Pre-assignment Health Screening – Avoiding Failed Assignments By Paul Andrews, Mercer According to Mercer’s Worldwide Survey of International Assignment Policies and Practices, between 20 and 40% of international assignments fail each year. The cost of this is estimated to be USD 2.5 million per failed assignment, a huge expense explained by the costs associated with repatriating the assignee and loss of future sales or technical support. Furthermore, there is then the need to recruit, train, and send a replacement. So why do assignments fail? Often there can be more than one reason, but those frequently cited are: Employee or family unhappy with relocation Unable to integrate into new country Professional reasons, such as role not as expected Physical or medical problems Companies take significant steps to reduce the cultural impact and provide support to their international assignees both before departure and on arrival. This support can include cultural and language training, relocation advice, and help to find housing, schools, and set up bank accounts. However, support on health-related questions remains limited and may only be via any guidance provided by an insurer where international medical cover is in place. Furthermore, according to the 2017 Benefits Survey for Internationally Mobile Employees, half of the companies responding stated they did not carry out pre-assignment medical assessments for their international assignees. Why Use Pre-assignment Health Screening? Clearly a failed assignment is one of the more serious consequences, as is a health problem of an assignee or their family. Many companies see the health of their mobile employees and family as their responsibility and that they are under a duty of care to ensure that they are not sending them into harm’s way. In addition to the financial risk of a failed assignment, other things to consider include the impact on the claims performance of a medical insurance plan for treatment that could be prevented. Finally, keeping employees healthy and happy avoids a drop in productivity, absence, and ultimately a failed assignment or underperforming assignee. Why Do So Few Companies Conduct Health Screenings? When asked, companies explain their reluctance to engage in pre-assignment health checks with the following: Unease over data protection Concern that if a proposed assignee has a medical condition that could jeopardize a relocation, how do they manage the situation A concern made even more acute if the medical condition is with a family member Overcoming These Obstacles Those companies carrying out pre-assignment checks use an independent third party and do not usually see medical information. This third party will carry out the medical examination or interview and check this against both the role requirements and the location that the employee is to then make recommendations. This eases any concerns on data protection whilst at the same time takes steps towards ensuring the health and safety of the employee and family. A medical condition identified at a check may not stop an assignment from happening and in fact can help that employee and/or family during the assignment. By working with the health insurer, for example, medication not available in the host location can be stick piled or a regime of monthly checks be implemented allowing monitoring and management. In our experience, most assignees tend to feel relieved that employers are providing help and support for the health of them and their families. Practical Considerations With such low take up, considering the strategy in place for pre-assignment can present opportunity to improve the odds of an assignment succeeding. Even where checks are been carried out, there may be a gap between these and the support from the health insurance provider, although some insurers do offer this as part of their propositions to larger clients. An international benefits consultant can advise on policy development and implementation. Contact the author, Paul Andrews, on LinkedIn.