Long Term Care Insurance Group, Executive Carve Out & Voluntary Plans
What is the definition of LTC? Ongoing Care (care needed for months or years) • Chronic medical conditions • Chronic severe pain • Permanent disabilities • Dementia • Ongoing need for help with activities of daily living
Employer Group LTD Coverage Group LTD (Long Term Disability Coverage) • Rehabilitation from a hospital stay • Recovery from an illness, injury, surgery • Claim approved if you cannot work • Pays percentage of income • Not generally portable • Usually ends by age 65
Costs of CareToday and in the Future $905,154 Private Room in a Nursing Facility $427,242 Assisted Living Facility $229,380 $467,847 Home Care* $108,270 $118,560 All Costs based on 2008 Genworth Financial Cost of Care Survey, conducted by CareScout, April 2008. Projected cost for 3 years of care for a 45 year old when they reach age 80 @ 4% annual inflation * Based on 40 hours of homecare per week @ $19 per hour. **
Multi-Life/Group LTC InsuranceLTCI Business Tax Incentives • Covered under HIPAA • LTCI premiums treated as accident and health insurance by IRS. • C-Corp: 100% deductible for owners, employees, spouses, retirees. • S-Corp, Partnership: 100% deductible for employees and partially deductible for owners per IRS published age & premium table. • Self-Employed: Partially deductible for owners perIRS published age & Premium table.
Multi-Life LTC Insurance PoliciesEligibility & Plan Details • Ages 18-65 eligible for Simplified Underwriting (5-6 health questions) • Executive Carve-Out Plans available at minimum of three (3) lives • Actively at work employees, spouses, family members, retirees, board of directors eligible for discounts. • Spouses/Board of Directors may be included in Simplified Underwriting with minimum of 10 total of employee & spouse lives covered. • Policies are individually owned and fully portable.
LTCI Premium Discounts Available Individual Policy Multi-Life Discounts: • Employer Paid: 10%; can include spouses • Employee Paid (Spouses/other family)- 5% • Spousal/Partner Discount: Up to 40% (with other spouse approved) • Marital Discount: Up to 15% (other spouse does not apply) • More suitable for executive carve-out plans or groups under 200 Group Certificate Policy Discounts: • Rates are blended per company census – age, salary, industry, job position, location • More suitable for larger employers with 500+ for voluntary plan or 200+ for employer paid (base plan), multiple locations and face-to-face meetings impossible.
2. Have you ever been treated for or medically diagnosed as having: a. AIDS (Acquired Immune Deficiency Syndrome) b. ARC (AIDS Related Complex) or c. any AIDS related condition(s)? 3. Do you currently reside in, or have you been advised to enter, or are you planning to enter a Nursing Facility or Residential Care Facility or are you currently receiving home health care services or attending adult day health care? 4. Do you require human help or supervision for any of the following: • bathing • dressing • eating • walking • toileting• transferring from bed or chair • controlling bowel or bladder. 5. Do you currently use any of the following: • dialysis • oxygen • wheelchair • walker • quad cane • crutches • *Health Questions: • *If answered Yes to any question, employee may receive offer • for limited policy per state minimum plan offered. Only for • groups of 10+ insured lives. • Have you had, do you currently have, have you ever been medically diagnosed as having or have you been treated for: • a. Stroke (CVA) • b. Multiple Transient Ischemic Attacks (TIA’s) • c. TIA within 5 years • d. Alzheimer’s Disease • e. Dementia • f. Mental Retardation • g. Schizophrenia • h. Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease) • i. Muscular Dystrophy • j. Multiple Sclerosis • k. Parkinson’s Disease • l. Diabetes with amputation or complications affecting • the kidney • m. Cancer that has spread to another area of your body • including lymph nodes; or cancer diagnosed or treated in the past 2 years (except basal cell cancer, squamous cell cancer of the skin or early stage breast or prostate cancer). • n. Organ Transplant
Home Care Assisted Living Care Nursing Facility Care Care Coordination Services How Does Long Term Care Insurance Work? It provides a “Pool of Benefit Dollars” for long term care when and where needed:
Multi-Life/Group LTC InsuranceLTC Plan Design - The Core Benefits • Daily/Monthly Benefit $100-$500 a day or $3,000 -$15,000 per month • Benefit Period/Pool of Money – 2,3,4,5, or 6 years (Lifetime benefit period available with full underwriting) • Elimination Period – 0, 30,45 or 90/100 days • 5% Simplified or Compound interest
$365,000 Today “Pool of Benefit Dollars” $730,000 in 15 years “Pool of Benefit Dollars” Designing Coverage • Three Main Decisions: • Monthly Maximum • Benefit Multiplier • Elimination Period • Inflation Protection Example $6000 Monthly Maximum x 60 months (5yrs) Benefit Multiplier $365,000 Coverage Maximum Today $730,000 Coverage in 15 years @5% Comp. IPO
Other LTC Benefit Options • Survivor Paid-Up Benefit – After policy is in force for 10 years, living spouse policy is paid-up after death of other spouse. • Shared Care Benefit – Spouse policy benefits can be shared with other spouse when living and at death. • Premium Payment Paid-Up Options – Premium payments can be paid-up in 10 years or by age 65.
Care Management • Assistance in finding an agency or facility to care for you or your loved one. • Someone who’s available to answer all the questions that arise when care is needed. • A helping hand that navigates and guides you through all the tough decisions. • Professional care management- when you need it!
Premiums • Premiums are waived while on claim. • Guaranteed Renewable – Coverage can not be cancelled as long as premiums are paid on time. • Company reserves the right to increase premiums by class subject to state insurance department approval.
LTCI Enrollment Support • Dedicated LTCI Team assigned to each employer • Employee/family educational website www.mylifemyfamily.com • Face-to-Face Employee Education & Enrollment • *Interactive company website for employee enrollment available • Web Cast technology available • Company List or Direct Billing available *For larger employers in multiple states
Pre-Educational/Financial LTC Web Site • Employee/family educational website www.mylifemyfamily.com
Employee Enrollment LTC Web Site • Employee enrollment website www.capitasltc.com • Employees can go onto site to view company LTCI plan coverage • Employees can remotely communicate with internal LTC specialist • Employees can request application for coverage • Employees/Family members can view menu of LTC educational information • Web site features direct assistance for care giving referrals