From Annual Renewal to Long-Term Strategy: Rethinking International School Health Insurance
In a recent article published by Sage Consultancy – The New Reality for International Schools – Mohammad Kazerouni offers a timely and thoughtful perspective on how the operating environment for international schools has fundamentally changed.
Mohammad is the former CFO of Shanghai American School and a long-time friend of One World Cover. His insights are grounded in lived experience at the sharp end of school finance.
While his article is not specifically about health insurance, many of the themes he raises are directly relevant to how schools should now be thinking about one of their largest and fastest-growing cost lines.
A More Volatile Operating Environment Changes Everything
Mohammad’s central argument is that international schools are no longer operating in a stable, predictable environment. Cost volatility, demographic shifts, geopolitical risk, and rising expectations from staff and parents have become structural, not temporary.
Health insurance sits squarely within this reality.
For many schools, faculty health insurance is one of the top operating expenses, and one of the least predictable. Two consecutive years of double-digit premium increases are no longer unusual. Yet too often, insurance is still treated as an annual administrative exercise rather than a strategic risk.
Short-Term Fixes No Longer Work
Mohammad highlights the danger of relying on short-term fixes in a structurally changed environment. This applies directly to health insurance.
- “Hoping for a better renewal”
- “Flipping insurers”
- “Waiting to see what the insurer comes back with”
These approaches may have worked a decade ago. In 2026, they rarely do.
Medical trend in 2026 remains structurally high (download our report below). Utilization patterns have shifted. Without visibility into what is actually driving claims, schools are left reacting rather than managing.
READ MORE >> Download One World Cover’s 2026 Medical Trend Report
Long-Term Planning Requires Better Data
A key theme in Mohammad’s article is the need for multi-year planning and scenario thinking. Health insurance is no exception.
Schools that achieve sustainable outcomes are not those that “win” a single renewal. They are the ones that:
- Understand their claims data in detail
- Identify real cost drivers (not assumptions)
- Make targeted, data-driven plan design changes
- Communicate those changes credibly to faculty
- Build a multi-year strategy rather than chasing a one-year result
This is not possible without meaningful data transparency.
READ MORE >> The Power of Data Transparency in Health Insurance Renewals
Health Insurance Is a Strategic Risk, Not a Procurement Exercise
Mohammad argues that risks need to be explicitly named and managed. Health insurance should be treated no differently from enrollment risk, staffing risk, or currency exposure.
When premiums increase by 15-20% in consecutive years, that is not a “bad renewal.” It is a strategic issue that requires leadership attention, and expert support.
At One World Cover, we see this repeatedly: once schools gain clarity on their data, the conversation changes. The renewal process stops being something that happens to them and becomes something they can actively manage.
READ MORE >> Why Health Insurance Renewals Feel Unfair (And What Changes When the Data Is Clear)
A Shared Perspective
We strongly agree with Mohammad’s broader message: the environment has changed, and schools must adapt how they plan, analyze risk, and make decisions.
Health insurance is not immune to this new reality. In many ways, it is one of the clearest examples of why deeper insight, better data, and long-term thinking are no longer optional.
If your school is facing rising health insurance costs and limited visibility into what is driving them, this is not a failure of effort – it is a failure of process. With the right data, the right partner, and the right strategy, it can be fixed.
FURTHER READING >> Sage Consultancy: The New Reality for International Schools
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