Group Long Term Care Insurance

Transcription

1 Group Long Term Care Insurance Employee presentation June 2, 2015

2 What is long term care? It is type of the care required when someone: Needs assistance with the basic Activities of Daily Living (ADLs): Bathing Dressing Toileting Transferring Continence Eating The need for this care can be triggered by: Aging An accident A catastrophic illness, like a stroke Suffers severe cognitive impairment Such as Alzheimer s 2

3 Why should I consider long term care insurance? Getting a long term care policy can help with Asset preservation financial planners recommend it. Maintaining control of some important decisions, like where you ll receive care and who will provide it. It can help people avoid Depleting their savings Liquidating most of their assets or Relying on help from a son, daughter, or another family member Self funding could be difficult Only 13% of Americans say they are very confident they will have enough money to pay for long term care expenses in retirement. 1 1 Employee Benefit Research Institute (EBRI) and Mathew Greenwald & Associates, Inc., 2011 Retirement Confidence Survey, March

4 How can long term care insurance help? Long term care insurance may help give you a sense of control and added peace of mind. People prefer to: Stay in their own communities Receive care at home if possible Choose their caregivers 4

5 Cost of Long term care Prolonged expenses can add up quickly. Just take a glance at these statistics: National average median rates for care: Home Health aide Assisted living Nursing home (private room) $21 per hour $5,247 per month ($62,964 per year) $240 per day ($87,600 per year) According to these statistics, a $250,000 nest egg would last less than three years if you were confined to a nursing home Statistics 5

6 Where can I receive care? Professional home care Includes visits to your home by a licensed home health care provider. The services provided can include: Skilled nursing care Physical, respiratory Occupational Dietary or speech therapy Adult day care or hospice care Homemaker services Assisted living facility An institution licensed by the appropriate agency (if required) to provide on-going care and services to a minimum of three inpatients in one location. Long term care facility An institution or distinctly separate part of a hospital that provides skilled, intermediate or custodial care under state licensing and certification 6

7 Does any other insurance pay for this care? Not necessarily, Medical insurance: is designed to pay for specific care for acute conditions not for long term help with daily living. Medicare: is designed to pay for specific care for acute conditions if you are age 65 or over not for long term help with daily living. Medicaid: generally, Medicaid doesn t pay for long term care but pays only for medically necessary skilled nursing care. Medicaid sometimes pays for nursing home care for older people with low incomes and limited assets. Who is eligible and what services are covered varies from state to state. 1 1 Medicare, "What Is Long-Term Care?" [cited December 23, 2010]; available from 7

8 Why buy long term care insurance now? The younger you are when you sign up, the lower the premiums Level premium** You could develop a health condition that makes it impossible or unaffordable for you to buy coverage at a later age Your plan has continuation of coverage you can keep it if you leave your present employer 10 Year Rate Guarantee If you decline coverage when newly eligible and decide to purchase at a later date, Medical underwriting and proof of good health will be required **We reserve the right to change any or all premiums. Any change in premium must apply to all similar policies issued, on this policy form, in the state in which the policy is issued. Premiums cannot be increased because of any change in the age or health of the persons covered under the policy. 8

9 How would I qualify for benefits? If you: Suffer severe cognitive impairment or the loss of two Activities of Daily Living (ADLs) Cognitive Impairment examples, dementia ADLs include personal hygiene, feeding, dressing, functional transfers and ambulation. Experience the loss/impairment that is expected to last 90 days As certified by a licensed health care practitioner Have a plan of care From a licensed healthcare practitioner Meet your policy s elimination period 9

10 Long term care insurance Your plan design

11 Benefit Provisions Eligibility Actively at work Minimum number of hours (20 hrs.) Delayed effective date Eligible Family Members Level of care Professional home care Assisted living Long term care facility 11

12 MITRE s Plan Design Plans Check one Option 1 Option 2 Option 3 Long Term Care Facility Long Term Care Facility Long Term Care Facility 75% Professional Home and Community Care 75% Professional Home and Community Care 75% Professional Home and Community Care Restoration of Benefits Simple Inflation Compound Inflation Non-forfeiture Shortened Benefit Period Restoration of Benefits Restoration of Benefits Non-forfeiture Shortened Benefit Period Non-forfeiture Shortened Benefit Period Facility Monthly Benefit Amount Check one $3,000 $6,000 $9,000 Facility Benefit Duration Check one. Note: Duration of benefits may vary depending on where benefits are received. 3 Years 5 Years All active employees and newly hired employees who enroll after the Guarantee Issue enrollment period must complete the Long Term Care Insurance Application (medical questionnaire). All other applicants must complete this Benefit Election Form and the Long Term Care Insurance Application (medical questionnaire) for any selection. A signed Authorization to Request Medical Information (form # in the kit) must accompany all medical questionnaires. 12

13 Inflation protection option 5% Simple Benefit Inflation protection option is an optional benefit that can help maintain the value of your LTC benefit over time. Even though your benefit dollars increase, your premiums will not. The pool of benefit dollars will increase by 5% of the original amount each policy anniversary for the life of the policy. For illustrative purposes only. Additional premium is charged for this option. 13

14 Inflation protection option 5% Compound Inflation Inflation protection option is an optional benefit that can help maintain the value of your LTC benefit over time. Even though your benefit dollars increase, your premiums will not. The pool of benefit dollars will increase by 5% on a compound basis each policy anniversary for the life of the policy. For illustrative purposes only. Additional premium is charged for this option. 14

15 Non-forfeiture option Shortened benefit period 3 years If premium payments stop after the shortened benefit period provision has been in force for at least 3 years, you will remain eligible for a non-forfeiture benefit. Your lifetime maximum benefit is equal to the total of all premium paid for the plan Minus the total amount of benefits already paid to you Once coverage is continued under this provision, other provisions that would normally increase the monthly benefit will end For illustrative purposes only. Additional premium is charged for this option. 15

16 Alternate Care Benefit Once you are eligible for a benefit payment, you will have access to the Alternate Care Benefit designed to assist you in living at home or in other residential housing. You do not need to complete your elimination period for the Alternate Care Benefit payment to begin The Alternate Care Benefit will decrease your lifetime maximum benefit 16

17 LTC Connect additional help for caregivers Trained information specialists Confidential and impartial help Toll-free access Policy # No additional cost and no obligation Quick answers on related long term care topics Discount on long term care facilities and equipment LTC Connect is provided by Life Plans, Inc. and is available with selected Unum Long Term Care insurance offerings. Exclusions, limitations and prior notice requirements may apply, and service features, terms and eligibility criteria are subject to change. The service is not valid after termination of coverage and may be withdrawn at any time. LTC Connect is not a Guaranteed service and may be discontinued at any time. Discounts may vary. Please contact your Unum representative for full details. 17

18 Restoration of Benefits Rider As long as you have not depleted all of your lifetime maximum benefits following recovery from a loss of ADLs or a severe cognitive impairment, we will restore: 100% of your LTC facility monthly benefit 100% of your lifetime maximum benefits Your LTC benefits will be restored after: You have not been disabled as defined in the policy for at least 180 consecutive days, and You have not received benefits during that 180-consecutive-day period There is no limit to the number of times the lifetime benefit amount can be restored 18

19 Exclusions Unum will not provide benefits for: A chronic illness caused by war or any act of war, whether declared or undeclared, that occurs while your coverage is in force. A chronic illness caused by intentionally self-inflicted injuries or attempted suicide, while sane. A chronic illness caused by the participation in a felony, riot or insurrection. Alcoholism or drug addiction Any period of time while you are chronically ill and you are confined in a hospital, other than if you are confined to a LTC Facility that is a distinctly separate part of a hospital. This exclusion does not apply to those periods covered under the Bed Reservation Benefit. Any period of time while you are chronically ill and you are outside the United States, its territories or possessions or Canada for 30 consecutive days or longer if Home Care Monthly Benefits are not selected. 19

20 Questions? This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy Forms GLTC04 and RGLTC04 or contact your Unum representative. Long term care insurance is underwritten by: Unum Life Insurance Company of America, 2211 Congress Street, Portland, Maine Unum Group. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. EN-1357 (9-11) 20