How a small firm set up group medical coverage for business travel

Teresa Alvarado owns a landscape architecture firm in Tucson, Arizona, with 14 employees. Most of the work is in the Southwest, but a few times a year someone flies abroad: site visits for a resort client in Hermosillo, Mexico, a design conference in Lisbon, a project review in Costa Rica. The trips run from three days to two weeks.

For years nobody thought much about health coverage on those trips. Then one of her designers came back from a conference with a story about a colleague from another firm who had spent a night in a foreign emergency room and paid the whole bill on a credit card. Teresa started asking questions.

This story follows her firm through its first year with Group Medical Coverage for Business Travel from BlueCross BlueShield Global Solutions (formerly GeoBlue). It shows why she set it up, how one employee used it and what she still had to check.

Why the firm’s health plan wasn’t the whole answer

The firm has a group health plan in the U.S. Teresa didn’t want to guess what it would do in Hermosillo or Lisbon, and the carrier’s own point is the one she kept coming back to: local health care isn’t always accessible or covered by your plan back home.

She had also seen business travel accident insurance. The carrier says its business travel plans go beyond that and offer more complete health coverage. That mattered to her. She worried as much about someone getting sick on a trip as about someone getting hurt, and an accident-only plan wouldn’t help with an illness.

Why this plan

The carrier describes Group Medical Coverage for Business Travel as health care for short trips abroad. A few things made it a fit for a small firm:

• One policy. One policy covers the whole team. Teresa didn’t have to buy a separate plan before every trip.
• Short trips. It covers trips abroad of up to 180 days. Her trips were all well under that.
• More than accidents. Coverage includes medical evacuation, hospital stays and sick visits, with options for family too.
• Support before the trip. The plan includes a pre-departure and care continuity program, telemedicine, evacuation services, global safety alerts, a member portal and a mobile app.

The carrier also offers custom plan options. Teresa requested information from its group sales team and worked through the choices. The deductible, the coinsurance and the benefit limits are set in the policy her firm chose; the carrier’s website doesn’t list them for its group plans. She kept the policy documents in the same folder as the firm’s other insurance.

To manage the plan, she uses the carrier’s group administrator portal. That’s where she manages the firm’s enrollment and finds the group’s benefit information.

She told every traveling employee to register on the Member Portal and download the app before their first trip. The app has a provider finder, medical translations, a medicine equivalents tool, Direct Pay requests, a digital ID card and news and safety alerts.

Before a trip: planning around a condition

Priya Shah, a senior associate, has type 1 diabetes. She was going to the conference in Lisbon for six days.

She used the pre-departure and care continuity program. The carrier asks you to complete a questionnaire about your current health, then you speak with one of its clinicians, who helps you build a health plan before you go. Priya talked through carrying insulin, what to do if her supplies were lost and how to find a pharmacy in Lisbon. She used the medicine equivalents tool to look up how her insulin is sold in Portugal.

One detail mattered to her as an employee. The carrier says only its clinical team sees the questionnaire, and it isn’t shared with your organization unless you say it can be. Teresa never saw Priya’s answers, and didn’t need to.

Priya’s trip went smoothly. She didn’t need care, but she said knowing the plan was in place made the trip easier.

The 2 a.m. emergency in Hermosillo

Marcus Webb, 29, is a project designer. In the spring he spent ten days in Hermosillo for site work on the resort project.

On the fourth night he woke at 2 a.m. with sharp, cramping pain in his right side and back. It came in waves and kept getting worse. He had never felt anything like it.

He opened the app and used the provider finder to find a hospital near his hotel, then took a taxi there. On the way he called the carrier’s service center, which the carrier says has multilingual staff available around the clock, to say where he was going. Behind that line is the carrier’s medical assistance team, which it says includes board-certified medical directors and licensed nurses across the U.S., Mexico and Asia, and offers clinical support for routine to critical care.

A CT scan showed a kidney stone. The hospital treated his pain with an IV and medication and kept him until morning, when the pain had eased. The doctors expected the stone to pass on its own.

Paying for it. The carrier offers Direct Pay, where the provider bills the plan for everything except your copay or deductible. You request it through the Member Portal or app at least 48 hours before an appointment. There’s no way to give 48 hours’ notice at 2 a.m., so Marcus paid the hospital with his own card and kept the itemized bill.

The bill, converted to dollars:

• Emergency room care: $1,150
• CT scan: $780
• IV fluids and medication: $410

Step 1. $1,150 plus $780 is $1,930.

Step 2. $1,930 plus $410 is $2,340.

Total: $2,340.

Back at his hotel, Marcus submitted an eClaim through the app with the itemized bill. He could track it there. How much the plan paid back depended on the deductible and coinsurance in the firm’s policy, so Teresa looked them up in the policy documents when he asked.

The next day. Marcus had questions about what to expect while the stone passed. He booked a telemedicine visit. The carrier says telemedicine is available through the app for non-emergency care at no extra cost, with multilingual doctors and same-day appointments around the clock. The doctor explained the warning signs that would mean going back to the hospital. Marcus felt well enough to finish the site work and flew home on his scheduled flight.

What an evacuation would have looked like

Marcus didn’t need one, but Teresa wanted to understand it.

The carrier says that if a doctor says you need to be moved to get medical care, it covers the cost of moving you to the nearest hospital that can treat you, or back to your country of residence, by the fastest and best way to get you there. It says it takes members to the nearest center of medical excellence, monitors them until they are released and will transport a member home if that’s right for their situation.

It also says that if a member is in the hospital for more than 7 days, it will help arrange flights and a place to stay for a family member to be with them.

Marcus’s stone could be treated well in Hermosillo, so none of that applied.

The add-on Teresa thought about

The carrier offers political and natural disaster evacuation as coverage that can be added to any of its group medical plans. The carrier describes it as support for getting to safety if the local area becomes unsafe, after an earthquake, terrorism or civil unrest, working with a global security firm, Crisis24.

It isn’t included automatically. Teresa looked at where her people travel and decided not to add it for now. She noted it as something to revisit if a project ever sent someone somewhere less stable.

What the plan did not do

It doesn’t replace the firm’s health plan. It is for trips abroad of up to 180 days. Teresa kept the firm’s U.S. group health plan in place for everyone. For someone on a long assignment overseas, the carrier offers separate group plans for expatriates.

The numbers are in the policy, not on the website. The carrier’s website doesn’t list the deductible, coinsurance, limits or exclusions for its group business travel plans. Marcus’s reimbursement depended on the policy his employer chose, so read it before someone needs it.

Telemedicine isn’t for emergencies. It’s for non-emergency care. Marcus’s pain at 2 a.m. was an emergency room visit, and he went to one.

Direct Pay takes notice. It’s requested at least 48 hours ahead, so an unplanned emergency visit can mean paying up front and filing a claim.

Some services the carrier advertises belong to other plans. The carrier describes an employee assistance program for mental health and wellness, but lists it for its expatriate, Globaline and academic travel plans, not for business travel.

Home country matters. The plan covers U.S. and non-U.S. citizens traveling outside their home country. Before sending an employee whose home country is the destination, ask how the policy treats that trip.

Security evacuation is extra. Political and natural disaster evacuation is an add-on, not part of the plan by default.

The short version

Teresa set up one policy that covers her employees on short trips abroad, with support before the trip, telemedicine, help finding care and medical evacuation when a doctor says it’s needed. It helped Priya plan around her diabetes privately and helped Marcus get through a kidney stone in Hermosillo, though he paid the $2,340 bill up front and claimed it back under the firm’s policy terms. The deductibles and limits, and whether to add security evacuation, were hers to look up and decide.

This is an outline of how the plan can work. The policy documents set the full terms, including the deductible, the limits and the exclusions.