We are moving from Europe to the US and the company is fairly open to building an expat package, with initial suggestions (relocation costs, rent expense, flights home, adj salary) reasonably generous. Healthcare in there too, but not yet clear on what this entails in the US.
Any advice on what else we should think about asking for or negotiating?

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Looks like you got it covered perhaps ask for euro work schedule (7 hours shift with 1 full hour lunch break? 😀)
If you got kids, ensure rentals are provided in location with good school system. Where you gonna be working from? Wall Street?

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SF to be exact, which I understand is very high CoL and taxes etc. Current effective tax rate is about 48% but not sure what it will be in SF - imagine similar. Will be earning enough and I don’t take that for granted but the company seems willing to assist, so wondering where to push.

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European expat here. You should probably ask about other insurance plans in addition to health care, I.e disability etc. The US does not have any security nets like we have in Europe should the worst happen. As for healthcare, ask about copays, the deductible and max out of pocket. All should be as close to zero as possible. My copays are $40-50, deductible $0, and max out of pocket $2,500 to give you some context. They usually give you a sheet outlining what the insurance covers and not. Coming from Europe, healthcare really sucks, so make an effort to understand it so you don’t end up with any surprises..

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My premium is $300 per month (PPO) and I don’t get any HSA dollars and don’t have the choice to choose any other plan. It’s this or nothing..

Location, Location, Location! Make sure your hood is safe and accessible

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Yeah, US public transport is going to be a tricky one to get a handle on!

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Cost of living increase

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We moved from Europe to NYC in 2019... I'd say negotiating the tax and healthcare landscape was a big one for us, as others have mentioned.
And personally, it was annoying having to use converters on all our electrical appliances so ended up replacing everything soon after it was shipped over, except for expensive B&O speaker. Doing that more than cleaned out the relocation misc. cash we got.
We had three months corporate housing included, but after was surprised to learn that in NYC we had to pay realtor fees when looking for a rental apartment (15% of annual rent). Thankfully the co. agreed to cover that

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Hi!
We’re in the same process at the moment-
Company offered 25k relocation and 25k per year for the family healthcare plan.
* Costs of shipping our furniture alone came in at over 20k, when I moved to Europe 8 years ago it was around 7k. So just keep an eye out on those shipping costs.

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Have them agree to pay import taxes on a vehicle you bring back to Europe, should you move back. Huuuuge money saver. Lots of my friends used this one.

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