students and global travellers.

YOUR BRAND RIGHT HERE

Your company bio and background goes here.

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MEDICAL INSURANCE 4 ALC HEALTH

EST: 2004 GEOGRAPHY: GLOBAL HQ: UK SECTOR: iPMI

+44 (0) 1903 817 970

alchealth.com

Chanctonfold Barn Horsham Road Steyning West Sussex UK. BN44 3AA

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INTERNATIONAL MEDICAL INSURANCE INTERNATIONAL HEALTHCARE INSURANCE INTERNATIONAL EXPATRIATE INSURANCE INTERNATIONAL TRAVEL INSURANCE

Made With Y By International Private Medical Insurance Magazine

For over 10 years, ALC Health has been looking after and protecting the health of individuals, their families and international companies from across the world with a range of flexible and innovative international health insurance plans that reflect the lifestyle of today’s expatriate international traveller and global citizen.

With many of our advisors having been expatriates themselves, we really do understand what it’s like to be living far away from home or in a country where healthcare treatment may not always be readily accessible.

We appreciate how important it is to have complete confidence in the medical treatment and support that you choose, should you need to call upon it in the future. We also realise that no two individuals or organisations are the same, which is why we take a more personal approach for each and every one of our clients.

LEARN MORE ABOUT ALC. VISIT THEIR MICRO SITE ON iPMIM, CLICK HERE.

PROVIDERS

sales@alchealth.com

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AntaĂŠ

Architect of international mobility solutions

International companies & organisations

NGOs

International schools

www.antae.ch

International students in Switzerland

LEARN MORE. CLICK HERE

CONTACT US. CLICK HERE

MEDICAL INSURANCE 4 ANTAÉ

EST: 2010 GEOGRAPHY: GLOBAL HQ: SWITZERLAND SECTOR: iPMI

+41 (0) 21 560 56 23

4 4 4 4

Antaé is a leading employee benefits specialist based in Switzerland.

We specialize in advising, designing and managing corporate employee benefit programs – including medical insurance, life & disability insurance, assistance and security, pension/ saving programs, kidnap & ransom.

Our expertise lies in the combination of a thorough knowledge of Swiss and international insurance benefits, consultancy know-how and caring services. Our clients include multinational companies, international IGOs, NGOs and international private schools.

antae.ch

We also distribute a specifically designed individual insurance plan to foreign students coming to Switzerland.

Voie du Chariot 3 1003 Lausanne Suisse Switzerland

Antaé works with first-rate partners only including Allianz Worldwide Care, Cigna, Swiss Life, Zurich International Life, Hiscox, International SOS.

INTERNATIONAL MEDICAL INSURANCE INTERNATIONAL HEALTHCARE INSURANCE INTERNATIONAL EXPATRIATE INSURANCE INTERNATIONAL TRAVEL INSURANCE

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LEARN MORE ABOUT ANTAÉ.

VISIT THEIR MICRO SITE ON iPMIM, CLICK HERE.

PROVIDERS

contact@antae.ch

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THERE FOR YOUR EXPATRIATE CUSTOMERS. EVEN WHILE YOU SLEEP. Be there for potential customers 24/7 with the new online AppLink quote portal from Cigna. Putting AppLink on your website lets your customers get a price and get the information they need quickly and easily. AppLink. So you can be there for your expatriate customers, all the way.

Learn more at cignaglobal.com/brokers/applink

“Cigna” and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, and not by Cigna Corporation. Such operating subsidiaries include Cigna Global Insurance Company Limited, Cigna Life Insurance Company of Europe S.A.–N.V, Cigna Europe Insurance Company S.A.-N.V. and Cigna Worldwide Life Insurance Company Limited.

LEARN MORE. CLICK HERE

CONTACT US. CLICK HERE

MEDICAL INSURANCE 4 CIGNA GLOBAL HEALTH OPTIONS

EST: 2011 GEOGRAPHY: GLOBAL HQ: SCOTLAND SECTOR: iPMI

+44 (0) 1475 788 682

cignaglobal.com/brokers

The Grosvenor Building 72 Gordon Street Glasgow G13RS Scotland

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INTERNATIONAL MEDICAL INSURANCE INTERNATIONAL HEALTHCARE INSURANCE INTERNATIONAL EXPATRIATE INSURANCE INTERNATIONAL TRAVEL INSURANCE

Made With Y By International Private Medical Insurance Magazine

Cigna Global Health Options specialise in providing expatriate health plans that are designed to give comprehensive overseas medical cover for people who are living and working abroad. Our core International Medical Insurance plans give you and your family cover for essential hospital stays and treatment, cancer and psychiatric care.

Maternity cover is also included in our Gold and Platinum plans. Our core plans can then be supplemented with a range of optional benefits which include International Outpatient, designed to cover outpatient treatment and prescriptions.

Cigna Global Health Options also offer International Medical Evacuation, International Vision & Dental and International Health & Wellbeing optional benefits that can be added to your core plan.

LEARN MORE ABOUT CIGNA. VISIT THEIR MICRO SITE ON iPMIM, CLICK HERE.

PROVIDERS

cgi.sales@cigna.com

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International Insurance Specialists

International Healthcare

Travel Insurance

Life Insurance

Income Protection

www.expatriategroup.com

LEARN MORE. CLICK HERE

CONTACT US. CLICK HERE

MEDICAL INSURANCE 4 EXPATRIATE GROUP

EST: 2002 GEOGRAPHY: GLOBAL HQ: UK SECTOR: iPMI

+44 (0) 20 3551 6634

expatriategroup.com

3rd Floor 36-38 Botolph Lane, London EC3R 8DE, UK

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INTERNATIONAL MEDICAL INSURANCE INTERNATIONAL HEALTHCARE INSURANCE INTERNATIONAL EXPATRIATE INSURANCE INTERNATIONAL TRAVEL INSURANCE

Made With Y By International Private Medical Insurance Magazine

For over a decade Expatriate Group have been underwriting, administering and providing claims services for its customers from its City of London headquarters. With a philosophy of providing comprehensive cover and 1st class service, Expatriate Group have a dedicated team of international insurance professionals looking after the whole customer journey.

Expatriate Group originally began trading in 2002 as Expatriate Healthcare, providing international healthcare insurance to expatriate living and working across the world. In 2015 Expatriate Healthcare changed its name to Expatriate Group, in acknowledgement of the increased product portfolio beyond iPMI; to include travel insurance, term life insurance and income protection insurance.

Expatriate Group look after 10,000's of customers around the world; which includes over 80 different nationalities in over 130 different countries globally.

LEARN MORE ABOUT EXPATRIATE HEALTHCARE. VISIT THEIR MICRO SITE, CLICK HERE.

PROVIDERS

info@expatriategroup.com

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Sometimes it’s good to have a lot on your plate.

With a wide range of international health plans providing coverage for expats, travelers, students, missionaries and more; GeoBlue keeps your plate full of options.

Our network of elite physicians in over 180 countries extends an all-access pass to an exclusive level of care worldwide. And because each GeoBlue policy is U.S. licensed and offers the most complete set of benefits and services in the industry, you can feel confident that your clients expectations will be exceeded.

For more information: Visit: www.geobluetravelinsurance.com Call: 1 (855) 481-6647 or 1 (610) 254-5850 Email: sales@geo-blue.com

Š2014 GeoBlue. All Rights Reserved. GeoBlue is a trade name of Worldwide Insurance Services, LLC, an independent licensee of the Blue Cross and Blue Shield Association.

LEARN MORE. CLICK HERE

CONTACT US. CLICK HERE

MEDICAL INSURANCE 4 GEOBLUE

EST: 2011 GEOGRAPHY: GLOBAL HQ: USA SECTOR: iPMI

+1 610 254 5850

geobluetravelinsurance. com

1 Radnor Corporate Center, 100 Matsonford Road, Suite 100, Radnor, PA 19087, USA

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INTERNATIONAL MEDICAL INSURANCE INTERNATIONAL HEALTHCARE INSURANCE INTERNATIONAL EXPATRIATE INSURANCE INTERNATIONAL TRAVEL INSURANCE

Made With Y By International Private Medical Insurance Magazine

GeoBlue is the trade name for the international health insurance programs of Worldwide Insurance Services, an independent licensee of the Blue Cross and Blue Shield Association.

Setting the industry standard, GeoBlue’s mission is to provide peace of mind to long-and short-term global travellers by offering competitive insurance protection and technologypowered assistance, including an elite community of thousands of carefully selected, contracted doctors and hospitals in almost every country in the world as well as its signature destination databases, mobile tools and concierge-level services.

The scope of GeoBlue’s services and technology creates a complete, reliable, convenient way to keep international travellers and expats healthy and productive.GeoBlue launched in 2011 for group products.

In 2012 GeoBlue started offering individual products.

LEARN MORE ABOUT GEOBLUE. VISIT THEIR MICRO SITE ON iPMIM, CLICK HERE.

PROVIDERS

customerservice@ geo-blue.com

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Global coverage, reliablity and service.

Seeking out new life and new civilisations. No matter how undiscovered and

Globality Health is the international health insurer with a special focus on expatriates. As part of Munich alien your new country may feel, DKV Globality provides you with outstanding healthcare wherever you go.

Health, we give you the strength and security of a leading global primary insurer and reinsurer. Under 速 速

With Globality CoGenio and Globality YouGenio we offer internationally operating companies and their

the Munich Health brand, Munich Re pools its primary insurance and reinsurance operations, as well as expatriate staff as well as individuals and their families flexible underwriting solutions, high-level products

related services in international healthcare business.

with comprehensive outpatient, inpatient and dental insurance cover and market leading services around the

Munich Re as a group stands for exceptional solution-based expertise, consistent risk management, globe. Plus the advantage of covering pre-existing diseases in the insurance policy. Trust in our expertise.

financial stability and client proximity. Some 40 million clients in over 30 countries place their trust in the services and security Munich Re provides.

www.globality-health.com

LEARN MORE. CLICK HERE

CONTACT US. CLICK HERE

MEDICAL INSURANCE 4 GLOBALITY HEALTH

EST: 2009 GEOGRAPHY: GLOBAL HQ: LUXEMBOURG SECTOR: iPMI

+352 270 444 22 11

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Globality Health is the international health insurer with a special focus on expatriates. Our approach is based on sound client portfolio management based on a long-term perspective, solid data and market expertise. The growing success of our individual and corporate plans clearly indicates that this approach is on track.

As part of Munich Health, we give you the strength and security of a leading global primary insurer and reinsurer.

globality-health.com

healthcare business. We draw on experience gained througout the world in health insurance and reinsurance over a period of more than 80 years.

13, rue Edward Steichen L-2540 Luxembourg

Over 3,000 experts at locations worldwide use this wealth of knowledge to offer our international clients innovative solutions, individual consulting and services.

Outstanding care for outstanding people. DKV Globality is the international ® ®

With Globality CoGenio and Globality YouGenio we offer international companies and their expatriate health insurer with a special focus on expatriates. As a member of Munich Health with more than 5,000

staff and individuals and their families, flexible underwriting solutions, high-level products with

experts at 26 locations worldwide we offer innovative healthcare solutions for clients and partners all over

comprehensive outpatient, inpatient and dental cover and market leading services around the globe.

the world. As an integral part of the Munich Re Group, we give you theLEARN financial strength and security of MORE ABOUT GLOBALITY one of the world’s leading insurers and reinsurers.

HEALTH. VISIT THEIR MICRO SITE ON iPMIM, CLICK HERE.

Call our experienced consultants at +352 270 444 2201 or visit www.globality-health.com to find out more.

4Call INTERNATIONAL INSURANCE our consultants MEDICAL at +352 270 444 2201 or 4visit INTERNATIONAL HEALTHCARE www.dkv-globality.com to find INSURANCE out more.

4 INTERNATIONAL EXPATRIATE INSURANCE 4 INTERNATIONAL TRAVEL INSURANCE

Made With Y By International Private Medical Insurance Magazine

PROVIDERS

Globality Health means …

Under the Munich Health brand, … feeling at home contact@globality-health.

Munich Re pools its primary insurance com and reinsurance operations, as well wherever you are. as related services in international

LEARN MORE. CLICK HERE

CONTACT US. CLICK HERE

MEDICAL INSURANCE 4 HEALTHCARE INTERNATIONAL

EST: 2004 GEOGRAPHY: GLOBAL HQ: UK SECTOR: iPMI

+44 (0) 207 590 8800

healthcareinternational. com

At HealthCare International, we recognise that individuals and families are becoming increasingly mobile internationally, whether because of a temporary relocation through work or a permanent lifestyle change.

These expats may find that public health services in their new location are basic and limited. The foreign health care that is available may not be of the same quality as the services they have been used to.

When you or your family need worldwide medical care while you are away from your home country, the last thing you want is to find that it is costly and difficult to arrange, particularly in an emergency. That’s why having the right international medical and life insurance cover in place is more important than ever.

95 Cromwell Road London SW7 4DL UK

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INTERNATIONAL MEDICAL INSURANCE INTERNATIONAL HEALTHCARE INSURANCE INTERNATIONAL EXPATRIATE INSURANCE INTERNATIONAL TRAVEL INSURANCE

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LEARN MORE ABOUT HCI. VISIT THEIR MICRO SITE ON iPMIM, CLICK HERE.

PROVIDERS

enquiries@ healthcareinternational. com

81

LEARN MORE. CLICK HERE

CONTACT US. CLICK HERE

MEDICAL INSURANCE 4 INTEGRA GLOBAL

EST: 1999 GEOGRAPHY: GLOBAL HQ: UK SECTOR: iPMI

+44 333 405 3003

4 4 4 4

IntegraGlobal is an international health plan provider since 1999.

IntegraGlobal is a U.K company that has service offices strategically placed worldwide in Europe, North America and Asia.

We specialise in providing health plans to organisations and individuals with unique health protection needs, such as expatriates, marine professionals and specialised risks. Our speciality is the uncommon. And we like to apply our understanding and experience to such unique groups rather than trying to put a round peg in a square hole.

integraglobal.com

And by doing so, we are confident of developing unique international health plans that offer you outstanding protection, excellent value and hands-on unbeatable personal service.

29/30, Fitzroy Square London UK

More and more people have discovered the unique value of an IntegraGlobal International Health Plan.

INTERNATIONAL MEDICAL INSURANCE INTERNATIONAL HEALTHCARE INSURANCE INTERNATIONAL EXPATRIATE INSURANCE INTERNATIONAL TRAVEL INSURANCE

Made With Y By International Private Medical Insurance Magazine

LEARN MORE ABOUT INTEGRA. VISIT THEIR MICRO SITE ON iPMIM, CLICK HERE.

PROVIDERS

integraglobal.com/front/ contact/email

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BROAD STATS SHOULD MEAN BROAD COVERAGE

JOIN US TO EXPAND YOUR COVERAGE TODAY

FACT

NO.

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The top three reasons for expatriate relocation are as follows: 01 Education 02 Employment 03 Relationship

Keeping You Well, While You’re Away.®

WellAway®

Keeping You Well, While You’re Away.®

 +1 441 296 0651  info@wellaway.com  www.wellaway.com

WellAway is a managing general underwriter specialized in worldwide expatriate healthcare.

WellAway is proud to underwrite the only ACA compliant expat solution offered in the international market.

LEARN MORE. CLICK HERE

CONTACT US. CLICK HERE

MEDICAL INSURANCE 4 WELLAWAY

EST: 2014 GEOGRAPHY: GLOBAL HQ: USA SECTOR: iPMI

+1 855 773 7810

wellaway.com

Canon’s Ct.22 Victoria St. PO Box HM1179 Hamilton HM EX Bermuda

4 4 4 4

INTERNATIONAL MEDICAL INSURANCE INTERNATIONAL HEALTHCARE INSURANCE INTERNATIONAL EXPATRIATE INSURANCE INTERNATIONAL TRAVEL INSURANCE

Made With Y By International Private Medical Insurance Magazine

WellAway specializes in health and travel insurance for expatriates including unique health programs for foreign nationals living throughout the world. Each of our products offer an extensive set of benefits coupled with the highest standard of customer service to provide unquestionable peace-of-mind for expatriates, employers, students and global travellers.

Each of our carefully designed Expatriate Health Programs offers comprehensive health coverage coupled with a variety of wellness and support tools to help individuals and their families start their new lives abroad.

We offer a number of targeted programs catering to different demographics and market segments.

These programs are some of the first expatriate plans to be approved as compliant under the Affordable Care Act.

LEARN MORE ABOUT WELLAWAY. VISIT THEIR MICRO SITE ON iPMIM, CLICK HERE.

PROVIDERS

brokerinfo@wellaway. com

85

of iPMIM

“THE INTERNATIONAL PRIVATE MEDICAL INSURANCE MAGAZINE HAVE GREAT MARKET KNOWLEDGE AND EXPERIENCE IN THE IPMI SECTOR AND THEY PRODUCE EXCELLENT MARKET UPDATES. WE ARE DELIGHTED TO BE ASSOCIATED WITH CHRISTOPHER KNIGHT.” CHRISTOPHER PERCIVAL BOARD DIRECTOR HEALTHCARE INTERNATIONAL

22//AUGUST//2015