Custom Care II and Essential Care II Product Comparison Chart

Transcription

1 Custom Care II and Essential Care II Product Comparison Chart Benefit Trigger 2/6 ADLs Same Same Same Cognitive impairment Hands-on or standby assistance 90-day certification NH/HHC Pools 1 Pool 1 Pool 1 Pool 1 Pool Issue Ages Same Same Same Maximum daily/weekly/ monthly benefits Same Same as EC LTC benefit amount: Covers NH, ALF, ADC, Home Care, Hospice Care, and Bed-holds NH daily benefit: $ in $10 increments (limit $250 for ages 80-84) Benefit Periods (*not available for ages 80-84) Elimination Periods (*options not available for ages 80-84) LTC benefit amount options: Monthly $1,500 to 15,000 for ages $1,500 to 7,500 for ages $100 increments Daily Benefit $50 to 500 for ages $50 to $250 for ages $10 increments 2,3,4*,5*,6* or 10* years, or Lifetime* Same Same Same 30*, 60*, 90, 180 or 365 days True cumulative EP, days do not have to be consecutive or within same claim 1-7 = 7. i.e., at least one day of HHC in a week equals 7 days towards EP Base rates include the 90-day EP Rates are (+20/+10/+0/-10/-20%) of base rates for 30/60/90/180/365 respectively Same 30*, 60*, 90, 180 or 365 days True cumulative EP, days do not have to be consecutive or within same claim 1=1. i.e., Each day of HHC benefits counts as one day only toward the EP Rates are (+20/+10/+0/-10/-20%) of base rates for 30/60/90/180/365 respectively Same For financial professional use only. Not for use with the public. 1.

2 Inflation Options Guaranteed Purchase Option New GPO: option to change II Increases = 5, 10 or 15% of from GPO to Compound at age original LTC benefit amount. 65 for an increased premium Offered every 3 years if no GPO is not available with benefits have been paid within Survivorship and Waiver of past 2 years and PH is <= 91. Premium, Limited Pay or Family Default if inflation not chosen Care (for those plans, if the 5% Simple client doesn t want simple or 5% Compound compound inflation, they get no (for limited pay, family care inflation, rather than GPO) or employer pay-all situations) 5% Simple Increases are applied to 5% Compound increase in remaining policy limit daily/monthly benefit and 5% Will allow inflation to be dropped compound increase in policy limit 5% Compound increase in daily/monthly benefit and 3% compound increase in policy limit Nursing Home Benefits Part of LTC benefit 100% of actual NH facility charges are covered, up to the LTC benefit amount All benefits will be deducted from this one LTC benefit amount 100% of actual NH charges are covered, up to the NH DB Same as EC Assisted Living Facilities Benefit Part of the LTC benefit 100% of actual ACLF charges are covered, up to the LTC benefit amount All benefits will be deducted from this one LTC benefit amount ACLF MDB is 80% of the NH MDB 100% of actual ACLF charges are covered, up to the ACLF DB Same as EC For financial professional use only. Not for use with the public. 2.

3 Home Health Care Benefit Part of the LTC benefit Choices of 50, 80 or 100% of the Same as EC 100% of HHC services are NH DB covered up to the Benefit Amount 100% of HHC services are Services covered include: Adult covered up to the HHC DB Day Care, Professional Care in Services covered include: Adult your home, Hospice Care Day Care, Professional Care in services, and incidental your home, Hospice Care homemaker services services, and incidental All benefits will be deducted from homemaker services this one LTC pool. Respite Care Benefits Monthly Option: Respite Care equal to 21 days x 1/30 th of the LTC B amount per day per calendar year Daily Option: Respite Care equal to 21 days at the LTC B per day per CY Not subject to nor does it satisfy the EP (Weeks in which respite care is received to not count toward EP) Reduces policy limit After the EP, respite care is paid under the LTC benefit Respite Care not paid during EP. Can be paid in a NH, ACLF, or via home care Paid under the facility or HHC benefit, depending on site of care Same as EC Bed Hold Benefit Part of LTC benefit amount Covers 6o days of bed-hold per calendar year Any reason Subject to EP Reduces policy limit Will pay up to the applicable DB for up to 21 days per calendar year For hospitalizations only Subject to EP Reduces policy limit For financial professional use only. Not for use with the public. 3.

4 Care Advisory Services/Care Management, etc. Monthly: Care Advisory actual Not Available Not Available charges up to 1/3 of LTC (monthly) B amount per calendar year Daily: Care Advisory actual charges up to 10 times the LTC B per calendar year Not subject to nor does it satisfy the EP Will not reduce policy limit Stay At Home Benefit Stay at Home Benefit pays for home modifications, emergency alert systems, home safety check, caregiver training, provider care check designed to enable a claimant to remain at home Monthly Separate lifetime pool equal to one time the maximum benefit amount Daily Separate lifetime pool equal to 30 times the maximum benefit amount Not subject to nor does it satisfy the EP. Not Available Not Available Upgrade Provision in contract allowing upgrade if PH is eligible Reserved the right to use attained age rates and underwriting required Must meet issue requirements under new product and no benefits have been paid under policy Any refusal may impact the availability of future orders Upgrade provision removed Loyalty Credit will allow current JH policyholders of a different policy series to purchase CCII with an annual reduction in premium of 5%. Current policy must have been inforce at least 2 years. CCII rates based on attained age, and fully underwritten. Same as CCII (provision is dropped) Loyalty Credit available For financial professional use only. Not for use with the public. 4.

5 Waiver of Premium After EP is met and while benefits After EP is met if confined in NH or Same as EC are payable ACLF See also Survivor Waiver Rider Not available if receiving HHC, Adult Day Care, and Hospice or Respite Care if provided in a non-facility setting Coordination of Benefits Will include policy provision to coordinate with other JH LTC coverage in place (will not duplicate benefits if have multiple individual LTC policies with JH). Does not include True Group LTC or combination policies Exclusions This Policy does not cover care, treatment or charges: for intentionally self-inflicted injury. required as a result of alcoholism or drug addiction (unless drug addiction was a result of the administration of drugs as part of treatment by a Physician). due to war (declared or undeclared) or any act of war, or service in any of the armed forces or auxiliary units. due to participation in a felony, riot or insurrection. normally not made in the absence of insurance. provided by a member of Your Immediate Family, unless: the family member is one of the following professionals -- a duly licensed registered nurse, licensed vocational nurse, licensed practical nurse, physical therapist, occupational therapist, speech therapist, For financial professional use only. Not for use with the public. 5. Same as CC II (coordinate with other JH policies)

6 respiratory therapist, licensed social worker, or registered dietitian; and the family member is a regular employee of a Nursing Home, Assisted Living Facility, Adult Day Center or Home Health Care Agency which is providing the services; the organization receives the payment for the services; and the family member receives no compensation other than the normal compensation for employees in his or her job category. provided outside the fifty United States and the District of Columbia except as described in the International Coverage section of this Policy. International Coverage Actual charges incurred for certain eligible LTC benefits at: 75% of the LTC Benefit amount All services covered except Stay At Home, Respite Care and care Advisory No restriction on countries, but onus to provide acceptable proof is on the policyholder If the 10-year or lifetime BP is elected, benefits paid outside the US will be limited to a 6 year BP Reimburse actual charges incurred up to 100% of applicable benefit for up to one year All services covered except Stay at Home, Respite Care, double accident benefit and Care Advisory No restriction on countries, but onus to provide acceptable proof is on the policyholder Reimburse actual charges incurred up to 100% of NH DB (regardless of type of care received) for up to one year. This was done to ease administration of the benefit with multiple DBs No restriction on countries, but onus to provide acceptable proof is on the policyholder For financial professional use only. Not for use with the public. 6.

7 Built-in Non-forfeiture Contingent NF Same benefit as before except triggers immediately rather than after 3 years Will be automatically included in the policy in the event that traditional NF is declined Longevity NF Not available Limited Pay Options 10-Pay, paid up at age 65 Guaranteed renewable during premium paying period, Noncan after Not available with GPO Paid-up to 65 only available on ages <=55 No longer separate endorsements, provision will be added to schedule page Not available with Family Care Not available with Survivorship rider Double Coverage for Accident Benefit John Hancock will reimburse expenses up to 2 times the daily or monthly benefit limit if qualified services are needed due to accident prior to age 65. The doubling of the limit will be for the entire duration of the claim (as long as the claim was incurred prior to age 65). Benefits paid in excess of the daily or monthly limit will not be deducted from the policy limit. Not available with Family Care or Lifetime For financial professional use only. Not for use with the public. 7.

8 Return of Premium at Death (NEW) If death occurs prior to age 65, while policy is in force, a benefit will be paid to beneficiary equal to total premiums paid less LTC policy benefits paid. Not available with Family Care RIDERS Enhanced Return of Premium at Death (NEW) Shared-Care Rider SharedCare offered as a rider on 2, 3, 4, 6 year benefit periods Expanded family members of the same generation or partners. Must have lived together for 5 years Guaranteed purchase offer of a 2-year benefit plan for PH whose benefits are exhausted by spouse if policyholder less than age 91 at the time and had no claim in the prior 2 years. No underwriting, attained age rates Now available with ROB Not available with Family Care Not available with 10 yr or Lifetime BPs Not available to ages If death occurs at age 65 or older, while policy is in force, a benefit will be paid to beneficiary equal to total premiums paid less LTC policy benefits paid. Not available with Family Care, Shared Care, and Ages 80 and above. Now available with 10 year BP Now available with 10 year BP (cost is 5%) Not available with Enhanced Return of Premium rider. For financial professional use only. Not for use with the public. 8.

9 Partner HHC Rider Nonforfeiture Rider Survivorship Benefit Rider 15-year restriction between spouses age no longer applicable Rates are +6%, +6%, +11%, +10%, +8% for 2/3/4/5/6 year BPs, respectively Expanded to non-spouses but must be family member of same generation or partners who have lived together for 5 years Not available with ROB Not available w/10 year or Lifetime BPs Not available to ages Rait remains the same +20% Minimum policy limit is one time the LTC monthly benefit Rider can now be dropped Price is 6% Expanded to family member or partners. Must have lived together for at least 5 years Both partners are not required to purchase the rider (but if one does not purchase the rider, the benefit will not apply to them) If both partners have inforce policies and no claims were payable in the first 10 years, the surviving partner s policy is paid up upon the death of the other, if the surviving partner has this rider. If both have inforce policies for 10 years, no claims were payable in the first 10 years, and one partner then goes on claim after 10 years, the premiums are waived for the For financial professional use only. Not for use with the public. 9. Not available Not available Not available Same as CC except with limited pay benefit can be triggered after one year II Not Available Not Available

10 Restoration of Benefits Rider Additional Cash Benefit Rider partner that is not on claim(if that partner has the rider) for the duration of the claim. Upon recovery, both must pay premiums again Available with 10 year or lifetime BPs. Also available with ages Available with ROB Not available with FamilyCare Not available with Limited Pay If If have Survivorship Rider, can t have GPO (will get no inflation if don t choose simple or compound) Net rate with the new design is +9% Policy limit is restored if insured is fully recovered and does not meet benefit triggers for a period of 180 days Not available with 10 year or Lifetime BPs Not available ages Now available with SharedCare and Survivor/Waiver Rate remains the same: +4% Provides monthly cash payment equal to 15% of monthly benefit limit or 4.5X daily benefit limit if at least one day of Home Health Care is received during month and was not confined in a facility (nursing home or ACLF) at any time during the month. Rider cannot be added to policy if the daily/monthly benefit exceeds $150/$4,500 Price is 10% except Tighter control over recovery (we choose doctor to certify recovery Only restore policy limits once Not available with 2 yr, 10 yr or lifetime BP s (only available with 3,4,5 or 6 yr BP s) but will eliminate the restriction making it not available for large policies and will add language that some of the benefits might be taxable Material will need to reflect that benefits paid in excess of per diem limitation are taxable to policyholder unless able to prove charges incurred are equal to or in excess of benefit payment Not available Not available For financial professional use only. Not for use with the public. 10.

11 Waiver of Elimination Period for Home Health Care Rider Waives EP for HHC, creating a Same Not Available Not Available 0-day EP for HHC Days of HHC count toward the facility EP Waiver of premium begins once the Facility EP is met Not available with 180 or 365 day EP Not available to ages Price is 9% but through Not available Not available a claims guideline remove the restriction that secondary insureds are not covered outside of the US/DC. Family Care Rider Allows PC to cover up to 3 additional family members as secondary insureds (each insured must be age 70 or less at issue) Any insured can access benefits but the daily or monthly benefit limit and policy limit are the same regardless of how many insureds are on claim A day where any insured receives services is counted towards the elimination period (a day where more than one insured receives services is counted as one day towards the EP) If any insured receives at least one day of home health care services in a calendar week, 7 days are counted towards the EP for that week Premium is waived if any individual is on claim after the EP is met Only available for 4,5,6 or 10 year benefit periods Inflation options with Family Care are none, simple or compound (cannot have GPO with Family Care) Return of Premium on death before age 65 and double coverage for accident before age 65 are not applicable for Family Care policies. Not available with Enhanced Return of Premium rider For financial professional use only. Not for use with the public. 11.

12 Cannot be combined with any other rider except Nonforfeiture, Additional Cash Benefit and Waiver of Elimination Period for Home Health Care Secondary insureds are not covered outside of the US (+DC); i.e., the international benefit does not apply to secondary insureds Underwriting Classes Preferred 15% Select Same II Discounts Available Class I and II (+25% and +50%) PARTNERS DISCOUNT Discount continues to be provided to a married couple Discount expanded to nonspouses, the following couples who have lived together for 5 years; o Family member of the same generation or o Same sex or different sex partners 10% discount granted if applicant is married or a member of a couple as defined above 20% discount is granted if both individuals apply and are eligible based upon their responses to Part 2 of the app SPONSORED GROUP 10% employer paid, 5% other FAMILY DISCOUNT 5%. Must have at least 3 members of immediate family buy separate individual policies. Note that a policy with Family Care PARTNER DISCOUNT 15% if have spouse/partner, 30% if both apply and are approved Maximum combination of preferred and partner discounts is 40% (i.e. for preferred and both partners applying, the discount is 40%, even though the sum of the two discounts is 45%). SPONSORED GROUP 5% FAMILY DISCOUNTS 5% (discounts are the same as Custom Care) LOYALTY CREDIT Will allow current JH policyholders of a different policy series to purchase Custom Care II with an annual reduction if premium of 5%. Current policy must have been inforce at least two years. CCII rates based on attained age, For financial professional use only. Not for use with the public. 12.

13 and fully underwritten does not automatically qualify for the family discount if 3 or 4 persons are insured. But a policy with Family Care will be eligible for the family discount of at least two other family members own individual policies with JH Can have both spousal discount, and either Family or Sponsored Group (not both) Discounts are additive Family Care has a blended discount based on the discounts applicable to each individual insured Sponsored Group Discount/Family Discount/Loyalty Credit are all multiplicative discounts, not added to the partner/preferred discount. For financial professional use only. Not for use with the public. 13.