Our Insurance Carriers | Expat Solutions International

Most employers don't shop international insurance carriers the way they shop domestic coverage. The global market is smaller, the plan structures are more complex, and the differences between carriers — networks, billing methods, evacuation benefits, claims handling — are significant enough to affect your employees' experience on the ground.

As an independent broker, we place coverage across multiple A-rated global insurers. We analyze each carrier's fit for your group's size, geography, and plan structure before we make a recommendation. The right carrier for a 12-person missionary team is rarely the right carrier for a 200-person corporate expatriate program — and we've placed both.

Carrier selection isn't a preference — it's an analysis. We look at your group's size, the countries where your employees live and work, your preferred plan structure (fully insured, partially self-funded, or fully self-funded), and your budget before we bring a carrier recommendation to the table.

That process is what our in-house Risk Analyst supports for every group we work with. It's also why clients who come to us after working with a single-carrier agent often find options they didn't know existed.

Which carriers offer international group health insurance for US employers?
The primary carriers serving US employer groups with overseas employees are Aetna International, Cigna Global, UnitedHealthcare Global, and International Medical Group (IMG). Each operates differently in terms of network structure, plan design, and geographic strengths. The best carrier for your group depends on where your employees are located, how many people you're covering, and what plan structure fits your organization.
Is IMG a good option for expat groups?
IMG is a well-established, A-rated carrier with a strong track record in the international and expatriate market. They are particularly well-suited for smaller groups, nonprofit organizations, and mission-sending agencies because of their plan flexibility and competitive cost structure. For larger corporate expatriate programs, one of the major US-based global carriers may be a better fit — which is exactly the kind of comparison we work through with every prospective client.
What does it mean that ESI is an independent broker?
It means we're not contracted to a single carrier and don't have a financial incentive to steer you toward one name over another. We hold relationships with multiple A-rated international carriers and recommend based on what fits your group — not what's easiest for us to place.
Do these carriers offer direct billing outside the US?
Yes. Aetna International, Cigna Global, and UnitedHealthcare Global all maintain direct-billing networks with hospitals and providers in many countries, which means your employees can often receive care without paying out of pocket and waiting for reimbursement. Network strength varies by region, and we factor that into carrier recommendations for groups with employees in specific geographies.
Which carrier is best for missionaries and nonprofit workers overseas?
IMG is a frequent fit for faith-based and nonprofit organizations because of their experience in this segment and their plan flexibility for smaller groups. That said, carrier selection depends on the specifics of your group. We've placed missionary and nonprofit groups with multiple carriers over more than two decades — and the right answer isn't always the same one.