Corrections or additions?
This article by Barbara Fox was prepared for the
October 24, 2001 edition of U.S. 1 Newspaper. All rights
Assist America: For Health Emergencies
The first phone calls coming in on September 11 were
from people stranded in Manhattan, desperate to find how to leave
the island. Then calls came from around the United States, from those
who were unexpectedly grounded. Then from 18 countries around the
world where travelers, among their other problems, would soon run
low on insulin and prescription medicines. Some of those in the Middle
East sought a safe haven.
Two dozen people at Assist America’s telephone center at Lawrence
Commons, near the Mercer Mall, fielded 107 questions in September
that were directly related to terrorist action. This crew is
to crises — they are the people who, when you break a bone in
Bolivia, can get you medivaced out of there and into a good American
hospital. Sleuthing out ferry schedules is not their usual job, but
they pride themselves on finding an answer to every call.
"When people realized they had our coverage, they reached out
to get any information they could," says George Howard, president
and CEO of the 11-year-old agency. "We don’t turn down requests
for help from anybody."
Assist America is a service provider for insurance companies; like
a hospital, it provides services for members of HMOs. It coordinates
travelers’ medical benefits for corporate insurers, and, through
companies run by ex-CIA and ex-Secret Service agents, it also helps
with security. Howard believes that including Assist America’s
in a benefits package is going to help insurance companies seal more
deals with human resources departments. "If a broker is looking
at four or five different choices, everybody looks pretty much the
same, but if one of those companies has our benefit at no additional
cost, then that will stand out," says Howard.
"Because of an event that happened here in the states, Americans
have a heightened sense that things can happen to you overseas,"
says Howard. "We expect to at least continue — or exceed —
our growth pattern."
Howard had his own personal experience with assistance services. When
his family was on vacation in Greece some years ago, his
son became very ill. "We did in fact call in and got a referral
to a hospital, and he was admitted because we were expected,"
says Howard, noting that while American hospitals are required to
take all comers, European hospitals are not. Doctors found the boy
was dehydrated. "He stayed for a day, was rehydrated, and had
a happy outcome."
The list of companies with policies that include Assist America
include Andersen Consulting, Boeing, Lucent Technologies, Kemper
Raytheon, and Schlumberger. Trade unions, such as the National
Association for the Self Employed (NAFE), IEEE, and the American
of Civil Engineers, also subscribe.
If you have an Assist America clause in your benefits package, and
you get sick when you are in a foreign country or even when you are
100 miles or more from your home, you dial the Assist America number
and the call desk takes care of everything.
First, it will arrange for you to be seen by a doctor
in Assist America’s network. Medicine overseas can be very good, but
Americans require a lot more handholding, says Howard. "We can
find U.S.-trained doctors practically anywhere in the world. We are
the only assistance company in the world that gives American-trained
case management with every case." If necessary, the company will
help you get admitted to a hospital or get medivaced to a better
If your stay will be a week or longer, Assist America will transport
a family member to stay with you.
Some harrowing episodes are related on the company’s website. An
on a consulting job in Antigua was injured when a heavy box fell on
his head. Assist America evacuated him immediately to Miami, where
doctors found he had fractured two vertebrae. A week later, after
successful surgery, Assist America "repatriated" him home
to New York for his convalescence.
Another member was on a cruise ship going to Cozumel, Mexico, when
he ruptured his bilateral tendon by falling on his knees during a
basketball game. Assist America arranged and paid for a private jet
air ambulance to Miami, where surgeons decided he needed immediate
surgery on both knees. So Assist America arranged for another private
air ambulance to his home in Pittsburgh, so he could spend his
recuperation period at home.
One episode on the Assist America home page tells how a covered
injured his leg and foot while climbing on a lawn chair on top of
his RV to adjust his antenna. On the way to the emergency room, to
which he was driving at high speed on his motorcycle, he was stopped
by police and ended up in jail. Assist America had to get him out
of jail and then fly him home in a first class seat that would
At the time of this interview a student from one of Assist America’s
100 college clients was enroute to China, accompanied by a medical
escort prepared to deal with psychological disability.
Howard’s favorite example of case management was 10 years ago in
where the insured employee’s two-month old baby had meningitis and
septicemia, and the prognosis was death. A medivac to Western Europe
would have been too traumatic. As if by a miracle, Assist America
got the baby medivaced to a white hospital in South Africa, despite
the fact that Burundi did not have diplomatic relations with South
Africa, and that the baby was black. Racial barriers had not yet been
crossed there. Howard’s clever secret: "We told the doctor that
if you arrange everything and get the baby in, we will pay you in
Switzerland. It was an opportunity, at a time when South Africans
couldn’t get money out of the country, for the doctor to convert
in rand to Swiss francs."
George Howard’s mother was a university professor, and
his father was a Vienna-trained civil engineer who, as director of
a large engineering laboratory, traveled on planes for 5,000 miles
a month in the pre-jet era. "The bee in my bonnet was always that
I wanted to travel," says Howard.
A native Virginian, he went to Randolph Macon College in Virginia,
Class of 1967, and to Thunderbird, the American Graduate School
of International Management. During his career in the insurance
for Cigna, Continental Insurance, and AIG, he lived in Japan, Mexico
City, Santo Domingo, Athens, Madrid, Brussels, Tehran, and Tokyo —
but never quite lost his Virginia-inflected speech. "My oldest
son was born in Greece, and the younger one grew up in Tokyo. One
of the reasons I came home is that when I was telling my nine-year
old about the satellite-feed tape delay of the Super Bowl, he asked,
`What’s the Super Bowl?’ I remember thinking, it’s been a good run,
and I’d better get back home, so my kids will know they are
"While I was in Japan, I had appended an assistance product to
an insurance product and became friendly with International SOS
a Swiss company, and had the opportunity to run the company in the
U.S," says Howard. In 1990 Howard — by then living in central
New Jersey — started his own company, in partnership with a
firm. Now more than 14 million people are eligible for Assist America
help through corporate and trade union benefits packages. The
global network consists of more than 600,000 health providers.
To be an Assist America client, you must work for a
member company; you cannot buy a policy. Membership is built into
a benefits/medical plan, and it costs a relative pittance for each
person covered. Howard doesn’t want to reveal his strategy, merely
saying that it is "a low enough rate not to destabilize employee
With his insurance experience, Howard applied special risk principles
to his product and designed a policy backed up by syndicates at
of London. The fee that Access America gets from member corporations
pays for the Lloyd’s insurance, network maintenance, operations center
expenses, and liability insurance.
Running a company like this requires special skills. "When you
try to run a 9 to 5 business on one side, and a 24-hour alarm center
on the other side, they have different mind sets. Those with emergency
dispatch credentials are motivated because they want to help a person.
You have to work with them in different ways," says Howard.
"When I first got in this business," he says, "an HR lady
said we had to talk about hiring a nurse. Fine, I said. `It’s got
to be a bilingual nurse, a Spanish RN.’ Fine, I said. `We also need
an RN who speaks Spanish willing to work midnight to 5 a.m.’ I
for the first time how different this business was."
Howard’s first office was at the Carnegie Center, and his current
headquarters is in 1,500 square feet at 1 Palmer Square, where he
has eight employees. Just this fall the company opened the 2,500
foot call center at Lawrence Commons, where 22 people share
shifts. "We had outsourced a lot of our services for years, and
we decided to take everything in the house ourselves," says
"It’s a quality control thing. We have Emergency Medical
(EMTs) answering the phone. They are good. They are the people to
count on in a real emergency."
The EMTs were drawn into the crisis on September 11. "We get
information from public sources — we have three flat-screen TVs
and our own sources," says Howard, explaining how two EMT staff
members went to the World Trade Center just after the calls started
coming in. "Those were the guys who could get through. They ended
up helping, but the reason they were there was to stream information
back to us."
Having just one worldwide call center is unusual in this business.
Howard’s European and Asian competitors believe that, in order to
deliver services in a country, they have to have alarm services there.
"Because telecommunications was so bad when the assistance
was started, most of the world’s assistance companies have 15 or 20
alarm centers around the world. Back then, in Europe or Asia, it could
take you 90 minutes to get an outside line."
Since then, telecom services have developed
yet the competing services are still maintaining all their mini
"I have to say, quite frankly, one of the reasons we have been
successful is luck," Howard says. "This call center had
to do with our original business model. We felt we had to have the
alarm centers out there too. We were outsourcing the alarm centers
to a place in Maryland."
Talent in the town where he lived was another lucky happenstance.
On the call desk now are speakers of seven languages: English,
Mandarin, Cantonese, German, French, and Greek. When an instantaneous
translation is needed, who better to call on than the people at the
world headquarters of Berlitz International in Alexander Park. And
the proprietary software that runs the operation ("the best in
the world" says the modest Howard) comes from Bob Weber of
who just happens to be Howard’s Princeton Junction neighbor.
Howard says he dominates his niche. Others focus on selling benefits
policies to travel agents, credit card holders, and tour operators.
"And we are the only company in the world that doesn’t screen
for pre-existing conditions," he says.
Paying for the claims can be expensive. Doctors get about $200 for
a consultation, in person or over the phone. For a Third World doctor,
that is a lot of money. Evacuations are staged out of Atlanta,
the base the anesthesiologist who is director of medical services.
The company has prenegotiated agreements with airlines that can meet
FAA standards for stretcher patients. Emergency evacuations can be
$25,000 to 35,000, and they have gone up to $200,000.
But Howard doesn’t have to worry about costs. He can concentrate on
the patients. "As soon as we have medical authorization, it is
paid for by our policy at Lloyd’s. I don’t think anybody treats
like we do. If an Englishman gets sick in France, you throw him in
the back of a pickup truck to take him back to England, and he’s
But you have to hold an American’s hand."
— Barbara Fox
08542. George Howard, president. 609-921-0868; fax, 609-921-0933.
Commons, Suite 205, Lawrenceville 08648. Diana Heredia, operations
manager. 609-452-0533; fax, 609-452-2042.
On a for-fee basis, Assist America clients have access
to such services as evacuation or crisis planning, security
key employee protection, and counter terrorism planning. Assist
is affiliated with two strategic security and risk management firms
providing services under the "SecurAssist" plan. Security
Management International is headed by ex-CIA agents, and the Annapolis
Group consists of former Secret Service agents and emergency response
"Someone who enrolls in the SecurAssist program gets a laundry
list of benefits," says George Howard, CEO of Assist America.
"If they sign up and say they have operations in six countries,
including Indonesia, we have Security Management International and
the Annapolis Group approach them and inform them of their potential
Basic disaster-planning packages are available. For a 50-person
at one location the package would cost from $5,000 to $7,500. A two
or three-person team would provide a high level risk assessment,
plan and walk through, physical security survey, employee briefings,
HR planning, redundancy of operations, and business resumption plans.
"This package is tailored for — God forbid — the same
kinds of things that happened at the World Trade Center. It is
to see how many people are not prepared for that," says John
managing director of the Annapolis Group. He spent 21 years in the
U.S. Secret Service and now teaches at George Washington University.
"We interview the executives, talk to all employees about how
to handle mail, put the plan together, and practice pushing the button
to evacuate the building. You want to mitigate your risk as much as
possible." This package can generally be delivered in two or three
days. Police and fire departments can help with fire and evacuation
planning and bomb threats, but they won’t be able to advise on
issues, he says. For instance, his clients keep duplicate or off-site
personnel files with fingerprints and hair samples for potential DNA
identification. "There should not be any privacy issues if it
is done correctly," he says.
Vezeris says the number of companies that need this service is
unlimited. "The overwhelming number of companies have not
says Vezeris. "If they do have an evacuation plan, it is some
staircase diagram. At a session with 30 high level executives, it
was impressive to find out that not one in the audience was satisfied
with their company’s planning."
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