Case Study: How One World Cover Helped an American International School in the Middle East Save 30%+ on Health Insurance in One Year – Without Compromising Care
A well-known American international school in the Middle East this year faced a challenge familiar to many American-style international schools in Asia: rapidly rising health insurance costs and a growing sense that their current plan design was unsustainable. With an annual premium exceeding close to US$900,000 and a target to reduce that to US$650,000 in just renewal cycle, the school turned to One World Cover for help with their goal of hitting their strict budget target without undermining the quality of coverage provided to faculty and staff.
By working collaboratively with school leadership, faculty representatives, and the insurer, One World Cover delivered a comprehensive plan redesign that not only achieved the savings target but retained the school’s globally competitive benefits.
Background: A School That Cares Deeply About Its Faculty
When the school first appointed One World Cover as their health insurance broker and consulting partner, the brief was clear: cost containment was critical, but not at the expense of staff well-being. This was a school with a deeply rooted culture of faculty support/wellbeing and a commitment to providing a best-in-class health insurance program.
At the same time, the school’s finance team was under pressure. Premiums had increased significantly over recent years. The existing insurer was proposing yet another double-digit increase, pushing total projected premiums close to US$1M.
Step 1: Understanding Constraints and Culture
Before making any recommendations, One World Cover spent time listening.
We worked closely with the CFO to understand the school’s internal structures and constraints – including how plan design changes needed to be managed collaboratively with faculty and what types of benefits were viewed as essential versus optional. We also took time to understand cultural and geographic realities that would affect care-seeking behavior among expat staff.
In this case, the school had been encouraging staff to use a local, cost-effective public health network. However, faculty had struggled to navigate it, citing language barriers, lack of support, and an unclear pathway to access care. This feedback would ultimately become a key focus of the redesign process.
Step Two: Engaging the Insurer to Explore Levers for Change
Next, we opened discussions with the insurer to understand what plan design levers were available within their internal structure and systems – and which changes could be priced meaningfully to bring down the renewal premium. This required not just knowledge of regional regulations, but also experience with the insurer’s pricing logic.
We zeroed in on three key areas of high-cost utilization:
- Private outpatient care in the host country
- Medical claims incurred in the United States
- Mental health claims with provider fees significantly above market norms
These were areas where we believed benefit structure changes could support responsible utilization – without denying access or reducing value.
Step Three: Exploring Every Option – and Getting Faculty Input
We worked closely with the insurer to explore nearly 20 possible plan design changes. These covered everything from co-pay structures in different countries to benefit caps and exclusions – including even the potential removal of elective treatment in the United States.
Each change was priced individually by the insurer so the school could understand the potential financial impact.
Of course, in any international school, getting faculty buy-in is essential. We therefore worked with the school to:
- Form a faculty benefits committee
- Present the plan changes using a ‘Traffic Light Worksheet’, which grouped changes into:
- Green: no major concerns
- Yellow: some concern but manageable
- Red: major concern or deal-breakers
This visual approach helped faculty quickly understand the changes and provide feedback in an informed way.
After the meeting, we followed up with a faculty survey to capture feedback from attendees and non-attendees alike. That step was critical — not only to surface further concerns or suggestions, but to demonstrate that staff input was being taken seriously.
Following the session, we distributed a faculty survey to gather structured feedback. The results confirmed that while some changes would require adjustment, staff felt heard, respected, and supported through the process.
The result? A data-driven, consultative process that culminated in agreement around five high-impact plan design changes.
Step Four: Designing a Sustainable Yet Generous Plan
Of the nearly 20 changes priced by the insurer, five were ultimately adopted. The changes included:
- Introduction of a co-pay on out-patient care at private medical facilities in the host country
- Introduction of a co-pay in the USA
- Lowered dental limit
- Removed maternity cover at private hospitals
- Capped mental health benefits
Importantly, none of these changes prevent access to essential care. The school continues to offer a globally competitive insurance plan with generous in-patient cover, out-patient flexibility, and support for chronic and complex medical needs.
It’s important to note that removing USA coverage entirely was on the table – and may still be in future years – the increased USA co-pay is a transitional measure to reduce elective overseas treatment without eliminating it overnight.
Step Five: Securing Final Pricing and Making It Happen
With faculty aligned and the school ready to move forward, we returned to the insurer with a clear message: The school has demonstrated extraordinary commitment and is serious about shifting (and improving) claims utilization patterns.
Now it was time for the insurer to meet the school halfway.
We framed the revised plan design not as a cost-cutting exercise, but as a strategic, long-term play to reduce the loss ratio – which benefits everyone, including the insurer. We were quickly able to secure the revised premium of US$650,000, bringing the total reduction to over 30% in a single year.
The Final Outcome
- Total Premium Before: US$880,000
- Target Proposed Renewal Premium: US$970,000
- Actual Renewal Premium Secured: US$650,000
- Savings Achieved: 33%
- Faculty Coverage: Still generous, globally competitive, and tailored to staff needs
For the school, this wasn’t just a renewal – it was a reset. A rebalanced health insurance program that reflects how people actually access care, in a way that supports both well-being and financial sustainability.
Why This Matters
In an environment marked by tighter school budgets and global medical inflation, this case shows what’s possible when everyone works together – leadership, faculty, insurer, and broker – to find practical, evidence-based solutions.
Even after the plan design changes, the school continues to offer one of the most generous packages in the region. But now, there’s a structure in place to support long-term sustainability and responsible utilization.
What’s Next
For One World Cover, this experience has reinforced our belief that true value comes not just from broking insurance policies, but from helping schools build smart, long-term benefit strategies. We look forward to continuing to support this school – and others – in managing costs while keeping faculty wellbeing front and center.
