HIPAA compliant insurance companies are required by federal law to provide insurance coverage for all new employees in a company / organization that elect the insurance. But, if you want to avoid undue insurance exposure it is good to have strict medical screening requirements for new overseas employees. If you accept a new person for overseas employment and that person has serious medical problems, e.g. overweight, cancer, heart problem, AIDs etc you will be putting your group health insurance plan at added risk. If such a person had a major medical claim it could cause the rates for the group coverage to increase dramatically. So one way to control increases in your insurance rates is the have tighter medical screening for your overseas workers!