Facts-at-a-Glance. Performance LTC. Long-Term Care Insurance. LTC /16 Rev. 10/16. For producer use only. Not for use with consumers.

Transcription

1 Facts-at-a-Glance Performance LTC LTC /16 Rev. 10/16 a For producer use only. Not for use with consumers. Long-Term Care Insurance

2 Facts-at-a-glance Performance LTC Policy Design Options 1 Issue Ages Maximum Daily/Monthly Benefits Benefit Periods Daily Benefit (Standard rates) $50 to $400 $10 increments 2, 3, 4, 5, 6 years Monthly Benefit (for an additional cost; daily to monthly conversion factor) $1,500 to $12,000 $100 increments Elimination/Deductible Periods Flex Credits, Premiums, & Inflation Options 30, 60, 90, 180, or 365 days of service 1 day = 1 day True cumulative Elimination Period (EP); days of service do not need to be consecutive or within same claim Base rates include the 90-day EP Rates are (+20/+10/+0/-10/-28%) of the base rate for 30/60/90/180/365, respectively For Home Health Care, a minimum of two hours of covered care per day is required to count as one day toward the Elimination Period Flex Credits Calculated according to a formula that takes into consideration the company s insurance and investment experience On each policy anniversary your client is eligible to earn Flex Credits Flex Credits are not guaranteed and can be negative. Negative Flex Credits are carried forward until offset by future positive Flex Credits Any positive Flex Credits are applied to your client s personal Flex Account Clients can choose to use amounts in their Flex Account to reduce Policy Premiums or keep Flex Credits in their Flex Account to accumulate with interest Premiums Policy premium The contractual premium for Performance LTC. Based on very conservative insurance and investment assumptions; may be offset by Flex Credits from the Flex Account Net premium (Premium) The amount of money your client pays for Performance LTC out of pocket after Flex Credits from the Flex Account are applied 3% Compound Inflation Automatically included The Daily/Monthly Benefit and Total Pool of Money will automatically increase annually by 3% compounded, even while your client is on claim The policy premiums for Performance LTC will increase annually, through age 90, with the possibility of being partially or fully reduced in the future by the growth in the Flex Account Your client can decide to opt out of receiving future inflation increases of 3% Compound, in which case Policy Premiums will no longer increase and future Flex Credits will be lower 5% Compound Inflation For an additional cost, your client can select the 5% Compound inflation benefit The Daily/Monthly Benefit and Total Pool of Money will automatically increase annually by 5% compounded, even while your client is on claim The Policy Premiums do not increase, and have the possibility of being offset partially or fully in the future by the growth in their Flex Account 1

3 Eligibility for Payment of Benefits Coverage 2 out of 6 ADLs with hands-on or standby assistance, or severe cognitive impairment with substantial supervision Subject to the Elimination Period Receiving covered care or services according to an acceptable Plan of Care Chronically Ill and need written certification from a Licensed Health Care Practitioner that claim is expected to last for a period of at least 90 days Nursing Home, Assisted Living Facility, Adult Day Care, Home Care, and Hospice Care Core Features 1 (no additional premium) Nursing Home and Assisted Living Facilities Home Health Care Flex Account International Coverage Care Advisory Services 100% of actual Nursing Home or Assisted Living Facility charges are covered, up to the Benefit Amount All benefits will be deducted from the Total Pool of Money Must meet policy definition of a qualified facility 100% of Home Health Care services are covered for qualified long-term care services defined in a comprehensive plan of care up to the Benefit Amount Services covered include Adult Day Care, care in the policyholder s home, and Hospice Care Services All benefits will be deducted from the Total Pool of Money Includes incidental homemaker services (shopping not included) Must meet policy definition of a qualified provider The place where Flex Credits are stored and grow at the Declared Rate Flex Account can be applied in the following ways: To reduce policy premiums To pay for services that can help your clients remain in their own homes To reimburse LTC expenses during the Elimination Period, instead of having to pay out-of-pocket To reimburse LTC expenses in excess of the long-term care benefit amount To provide a refund of premium upon death or surrender In order to keep the policy in-force, any portion of the policy premium not paid by the policyholder will automatically be deducted from any available Flex Account balance on each premium due date. Example: If the quarterly policy premium is $400, the available Flex Account balance is $200, when the policyholder pays a Net Premium of $300, then $100 will be deducted from the Flex Account Provides coverage anywhere outside of the United States Coverage is 365 times the Daily Benefit or 12 times the Monthly Benefit All services are covered except for Care Advisory Services, Additional Accident Benefit, Additional Stay at Home Services as described in the Flex Account Benefit in this list of exceptions, and Waiver of Home Health Care Elimination Period Not applicable for care or treatment in any sanctioned countries or territories Daily: Limit equals the actual charges up to 10 times the Daily Benefit amount each calendar year Monthly: Limit equals the actual charges up to 1 /3 of the Monthly Benefit amount each calendar year Not subject to, nor does it satisfy, the Elimination Period Does not reduce the Total Pool of Money 2

4 Bed Hold Benefit Additional Accident Benefit Return of Premium Benefit Care Support Services Hospice Care Benefit Policy Management Tools Covers 60 days of bed-hold per calendar year for any reason Subject to the Elimination Period; reduces the Total Pool of Money If your client needs care as a result of an accidental injury that occurs before the age 65, the total benefit will be calculated as follows: If the LTC Benefit Amount is less than $250 Daily Benefit (DB), the total benefit available is 2 times DB If the LTC Benefit Amount is greater than or equal to $250 Daily Benefit (DB), the total benefit available is $500 If the LTC Benefit Amount is less than $7,500 Monthly Benefit (MB), the total benefit available is 2 times MB If the LTC Benefit Amount is greater than or equal to $7,500 Monthly Benefit (MB), the total benefit available is $15,000 Benefit increases with inflation. Subject to underwriting approval If death occurs prior to age 65, John Hancock will pay a benefit to the designated beneficiary equal to the total Net Premiums paid less any claims paid Extends services to policyholder s family members Personalized support via toll-free call Website access and information John Hancock reserves the right to change vendors, modify, or discontinue this service in the future This benefit will cover end-of-life care for your clients in their home or in a facility Also includes support for your client s family In-force Illustration Accompanies the annual statement and provides a hypothetical projection of future Flex Credits and Net Premiums Flex Credit Deferral Automatically defer 25%, 50%, 75% or 100% of Flex Credits to accumulate in the Flex Account for future use The portion of the Flex Credit not deferred will be used to determine the Net Premium Levelize Benefits option to decline a 3% Compound benefit increase to lower future Net Premiums Benefit Reduction option to reduce the benefits thereby lowering Net Premiums 3

5 Consumer Protection Provisions 1 Alternate Services Benefit Independent Third-Party Review Timely Payment of Claims Third-party billing notification Contingent Nonforfeiture Lapse Prevention Safeguard Helps to ensure that policyholders have access to emerging services that may develop over time, but are not currently identified in their policy Example: In certain circumstances, benefits for services not specifically covered under the policy may be authorized at the time of the claim, such as robotics Benefit paid must be a lower-cost alternative to covered services In the event that an insured is determined not to be Chronically Ill and denied benefits, the policyholder will have the right to request an independent third-party review Decision of that third party will be binding and must be upheld by John Hancock In the event (upon receipt of proof of loss) that a claim payment takes longer than 30 days to process, we will pay the policyholder an interest penalty of 1% of the claim amount per month The policyholder may designate someone to receive notice of the overdue premium before the policy lapses In the event John Hancock cumulatively increases rates by more than the specific amount shown in the Contingent Nonforfeiture provision, we will provide policyholders with the opportunity to: pay the increased premium decrease their benefits to a level supported by their current premium elect the Contingent Nonforfeiture Benefit Under the Contingent Nonforfeiture Benefit, the policy will remain in-force with a reduced Total Pool of Money equal to the sum of the premiums they have paid, but not less than 30 times the Daily Benefit amount or one times the Monthly Benefit amount Any balance in the Flex Account will continue to earn interest, but the policyholder will no longer be eligible to receive Flex Credits Will be automatically included in the policy at no cost, in the event that traditional Nonforfeiture is not purchased The policy cannot lapse while your client is receiving benefits at least one day a week If your client is on claim and misses a premium payment, the Flex Account Benefit will automatically apply any Flex Account balance toward their premium to help keep the policy in-force If the Flex Account balance is insufficient, the policy s 65-day grace period will begin If there continues to be premium due at the end of the grace period, the Lapse Prevention Safeguard benefit will automatically deduct the remaining premium from the benefit payments, until the premiums have been paid in full to ensure that the coverage remains in-force If benefit payments made under this policy are less than the premium due at the end of the policy year, the Lapse Prevention Safeguard benefit will waive the remaining premium due for that policy year. The premium payment requirement and Flex Credit eligibility resets every policy anniversary 4

6 Ratings & Discounts 1 Underwriting Classes Discounts Available Loyalty Credit Payment Options Billing Information Preferred 10% discount off Select rates Select (Standard) Class I (125% of Select premium) Class II (150% of Select premium) Couples/Partner Discount 30% if both individuals apply at the same time, are approved for coverage, and accept the individual LTC insurance policies 35% for unisex/employer sponsored groups Partners are defined as: married couples people who have lived with a family member of the same generation for at least three years people who have lived with a partner of the same sex or opposite sex in a committed relationship for the past 12 months people who have a valid certificate or license of Civil Union or Registered Domestic Partnership as recognized by the state in which they are applying Preferred Discount 10% discount off Select rates (maximum combination of Couples/Partner and Preferred Discounts is 35%) 40% for unisex/employer sponsored groups Sponsored Group 5% Valued Client 5% Family Discount 5% (must have at least three members of immediate family buy separate individual John Hancock LTC insurance policies within 6 months) A policy can have either the Family, Sponsored Group, or Valued Client discount (not more than one) Discounts are multiplicative and reduced commission rates apply Allows current John Hancock LTC insurance policyholders of a different policy series to purchase Performance LTC with a 5% reduction in the annual premium Original policy must have been in-force at least three years Rates are based on attained age, and are fully underwritten This discount is multiplicative Direct bill Annual, Semi-annual, Quarterly Bank draft Annual, Semi-annual, Quarterly, Monthly List bill all modes for Sponsored Group cases (Modal Factors: Semi-annually 0.515, Quarterly and Monthly 0.087) The Net Premium will be the billed premium amount for all modes and methods. The amount of the Net Premium will be communicated to policyholders on Bank Draft and on List bill annually. For purposes of billing, the Net Premium is calculated as follows: When there is no Flex Credit deferral, the Net Premium will equal the Policy Premium less the Flex Account balance as of the beginning of the policy year. This means that for modes other than annual, any interest earned on the Flex Account balance throughout the policy year will not be taken into account until the following anniversary When there is a Flex Credit deferral, the Net Premium will equal the Policy Premium less the portion of the Flex Credit that is not being deferred 5

7 Optional Benefits 1 (Requires additional premium) SharedCare Waiver of Home Health Care Elimination Period Nonforfeiture This benefit allows partners to access the available benefits (including any Flex Account balance) under the other s policy once their own policy and Flex Account have been exhausted. If either partner dies: The survivor s policy is automatically increased by the remainder of deceased s Total Pool of Money. Any remaining balance in the deceased partner s Flex Account will be paid as a death benefit to the survivor, up to the total amount of Net Premiums paid If the Flex Account exceeds the total Net Premiums paid, the remainder will be added to the survivor s Flex Account Premiums for both riders and the deceased s policy cease There is also a 60-day purchase offer for a 2-year benefit plan for the policyholder whose benefits are exhausted by their partner. Rates are based on attained age; the policyholder will not be subject to underwriting and cannot be determined Chronically Ill in the prior two years in order to qualify. This offer is good through age 90. Note: Partners (spouses/couples) include policyholders who: Are married Have lived with a family member of the same generation (sibling or cousin) for at least three years Have lived with a partner of the same sex or opposite sex in a committed relationship Partners must select the same benefit options, except Elimination Period In AZ, available only with the 4-, 5-, or 6-year Benefit Period. For policies issued Substandard class, SharedCare is only available with a 2- or 3-year Benefit Period (in AZ it is only available with a 4-year Benefit Period) Annual Rider cost is 26% for 2-year Benefit Period, 16% for 3-year Benefit Period, 11% for 4-, 5-, 6-year Benefit Period Waives the Elimination Period for home health care, creating a Zero-Day Elimination Period for home health care Days of home health care services count toward the facility Elimination Period Not available with 180- or 365-day Elimination Periods Annual rider cost is 17% If the policy lapses after three years, a policyholder will have a paid-up policy with the Total Pool of Money reduced to the greater of Net Premiums paid, or one times the Monthly Benefit amount, or 30 times the Daily Benefit amount Any balance in the Flex Account will continue to earn interest, but the policyholder will no longer be eligible to receive Flex Credits Annual rider cost is 10% 6

8 For producer use only. Not for use with consumers. Long-term care insurance is underwritten by John Hancock Life Insurance Company (U.S.A.), Boston, MA (not licensed in New York) and in New York by John Hancock Life & Health Insurance Company, Boston, MA MLI