No Surprises Act

October 8th, 2021 by Ross Mason

On December 27, 2020 the No Surprises Act was signed into law with the main goal of addressing the issue of surprise medical bills under health insurance plans when treatment is sought out-of-network. The majority of the legislation goes into effect on January 1st 2022, and with that date rapidly coming up we wanted to outline what this legislation means for international students and how it will impact them. There are many parts of this bill, but here is a brief summary of a few of the key items that could affect international students. 

Out of Network Billing

The main crux of the act is revolving around the balance billing of patients when medical treatment is sought out-of-network. Nearly all insurance plans for international students include a provider network (also known as a PPO Network) where students can seek medical care without the need to pay upfront. In cases like these, the insurer encourages you to seek medical treatment within this network as the insurance company has pre-negotiated, fixed rates ahead of time. It is a way for insurers to control costs in the US medical system. 

While students may have the option to go in-network, some students still may not. Most of these cases occur at the emergency room where the student needs immediate medical care and is not in a position to choose a hospital that is part of their network. Still others may choose an out-of-network provider based on convenience, recommendation, or availability.

When treatment is sought out-of-network, the provider can bill a much larger sum than if a patient were to seek medical treatment at an in-network provider. In other cases, students who choose to go out of network may also be responsible for additional costs such as if the plan only pays reasonable and customary expenses (leaving the insured to pay the rest) or if the plan only pays the equivalent in-network fees (again, leaving the insured to pay the remaining amount). This act of balance billing by the provider will be illegal starting on January 1st 2022. 

Provider Networks

As part of the act, PPO Networks will also be in the spotlight for attention as they will be required by law to adhere to a few key guidelines:

  • Update and verify their directories every 90 days
  • Have an established procedure to remove providers who they cannot verify
  • Update information from providers within 2 days of receiving it
  • Respond to provider status within their network within 1 business day
  • Maintain a website directory with contracted providers full details

Obviously, most PPO Networks already have a website directory and procedures to keep it updated, but this law will now make it compulsory and should see smaller PPO Networks need to step up their game to keep their networks fresh and updated. 

Advanced Explanation of Benefits

Insurance plans will now need to provide an advanced explanation of benefits when requested. This advanced explanation of benefits can be requested by the insured prior to any medical treatment and will show them the contracted rate for that procedure, if the provider is part of the network. When the provider is not part of the network, the advanced explanation of benefits will need to show them information on where they can find in-network providers, along with a good faith estimate from the provider and a good faith estimate of what the insurance plan will pay.

Insurance ID Cards

ID cards will now need to show:

  • Any deductibles
  • Out-of-pocket maximums
  • Assistance phone number
  • Website for assistance

Nearly all insurance ID cards already include this information already, so there will probably not be much to change here, but this law is making these items a requirement. 

International Plans Exempt?

The Act applies to “health insurance plans” and it should be noted that this really means domestic insurance plans that insure US citizens and residents, for example a health insurance plan provided by an employer or individual plans offered on the exchange (healthcare.gov). Most international student plans are written on an international basis (surplus lines), and many will not consider themselves “health insurance plans” and thus there could be pieces of this bill that will not apply to them. However, that is not to say that international students will not benefit from this act – because they will. Most international plans utilize nationally recognized PPO Networks who will be complying with the act, and most providers will now make it standard practice that balance billing is not allowed and thus we will most likely see this practice stop when it comes into effect. 

If you would like to dive into this in more depth, the American Medical Association has an excellent resource that goes into the finer details of the policy and please also reach out to your insurance company as they will also be able to let you know the changes they see happening from the Act. 

The Importance of Sleep – Practicing Self Care

August 20th, 2021 by Sally McLeod

As we strive to maintain our emotional wellness throughout the pandemic, it’s important to look at various ways we can improve our wellbeing. One notable component to focus on is getting a good night’s rest. Lack of sleep can lead to several issues and impact both our mental and physical health. Without adequate sleep, we may experience symptoms such as increased anxiety, depression, irritability, issues with memory retention, and increased fatigue. We also see physical impacts such as a weakened immune system, weight gain, and other medical conditions such as heart disease, high blood pressure, and diabetes. 

While it’s been noted that more than 70% of college-age students suffer from a lack of sleep, evidence suggests that poorer sleep quality is more present now than before the pandemic. Causes of poorer sleep quality can be attributed to less of a distinction in routine and increased anxiety. Multiple studies suggest that as students were isolated, many of the day-to-day tasks such as school, work, exercise, eating, and sleeping were taking place in the same space and dissolved a sense of routine. 

The issues that college students are facing throughout the pandemic, such as an adjustment to online learning, have been challenging for all but taken an even greater toll on international students. International students that returned to their home countries faced the increased challenge of attending classes in different time zones. Given that 60% of the international student population in the United States comes from China, India, and South Korea, those that returned home are taking classes in the middle of the night, leading to the inevitable lack of focus and concentration and overall poorer academic performance. 

The altered class schedule affecting sleep patterns in many international students can be seen as an additional factor in contributing to poorer mental health compared to that of domestic students. International students have also faced additional anxiety-inducing situations this past year. Unfortunately, poorer sleep quality only exacerbates these additional stressors. So, the question is, what can be done to help? 

Provide students with asynchronous learning activities

Having live classes that meet at specific times undoubtedly makes it challenging for international students in different time zones to stay engaged and attend. Adapting to an asynchronous style of teaching will help alleviate stress in many ways. This will allow students to stick to a more normalized sleep schedule. Students also can learn at their own pace, such as rewatching material by making recorded lectures available. Additionally, many virtual platforms such as zoom, also have automated captioning available making it even more beneficial for students where English is their second or even third language to comprehend the material. 

Other types of asynchronous learning can be conducted through discussion boards, and allow for reading and writing assignments due on a certain date, but done at one’s own pace. This allows students to keep a somewhat normal sleep schedule, along with being able to participate in other important activities that stimulate mental health such as meals with family, synchronized routines with others that they may be living with, etc.  

Be aware of the time zones, weekend days, and holidays of your students

International students studying at home may have different weekend days than in the US, in addition to different holidays and of course, a different time zone. By familiarizing yourself with what’s going on in your students’ home countries, you can try to adapt their assignments accordingly. If you have multiple students studying from the same country, organizing a social hour in their time zone can increase feelings of inclusivity and belonging, in addition to accommodating their sleep schedule! Being aware of students’ schedules and making an effort to adapt where possible, can promote a deeper connection and understanding with students, making them feel less isolated and alone.  

Encourage creating new routines 

If it is necessary for students to attend classes during the evenings or at night, creating a new routine and new habits are necessary. Encourage students to pick a bedtime they can stick with, in which they are going to sleep and waking up at the same time each day. Emphasize the importance of at least 7 – 9 hours of sleep in addition to aligning sleep as close to being awake in hours of daytime or sunlight and asleep in hours of nighttime or darkness, as possible. Creating an environment conducive to sleep, such as creating darkness to sleep, is also helpful. 

Underline the importance of sleep and provide resources 

Educate students on the importance of getting adequate sleep and its close ties to cognitive function and overall improved academic performance. It’s important to provide students with resources such as meditation and relaxation techniques, which not only helps foster sleep but also assists in the relief of anxiety and depression. Many colleges and universities have released content surrounding this with suggestions and tips such as trying a sleep app, keeping a sleep journal, along with various relaxation and breathing exercises. The University of Minnesota has done great work in educating its students on the importance of sleep and released a series of on-campus initiatives. If you’re interested in including more resources on sleep for your students, some great places to start are: 

https://www.sleepfoundation.org/

The sleep foundation is a go-to source for trustworthy sleep information. The site features a medical board, extensive articles based on sleep science, and comprehensive reviews of different sleep and wellness products.

https://sleepeducation.org/

The American Academy of Sleep Medicine is dedicated to promoting discoveries that advance the understanding of sleep for healthier lives, including articles, studies, opportunities to volunteer and participate in furthering sleep education, along with other valuable resources to share.

https://www.sleepassociation.org/

The American Sleep Association, with a mission to help increase the awareness of the importance of sleep and the harmful effects of sleep disorders.

https://www.nhlbi.nih.gov/health-topics/publications-and-resources

The National Heart, Lung, and Blood Institute, which develops materials and resources for both health professionals and consumers.

References: 

Zara Abrams “Growing concerns about sleep” 2021. [online] apa.org. Available at: https://www.apa.org/monitor/2021/06/news-concerns-sleep [Accessed 10 August 2021]

Grant Benham “Stress and sleep in college students prior to and during the COVID-19 pandemic” 2020. [online] onlinelibrary.wiley.com. Available at: https://onlinelibrary.wiley.com/doi/10.1002/smi.3016 [Accessed 10 August 2021]

UMD Health Services “Sleep Education & Initiatives” 2019. [online] unm.edu. Available at: https://health-services.d.umn.edu/health-education/sleep-education-initiatives [Accessed 9 August 2021]

How to prioritize yourself so you can help your students?

August 9th, 2021 by Yessica Prato

During one of our previous NAFSA Regional conferences, many attendees brought up topics that they had dealt with in their corresponding campuses. Topics ranged from helping students navigate the US healthcare system, tools for mental and emotional wellness, and the struggles with sexual assault and suicide. However, all of the resources discussed were focused on helping students. So what about the educators and administrators? 

At ISI, we understand the important role that emotional and mental health plays in our daily lives. We’ve developed many free resources over the years focused on the mental wellbeing of international students and scholars. However, in 2019, a published study done in collaboration between universities in the United Kingdom revealed that many factors can affect the environment of teachers at school and the state of their mental health directly impacts students’ mental health and well-being. A teacher that is able to be more present and be emotionally healthy will be able to build a stronger teacher-student relationship.

We cannot continue to ignore our international educators’ and administrators’ mental health. Many in our international community invest countless hours to help guide the incoming international students and scholars in their journey. In this blog we will begin the conversation and discuss some of the challenges teachers or educators face and some of the resources out there available for them specifically.

What is going on?

Research on teacher wellbeing has largely focused on factors such as stress, burnout, organizational and social pressures, and lack of supervisor or team support. It’s also important to note that the pressure on university/college leadership can oftentimes be greater. Add to that the very unique situation we all find ourselves in with the pandemic and it’s not surprising that many in the academic community are experiencing a state of chronic exhaustion. In a survey conducted by The Chronicle of Higher Education over the last year, more than half (55%) of college and university faculty considered changing careers or retiring early due to the increasing needs their job required. Some of the key findings included:

  • 69% of faculty members are stressed, compared to 32% in 2019
  • 68% of faculty members felt fatigued, compared to 32% in 2019
  • 74% of female faculty and 63% of male faculty members indicated their work/life balance has deteriorated

So how can this be improved?

Taking care of yourself while trying to help others is a difficult task. Nevertheless, there are resources available for teachers and administrators out there to help navigate these mental health challenges. 

  • Take your own advice: When a student is going through a tough time, you as an administrator or faculty member are usually the first to lend a helping hand. You are trained to recognize the symptoms of stress, trauma, or discomfort. It’s important to apply your own knowledge and give yourself a break.
  • Remind yourself why you began this journey: You have joined the profession for a reason. This profession is many times driven by wanting to help others and creating communities to make a difference in the lives of international students. Remind yourself of your “why”.
  • Learn not to internalize burnout as failure: Expecting anyone to overwork themselves is harmful and can create a cycle of burnout. The more tired you are, the less effective and productive you can be. Taking a break does not mean you’re failing, we’re humans not machines. 
  • Prioritize mental health and normalize conversations about it in the workplace: Many faculty members conduct research on topics of mental health and yet our society continues to consider it an uncomfortable subject until the physical effects appear. It’s important to be able to speak freely about mental health. 
  • Using the available resources on your campus: Many of the resources we’ve made available to students can be utilized by faculty and staff. As an international community, we tend to collect all these resources and share them with our students but fail to remember them when it’s time to care for us. 
  • Creating boundaries with yourself: Stick to doable work hours, carve some time for your meals, get enough sleep, and be sure to exercise!

Resources

Here are some additional resources that you may find useful as you begin prioritizing your mental health:

Teachers of America offers many resources for educators which also address mental health. These include worksheets and mindfulness applications that can be downloaded right to your phone. 

Breath for Change is another resource that encourages educators to practice mindfulness, yoga, and social-emotional learning.

Onward provides a series of worksheets and readings which help cultivate resilience and help better understand one’s emotions. 

Our aim with this information is to begin the important conversation of mental health and the challenges faced specifically by educators, faculty and administrators in the international community. There is little research done on this important community and we hope that by addressing it in our forum, this will spark more discussion. 

Telemedicine: A great way to reduce claims costs

June 23rd, 2021 by Ross Mason

Over the last 5 years, telemedicine services have really gained popularity around the world as an easy and affordable way for people to seek medical care. While the number of providers offering such services was rising, the recent COVID-19 pandemic has really given fuel to the telemedicine movement to a point where it is now becoming a staple in most insurance plans. Especially when it comes to international and study abroad students, having access to a telemedicine provider has a wealth of advantages.  

The original idea behind the development of telemedicine was to treat people who are in remote locations and do not have access to medical care. Now, with mobile phones in abundance, it is now being used with great effect to offer medical care to those at home and abroad. 

Why Telemedicine?

As an international student or study abroad student based in a new country, the prospect of seeking medical care if you are sick can be a little daunting. There could be a language barrier, a new healthcare system to juggle and everything in between that can make it hard to seek medical care. So why is telemedicine a good idea?

Easy Access

Nearly everyone these days has a mobile phone and thus telemedicine is more accessible than ever before. Telemedicine allows your students to seek medical care from the comfort of home without the need to find a provider, go to the office, wait in the waiting room and be seen. With most telemedicine companies, students can open the app, register and speak with a medical professional over the phone or via a video chat. 

Cost

Telemedicine services, especially in the USA, are a much cheaper solution than a student going to an urgent care clinic or emergency room. Most plans will have higher co-pays for in-person visits, whereas telemedicine services tend to have very low copays, or none at all. 

Language

Most telemedicine providers tend to offer a range of languages with their service, with English and Spanish the two most common. Depending on the provider, they may also have other languages on hand or can get an interpreter on the line. This can make seeking medical care that much easier if treatment can be sought in the students’ mother tongue.

Lower Claim Costs

Of course the benefits for your students to be able to seek medical care remotely are huge, but there are also benefits to your plan as a whole when incorporating a telemedicine service into your plan. Doctors are not typically available on a walk-in basis, so if a student needs to be seen right away, they would typically only be able to go to an emergency room or urgent care center. The average cost of an urgent care visit in the USA can range from $200 up to $500, and an emergency room visit typically starts at $500 to $1,000 and goes up from there based on treatment. Telemedicine offers a convenient way to be seen right away and at the same time avoid many of these expensive costs. 

An average telemedicine visit will cost anything from $30 up to $75 per visit – and when integrated into your insurance plan the average cost can be reduced substantially more. So you have the initial cost saving on your plan, if students opt to seek medical care from a telemedicine provider first, and when multiplied out over the overall student body, the savings can be quite substantial.

Telemedicine Drawbacks

Telemedicine cannot solve everything, so there are obvious drawbacks and limitations when it comes to telemedicine. With the remote nature of the service, only basic medical care can be sought via this method, so it’s a great way to triage medical conditions. A quick call to the telemedicine provider can put a student’s mind at ease and get them the prescription they need. However, for more complex medical needs or emergency situations, a telemedicine provider could not help. 

The other main drawback is there is the potential for misdiagnosis, as the doctor cannot perform a physical exam as the only information they will get is what the student states as the issue and what can be seen via video camera. This could potentially lead to problems further down the road with further treatment needed.

Telemedicine: or

For basic medical care, and to give students a quick and easy way to seek medical care, telemedicine services are an excellent addition to any insurance plan. It has the potential to greatly reduce claim costs, especially if your plan is suffering from lots of smaller urgent care or emergency room visits that are adding up, as many of those could have been handled by a telemedicine provider for a fraction of the cost. Included as part of a comprehensive international student insurance plan, it should only enhance the service and benefits you are providing to your students. 

Is Too Much Technology Too Much?

May 25th, 2021 by Jennifer Frankel

The COVID-19 pandemic disrupted the lives of people around the world in ways both seen and unseen. In addition to the visible effects of the pandemic – notably the closure of businesses and schools, the elimination of non-essential travel, and increased isolation due to “stay at home” orders and social distancing – the pandemic appears to have caused widespread “collective trauma”, a term referring to the psychological impact of a society after a traumatic event. Many people have understably turned to technology for relief.

Now that COVID-19 vaccination rates continue to increase worldwide, however, many newly-reopened businesses, schools, and other institutions are grappling with the role that technology can play in our post-pandemic world. After more than a year of increasingly blurring the lines between work/school and home, online and in-person, how can we achieve a mindful and healthy balance with all of this technology? 

In keeping with the importance of this topic, we will be doing a series that will investigate the different types of technology and the impact it has on our emotional wellness. This blog, as our first in this series, will focus on social media and its impact on our wellbeing. After all, humans are naturally social creatures and with the opportunity for in-person connections dramatically reduced, many have looked to this particular form of technology for entertainment, health, and other forms of engagement over the last year. 

What We Know About Social Media

Social media has been a lifeline for many people of late but surprisingly little attention has been paid to the implications of its expanding role in our lives. While there are no doubt benefits of connecting people, it is important to recognize that social media algorithms dictate the way we receive our information and digest it. Each of these platforms are owned and operated by businesses which profit off of user engagement, so their clearest objective is to capture and hold their users’ attention. Even before the pandemic these social media platforms were intentionally designed to be addictive and to keep their users’ attention with no end in sight. However, there can be serious consequences to your scrolling. 

The Consequences of Social Media

Although the research has not quite caught up with the current situation, we know from previous health crises that the increase in media exposure has been associated with a heightened psychological distress and impaired functioning over time. While many of us have relied on these forms of technology to stay connected, previous studies have shown us that we need to be cautious against the potential harm that could exist from an over-reliance. 

Even in the best of times, research suggests that all of these social media platforms – Snapchat, Instagram, Facebook, Twitter, YouTube, TikTok, etc. – can contribute to one’s anxiety, depression, and have other mental and physical consequences. Study after study has found that the more one uses social media, the more likely they are to experience anxiety and depression. These platforms can impact one’s self esteem as the user may be focused on getting as many likes as they can (and wondering why they didn’t get as many likes as their friends?), searching for validation, and FOMO – fear of missing out – which can further add to anxiety and depression. 

Worse still, a 2018 British study linked the use of social media with a decrease and disruption in sleep, which – if it is continuous – can be associated with depression, memory loss, and poor academic performance.

The Type of Connection Matter

Preliminary studies performed at the height of the recent pandemic provide more context and suggest that social media is not just like its technological predecessors. A study conducted by Chao in early 2020 suggests that it is important to be mindful about which platform someone uses and when, as different mediums can affect users in different ways.

The Chao study looked at 917 Chinese residents during the initial COVID-19 outbreak. Their findings suggest that people who engaged in new media such as online news sites and social media had more negative psychological outcomes as compared with those who engaged more with traditional media use such as television, radio or newspaper. This study reinforces the importance of being thoughtful about which media to engage in and how that can impact one’s psychological health.

Moreover, as the Chao study suggests, not all technology has a negative impact. In fact, research suggests that instead of using your phone to endlessly scroll through feeds of friends, family, and acquaintances, time would be better spent engaging with people in a more direct and personal way. In fact, research shows that videoconferencing can help alleviate depression and loneliness, and can further improve one’s overall social support. With that in mind, spending time connecting via videoconference can have the opposite effect of social media. Finding time to connect with friends and family, celebrate milestones, speak with students and colleagues, and engage with the community directly can instead positively impact one’s emotional wellness.

Finding a Balance

We live in an hyper-connected world where many of us can easily access our social media accounts from our computer, tablets and phones. It is tempting to turn to your social media feed and see what others are doing as a way to feel connected but just like empty calories, social media use should be monitored. Few people track the time they spend using social media but those that do are often surprised by the extent of their usage. While it can be hard to completely disconnect, understanding how these platforms work and finding a balance is key. There are even apps that will limit your social media – since we sometimes can’t rely on ourselves to do it! Be mindful and thoughtful of when and how you use social media. As we slowly start to open up again, we will hopefully embrace old friends and make new ones. Along the way we should reflect on how invaluable one-on-one contact is and it’s inability to be replaced even by the most eye-catching social media platform.

Discrimination and the Impact on International Students

April 7th, 2021 by Sally McLeod

One year after the initial shutdowns of colleges and universities across the United States, mental health and the impact on international students has been widely discussed and looked at across the international student community. Studies have shown that college-age students in the 18-24 year old range have been hit the hardest by the pandemic in terms of the highest rates of depression and thoughts of suicide. The more particularly vulnerable populations of international students in this age group have been forced to deal with additional obstacles and challenges. With travel bans and new measures on maintaining visa status implemented at the start of the pandemic, along with navigating a new normal of quarantine and isolation in a foreign country away from friends and family, it’s no question that stress and anxiety have been at all time highs. International students from China, which are noted for being the largest population demographic studying in the United States for the last 15 years, have faced even more difficulties with heightened scrutiny and racism throughout the pandemic. 

Anti-Asian Racism in the United States 

International Students of Asian descent, particularly those from China, have dealt with stigmas and discrimination in the United States prior to the pandemic due to a number of factors related to political and trade tensions, along with alleged security threats. However, this past year has exceeded others by far with an increase in anti-Asian hate crimes by nearly 150% and an increased 833% of anti-Asian attacks in New York City. The suspected rise stems from xenophobic rhetoric perpetuated through various platforms, thought to exacerbate notions of linking a place or a people to disease, in addition to the resurfacing of negative sterotypes on Chinese culture and traditions. In a recent study, 26% of Asian-American adults across the US said they feared being threatened or physically attacked because of their race, which is a higher percentage than Black, Hispanic or white adults. One of the latest shooting massacres in Atlanta that killed eight people, among which six were Asians, by a white gunman, has only heightened anxiety and fear amongst those of Asian descent and highlights the importance of creating racial justice and solidarity. 

Looking at the Numbers 

According to the most recent Open Doors report, China remained the top country of origin for international students across the US in the 2019-2020 academic year. However, this increase was significantly smaller compared to years past and more notable was a smaller rise of .8% for those willing to host the 372,532 Chinese students. It will be interesting to see how the recent events from this past year reflect numbers going forward of this demographic and what this means for the US economy, as international students contributed over $44 billion dollars to the US in 2019 with over $15 billion from Chinese students. 

Creating Solidarity

With a rise in hate crimes against minorities, along with the countless deaths of those such as Ahmaud Arbery, Breonna Taylor and George Floyd taking on a movement of its own this past year, social justice is at the forefront of our society and can no longer be ignored. Just as hate and racism can spread quickly through the media, so can reform. This could be viewed as the silver lining, as light is shed on the injustices and voices are being heard. NYU’s Office of Global Inclusion denounced anti-Asian racism in April of 2020, but recently issued a statement on February 16th communicating their solidarity with the Asian, Asian American and Pacific Islander (AAPI) communities encouraging students to attend various university and student-led virtual events promoting inclusion and understanding. Many universities have followed suit. After UC Berkeley’s apology for listing xenophobia under ‘common reactions’ to coronavirus in early 2020, the University, along with others, have since created AAPI support groups along with easy and accessible ways to report incendences of hate, violence, discrimination and harassment. Other organizations are making efforts to raise awareness as well, such as the Massachusetts General Hospital Center for Cross-Cultural Student Emotional Wellness creating an annual conference for professionals dedicated to support the wellbeing of Asian and Asian American students. 

International Students in the Future 

The new White House Administration is already taking steps to revoke travel bans and reform restrictive policies impacting international students, in addition to strengthening relationships and creating strong ties allowing for shared information across foreign governments. The initiatives are not going unnoticed, and the volume of applications for international students is up! According to numbers from the Common App, international student college applications have increased by 9 percent as of January 22, 2021 from the year prior. With the lifting of travel bans and other visa restrictions in conjunction with COVID-19 vaccines becoming more available worldwide, it’s hopeful that these numbers will continue to climb. While this is all good news, what’s also notable is that the number of applications from China is down by 18%. The US has a lot of work ahead in terms of continuing to create a place of peace and unity for all. It’s the hope that through education, continued discussion and programming that change can be made and all voices are heard. 

References: 

Leah Campbell “Adults Under 24: The Loneliest Age Group During COVID-19 Restrictions” 2020. [online] Healthline.com. Available at: https://www.healthline.com/health-news/adults-under-24-the-loneliest-age-group-during-covid-19-restrictions [Accessed 29 March 2021]

Tiffany Hsu “Anti-Asian Harassment Is Surging” 2021. [online] nytimes.com. Available at: https://www.nytimes.com/2020/07/21/business/media/asian-american-harassment-ad-council.html [Accessed 29 March 2021]

Mei Lamison “University community responds to surge in anti-Asian racism” 2021. [online] nyunews.com. Available at: https://nyunews.com/news/2021/03/15/anti-asian-hate-crimes-covid [Accessed 30 March 2021]

Viggo Stacey “Open Doors: fall survey suggests new starts down 43%” 2020. [online] thepienews.com. Available at: https://thepienews.com/news/us-sees-first-drop-intl-student-numbers-in-15-years-as-covid-adds-pressure/ [Accessed 30 March 2021]

Lei Zhang and Erika Lee “Anti-Asian Xeneophobia” 2020. [online] unm.edu. Available at: https://immigrantcovid.umn.edu/anti-asian-xenophobia [Accessed 29 March 2021]

The Open Doors Report on International Exchange 2020. [online] opendoorsdata.org. Available at: https://opendoorsdata.org/annual-release/

Report: US introduces restrictions for some Chinese visas. 2018. [online] icef.com. Available at: https://monitor.icef.com/2018/05/report-us-introduces-restrictions-for-some-chinese-visas/ [Accessed 30 March 2021]

Service Standards at ISI

March 2nd, 2021 by Yessica Prato

Have you ever called a service line, like your internet provider or your cell phone service, and when you hung up the phone, you were smiling because the person on the other end of the line was prompt and empathetic? Customer service can truly make or break a company. Word of mouth travels faster than any means of communication, and in the age of technology, it’s easy to find online reviews detailing one’s opinions or experiences with a particular business. 

At ISI, we pride ourselves on having the best customer service in the industry. This wouldn’t be possible without our clients, both individual and group! Our customer service representatives go through an intensive training program to ensure they provide the best information to you and your students. As the customer service manager at ISI, my experience of moving to the United States from Colombia and the struggles I went through have inspired me to help others in their international education journey and share my experience with my team. So what kind of training does our customer service team go through? And what can your students expect when contacting us? 

Here is a look behind the scenes:

Licensed Insurance Experts

All of our customer service representatives go through the state’s licensing process to obtain their insurance licenses. Insurance in the US is regulated at the state level, for this reason you must be licensed to sell health insurance in the state where you reside. Not all companies invest in their customer service representatives to have an insurance license but we are committed to providing our representatives with additional certifications to ensure they are informed and educated. Going through the insurance class allows our representatives to learn the concepts and terminology of health insurance in depth. It ensures that we will provide our clients with the most accurate information in a way they will understand.

International Education and Industry Knowledge

Higher education can be as complex as the US healthcare system. At ISI, we want our team to be educated not only about insurance, but the specific needs of students or scholars learning abroad. We encourage our team to attend many conferences throughout the international education industry, like NAFSA and ICEF, so they can understand the unique needs these students have and the challenges that face them. We also create presentations on relevant topics to our international community and develop free resources and trainings to help you discuss these subjects with your students.

Empathy and Professionalism

Our insurance representatives are trained to listen to each and every one of our clients. Every international student, scholar, and traveler has their own unique story, and we want to understand their individual needs. We value empathy to really understand the unique needs and help them find the plan and address any additional help they may need. Our clients can be assured that when they contact us, the person on the other end of the line will take ownership of their case and empower them to answer any questions or solve any problems they may encounter.

Immigration and Policy Updates

International students have to learn how to navigate a wide range of immigration policies when planning their studies abroad. We are in constant communication with experts in the industry to stay up to date with the latest regulations. Pandemic or not, we are staying updated on travel warnings from the US Department of State and the CDC, so your students know if and when it’s safe to travel, and that your students are covered no matter where their travels take them.

Cultural Sensitivity

ISI is headquartered in Neptune Beach, FL, US. However, we have three international offices located in Xiamen, China, Mexico City, Mexico, and Leipzig, Germany. Our team includes members from different countries and backgrounds that speak multiple languages and can relate to someone traveling abroad. Like myself, all of our representatives have studied or lived abroad at some point in their lives, allowing them to put themselves in our clients’ shoes.

Ongoing Trainings

Quality assurance is at the top of our list; our Trustpilot is a true testament to the quality of service we promise our clients. Our representatives have quarterly reviews where they listen to their phone calls from past experiences and review emails and interactions with past customers to help them improve their communication and effectiveness. Additionally, we have monthly training sessions to improve our overall knowledge of the products we serve and enhance our professional skills. 

Our customer service representatives can help your students in many ways. Whether it is providing a visa letter for an appointment at the embassy or helping to find providers in-network near their home, our team at ISI will always ensure that you and your students receive the best experience possible when you contact us!

We’re here to help you and your international students. Our hours of operation are Monday – Friday, 8am to 6pm EST.

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Look Back 2020, Plan Ahead 2021

January 5th, 2021 by Elaine Del Rossi

The international education system witnessed a chaotic start of 2020 due to the COVID-19 pandemic. It created the most considerable historical education system disruption, affecting almost 1.6 billion learners from over 190 countries on all continents (United Nations, 2020, 2). While each education level is undergoing unique challenges, the higher education segment might trigger an international learning revolution—one that we are seeing in this country now.

The greatest challenge in international higher education was the loss of learning. The introduction of online learning was a way of rescuing the situation and preventing the academic year’s loss. This was a new experience for some institutions, and the transition from campus study was not easy for most students but especially international students. Higher education institutions in industrialized nations had the resources to transition to online learning smoothly, but those in developed countries struggled to cope. Approximately 40% of those nations failed to support learners during the pandemic (United Nations, 2020, 8). Similarly, many international students could not access learning materials because they lacked equipment and internet.

The international higher education system has been shaken to the core during 2020, and this can be the catalyst for changes in education models. Blended in-person and online education can be expected to continue globally from next year. Campus-based higher learning institutions are likely to adapt to new technological approaches to learning. Likewise, resilient and efficient technology-based education systems capable of withstanding the drawbacks of pandemics will develop. Changes will range from pedagogy, tools and assessment methods, learning outcomes to and educational investment. Additionally, the move towards a profit-making private education sector in most nations will continue to aggravate higher education inequalities (“Higher Education, International Issues,” 2020, 1). Most deserving candidates will miss enrollment opportunities since they cannot afford the escalating costs of higher education. There is the possibility that broader public goals and traditional universities’ functions such as academic freedom and autonomy will be ignored (“Higher Education, International Issues,” 2020, 1). The adverse economic impact of 2020 and higher education costs will also lead to many students not being able or deciding not to attend college thereby making other education/career choices.

A major area of disruption has been education abroad. Before the current crisis, the number of U.S. students studying abroad was growing according to Education Dynamics. During the 2017-2018 academic year, the number of study abroad students grew by 9,000 to a total of 341,751. However, the pandemic caused unprecedented disruptions to study abroad programs over the past year, with colleges and program providers evacuating students from their host countries in large numbers and suspending most international programs for the summer and fall. Some colleges have extended existing restrictions on university-sponsored study abroad travel through next spring, while others are evaluating programs on a case-by-case basis. (Inside Higher Ed, 2020). And there doesn’t seem to be any light at the end of that tunnel. Many schools have stated to offer virtual study abroad programs. Virtual Study Abroad experiences are an innovative way to reach more students and faculty, as well as further promote traditional study abroad. These virtual study abroad opportunities have far fewer limits and are accessible to all. Virtual study abroad experiences will continue to develop, diversify, and evolve into the future while going hand in hand with existing programs. While it is not the intention that virtual study abroad replace traditional programs, rather they are another avenue for students to participate in the international experience.   

2020 has been a challenging year for international higher education. There has been a loss of learning, and educational inequalities have also exacerbated. It seems like these issues will extend beyond the pandemic, and most disadvantaged learners will lose opportunities in higher education institutions. It is also expected, in 2021, that new resilient and technology-based education systems will emerge and that heart of the coming transformation of higher education is technology. Gap years might also become more attractive in 2021. It is no secret that most 18-year olds are not quite ready to assume the rigor of college and a gap year might afford them the opportunity to expand their experiences and gain the maturity necessary for college life. Ninety percent of kids who defer and take a gap year return to college and are more likely to graduate with better grades. (Post Corona: From Crisis to Opportunity). Virtual study abroad will also be more available and allow these experiences to many more students who prior could not afford the cost or time away due to family or work situations. With the arrival of new vaccines for COVID-19, it is hopeful that international student enrollments will resume to a “normal” level in the Fall. There are serious challenges for 2021 but this new year also presents many opportunities for growth and introducing new and exciting changes.

References

  • Inside Higher Education: November 19, 2020.

The Additional Stressors Covid Brought and Its Impact on the Mental Health of International Students

December 1st, 2020 by Jennifer Frankel

Covid-19 has changed the landscape of education across the globe, and nowhere has that been more apparent than within international education. One of the major impacts has been on the emotional wellbeing of international students, where the American College Health Association found that international students have been disproportionately impacted by this global pandemic. 

In the past, international students have struggled with their mental health at higher rates than domestic students, and this was understandable given the additional challenges international students faced when it comes to learning a new language, adjusting to a new culture, adapting to a new educational system, being far away from their safety net, and being in a new country. With the introduction of Covid earlier this year, however, the stressors were exacerbated and international students were particularly vulnerable.

The COVID Stressors

What made Covid so unique was that it wasn’t an isolated event. It wasn’t geographically limited. It wasn’t a local problem – it was a pandemic that spread across the globe hitting some places harder than others, but almost everyone – no matter where they were – were affected.

Students, no matter what country they were from, were concerned about their families back home, their health and access to care locally, their education and the form it would take, and their relationships from family to friends to teachers to peers. Let’s take a few of these issues to explore their impact.

Immigration and Visa Issues

Covid is a particularly contagious virus, spreading quickly through populations in close contact. Countries had to respond, and many of those responses had to do with travel. It meant shutting down airports, closing down embassies, canceling flights, and restricting entry. Students had to decide – and quickly! – whether they would continue to stay abroad or return home. There was no guarantee that if they went home, they would be able to return to continue their studies. There was also uncertainty about what constituted meeting the requirements of a valid student visa – would online classes be acceptable? What about hybrid learning? And even if you did go home, what would learning be like online? There were so many questions, and some questions still remain unanswered today. But one thing is certain, all of this created so much uncertainty, stress, and anxiety about what to do and what the future might look like.

Housing

Many schools abruptly canceled their classes and told students that they should not plan to return to school after spring break. While this would cause panic for any student who had grown accustomed to their independence in dorms and college living, it particularly impacted international students who may have had very little back up options. Some students were able to find alternative accommodations such as living with family members who may have been local – or perhaps living in a different state. In NAFSA’s Brief on International Students at Community Colleges, they found that students at community colleges were particularly impacted since they were less likely to offer on-campus housing and students were not only distanced by the transition to online classes, but “international students may find themselves challenged by suddenly distanced – physically, socially, and emotionally – from their college campuses.” Not only do we see that housing was uncertain for many, but that students were being isolated from all parts of life and this was validated by a number of surveys done on college campuses which reported barriers to making friends and feelings of loneliness.

Finances

Another top struggle international students have placed as a top stressor during the pandemic has been their finances. People around the world have lost their jobs or have become unable to work, and this happened in record numbers. Many of these international students were relying on those very incomes to help cover a very expensive education. In other cases, students who had on-campus or off-campus jobs were suddenly unemployed and their extra income had disappeared. One way to gain insight is that some college campuses have seen a rise in economic hardship requests going up and some schools are taking a hard look at the costs to see what they can do – but there isn’t much as many of these schools are also strapped facing tuition concessions, staff furloughs and layoffs, COVID protection programs, etc.

Online Learning

Online learning has been both a struggle and a blessing for many, oftentimes it depends on where the student is located and what access they have. For any of us who have taken an online class, we can all attest that it is a very different experience from an in-person class, and requires a sense of focus that is otherwise instilled in an in-person learning environment. Many international students have struggled, especially those who have returned home, to find that they are having to take a class at 11 pm local time, and it can be hard to bring your A-game when you are already so tired. Then, there is of course, the access of having reliable internet connection that can support many of the technologies that schools are using to deliver their education. It can be difficult to participate if you do not have a reliable connection, if you don’t have a quiet place to learn away from distractions, and you don’t have all the equipment you need to make sure you are able to engage in the expected manner. Online learning has also impacted the way international students engage and make friends. Remember that study from 2012 about the difficulties international students had making American friends? This has been more challenging than ever. Many international students would show up to class, and rely on the classroom interactions to start making friends with their peers. Now, making friends in an online setting has become much more difficult – and for many, even more isolating.

Health & Insurance

Many international students were concerned about their health and what impact Covid might have on them, and they of course were not alone. But when you are in a foreign country, it can be all the more scary. Does your insurance plan cover Covid testing and if you get sick? Where do you go if you get sick? Where can you get testing, how much does it cost, and do you have access to a testing center? There were many, many questions that we had from students wondering what to do if they got sick, where to go, and whether their insurance plans cover them. There was also a lot of health information coming out, but as we were learning more about the virus, the recommendations continued to change. All of the changes, including how you can contract the virus, whether or not to wear a mask, where you should or shouldn’t go – all of this kept creating fear and uncertainty.

Discrimination

We also saw an uptick in “discrimination and isolation” according to the Lancet, where “some media outlets have used derogatory headlines, perpetuating stereotypes, and prejudices about Chinese people.” I spoke to one advisor who said that a Chinese student came into the office and said that she just wanted to let them know that she didn’t have Covid, just in case they were wondering. 

Dealing with all that Stress

All of these stressors, and still others not mentioned above, continue to contribute to the stress our international students are experiencing. While every international student experiences different stressors and may handle stress differently, some studies are finding increases in depression and anxiety. Based on a poll conducted in March by Inside Higher Ed, “more than 90% of presidents reported being very or somewhat concerned about COVID-19’s impact on student mental health.” And the numbers coming out continue to support and justify this concern.

Based on these struggles it is important that students have access to mental health counseling, and many of these resources are available on college campuses. While keeping up with demand can be difficult, it is important to have multiple ways for students to access care. Having an insurance plan that includes mental health coverage can also provide more options to students who may be unable to access counseling services on campus or would like additional options. And beyond that, telecounseling has become embraced during the pandemic as a means to get confidential counseling over the phone, by chat, or through video without leaving home – some also include language support for international students who prefer to speak in their native language. 

It is important to note, however, that stigma around mental health continues to persist globally, and finding creative ways to reach students who may not be inclined to use these services continues to be critical. Finding ways to connect students, create community, to check-in, and find ways to help students find a healthy life balance is also key to efforts in reaching students and encouraging resilience. 

For additional student resources, be sure to check out and share our Emotional Wellness During the COVID-19 Outbreak page and our latest videos of how international students are dealing with Covid. You can also access our free emotional & mental health training program online. 

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