Element. Fundamental protection for your future. A Privileged Choice Flex 3 Long Term Care Insurance Solution

Transcription

1 SM Element A Privileged Choice Flex 3 Long Term Care Insurance Solution Fundamental protection for your future. Long Term Care Insurance underwritten by Genworth Life Insurance Company Administrative Office: Richmond, VA 03/07/16 To order please use form Number: 04/18/16

2 1 What is long term care? Long term care (LTC) provides assistance with basic activities of daily living (ADLs) we often take for granted bathing, dressing, eating, transfering (such as moving from a bed to a chair), toileting, and continence. LTC could be needed because of an accident, illness, cognitive issue, or as a result of aging. The progression towards needing LTC can go hand-in-hand with the struggle to maintain your independence. LTC insurance can give you time to weigh your options by providing the ability to pay for extended home care or facility care if needed. You may qualify for LTC insurance benefits if a licensed health care practitioner certifies that you are unable to perform two or more ADLs by yourself for a period that is expected to last at least 90 days or require substantial supervision if you suffer from a severe cognitive impairment.

3 2 The Element SM advantage When it comes to the long term, most of us want to make sure our family, our lifestyle and our future are as secure as possible. Element is a practical and cost-effective way to help reimburse the high costs of LTC services; and it may be more affordable than you think. A few other points to consider: Reduce financial impact on your family LTC insurance can help reduce the financial responsibilities of those who you would need to rely on to take care of you. Maintain your control Create more options for how and where you receive care and who provides that care. Extend and protect your savings Make up the difference between what you have available in retirement savings and income and what you ll need to pay for LTC. What motivates you? The top 3 reasons people buy long term care insurance: 1 To not place the burden on my family To be able to afford quality care in the setting I choose With Element, you have more control when it comes to making decisions about your care. 2 Include it in your financial plan now, and you could have greater flexibility in the future. To protect my spouse s and loved ones quality of life and future security 1 Online Focus Groups conducted by Genworth Customer Insights Team, October To qualify for benefits, among other requirements, covered long term care services must be received in accordance with a Plan of Care prescribed by a Licensed Health Care Practitioner.

4 3 Element can help Element can be an economical way to help you stretch your LTC dollars by staying at home 3 and only paying for the level of care and time that you need. However, if you need advanced care, it can also be used at an Assisted Living Facility 4 or Nursing Facility. Home Care Home care allows you to get the LTC services you need in the comfort of your own home. For example, someone to help prepare your meals, provide medication reminders or to help you move around. It can also include more specialized care, like physical therapy or skilled nursing. Median Cost: $20/hour 5 Community Care Also called Adult Care Services, this type of care lets you live at home and enjoy the powerful benefits of getting out for social interaction and mental stimulation. It can give your caregivers the help they need as they juggle family and work responsibilities of their own along with caring for you. Median Cost: $69/day 5 Assisted Living Facility Assisted Living Facilities can help you maintain your independence in a place that is equipped to assist you with activities of daily living like dressing, eating and moving around. These facilities typically provide personal care and health services to people who don t need the advanced level of care provided in a Nursing Facility. Median Cost: $3,600/month 5 Nursing Facility Nursing Facilities provide skilled around-theclock care. These facilities provide personal care assistance, room and board, supervision, medication management, physical therapy and rehabilitation for people with functional or severe cognitive impairments. Median Cost: $7,600/month 5 Long term care costs can be high, but even a small amount of Element insurance can go a long way in helping relieve the pressures of managing needed care. 3 To qualify for benefits, among other requirements, covered long term care services must be received in accordance with a Plan of Care prescribed by a Licensed Health Care Practitioner. 4 In Connecticut, a Managed Residential Community will be considered an Assisted Living Facility. 5 Genworth 2015 Cost of Care Survey, conducted by CareScout, April Based on national median daily or monthly costs. CareScout is a Genworth company.

5 4 Element in action (a hypothetical example) Maria and Marisol Maria has mobility issues and lives with her daughter, Marisol. Marisol works outside the home so she isn t able to help her mother while she is at work. She has a Home Health Aide come in during the work week to help her mother. With Maria s limited mobility she is unable to dress or bathe herself. Maria qualifies for LTC benefits, since she needs assistance with two of the six Activities of Daily Living (ADLs) and meets other requirements. Maria only needs care for 5 hours, 5 days a week. Her at-home care expenses average out to $2,000 a month. 6 With the Element 75 plan, Maria has a $3,125 monthly benefit. This is the maximum amount available monthly to reimburse her covered care. With total coverage of $75,000, Maria s current at-home care plan would be covered for more than 3 years. 6 Genworth 2015 Cost of Care Survey, conducted by CareScout, April Official Social Security website FAQs, faq.ssa.gov 12/18/15. Did you know? $20/hr That s the national median cost of care for a Home Health Aide. 5 The average Social Security retirement benefit is $1,328/month. 7 Element can help make up the difference between the money you have available and the cost of LTC services.

6 5 Element Coverage Plans Element has four plans, so you can choose the level of coverage that works best with your needs and budget. Element Coverage Plans 8 Element 25 Element 50 Element 75 Element 100 Coverage Maximum This is the policy limit of how much money will be paid for services or facilities. $25,000 $50,000 $75,000 $100,000 Monthly Benefit Amount Benefits are reimbursed up to a monthly benefit amount. Each Element plan has a set monthly benefit amount which is the maximum amount that will be paid out in any one-month time period. Those amounts are outlined on the worksheet on page 14. Benefits are reimbursed up to this amount monthly until you have used all of your Coverage Maximum. Your Element plan will include: Informal Care Informal Care reimburses covered Homemaker and Chore Care expenses up to 50% of your monthly benefit. Examples would be assistance with meal preparation, laundry and light housecleaning, and minor household repairs related to your safety while you live in your home. With this benefit, Homemaker and Chore Care may be received from an informal provider not affiliated with an agency. Home Modifications Home Modifications that help to relieve the need for direct physical assistance may be covered. This may include ramps that help you move around your house, or grab bars to assist in toileting or bathing. The total amount of coverage you would have available would be 3 times your monthly benefit. 1st Day Home Care This benefit waives the elimination (waiting) period for Home and Community Care so that payment for covered Home and Community Care services can start immediately. Inflation Protection Inflation protection helps your benefits keep up with the rising cost of care. Each year on your policy anniversary, we will apply an automatic 2% compound inflation increase to both your monthly benefit and Coverage Maximum. 5% compound inflation protection is available with a customized Privileged Choice Flex 3 plan, at an additional cost, which may be substantial. Increase Coverage Option This feature provides an option to apply for additional coverage on each policy anniversary. You can increase your coverage subject to the limits set forth in the policy. Waiver of Premium No premium payments will be due while you are receiving benefits under the policy. Refund of Premium up to Age 65 If you die before age 65, we ll give everything you ve paid in minus any claims to someone you designate. 8 Element 25 not available in Arizona. Additional benefit options are available within Privileged Choice Flex 3. Please see worksheet on page 14 for additional information.

7 A couple of things to know Our benefits and rates are especially designed with couples in mind. John and Sue 6 Shared Benefit You and your spouse or partner can purchase an optional Shared Benefit that allows you to combine your Coverage Maximums. Even if one person ends up using all of your combined coverage, the remaining spouse or partner will still get half of their original coverage amount for their long term care needs. 9 Couple s Premiums and Discounts If you and your spouse or partner apply for and are issued coverage, you will both receive Couple s Premiums which are lower than if you apply as an individual. There is also a 15% discount off of the gender-specific, individual premiums for individuals that have a spouse or partner, but are applying alone. Element in action (a hypothetical example) John and Sue both purchase an Element 50 plan. Each insurance plan has a $50,000 Coverage Maximum (Max). So with the Shared Benefit option, they have a combined $100,000 for eligible LTC expenses. The top 3 reasons couples say they bought long term care insurance: 10 Coverage Max John: $50,000 Coverage Max Sue: $50, Increase the likelihood we could stay together while receiving care Minimize the financial and emotional impact on the rest of the family by having insurance pay for our care $100,000 Total Shared Coverage Max John ends up going into a nursing facility while Sue remains at home. John s care ends up costing $90,000, which is reimbursed under the policy, before he passes away. $90,000 used for John s long term care Sue: $10,000 9 If you reduce your coverage amount any time after starting your policy, the guaranteed benefit will be based on the new reduced amount. In Arizona, if you use the entire shared Coverage Maximum, your spouse's/partner's Coverage Maximum is guaranteed to be the greater of 50% of their original individual coverage or their Monthly Benefit multiplied by 24. In Connecticut,the 50% minimum guarantee is not available. 10 Online Focus Groups conducted by Genworth Customer Insights Team, October Can t afford to miss time from work to provide care around-the-clock Now that Sue requires care herself, she is still guaranteed $25,000 of coverage to reimburse her covered LTC expenses. $100,000 Total Shared Coverage Max Original Coverage Max Sue: $25,000 Guaranteed Coverage

8 7 Care for today and tomorrow Whether it s helping protect your assets or helping you find resources to meet an LTC need, we are here when you need us. Caregiver Support Services 11 Caregiver Support Services can provide helpful information if you have an immediate family member, such as a spouse/partner, parent or grandparent, who may be in need of LTC. These professionals can: Answer any care-related questions. Help with needs assessments and create care plans. Help you find providers and connect you with online resources. Create a customized resource guide of local care providers and organizations. Genworth Life pays for the cost of this service, and your available benefits are not reduced if you use these services genworth.com/caresupport Live+Well SM Live+Well 12 is a wellness program available to new LTC insurance policyholders. With this free program you ll have access to Mayo Clinic s premier healthyliving tips, educational information, and specialized wellness tools. Privileged Care Coordination Your Privileged Care Coordination Team will include a nurse or other licensed health care practitioner. They re available as soon as you make a claim. This team can: Assess your capabilities and needs. Help identify services and qualified providers. Develop and suggest plans of care. Make sure facilities and services you re using are certified. Help you understand and complete your initial claim forms. Genworth Life pays for the cost of this service. Your available benefits are not reduced if you use these services genworth.com/caresupport genworth.com/livewell 11 Caregiver Support Services are currently provided through CareScout. CareScout is a Genworth business that provides professional elder care related support activities. The Caregiver Support Services listed above are the services Genworth is currently offering under this program. Genworth may change the provider and/or these services at any time. In Connecticut, Caregiver Support Services are not part of the policy and may be discontinued at any time. 12 Live+Well is a wellness program. It is not an insurance benefit. Live+Well services are currently provided through Mayo Clinic. The Live+Well services listed above are the services Genworth is currently offering under the Live+Well program. Genworth may change the provider and/or these services at any time. Participation in the wellness program is optional. In Connecticut and NJ, Live+Well is not part of the policy and may be discontinued at any time.

9 8 We want you to know Elimination Period If you receive your care at home or through community care, your benefits start as soon as you qualify for long term care services. If you receive care in a nursing home or assisted living facility, there is a 90-day time period where you will need to pay for those expenses. This is called an Elimination Period. Days that you receive home and/or community care count toward satisfying the Elimination Period as well as any days that are paid by Medicare or its coinsurance. Tax-qualified Long Term Care Insurance Element is intended to meet the requirements for federally tax-qualified long term care insurance. As such, it reimburses covered expenses for qualified long term care services under IRC Section 7702B(b). Guaranteed Renewability Once you re insured, as long as you pay your premiums on time and do not exhaust your benefits, your coverage is guaranteed renewable and cannot be canceled except as may be provided by the Misstatements and Incontestability Provision. Late Payment Protection In order to keep your policy in force you must make premium payments as specified in your policy. To help ensure that your policy doesn t lapse by mistake, you may designate another person for us to notify if we do not receive your premium payment on time. We will inform you in writing at the beginning of a Grace Period of a payment that must be made to avoid lapse. If that payment is not made within 66 days of entering the Grace Period, the policy will lapse. Premiums We have the right to increase premiums in the future, as stated in the policy. Premiums may not, however, be increased due to changes to your health status or age. Premiums must be paid as specified in your policy to maintain coverage. 30-Day Free Look This gives you the opportunity to review your policy and, if you are not completely satisfied, return it within 30 days for a full refund. State Partnerships for Long Term Care 13 The coverage advertised may meet the requirements for participation in a Long-Term Care Insurance Partnership Program in some states. Under this Program, the policyholder may be able to protect assets from Medicaid spend-down requirements through a feature known as "asset disregard." Nothing in a policy or certificate issued by a company is a guarantee of Medicaid eligibility, nor a guarantee of any ability to disregard assets for purposes of Medicaid eligibility. Please also note that states do not take part in company-specific marketing plans, and states do not endorse specific companies or company specific policy and certificate forms. If you have questions about the availability of this Program in your state, please contact the company or your state insurance department. Medical Exam As part of the application process, a medical exam may be required to determine eligibility. 13 Element does not qualify for Partnership in Indiana.

10 9 Additional Information Exclusions and Limitations We will not pay Benefits for any expenses incurred for any room and board, care, treatment, services, equipment, or other items: For which no charge is normally made in the absence of insurance; Provided outside the United States of America, its territories and possessions, unless specifically provided for by a Benefit; Provided by Your Immediate Family, unless: specifically covered by a Benefit or he or she is paid as a regular employee of the organization that provides the services to You; Provided by, or in, a Veteran s Administration or Federal government facility, unless a valid charge is made; Resulting from illness, treatment or medical condition arising out of any of the following: War or any act of war, whether declared or not; Attempted suicide or an intentionally self-inflicted injury; Resulting from Your alcoholism or drug addiction (except for an addiction to a prescription medication when administered in accordance with the advice of a Physician). Non-Duplication Benefits will be paid only for Covered Expenses that are in excess of the amount paid or payable under: Medicare (including amounts that would be reimbursable but for the application of a deductible or coinsurance amount); and Any other Federal, state or other government health program, or law except Medicaid. This Non-Duplication provision will not disqualify a Covered Expense from being used to satisfy any Elimination Period requirement. Other Coverage 14 If you have other coverage that pays for long term care expenses, benefits that are otherwise payable to you will be reduced so that the combined benefits under all coverage do not exceed 100% of your actual expenses for covered care. Review the Outline of Coverage and your policy for state-specific details of the exclusions and limitations. THE POLICY MAY NOT COVER ALL THE EXPENSES ASSOCIATED WITH YOUR LONG TERM CARE NEEDS. What's next? Read through "Is Element right for you?" on the next couple of pages to assess your eligibility. Select the appropriate Premium rates on pages 12 and 13 to find out how much your monthly premium will be for the Element plan you select. Work with your agent/producer to complete the initial application. Schedule and complete an interview with our underwriter. Based on the results of your interview, the underwriter will determine if additional requirements are needed. Once a decision has been made, Genworth will notify your agent/producer and they will contact you. If approved, Genworth will mail your policy to you and collect your initial premium. 14 Other Coverage is only applicable in the District of Columbia and Delaware.

11 10 Is Element right for you? Certain conditions limit eligibility for long term care insurance. You can use the following guidelines to assess your eligibility and determine if you want to move forward with Element. Answering no to all of these questions does not guarantee acceptance. All applications are subject to underwriting. Are you currently covered by Medicaid? Do you need any assistance with everyday activities such as bathing, bowel/bladder control, dressing, eating, moving in and out of a bed/chair, and toileting? Do you currently use a quad cane, walker, wheelchair, motorized scooter, stair lift, hospital bed, oxygen, respirator or receive kidney dialysis? Do you take any of the following medications? Brand Name Generic Height and Weight Chart Please review the chart below to determine if you fall within the acceptable weight range for your height. Maximum Weight Minimum Weight Height (ft/in) Male Female Diabetic All Antabuse Aricept Avonex (if for MS) Betaseron (if for MS) Campral Depade Exelon Namenda disulfiram donepezil HCl interferon beta-1a interferon beta-1b acamprosate calcium naltrexone rivastigmine memantine (continued next page)

12 11 Is Element right for you? (continued) How much will my Element Plan cost? Have you ever been diagnosed or treated for any of the following conditions? Alzheimer s Disease/Dementia/Memory Loss Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig s Disease) Bipolar Disorder (Manic Depression) Cancer (except basal cell) treated within the past 12 months; or Metastatic Cancer (spread from original site/location) Cystic Fibrosis Diabetes (Type 1) Huntington s Disease Multiple Sclerosis (MS) Muscular Dystrophy Organ transplant (other than kidney or cornea) Parkinson s Disease We have included our premiums 15 so you can easily access how much the different Element Plans would cost you. Couples Applying Together If you are applying with a spouse or partner, refer to the Couple's Premiums on page 12. These premiums are per person and already incorporate discounted pricing for couples. Individual Applicants If you are the only person applying for coverage, please refer to the genderspecific individual premiums on page 13. If you have a spouse or partner, you may apply a 15% discount to your premium. The premiums on the following pages are monthly. You have the flexibility to pay your premium annually, semi-annually, quarterly or monthly. 16 Schizophrenia or other forms of Psychosis Stroke Transient Ischemic Attack (TIA) within the past 5 years, two or more TIAs, or a TIA in combination with Heart Disease/Surgery 15 We have the right to increase premiums in the future, as stated in the policy and subject to state regulations. Premiums may not, however, be increased due to changes in your individual health status or age. Rather, any premium rate increases that may be implemented must be on a class-wide basis. Premiums must be paid or specified in your policy to maintain coverage. 16 You have the ability to choose to pay premiums annually, semi-annually, quarterly, or monthly. Additional charges apply if you pay your premiums more frequently than annually. The more frequent the payment mode, the more charges you will incur. The monthly premiums shown include the additional premium for monthly mode. For more information, please refer to the Modal Premium Disclosure in your Policy.

13 12 Monthly Premiums for Couples Couples without Shared Benefit (rate per person) Issue Age Element 25 Element 50 Element 75 Element $32.54 $46.48 $69.69 $ Couples with Shared Benefit (rate per person) Issue Age Element 25 Element 50 Element 75 Element $37.55 $53.63 $80.42 $

14 13 Monthly Premiums for Individuals 15% discount available for individual applicants that have a spouse/partner Male Issue Age Element 25 Element 50 Element 75 Element 100 Female Issue Age Element 25 Element 50 Element 75 Element $40.44 $57.78 $86.64 $ $55.00 $78.58 $ $

15 14 My Element Plan Name: Name: Element 25 Element 50 Element 75 Element 100 Element 25 Element 50 Element 75 Element 100 Choose your plan: 17 Coverage Maximum This is the policy limit of how much money will be paid for services or facilities. $25,000 $50,000 $75,000 $100,000 $25,000 $50,000 $75,000 $100,000 Monthly Benefit Amount This is the most that will be paid out in any one-month time period. $2,084 $2,084 $3,125 $4,167 $2,084 $2,084 $3,125 $4,167 OPTIONAL Shared Benefit Option This allows you to combine Coverage Maximums. Yes No The Shared Benefit option requires couples to select the same Element Plan. Your Monthly Premium will be: $ $ 17 Element 25 is not available in Arizona. Under the Element plans, we offer only one underwriting category the Select category for original coverage and for any future additional coverage you may be able to purchase. We will also use a more streamlined underwriting process than we use with higher benefit level coverages within Privileged Choice Flex 3. By going through more thorough underwriting than you would for an Element plan, you may be able to obtain more coverage at the same or different premium than available with Element, although this is not guaranteed. Further, there are additional benefit options available within Privileged Choice Flex 3 at an additional cost, including 5% Compound Inflation Protection. Please talk to your licensed agent/producer if you have any additional questions.

16 Why Genworth? Our Commitment to Service Choosing an insurance company is an important decision. You want to feel confident that the company will take care of you at your greatest time of need. We understand that our relationship with you is at the heart of everything we do. Whether you re calling with an inquiry, to access your benefits, or simply update your policy, you ll find well-trained customer service representatives that are empowered to handle your request. Our strength is in our people. We believe in our products and our promise because we witness how it benefits our customers lives every day. We are here to serve you with award-winning service today and in the future. Dalbar Long-Term Care Service Award * * Element SM Read the policy for full information about product features, benefits and limitations. The descriptions contained in this brochure are only summaries and are not intended to be a substitute for the policy. In the event of a conflict, policy terms and provisions will prevail. This is a solicitation of insurance for policy form series 8000R1 and 8001R1. Policy form number may be followed b y the state's two letter abbreviations, for example, 800R1DE. Details about the costs, benefits, limitations and exclusions of these long term care insurance policies will be provided to you by a licensed insurance agent/producer. When you respond, an insurance agent/producer will contact you. All benefits of the insurance policy are backed by the claims paying ability of the issuing insurance company. They are not backed by the insurance agency from which this insurance policy is purchased or any affiliates of that agency, including without limitation its affiliate broker/dealer, and none of these entities makes any representations or guarantees regarding the claims-paying ability of the issuing insurance company. All applications are subject to the underwriting requirements of Genworth Life Insurance Company and are subject to change. Genworth Life Insurance Company has the right to increase premiums in the future, as stated in the policy. Premiums must be paid as specified in the policy to prevent lapse of coverage. Underwritten by Genworth Life Insurance Company, Richmond, VA 2016 Genworth Financial, Inc. All rights reserved. Insurance and annuity products: Are not deposits. May decrease in value. Are not insured by the FDIC or any other federal government agency. Are not guaranteed by a bank or its affiliates.