MSH NOW! What s new this quarter?

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1 What s new this quarter? Global Network - new partners in Canada! MSH INTERNATIONAL s global network of healthcare providers is growing this quarter with two new partners. Learn more on page 1! Meet our Employees Introducing Paul Clitherow, our new Manager of Sales and Marketing, based in our office in Toronto. Regional Focus - Brazil With its resource-rich economy and booming mining, agricultural and manufacturing sectors, Brazil is home to an ever-expanding expat population. Learn more about its local Healthcare system and our Preferred Provider Organisation Network in this country. Legal news - IRS Information Reporting Requirements Update The Internal Revenue Service has extended the due dates for 2015 Information Reporting requirements for Group Health Plans for the 2015 tax year. Expat Health - Depression in the Expat population Around the world, depression is one of the first causes of disability. It is more common than we often think, especially among the expat population. Learn more before you go! About MSH INTERNATIONAL From President and CEO Philippe de Dreuzy p.8

2 PARTNERSHIPS Global network grows with Medisys and Centric Health MSH INTERNATIONAL s global network of healthcare providers is growing this quarter with two new partners: Medisys Corporate Health, Canada s leader in preventive healthcare, and Centric Health, Canada s number one independent healthcare services provider. Medisys comprehensive medical and pre-expatriation exams are everything expatriate employees need for their preventive health. With over 26 years of experience, Medisys is the only national provider with clinics across Canada, including Vancouver, Calgary, Toronto, Ottawa, Montreal and Quebec City. What is more, we can offer direct billing services for all preventive checkups before the expatriation date, so our members do not need to pay up-front. The Medisys approach is to plan, educate and protect. Travel health experts will gather details on travel and their current health status. All vaccinations are provided on-site, including routine and travel-related vaccines. Insured members will also receive medical guidance specific to their travel plans and tips on staying healthy while travelling abroad. Centric Health is Canada s largest and most comprehensive independent provider of healthcare services focused on producing leading patient outcomes and delivering high quality care. Centric Health offers the largest network of private surgical and diagnostic centers in state-of-the-art facilities all across Canada. Expedited access to surgical and diagnostic services could shorten disability durations which may lead to meaningful quality of life implications for Canadians and expats working in Canada. In Canada the average wait time between general practitioner s referral and most specialists treatments is 18.2 weeks. At Centric Health surgical facilities wait times for specialists are usually just 1-4 weeks! > LEARN MORE! Find Medisys and Centric Health facilities online through our members area, under the Find a Facility tool. For more information, contact our Customer Service Center: or adminamerica@msh-intl.com. 1

3 MEET OUR EMPLOYEES We are pleased to welcome Paul Clitherow as our new Manager of Sales and Marketing. Paul brings over 18 years of expertise in the international and expatriate benefits market as well as individual and group insurance. Based in Toronto, Paul will also be focused on strengthening our brand and developing our activity in Eastern Canada. Welcome on board! Paul Clitherow Manager, Sales & Marketing I am delighted to join the team at MSH and I am very excited about the future opportunities that exist for the company. 2

4 REGIONAL FOCUS - BRAZIL The Brazilian Healthcare Insurance System The Brazilian healthcare system known as Sistema Único de Saúde (SUS) is a public health system which provides free and universal access to healthcare. Although, around 25% of the citizens have private medical insurance as a consequence of the public system s shortcomings (medical staff and equipment, etc.). It is indeed highly recommended to take out complementary healthcare insurance for your medical care in the private sector as you will be provided with a much better quality of service. Capital Population Currency (Jan. 2016) Main cities KEY INFO Brasilia 202 millions Real (BRL) 1GBP = 0.35CAD = 0.27USD São Paulo, Rio de Janeiro, Porto Alegre, Fortaleza... Doctors visits in Brazil Doctors in large cities such as São Paulo or Rio de Janeiro usually speak several languages other than portuguese (English, French and/or Spanish). The private sector is strongly developing and services are of very high quality, but also very expensive. To our individual insured members, we recommand a FIRST EXPAT+ Diamond plan, which is our highest level of coverage. Specialist doctors It is not necessary to see the General Practitioner in order to get an appointment with a specialist. Please note that waiting times for both GPs and specialists can be long due to the lack of healthcare professionals in general. Hospital care Medical care is provided free of charge in public hospitals. However, Brazilian public hospitals are overcrowded and waiting rooms are full of patients. Some of the Brazilian hospitals have their own ambulance service. Once again, we recommend that you use private facilities, which use advanced technology and provide high-quality medical equipment. Medical tourism is famous in Brazil for the quality of its surgeons and high-end medical equipment. Medicines Drugs listed in the national list of essential medicines are covered by the SUS. As for drugs which are not covered by the national health system, pharmacies (farmacias populares) offer affordable prices. General emergency number: 192 > more info about healthcare in Brazil LEARN MORE! 3

5 REGIONAL FOCUS - BRAZIL Our Medical Network in Brazil In partnership with World Assist our medical network in Brazil gives our insured members access to quality healthcare facilities, with 10% to 25% discounts on medical claims for contracted providers. World Assist advantages > Direct payment available with network providers via Letter of Guarantee > Preferred rates with World Assist contracted providers > Over 180 preferred providers in Brazil including 50 top-tier hospitals > Over 1,000 registered pharmacies > Imaging centers, labs, checkup facilities, home health & centers of excellence Focus on: Clinica São Vicente Location - Rio de Janeiro +(55-21) Specialties and Treatments > All types of surgeries > Hemodynamic, electrophysiology, angiology, cardiology, internal medecine, neurosurgery, oncology, orthopedic, urology... Assistance and Support Units Quality Control > WHO guidelines > Hospital Infection Control Committee (CCIH) > Investments in training and technology > ONA II Certification Complementary Services Hotel facilities and Transportation services > Intensive Care > Day hospital > Emergency section > Intensive cardiology > Nursing > Nutrition and Dietary Sevice > Physiotherapy > Hospital psychology 4

6 LEGAL NEWS IRS Information Reporting Requirements Update The Internal Revenue Service has extended the due dates for 2015 Information Reporting requirements for Group Health Plans for the 2015 tax year. The update Under the Affordable Care Act (ACA), Group Health Plans that meet the minimum essential coverage requirements must comply with the Information Reporting requirements. Following consultations with stakeholders, the Department of the Treasury and the Internal Revenue Service have determined that some employers, insurers, and other providers of minimum essential coverage need additional time to implement systems and procedures to gather, analyze, and report the information. Therefore, on December 28, 2015, the IRS issued Notice , which extends the due dates for the 2015 Information Reporting requirements, both furnishing to individuals and filing with the Internal Revenue Service, for insurers, self-insuring employers, and certain other providers of minimum essential coverage, and the information reporting requirements for applicable large employers. Transition Relief Specifically, this Notice extends the due dates as follows: extends the due date for furnishing the 2015 Information Returns to the individual taxpayer from February 1, 2016, to March 31, 2016; extends the due date for filing with the Service from February 29, 2016, to May 31, 2016, if not filing electronically, and from March 31, 2016, to June 30, 2016, if filing electronically. Notwithstanding the extensions provided in the Notice, employers and other coverage providers are encouraged to furnish statements and file information returns as soon as they are ready. 5

7 LEGAL NEWS IRS Information Reporting Requirements Update (cont d) How does this impact individual taxpayers Individual taxpayers may be affected by the extension of the due date, because, as a result of the extension, individuals may not receive the information return before they file their income tax returns. The due date to file U.S. tax return is April 18, 2016 instead of April 15, because of the Emancipation Day holiday in the District of Columbia, even if you do not live in the District of Columbia. If you live in Maine or Massachusetts, you have until April 19, That is because of the Patriots Day holiday in those states. The Notice makes it clear that individuals do not need to include the information return (form 1095) with their individual tax returns. The Notice also provides that for the 2015 tax year only, individuals may rely upon other information received from their coverage providers to confirm that they have minimum essential coverage for Disclaimer: The information provided is for informational purposes only and is not intended to be legal or tax advice. The reader should consult with a tax attorney or other tax professional before relying on any such information. As is our practice generally, we seek to provide accurate and timely information. We have endeavored to comply with all applicable legal and ethical requirements in compiling this information. 6

8 EXPAT HEALTH Depression in the Expat population Around the world, depression is one of the first causes of disability. It is more common than we often think, especially among the expat population. Why? Because expats can experience high levels of stress, isolation, and all sorts of challenges that come with such a big life change as moving abroad. Depression is deeper and more complex than culture shock or homesickness, and it s something that expats should prepare for. The challenge of being an Expat Expatriate employees often go abroad on their own, and relationships - or lack of relationship - is often a big challenge. Expats are likely to feel isolated and, without direct family support, this is one factor that could lead to depression. Work conditions can also be a factor if the employee experiences a lack of recognition, job fulfilment, or a poor integration in the team, work overload, etc. Typically, the first signs of depression could appear during a desillusion/ frustration phase, but it can also happen after several months, or years, even though the expat feels integrated in his/her new country. Honeymoon Excitement of a fresh start Desillusion Culture shock Frustration Deeper cultural issues and/or personal problems 1st adjustment phase Adaptation to the foreign culture Integration Settlement of the professional and personal life 2nd adjustment phase Acceptance of the foreign culture The Symtoms? > Loss of interest in all kinds of relationships and activities > Loss of energy, lack of motivation > Sleeping issues, appetite issues > Headaches and pains > Negative feelings and thoughts > Unhealthy behavior (alcohol abuse, junk food, lack of physical activities...) To avoid depression 1/ Prepare your expatriation to avoid cultural shock: read about the country s history, economy, food, healthcare system... 2/ Develop healthy habits: exercise, avoid alcohol, and try relaxation activities like yoga or meditation if you feel under stress or pressure. 3/ Take some time to think about your personal needs for your wellbeing: physical, emotional, recreational, relational, financial, spiritual, etc. 4/ Joining social clubs and expat groups will help you develop your social network outside of work. 7

9 EXPAT HEALTH Depression in the Expat population (cont d) MSH Expatriate Employee Assistance Program (EEAP) Professional Counseling Support and Consultation In partnership with Shepell Your Expatriate Employee Assistance Program is a voluntary and confidential professional consultation and information service that has been made available to support you while you are on international assignment. You and your immediate family members can receive support over the telephone, in person and online. You can also take advantage of online resources to help manage your work-life and personal wellbeing. The EEAP can help you: Cope with isolation and loneliness Adapt across cultures Identify and cope with culture shock Address the personal impact of the relocation Strengthen relationships Improve communication Work towards life goals Deal with stress, anxiety and depression Address alcohol and drug misuse Resolve marital and relationship difficulties Find solutions for work-related issues Access crisis and trauma support while on assignment Discover ways to improve your nutrition in your new environment Focus on your health with natural healing strategies Worldwide Access Phone numbers Visit Shepell online at workhealthlife.com for online support or to book an appointment.

10 FROM OUR PRESIDENT With the coming of the New Year means New Years resolutions. I see the beginning of 2016 as a perfect opportunity for MSH Canada to consolidate and improve upon the positive initiatives that we have recently launched. Despite a less than perfect 2015 for Canada and the worldwide commodity market, we persisted and were still able to establish a strong foundation for the upcoming years. In just 12 months, we have completely revamped our product offering. Insurance group programs for up to 50 employees worldwide can now use our versatile insurance solution system called MSH Expaguard. Combined with Aviator, our online dashboard providing detailed information on claims and premiums, we now complement our offering by providing up-todate information alongside predictive analysis. The end of 2015 also signaled the launch of our new individual product First Expat+ available worldwide including the United States. The substantial amount of positive feedback received from brokers shows that we are on the right track for a very successful year, and we will continue fostering trust and reciprocity to the North American brokerage community. Philippe de Dreuzy President and CEO 2016 must also mark our thorough implementation of the best practices within our organization. We must humbly learn from our past mistakes by more closely listening to our client base as well as being more in tune with new trends in the international benefits arena. And so as we turn the page to 2016, we will continue to improve on the positive changes of My best wishes to all for 2016! 9