Mutual Care Mutual of Omaha Isurace Compay Plus Portfolio Log-Term Care Isurace AGENT ad UNERWRITING GUIE Mutual Care 3 & 5 Mutual Care My Way Mutual Care at Work M27833 For producer use oly. Not for use with the geeral public.
Table of Cotets Cotact Iformatio... ectio 1 Mutual Care Plus... ectio 2 Product etails Beefit escriptios Applicatio Requiremets Additioal Policy etails Billig Iformatio Mutual Care at Work... ectio 3 Program Overview Uderwritig Programs Program Optios Product etails Beefit escriptios Additioal Policy etails Tax Advatages Gettig tarted Applicatio Requiremets Billig Iformatio Associatio Marketig... ectio 4 Program Overview Associatio Marketig Guidelies Gettig tarted Admiistrative Iformatio... ectio 5 Admiistrative Hadlig Upgrades owgrades Uderwritig Guidelies... ectio 6 Geeral Uderwritig Guidelies Policy Uderwritig Uderwritig Requiremets Uderwritig Philosophy Rate Classes Preferred Criteria Build Chart Health-Related Uderwritig Guidelies Uisurable Health Coditios ome Medicatios Associated with Uisurable Health Coditios Uisurable Health Combiatios Medical Impairmets Producer Requiremets... ectio 7 Licesig ad Appoitmets Producer Traiig M27833_0812
Cotact Iformatio Mutual Care Plus Mailig Addresses Mutual Care at Work Mailig Addresses Geeral Mail Expedited Mail Mutual of Omaha Isurace Compay Log-Term Care ervice Office Log-Term Care ervice Office LTC Multi-Life Uderwritig 6th Floor P.O. Box 64901 7805 Hudso Rd., uite 180 Mutual of Omaha Plaza t. Paul, MN 55164-0901 Woodbury, MN 55125-1591 Omaha, NE 68175 ectio 1 LTC ervice Office Claims Phoe: 877-894-2478 Hours: 7 a.m. to 5 p.m. Cetral time Moday Friday Customer ervice Phoe: 877-894-2478 Hours: 7 a.m. to 5 p.m. Cetral time Moday Friday New Busiess ervice Policy Issue Billig ad Collectio Mutual Care at Work Multi-Life Uderwritig Coordiator Phoe: 877-778-0838 Fax: 402-351-5958 Hours: Email: 8 a.m. to 4:30 p.m. Cetral time Moday Friday LTC.Multi.Life@mutualofomaha.com Case Quotig Group Approval Multi-Life Iquiries Fax Numbers 888-539-4672 Applicatio Requiremets 800-921-9335 Medical Iformatio elivery Requiremets Policy Chage Requests Correspodece 1
Geeral Cotact Iformatio Premium ubmissio (other tha premium collected with the applicatio) Geeral Mail Expedited Mail Mutual of Omaha 1st Natioal Bak P.O. Box 30154 Att: top 2203, Box 30154 Omaha, NE 68103-1252 1620 odge t. Omaha, NE 68197-2203 Licesig Phoe: 800-867-6873 Hours: 8 a.m. to 4:30 p.m. Cetral time Moday Friday ales upport Phoe: Agecy: 877-617-5589 Brokerage: 800-693-6083 Hours: Email: 7:30 a.m. to 5:30 p.m. Cetral time Moday Friday sales.support@mutualofomaha.com Appoitmets Cotractig Licesig Proposals ales/product upport Uderwritig Phoe: 800-551-2059 Hours: 8 a.m. to 4:30 p.m. Cetral time Moday Friday Email: ltcuderwritig@mutualofomaha.com Prequalificatio Risk electio To Iitiate the Persoal Health Iterview Phoe: 866-544-1617 2
Mutual Care Plus Mutual Care 3 Mutual Care 5 Mutual Care My Way Product etails The followig chart cotais the built-i ad optioal beefits of Mutual Care 3, Mutual Care 5 ad Mutual Care My Way. Beefits may vary by state. Mutual Care 3 Mutual Care 5 Mutual Care My Way Built-i Beefits Beefit Period 3 years 5 years 2 years (24 moths) 3 years (36 moths) 4 years (48 moths) 5 years (60 moths) 6 years (72 moths) 8 years (96 moths) Maximum Mothly Beefit $3,000 to $15,000 $3,000 to $15,000 $1,500 to $15,000 ectio 2 Cash Beefit 35% of home health care maximum mothly beefit 35% of home health care maximum mothly beefit 35% of home health care maximum mothly beefit Elimiatio Period 90 caledar days 90 caledar days 0 caledar days 30 caledar days 60 caledar days 90 caledar days 180 caledar days 365 caledar days Iflatio Protectio Optioal Beefits 3% Compoud (lifetime) 5% Compoud (20-year) 5%, 4% or 3% Compoud (lifetime) 5% Compoud (20-year) 5% imple (lifetime) Mothly Beefit Optios (percetage of maximum mothly beefit) No Iflatio Protectio with Future Purchase Optio 100% 100% Home Health Care 100%, 75%, 50% Assisted Livig 100%, 75%, 50% Nursig Home 100% 3
pouse Beefits pouse hared Care pouse ecurity Beefit pouse Waiver of Premium pouse urvivorship No-forfeiture Optios Cotiget No-forfeiture No-forfeiture horteed Beefit Period Retur of Premium Optios Retur of Premium Less Claims Paid Retur of Premium Less Claims Paid if eath Occurs Before Age 65 Full Retur of Premium Other Optioal Beefits Waiver of Elimiatio Period for Home Health Care Restoratio of Beefits Additioal Beefit for Ijury 5-Year Rate Guaratee Mutual Care 3 Mutual Care 5 Mutual Care My Way Optioal Beefits Optioal Not available Not available Not available efault Optioal Not available Not available Not available Not available Not available Not available Not available Optioal Not available Not available Not available efault Optioal Not available Not available Not available Not available Not available Not available Not available Optioal Optioal Optioal Optioal efault Optioal Optioal Optioal Optioal Optioal Optioal Optioal Optioal 4
Beefit escriptios This sectio cotais a explaatio of the built-i ad optioal beefits of Mutual Care 3, Mutual Care 5 ad Mutual Care My Way. Additioal Beefit for Ijury Pays a additioal beefit if the isured sustais a ijury resultig i eed for log-term care services (home health care, assisted livig facility or ursig home). The ijury must be sustaied while the policy is i force ad the isured is ot chroically ill. The additioal beefit for ijury is payable ay moth the isured icurs eligible expeses i excess of the ursig home, assisted livig facility or home health care beefits paid that moth, up to the maximum mothly beefit of the policy. Available oly o Mutual Care My Way Not available for issue ages over 60 Cash Beefit Whe elected, pays a cash beefit (equal to 35 percet of the home health care maximum mothly beefit) i advace each moth. The elimiatio period does ot eed to be satisfied for the isured to receive the cash beefit. ectio 2 If we determie the isured is eligible for a cash beefit for less tha a etire moth, we will adjust the cash beefit for that moth. We will assume such a moth cosists of 30 days, regardless of the actual umber of days i the moth. If i ay moth, the isured receives a cash beefit i excess of the amout for which they are eligible, we will reduce ay future beefits paid uder the policy by the amout of the ueared cash beefit. Whe the isured is receivig a cash beefit, o other beefits are payable uder the policy. The isured may elect to discotiue the cash beefit by providig writte otice to us. After the cash beefit is discotiued, other eligible policy beefits may be payable o a reimbursemet basis. The isured may elect to receive the cash beefit oe moth ad reimbursemet the ext. We reserve the right to require a ew pla of care at least oce every 60 days whe the isured is receivig the cash beefit. Please ote, days i which the cash beefits are utilized do ot cout toward the elimiatio period for reimbursemet beefits. Elimiatio Period Oce the policy s elimiatio period has bee satisfied, the policy pays up to the maximum mothly beefit amout for covered log-term care services. No elimiatio period to satisfy whe the cash beefit is elected (if isured chages to reimbursemet beefits, elimiatio period must be satisfied) If isured is Class I or II risk, oly 90-, 180- ad 365-day elimiatio periods are available Five-Year Rate Guaratee Guaratees the iitial rate for a five-year period. Available oly o Mutual Care My Way Iteratioal Beefit The Iteratioal Beefit will pay a beefit if cofied to a Nursig Home, Assisted Livig Facility or receivig Home Health Care or Adult ay Care outside of the Uited tates, its possessios or territories, Caada, or the Uited Kigdom. The Iteratioal Beefit is equal to 12 times the Maximum Mothly Beefit. This beefit is paid regardless of whether Eligible Expeses icurred i ay moth are more or less tha the Maximum Mothly Beefit. No additioal Iteratioal Beefits are payable uder this policy oce the beefits paid are equal to the Iteratioal Beefit Lifetime Maximum. The Cash Beefit is ot available uder this beefit. Iflatio Protectio Optios The isured has the choice of the followig iflatio protectio optios: Compoud Iflatio Protectio: Compoud Lifetime Your curret maximum mothly beefit ad maximum lifetime beefit amouts will icrease by the percetage you select o each policy aiversary date for the remaider of your lifetime. 5
6 3% Mutual Care 3 5% Mutual Care 5 3%, 4%, 5% Mutual Care My Way Five Percet Compoud 20-year (Mutual Care My Way) Your curret maximum mothly beefit ad maximum lifetime beefit amouts will icrease by five percet o each policy aiversary date for 20 years. imple Iflatio Protectio: Five Percet imple Lifetime (Mutual Care My Way) O each policy aiversary date, your maximum mothly beefit will icrease by five percet of its origial value. I additio, the maximum lifetime beefit will icrease by five percet of its origial value or its curret value, whichever is less. No Iflatio Protectio: Future Purchase Optio If you elect o iflatio protectio at this time, you may purchase either three or five percet compoud lifetime iflatio protectio (at the rate applicable for your attaied age) ay time up to five years after the issue date of your policy with o additioal uderwritig required.* Caot be exercised if the isured is o Waiver of Premium Caot be added, removed of decreased after issue at the isured s request, except for the first 60 days followig policy iceptio (durig the first 60 days, the isured ca remove the Future Purchase Optio, but must select aother iflatio protectio optio) Whe the isured elects to exercise the Future Purchase Optio, he or she will be offered either a three percet compoud (lifetime) or five percet compoud (lifetime) iflatio protectio rider, which will be effective o the ext policy aiversary date. Oce this optio has bee exercised, o additioal icreases or decreases to the Future Purchase Optio rider will be allowed. Not available with ay other iflatio protectio optio Available oly with the Lifetime paymet optio *ubject to the followig limitatios: Your premiums are ot waived o the policy You are ot curretly eligible to receive policy beefits or you have ot received policy beefits i the two years prior to electig the icrease Noforfeiture horteed Beefit Period As log as the policy has bee i force for a specified time, this optioal rider allows coverage to cotiue o a reduced basis i the evet the policy is termiated. If ot selected, Cotiget No-forfeiture is the default Restoratio of Beefits If beefits have bee paid uder the policy ad the isured o loger requires log-term care services for 180 cosecutive days, we will restore the maximum lifetime beefit to the amout that would have applied if o beefits had bee paid uder the policy (except for beefits paid for the spouse uder the pouse hared Beefit). This restoratio may occur oe time durig the term of the policy. Available oly o Mutual Care My Way Retur of Premium Optios Upo the death of the isured, the premium paid o the policy may be retured to the isured s heirs. The followig optios are available o Mutual Care My Way: Retur of Premium Less Claims Paid If the isured dies while the policy is i force, we will retur the total amout of premium paid for the policy, less the amout of claims paid uder the policy. Available oly o Mutual Care My Way Not available with pouse hared Care Not available for issue ages over 64
Retur of Premium Less Claims Paid if eath Occurs Before Age 65 If the isured dies while the policy is i force, but prior to the policy aiversary date coicidig with or ext followig his or her 65th birthday, we will retur the total amout of premium paid for the policy, less the amout of claims paid uder the policy. Available oly o Mutual Care My Way Not available for issue ages over 64 Full Retur of Premium If the isured dies while the policy is i force, we will retur the total amout of premium paid for the policy Available oly o Mutual Care My Way Not available with pouse hared Care Not available for issue ages over 64 pouse ecurity Beefit Pays a beefit equal to 60 percet of the reimbursemet beefits payable each moth (excludig the cash beefit, if ay). pouse security beefits will ot reduce the maximum lifetime beefit of the policy. Available oly o Mutual Care My Way Not available for Class I ad II risks Not available with other spouse beefits (pouse hared Care, pouse Waiver of Premium or pouse urvivorship) Not available with pouse or Two-Perso Household premium allowaces Not available for issue ages over 69 ectio 2 pouse hared Care Beefit Oce beefits have bee exhausted uder the isured s policy but the eed for log-term care services cotiues, the isured may access beefits uder his or her spouse s idetical policy util a miimum of 12 times the curretly mothly beefit remais. I additio, if oe spouse dies while both policies are i force, the survivig spouse will receive the deceased spouse s remaiig maximum lifetime beefit with o effect o the survivig spouse s premium. This optioal beefit is available oly whe both spouses or domestic parters apply at the same time ad are issued idetical coverage. Not available for Class II risks Not available for Class I risks with a maximum lifetime beefit greater tha 3 years Not available with the pouse ecurity Beefit Not available with Retur of Premium at eath Less Claims Paid or Full Retur of Premium Not available if uderwritig determies oe or both applicats pose a greater tha ormal risk of premature death Not available with Married or Two-Perso Household premium allowaces pouse urvivorship Beefit If the policy has bee i force for 10 years or more, o further premiums are due ad payable o the policy from ad after the date the spouse dies. Note: If premiums are icreased after policy issue due to a icrease or additio of coverage, the icreased premium must be i effect for 10 years or more before the icreased amout will be waived. Available oly o Mutual Care My Way Not available with pouse ecurity Beefit Not available with Married or Two-Perso Household premium allowaces Not available o Class I ad Class II risks 7
pouse Waiver of Premium We will waive the paymet of premium for the isured whe ad for as log as the premium for the spouse s policy is waived. Whe the waiver period uder the spouse s policy eds, premium paymets will resume for the isured s policy ad must be paid to keep the policy i force. Note: If premiums are icreased after policy issue due to a icrease or additio of coverage, the icreased premium must be i effect for 10 years or more before the icreased amout will be waived. 8 Available oly o Mutual Care My Way Not available with pouse ecurity Beefit Not available with Married or Two-Perso Household premium allowaces Not available with Class I ad Class II risks Waiver of Elimiatio Period for Home Health Care No elimiatio period must be satisfied i order to receive home health care beefits uder the policy. At this poit, the elimiatio period for ursig home ad assisted livig will begi to be satisfied o a caledar-day basis. This meas days you receive home care as well as days you do ot receive home care both cout toward satisfyig this elimiatio period. Available oly o Mutual Care My Way Not available for Class I or II risks Applicatio Requiremets Thigs to Remember The applicatio packet icludes the applicatio ad ay vital state forms Note: No-residet state applicatios or forms will ot be accepted. If the applicatio must be take o the cliet s residet state applicatio packet. ubmissio of a oresidet state applicatio will require submissio of the correct state applicatio before a policy ca be issued. The aget must be licesed i the sigig state Note: If a applicatio is take o a Kasas residet, the producer must be appoited i Kasas ad i the state where the applicatio is siged. Two applicats are allowed per applicatio. Oly the applicats for isurace may complete ad sig the applicatio White out is ot allowed. If a questio is aswered i error, draw a sigle lie through the error, ad have the correctio iitialed by the applicat. N/A is a uacceptable aswer. Istead the questios should be aswered o or oe Iclude a copy of isured s quote with the applicatio packet Idicate o the applicatio the best time to cotact the applicat for a telephoe iterview or face-to-face examiatio Iform the applicat of the iterview or face-to-face process, provide them with, ad help them complete the Preparig for the Health Iterview form (M26798) located i the Cosumer Guide (applicatio book). It is recommeded that prior to leavig your cliet you call 1-866-544-1617, idetify yourself as the aget ad itroduce your cliet to the service represetative. If a urse is available, a o the spot iterview ca be doe. If a urse is ot available, or if it is ot a coveiet time for the applicat, a appoitmet ca be made for a future date. Otherwise your cliet will be called to schedule a iterview after the applicatio is received Additioal Policy etails The followig policy details apply to all Mutual Care Plus policies. Issue Ages Issue ages for all Mutual Care Plus policies are ages 18 to 79.
30-ay Right to Review The applicat has 30 days from the day of its receipt to review the policy. If durig that time they are ot satisfied with it, they may retur the policy to us or the aget for a prompt refud of all premiums paid. The policy will the be cosidered ever to have bee issued. Tax tatus All Mutual Care Plus policies are iteded to be tax-qualified. Premium Allowaces All Mutual Care Plus policies offer the followig premium allowaces: pouse/parter 35 percet each if both the isured ad spouse or domestic parter purchase log-term care isurace from Mutual of Omaha Not available with pouse ecurity Beefit If oe applicat cacels their cotract ad it results i a cacel back to issue or ot take, the pouse/parter Allowace (35 percet) will be removed from the remaiig issued policy ad the Married Allowace (15 percet) will be added ectio 2 Preferred 15 percet for beig i good health Ca be combied with all Household allowaces Married 15 percet if the isured is married, but the spouse or domestic parter does ot purchase log-term care isurace from Mutual of Omaha Not available with pouse Waiver of Premium, pouse urvivorship or pouse hared Care beefits Two-Perso Household 10 percet each if both the isured ad aother adult livig i the same household for a cotiuous 12 moths (ot the isured s spouse or domestic parter) purchase log-term care isurace from Mutual of Omaha Not available with pouse Waiver of Premium, pouse urvivorship, pouse ecurity or pouse hared Care beefits If oe applicat cacels their cotract ad it results i a cacel back to issue or ot take, the Two-Perso Household Allowace (10 percet) will be removed from the remaiig issued policy Associatio Group 5 percet if the isured or a eligible member of the isured s family is a member of a qualifyig associatio group Not available with Producer Allowace Medicare upplemet 5 percet if the isured is a Mutual of Omaha, Uited of Omaha, Uited World or Omaha Isurace Compay Medicare supplemet policyholder Not available with Producer Allowace Producer 5 percet if coverage is writte o you ad/or your spouse or domestic parter All available allowaces will apply* * Oly oe household allowace ca be selected. Producer allowace ca ot be combied with the Associatio Group or Medicare supplemet allowace. Preferred health allowace ca be combied with ay other allowace. Allowaces are multiplicative, ot additive. Premium Paymet Optio Lifetime Premium paymets are level ad made over the life of the isured 9
Billig Iformatio (Iitial Premium) Please use the followig modal factors to calculate premium: Mothly Bak raft.09 Quarterly.26 emiaual.51 Aual 1.00 Cash with Applicatio: If Mothly Bak raft is elected ad premium is icluded, two moth s premium should be submitted If a quarterly, semiaual or aual mode is elected, the full premium for that mode should be submitted No Cash with Applicatio: If Mothly Bak raft is elected ad o premium is icluded, oly oe moth s premium will be drafted oce the policy is issued If quarterly, semiaual or aual mode is elected, the customer will receive a bill for the full modal premium selected oce the policy is issued All checks should be made payable to: Mutual of Omaha Isurace Compay. 10
Mutual Care at Work Program Overview What is Mutual Care at Work? Mutual Care at Work is a multi-life program for busiesses with three or more employees. The program uses a traditioal log-term care isurace product that s completely customizable Each participat applies for ad, if approved, is issued a idividual log-term care isurace policy Premium allowaces make the coverage less expesive tha if participats purchased idividual log-term care isurace policies o their ow How does it work? Employers decide who participates i the program all employees or a select group of employees (i.e. all maagers). They also determie how they would like to fud the program. Employer-paid the employer pays the etire cost of the program either for all employees or a select group of employees Volutary (employee-paid) the employer makes the coverage available to employees o a volutary basis, with each employee payig his or her ow premium Executive carve-out the employer pays the cost for a select group of employees. If this optio is selected, the employer also may make the program available to other employees o a volutary basis ectio 3 Who is eligible to participate? Coverage is available for the busiess ower, employees, spouses ad exteded family members (parets, childre, sibligs, gradparets, i-laws ad all step equivalets). A miimum of three isured employees is required for full uderwritig ad 10 isured employees for Modified Guaratee Issue or implified Issue. Employees age 18-64, ad actively at work* 30+ hours per week are eligible for Modified Guarateed Issue, implified Issue ad Full uderwritig pouses age 18-64, ad actively at work* 30+ hours per week are eligible for implified Issue ad Full uderwritig Other participats are eligible for full uderwritig if they are employees 65+, retirees, spouses age 65+ (or ot workig full time), childre (age 18 ad older), parets, gradparets, i-laws, sibligs ad all step equivalets What types of busiesses make good prospects? The quality of a perspective cliet is the first step for a successful case to be give careful cosideratio. Listed below are some guidelies that will help maximize your success: Typically Acceptable Busiess Prospects Law firms Egieerig firms Architectural firms Accoutig firms Health care professioals Bakig ad fiacial services professioals Educators Typically Uacceptable Busiess Prospects Athletes (professioal, jockey, rodeo, racig) Aviatio Chemical idustries (acids, alkalis, carcioges, explosives) Costructio/asbestos workers Law eforcemet, priso or correctioal facility workers Marie (divig, salvage, towig, fishig) Maufacturig (warehouse, packig house) Petroleum ad gas workers (drillig, removal, off-shore) easoal workers Firefighters 11
esirable Employer Characteristics table or high-growth compaies with few locatios Committed to supportig the program Agreeable to o-site employee meetigs ad erollmet durig compay time Willig to cotribute toward premium (executive, officers, all employees based o age ad/or years of service) Employees with log teure ad/or affiity to employer High cocetratio of well-educated ad highly compesated idividuals uccessful volutary employee beefit offerigs Required Employee Characteristics 40% of employees are above a salary of $40,000 50% of employees are age 40 or above trog loyalty to compay W-2 Employees oly Maximum group size is limited to 250 eligible employees What are the beefits of offerig log-term care at work? Beefits to the Employer Helps attract ad retai quality employees Ehaces a compay s reputatio as a place people wat to work Builds morale ad develops a workforce of loyal employees Provides premium allowaces that are ot available to the geeral public Provides relatively low miimum participatio requiremets Provides flexible uderwritig programs Improves productivity ad reduces abseteeism Provides tax advatages to the busiess Beefits to Employees Helps protect retiremet savigs from the high cost of care Allows them to purchase coverage for exteded family members Provides premium allowaces ot available to the geeral public Provides flexible uderwritig programs Provides the ease of purchasig isurace at work ad payig through payroll deductio Allows them to take their policy with them, eve if they leave the compay Uderwritig Programs Mutual Care at Work offers three uderwritig programs that allow you to suit the eeds of ay group. Uderwritig Program Modified Guarateed Issue implified Issue Full Uderwritig Advatages Three isurability questios Ease of doig busiess ix isurability questios pouses ca apply if actively at work* 30+ hours per week (copy of W-2 required at time of applicatio) Icreased available beefits All issue ages ad beefit levels available Preferred health allowace (15%) available Premium Allowace Uderwritig Classes 10% elect 10% elect 5% Preferred elect Class I Class II Modified Guarateed Issue Available oly with employer-paid programs Miimum group size is 10 eligible employees; miimum participatio is 10 isured employees (program must be take by 100 percet of the group to which the offer is made, icludig carve-out groups) pouses are eligible for simplified issue uderwritig with a 10 percet premium allowace if actively at work,* regardless of employer fudig for the spouse 12
Exteded family members are eligible for full uderwritig with a five percet premium allowace Maximum mothly beefit of $1,500 to $4,500 Maximum lifetime beefit of $150,000 Available premium allowaces iclude: 10 percet Multi-Life Program Allowace 15 percet married allowace 10 percet two-perso household allowace implified Issue Available with employer-paid ad volutary programs Miimum group size is 10 eligible employees; miimum participatio is 10 isured employees pouses are eligible for simplified issue uderwritig with a 10 percet premium allowace if actively at work* (copy of W-2 required at time of applicatio), regardless of employer fudig for the spouse/employee Exteded family members are eligible for full uderwritig with a five percet premium allowace Maximum mothly beefit of $1,500 to $9,000 Maximum lifetime beefit of $400,000 Available premium allowaces iclude: 10 percet multi-life program allowace 35 percet spouse allowace 15 percet married allowace 10 percet two-perso household allowace Full Uderwritig Available with employer-paid or volutary programs Miimum group size is three eligible employees; miimum participatio is three isured employees pouses ad exteded family members are eligible for full uderwritig with a five percet premium allowace Maximum mothly beefit of $1,500 to $15,000 Maximum lifetime beefit of $500,000 Available premium allowaces iclude: 5 percet multi-life allowace 15 percet preferred allowace 35 percet spouse allowace 15 percet married allowace 10 percet two-perso household allowace ectio 3 *Actively at work: Meas a employee whom, o the date of their applicatio ad throughout the prior six moths is Age 18 to 64 is ad has bee curretly paid by the employer is ad has bee regularly scheduled to work at least 30 hours per week is ot ad has ot bee o a authorized absece due to illess, ijury or leave without pay, ad is ad has bee performig the material ad substatial duties of their job at their place of employmet or a alterative work site desigated by their employer If workig from home, it is cosidered actively at work if o the date of the applicatio ad throughout the prior six moths, the idividual is ot ad has ot bee cofied to a hospital or disabled to a degree that oe could ot have performed the material ad substatial duties of their job at least 30 hours per week at the employer s usual place of busiess. Additioal etails New hires are allowed to purchase withi 60 days after completig six moths of employmet Re-erollmet is allowed if the employer decides to offer coverage to a employee class ot previously offered, or if the employee is ew to a employee class to which a offer was previously made New family members (life evet) ca eroll withi 60 days from the date of the life evet with full uderwritig, provided the employee qualified at the time of the origial offer If a Multi-Life product was offered to a compay i the past five years, implified Issue will be offered to employees that were ot solicited at the prior offerig. The eligible employee group will eed to meet the group approval requiremets. Full uderwritig for the Multi-Life product may be allowed for the rest of the employees watig to apply 13
Program Optios Program Optio Who Pays the Premium Miimum Group ize & Participatio Requiremets Eligible Group Members Uderwritig MOIFIE GUARANTEE IUE (MGI) Employer Paid Compay must employ 10 or more employees uder the age of 65 i the defied group ( Eligible Employees* ) ad 100% of all Eligible Employees* must eroll i at least a base pla Eligible Employees* Eligible pouses** Employees age 65 ad older, retirees, spouses or domestic parters, childre, parets, gradparets, sibligs ad all i-law ad step equivalets*** Modified Guarateed Issue implified Issue Full Uderwritig Eligible Employees* ad Eligible Employee pouses** implified Issue IMPLIFIE IUE (I) Employer Paid Volutary Compay must employ 10 or more employees uder the age of 65 i the defied group ( Eligible Employees* ) ad at least 10 Eligible Employees* eroll i the pla Compay must employ 10 or more employees uder the age of 65 ( Eligible Employees* ) ad at least 10 Eligible Employees* eroll i the pla Employees age 65 ad older, retirees, spouses or domestic parters, childre, parets, gradparets, sibligs ad all i-law ad step equivalets*** Eligible Employees* ad Eligible Employee pouses** Employees age 65 ad older, ieligible spouses or domestic parters, childre, parets, gradparets ad sibligs ad all i-law ad step equivalets*** Full Uderwritig implified Issue Full Uderwritig FULL UNERWRITING (Full) Employer Paid or Volutary Compay must employ at least 3 Employees ad at least 3 Employees* eroll i the pla All employees, retirees, spouses or domestic parters, parets, gradparets, childre, sibligs ad all i-law ad step equivalets*** Full Uderwritig 14 Additioal Program Notes: pouse caot select beefit limits higher tha those selected by the eligible employee More tha oe program optio ca be selected for a group depedig o fudig ad desired program limits To qualify as employer-paid, the employer must fud the miimum beefit level (e.g., $1,500 MMB)
Phoe Iterview Medical Records & Face-to-Face Preferred Health Premium Reductio Program Limits (does ot accout for iflatio) NO NO YE for Cause NO NO YE Up to $4,500/ moth & Up to $150,000 Lifetime Up to $9,000/ moth & Up to $400,000 Lifetime Up to $15,000/ moth & Up to $500,000 Lifetime Available Premium Reductios for Modified Guarateed Issue Group/Preferred Allowace Group Preferred Household Allowace (oly oe available per policy) Household Married pousal Employee* 10% /a 15% /a 10% ad ad pouse** 10% /a 15% 35% 10% Other Eligibles 5% 15% 15% 35% 10% NO NO Up to $9,000/ moth & Up to $400,000 Lifetime ectio 3 YE for Cause NO YE NO Up to $15,000/ moth & Up to $500,000 Lifetime Up to $9,000/ moth & Up to $400,000 Lifetime Available Premium Reductios for implified Issue Group/Preferred Allowace Group Preferred Household Allowace (oly oe available per policy) Household Married pousal Employee* 10% /a 15% 35% 10% ad ad pouse** 10% /a 15% 35% 10% Other Eligibles 5% 15% 15% 35% 10% YE for Cause YE Up to $15,000/ moth & Up to $500,000 Lifetime YE for Cause YE Up to $15,000 per moth & Up to $500,000 Lifetime * Eligible Employee: Age 18-64, actively at work 30+ hours per week ** Eligible Employee pouses uder age 65, actively at work 30+ hours per week *** Eligible Employee pouse & Other Participats: Employees age 65+, retirees, spouses age 65+ (or ot workig full time), childre (age 18 ad older), parets, gradparets, i-laws, sibligs ad all step equivalets Available Premium Reductios for Full Uderwritig Group/Preferred Allowace Group Preferred Household Allowace (oly oe available per policy) Household Married pousal Employee* 5% 15% 15% 35% 10% ad ad pouse** 5% 15% 15% 35% 10% Other Eligibles 5% 15% 15% 35% 10% 15
Product etails Mutual Care at Work The followig chart cotais the built-i ad optioal beefits of Mutual Care at Work, which vary by state. Built-I Beefits Maximum Lifetime Beefit (umber of moths selected x MMB) Mutual Care at Work Maximum Mothly Beefit (MMB) $1,500 to $15,000 2 years (24 moths) 3 years (36 moths) 4 years (48 moths) 5 years (60 moths) 6 years (72 moths) 8 years (96 moths) Program Limits: $150,000 Maximum Lifetime Beefit for Modified Guarateed Issue $400,000 Maximum Lifetime Beefit for implified Issue $500,000 Maximum Lifetime Beefit for Full Uderwritig Cash Beefit Elimiatio Period Mothly Beefit Optios (percetage of maximum mothly beefit) Program Limits: Up to $4,500 for Modified Guarateed Issue Up to $9,000 for implified Issue Up to $15,000 for Full Uderwritig 35% of home health care maximum mothly beefit 90 caledar days 180 caledar days 365 caledar days Home Health Care 100%, 75%, 50% Optioal Beefits 16 Assisted Livig 100%, 75%, 50% Nursig Home 100% Iflatio Protectio Compoud Lifetime 3%, 4%, 5% Compoud (20 Year) 5% imple Lifetime 5% No Iflatio (Future Purchase Optio is oly available i OH) pouse Beefits pouse hared Care pouse ecurity Beefit pouse Waiver of Premium pouse urvivorship No-Forfeiture Optios Cotiget No-Forfeiture No-Forfeiture/horteed Beefit Period Retur of Premium Optios Full Retur of Premium Retur of Premium at eath Before Age 65 Less Claims Paid Retur of Premium at eath Less Claims Paid Optioal Optioal Optioal Optioal efault Optioal Optioal Optioal Optioal
Other Optioal Beefits Waiver of Elimiatio Period for Home Health Care Restoratio of Beefits Additioal Beefit for Ijury 5-Year Rate Guaratee Optioal Optioal Optioal Optioal Beefit escriptios This sectio cotais a explaatio of the built-i ad optioal beefits of Mutual Care at Work. Additioal Beefit for Ijury Pays a additioal beefit if the isured sustais a ijury resultig i eed for log-term care services (home health care, assisted livig facility or ursig home). The ijury must be sustaied while the policy is i force ad the isured is ot chroically ill. The additioal beefit for ijury is payable ay moth the isured icurs eligible expeses i excess of the ursig home, assisted livig facility or home health care beefits paid that moth. Not available for issue ages over 60 Cash Beefit Whe elected, pays a cash beefit (equal to 35 percet of the home health care maximum mothly beefit) i advace each moth. The elimiatio period does ot eed to be satisfied for the isured to receive the cash beefit. If we determie the isured is eligible for a cash beefit for less tha a etire moth, we will adjust the cash beefit for that moth. We will assume such a moth cosists of 30 days, regardless of the actual umber of days i the moth. If i ay moth, the isured receives a cash beefit i excess of the amout for which they are eligible, we will reduce ay future beefits paid uder the policy by the amout of the ueared cash beefit. ectio 3 Whe the isured is receivig a cash beefit, o other beefits are payable uder the policy. The isured may elect to discotiue the cash beefit by providig writte otice to us. After the cash beefit is discotiued, other eligible policy beefits may be payable o a reimbursemet basis. The isured may elect to receive the cash beefit oe moth ad reimbursemet the ext. We reserve the right to require a ew pla of care at least oce every 60 days whe the isured is receivig the cash beefit. Please ote, days i which the cash beefits are utilized do ot cout toward the elimiatio period for reimbursemet beefits. Elimiatio Period Oce the policy s elimiatio period has bee satisfied, the policy pays up to the maximum mothly beefit amout for covered log-term care services. No elimiatio period to satisfy whe the cash beefit is elected (if isured chages to reimbursemet beefits, elimiatio period must be satisfied) Five-Year Rate Guaratee Guaratees the iitial rate for a five-year period. Iflatio Protectio Automatically icrease the isured s curret maximum mothly beefit ad maximum lifetime beefit o each policy aiversary date to help keep pace with iflatio. 17
Iflatio Protectio Optios The isured has the choice of the followig iflatio protectio optios: Compoud Iflatio Protectio: Compoud Lifetime Your curret maximum mothly beefit ad maximum lifetime beefit amouts will icrease by the percetage you select o each policy aiversary date for the remaider of your lifetime. Optios: 5%, 4%, 3% Five Percet Compoud 20-Year Your curret maximum mothly beefit ad maximum lifetime beefit amouts will icrease by five percet o each policy aiversary date for 20 years. imple Iflatio Protectio: Five Percet imple Lifetime O each policy aiversary date, your maximum mothly beefit will icrease by five percet of its origial value. I additio, the maximum lifetime beefit will icrease by five percet of its origial value or its curret value, whichever is less. No Iflatio Protectio (Future Purchase Optio is oly available i OH) A iflatio protectio optio may be removed after issue with o refud of premium. The maximum mothly beefit ad remaiig maximum lifetime beefit will remai at the level to which they had bee icreased by this beefit as of the date the beefit is removed. The premium will be chaged to the appropriate premium amout for the icreased beefit amout provided, based o the age at issue. Iteratioal Beefit The Iteratioal Beefit will pay a beefit if cofied to a Nursig Home, Assisted Livig Facility or receivig Home Health Care or Adult ay Care outside of the Uited tates, its possessios or territories, Caada, or the Uited Kigdom. The Iteratioal Beefit is equal to 12 times the Maximum Mothly Beefit. This beefit is paid regardless of whether Eligible Expeses icurred i ay moth are more or less tha the Maximum Mothly Beefit. No additioal Iteratioal Beefits are payable uder this policy oce the beefits paid are equal to the Iteratioal Beefit Lifetime Maximum. The Cash Beefit is ot available uder this beefit. No-Forfeiture/horteed Beefit Period As log as the policy has bee i force for a specified time, this optioal rider allows coverage to cotiue o a reduced basis i the evet the policy is termiated. If ot selected, Cotiget No-Forfeiture is the default Restoratio of Beefits If beefits have bee paid uder the policy ad the isured o loger requires log-term care services for 180 cosecutive days, we will restore the maximum lifetime beefit to the amout that would have applied if o beefits had bee paid uder the policy (except for beefits paid for the spouse uder the pouse hared Care Beefit). This restoratio may occur oe time durig the term of the policy. Retur of Premium at eath Before Age 65 Less Claims Paid If the isured dies while the policy is i force, but prior to the policy aiversary date coicidig with or ext followig his or her 65 th birthday, we will retur the total amout of premium paid for the policy, less the amout of claims paid uder the policy. Not available for issue ages over 64 18
Retur of Premium at eath Less Claims Paid If the isured dies while the policy is i force, we will retur the total amout of premium paid for the policy, less the amout of claims paid uder the policy. Not available with pouse hared Care Not available for issue ages over 64 Retur of Premium Full If the isured dies while the policy is i force, we will retur the total amout of premium paid for the policy. Not available with pouse hared Care Not available for issue ages over 64 pouse ecurity Beefit Pays a beefit equal to 60 percet of the reimbursemet beefits payable each moth (excludig the cash beefit, if ay). pouse security beefits will ot reduce the maximum lifetime beefit of the policy. Not available for Class I ad II risks Not available with other spouse beefits (pouse hared Care, pouse Waiver of Premium or pouse urvivorship) Not available with pouse or Two-Perso Household premium allowaces Not available for issue ages over 69 ectio 3 pouse hared Care Beefit Oce beefits have bee exhausted uder the isured s policy but the eed for log-term care services cotiues, the isured may access beefits uder his or her spouse s idetical policy util a miimum of 12 times the curretly mothly beefit remais. I additio, if oe spouse dies while both policies are i force, the survivig spouse will receive the deceased spouse s remaiig maximum lifetime beefit with o effect o the survivig spouse s premium. This optioal beefit is available oly whe both spouses or domestic parters apply at the same time ad are issued idetical coverage. Not available with Married or Two-Perso Household premium allowaces Not available for Class II risks Not available for Class I risks with a maximum lifetime beefit greater tha 3 years Not available with the pouse ecurity Beefit Not available with Retur of Premium at eath Less Claims Paid or Full Retur of Premium Not available if uderwritig determies oe or both applicats pose a greater tha ormal risk of premature death pouse urvivorship Beefit If the policy has bee i force for 10 years or more, o further premiums are due ad payable o the policy from ad after the date the spouse dies. Not available for Class I or II risks Not available with the pouse ecurity Beefit Not available with Married or Two-Perso Household premium allowaces 19
pouse Waiver of Premium We will waive the paymet of premium for the isured whe ad for as log as the premium for the spouse s policy is waived. Whe the waiver period uder the spouse s policy eds, premium paymets will resume for the isured s policy ad must be paid to keep the policy i force. Note: If premiums are icreased after policy issue due to a icrease or additio of coverage, the icreased premium must be i effect for 10 years or more before the icreased amout will be waived. Not available for Class I or II risks Not available with the pouse ecurity Beefit Not available with Married or Two-Perso Household premium allowaces Waiver of Elimiatio Period for Home Health Care The elimiatio period selected will be waived for home care ad adult day care, which meas beefits will begi with the first day of services. At that poit, the elimiatio period for ursig home ad assisted livig will begi to be satisfied o a caledar-day basis. This meas that days that home care is received, as well as days that home care is ot received will cout toward satisfyig the elimiatio period. Not available for Class I or II risks Additioal Policy etails Issue Ages Modified Guarateed Issue ad implified Issue issue ages are 18-64 Full Uderwritig issue ages are 18-79 30-ay Right to Review The applicat has 30 days from the day of its receipt to review the policy. If durig that time they are ot satisfied with it, they may retur the policy to us or the aget for a prompt refud of all premiums paid. The policy will the be cosidered ever to have bee issued. Tax tatus All Mutual Care at Work policies are iteded to be tax-qualified. Partership Qualified Policies Mutual Care at Work policies may qualify for partership based o the state of issue ad the aged based iflatio requiremets of those states where Mutual of Omaha partership sales are available. To determie partership qualificatio of each cliet, please see the Idividual ummary proposal page i WiFlex. Premium Allowaces All Mutual Care at Work policies offer the followig premium allowaces: pouse/parter 35 percet each if both the isured ad spouse or domestic parter purchase log-term care isurace from Mutual of Omaha Not available with pouse ecurity Beefit Not available with Modified Guarateed Issue Uderwritig If oe applicat cacels their cotract ad it results i a cacel back to issue or ot take, the pouse/parter Allowace (35 percet) will be removed from the remaiig issued policy ad the Married Allowace (15 percet) will be added 20
Preferred 15 percet for beig i good health Oly available with Full Uderwritig Ca be combied will all household allowaces Married 15 percet if the isured is married, but the spouse or domestic parter does ot purchase log-term care isurace from Mutual of Omaha Not available with pouse Waiver of Premium, pouse urvivorship or pouse hared Care beefits Two-Perso Household 10 percet each if both the isured ad aother adult livig i the same household for a cotiuous 12 moths (ot the isured s spouse or domestic parter) purchase log-term care isurace from Mutual of Omaha Not available with pouse Waiver of Premium, pouse urvivorship, pouse ecurity or pouse hared Care beefits If oe applicat cacels their cotract ad it results i a cacel back to issue or ot take, the Two-Perso Household Allowace (10 percet) will be removed from the remaiig issued policy ee Program Optios grid (page 14) for details o how these Premium Allowaces coordiate with each Uderwritig Program. Please ote: Program Allowaces are available at issue ad caot be chaged after 60-day period followig policy issue. Allowaces are multiplicative, ot additive. Premium Paymet Optio Lifetime Premium paymets are level ad made over the life of the isured ectio 3 Tax Advatages epedig o the tax-structure of the busiess, there may be sigificat tax savigs whe usig busiess dollars to purchase log-term care isurace. Additioally, employees may ejoy tax savigs o the log-term care isurace policy they purchase uder a compay-sposored program. Premiums may be tax-deductible Uder curret tax laws, the busiess ad its employees may be able to deduct a portio of the premium paid o a tax-qualified log-term care isurace policy. 21
Policy beefits may be tax-free Beefits paid by a tax-qualified log-term care isurace policy are tax-free as log as they do ot exceed the greater of qualified log-term care daily expeses or the per-day limitatio, which is $300 i 2011. ource: ectio 7720B ad ectio 106 of the Iteral Reveue Code (IRC) The Tax Advatages of Log-Term Care Isurace For the Busiess For Employees elf-employed Busiess Owers ole proprietor Partership LLC corporatio Log-term care isurace premiums paid by the compay for the ower, spouse ad depedets may be tax deductible as a busiess expese. The deductible amout is based o eligible premium guidelies. Owers of C Corporatios Log-term care isurace premiums paid by the compay for the ower/employee, a desigated class of employees, spouse ad depedets may be tax deductible as a busiess expese. The deductible amout is ot subject to eligible premium guidelies. Employees may be able to claim the log-term care isurace premiums they pay as a medical expese as log as these expeses exceed 7.5 percet of adjusted gross icome ad deductios are itemized o idividual s icome tax retur. The deductible amout is based o eligible premium guidelies. Refer to the most recet tax guide available o ales Professioal Access (PA) Gettig tarted tep 1: Geerate a Case Quote Complete a case quote ad preset it to the orgaizatio. You have two optios for geeratig a quote: Use Mutual of Omaha s WiFlex Multi-Life Proposal oftware Optio to ru three side-by-side quotes for a employer or idividual Cotact Mutual of Omaha s Multi-Life Uderwritig epartmet ed a email to LTC.Multi.Life@mutualofomaha.com Fax 402-351-5958 Call 877-778-0838 Usig WiFlex Multi-Life Proposal oftware Mutual of Omaha s WiFlex Multi-Life Proposal oftware gives you the capability to select illustratio reports based o your cliet ad the specific sales eeds of each case. All Ages Quote This report shows a summary of premiums for all ages from 18-79.* Up to three pla desigs ca be compared side by side. No cesus is required to obtai this report. *Ages 18-64 i a Modified Guarateed Issue or implified Issue case Group ummary This report shows a summary of premiums for each eligible idividual as well as the total group premium for all idividuals icluded o the cesus. Up to three pla desigs ca be compared side by side ad the premium ca be illustrated i all available premium modes. A full cesus is required to obtai this report. Idividual ummary This report shows a idividual summary page for each eligible idividual. Up to three pla desigs ca be compared side by side. This report illustrates aual, semiaual, quarterly ad mothly premium modes as well as oe additioal premium mode, if selected. The total amout for all allowaces will also be illustrated. A separate page will prit for each prospective cliet. A full cesus is required to obtai this report. 22
tep 2: ubmit the Group for Approval Oce the orgaizatio is ready to proceed based o the case quote, complete the Multi-Life Group Approval Request Form (M26936) ad submit it alog with a copy of the case quote ad a full cesus i Excel format to Mutual of Omaha s Multi-Life epartmet for review. The Group Approval Form ad Full Cesus Excel template ca be located o the ales Professioal Access (PA) website Mail to: Mutual of Omaha Isurace Compay LTC Multi-Life Uderwritig 6 th Floor Mutual of Omaha Plaza Omaha, NE 68175 Fax: 402-351-5958 Email: LTC.Multi.Life@mutualofomaha.com tep 3: Group Approval Withi oe to two busiess days, the Multi-Life Uderwritig Coordiator will review the Group Approval Request Form ad: Approve the group Request additioal iformatio Or declie the group If the group is approved, a Offer Letter cotaiig the details of the program will be set to you ad your marketer or divisio office. ectio 3 tep 4: eliver the Offer Letter Whe you receive the Offer Letter, you should immediately deliver it to the orgaizatio. Review the letter with the orgaizatio Obtai sigatures from the appropriate perso at the orgaizatio Retur the siged form to the Multi-Life Uderwritig Coordiator withi 30 days If group is utilizig List Bill/Payroll eductio, please complete the LTC New Employer Questioaire (M26939) ad retur the completed form to the Multi-Life Uderwritig Coordiator The group caot be activated util the siged Offer Letter is retured to the Multi-Life Uderwritig Coordiator. tep 5: The Implemetatio Call Upo receipt of the siged Offer Letter, the Multi-Life Uderwritig Coordiator will issue a ivitatio for a Implemetatio Call. The call may iclude: The Multi-Life Uderwritig Coordiator The aget ad/or marketer/divisio office The orgaizatio s beefits admiistrator The orgaizatio s billig cotact Log-Term Care ervice Office urig the call, the implemetatio process will be discussed, icludig billig set-up ad the erollmet start date. Followig the call, the Multi-Life Uderwritig Coordiator will assig a group umber ad sed a Implemetatio Memo to you or your marketer/divisio office via email. The Implemetatio Memo will cotai the details of the program. 23