Partnership Programs: Opportunities For Producers

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Partnership Programs: Opportunities For Producers Speakers: David Hillelsohn, Haslett Management Group, (703) 709-1160, dhill@hmgltc.com Claude Thau, 913-403-5824, cthau@targetins.com

Partnership Programs Our Focus: NEW Partnerships Some comments may apply to original states as well, but features and rules are somewhat different. We don t want to confuse people by discussing different programs. However the historical impact of Partnership on sales is relevant.

Partnership States Growing Market Share 25% % of LTCi policies sold in CA, CT, IN, NY 20% 15% 10% 5% 0% 1993 1994 1995 1996 1997 1999 2001 2004 2005 2006

The State s Partnership Budgetary Advantages Fewer Medicaid payments for LTC Fewer expenses fewer people reviewed for qualification fewer payments processed less estate recovery processing More tax revenue from insurers (premium tax) brokers (commissions) providers (income) and/or their staff (higher salaries) insureds (investment income on retained assets)

The State s Partnership Non-Budgetary Advantages Consumers get care where they want it Providers get private pay rates More LTC competition and investment Citizens get better care Less political pressure for Medicaid to pay for home care and against estate recovery and other tightening

Partnership Impacts on Consumers More suitable coverage (CBIO) Better-trained LTCi Professionals Better care More cash flow for providers Less turn-over of LTC staff More consumer-driven choices More investment in LTC services Lower LTC prices Less cost transfer from Medicaid to Private Pay clients Healthier state finances (lower taxes???)

Impact on LTCi Industry Media, Financial Advisor, etc. perspective In new Partnership states Increased sales to less affluent; better direct mail Increased sales in general (+25% over 10 years) Increased sales in work-site? Increased sales in existing Partnership states Stronger support from insurers, multi-state GAs Work-site in general, especially multi-state employers? More limited benefit period sales Increased need for specialists due to CE and interest from FPs with less affluent clients More tax breaks?

Partnerships Attract Less Affluent Buyers (Data from CA Partnership) 36% of buyers buy a 1-Yr or 2-Yr benefit period Affluent don t buy less than 3 years So these must be NON-affluent buyers Other NON-affluent might buy 3 or more years These people would NOT have been insured without the Partnership programs. Hence opens up less affluent market.

How I Explain Partnerships Claude Thau The Partnership: an additional back-end safety net Because people with LTCi are unlikely to ever qualify for Medicaid, states benefit greatly Therefore State provides safety net for the few who exhaust their LTCi If some assets are protected, balance still exposed So well-focused on less affluent Brokers: safe harbor with 5% CBIO ( ABI )

How I Explain Partnerships David Hillelsohn New program from state which: Endorses LTCi Asks citizens to take personal responsibility As benefits are paid, assets are protected beyond the minimum threshold $1 for $1 protection, extends to estate recovery Mandates inflation protection Does not mean you ll automatically qualify for state assistance

Partnership Expansion The Basics Further Legitimizes Private LTCi As An Important Financial Planning Tool By Weaving Product Into Nation s LTC Strategy Provides Dollar-For-Dollar Asset Protection As An Incentive For Consumers To Purchase Private LTCi Creates LTC Educational Clearinghouse To Help Educate Public About The Merits Of LTCi Funded At $3MM Annually Provides for LTCi Coverage Standards

Misguided Thoughts Appropriateness of using a program normally reserved for very poor to promote the private sector market for LTCi Whether the asset protection promised is necessary or sufficient to encourage people who would otherwise not purchase LTCi Program could allow people to retain large sums of money in excess of Medicaid limits that apply to everyone else Whether the program promotes Medicaid savings

Important LTC Themes Success hinges on convincing lower and middle income consumers to purchase LTCi No Medicaid savings with wealthy purchasing coverage Purchasers of LTCi under Partnership plans tend to purchase comprehensive coverage Partnership policies tend to include inflation protection Plans tend to be of 3 year duration or greater

Lessons Learned Existing Partnerships Genworth Experience Partnership States (CA, CT, IN, NY) Experienced Higher Growth Rates Than Non-Partnership States (7% vs Flat Growth; 00-05) Agents In Partnership States More Efficient (7.5 Policies Per Agent vs. 6.5 Average In All Other States) Industry Experience 28% of CT Partnership Policyholders would not have Purchased LTCi Without the Partnership 1 15-30% of Respondents to Partnership Surveys State that they Purchased a Policy as an Alternative to Transferring Assets 2 1 CRS Report for Congress, Long-Term Care Insurance Partnership Program, Sep. 27, 2004 p.28; 2 Ibid, p. 26-27 Sales In Partnership States Growing Faster Than Non-Partnership

Typical Buyer (CA and CT) 50% have assets in excess of $350,000 (excluding the home) An average of 20% have assets under $100,000 (excluding the home) 58% of buyers in California have income in excess of $5,000 per month Over half the purchasers in CT have income under $2,500 per month Limited data shows partnership purchasers to be slightly younger than general purchasers Source: Purchaser Survey, California Dept of Health Services; Annual Report for the Connecticut for Long Term Care Research: Evaluation Studies July 1, 2001 June 30, 2003. Issued Oct 2003

Typical Buyer (CA and CT) State California Connecticut Married 69% 79% Gender 59% Female 56% Female Median Age 61 58 Other 71% Ages 55-74 8% Widowed Declination Rate 17% 11% Source: Purchaser Survey, California Dept of Health Services; Annual Report for the Connecticut for Long Term Care Research: Evaluation Studies July 1, 2001 June 30, 2003. Issued Oct 2003

Buyer Survey To pay for future services (90%) To protect the spouse and family (81%) To protect assets of the purchaser (74%) Slightly under 25% stated that they purchased coverage as an alternative to transferring assets 79% of respondents found it was important to very important to have the state seal of approval on the policies 82% felt that Medicaid asset protection feature was important to very important Source: CA Partnership Survey

Messaging Pay for Care Protection for Family Members (Medicaid) Asset Protection State Seal of Approval Additional Safety Net Estate Reduction Expanded Medicaid Qualification Affordable LTC Alternatives Health Qualification

Messaging Issues Market Pre-Partnership Post-Partnership Pay for Care Protection for Family Members Leveraging Existing Wealth Already a Core Issue Need to Create Wealth Increasing Importance Asset Protection Primary Focus Creating Resources State Seal of Approval Limited to Tax Deduction Tax Benefits and State Endorsed LTC Plans Safety Net LTC Policy Added Safety Net

Messaging Issues Market Pre-Partnership Post-Partnership Estate Reduction Expanded Medicaid Qualification LTC Plans Health Qualification Tax Planning; Gifting Medicaid Avoidance Coverage Becoming More Expensive Changing Market Variance from Older to Active For Medicaid Eligibility Testing Potential Medicaid Participation Finding Affordable Solutions Broader Segment of Population

Market Asset Protection State Seal of Approval Family Members Messaging Lower Middle Class Protect What You ve Got; Medicaid Asset Protection State Encouraged LTCi Plans Help for Friends and Family Upper Middle Class Accumulated Personal Savings and Assets State LTC Partnership Plans Maintain Independence for Friends & Family

Messaging Market Lower Middle Class Upper Middle Class Expanded Medicaid Qualification Enrollment LTC Plans Health Qualification Plans which ease Medicaid qualification; added protection from estate recovery Simple Enrollment Process New, Affordable LTC Plans Many Health Conditions Considered Plans to keep you off of Medicaid Plan Options Available New Coverage to Meet LTC Partnership Guidelines Good Health Discounts Available

Coverage Design Market Lower Middle Class Upper Middle Class Daily Benefit 100% of Lower-End cost of care 75% - 80% of Average Cost of Care Benefit Period 2 year and 3 year plans 3 year and 5 year plans Elimination Period 90 / 100 day EP 90 / 100 day EP Home Care Included with Focus on Informal care Inflation Protection GPO, 3% Compound, 5% Compound, 5% Compound to Age 70, CPI COLA Included with Focus on Independent Home Care 5% Compound COLA Coverage Design Higher DB, Lower BP Moderate DB, Higher BP Coverage Limits $75,000 - $150,000 $200,000 - $500,000

Messaging for Low-Income Easy Basics Structure Value Word of Mouth Protection Affordable Access

Messaging for Lower-Income State Residents Easy to Sign-Up Low-Monthly Premiums Access to Care When you Need It Standardized Plan Features Community Care Benefits Instant Dollars Available Enhanced Medicaid Assistance for Plan Participants Simple Planning

Messaging for Lower-Income Markets School Teachers Life Lessons Learned Municipality State Approved Plans Public Safety Protection from the Unexpected Not-for-Profit Not for Profit For Need Other Plans for the Average American Religious Affiliation Simple Values, Believe in Yourself

Messaging for Upper - Middle Safety Savings Security Life Stages Staying Active With it Aging in Place Family Empowered

Messaging for Upper-Middle Tax Advantaged Risk Management Capitalize Security for an Active Lifestyle Protecting your Wealth Prepare Yourself Plan for Longevity Live Comfortably Age in Place

No golden parachute here. If one of us gets sick, we could lose everything we have. Get peace of mind by protecting your hard-earned nest egg. Long-Term Care Partnerships team up state governments and insurance companies so you can get the protection you need at a price you can afford. If a loved one needs extended care at home or in a facility, the Partnership plan is there to help shield your family from having to deplete all of your assets in order to cover the cost of long-term care. Find out more about the protection that Long-Term Care Partnerships offer. Visit us online at www.nahu.org.

Marketing Results from Own Your Future Joint Campaign between US Dept of Health and Human Services and National Governor s Association Press Conference Governor Letter Mailing Media Public Service Announcement (Radio and/or TV) Follow Up Post Card Fulfillment Kit for Responders Campaign had positive impact Response rate increase of 37-172% during prime phase of mailing (receipt of Governor letter) Sales volume in campaign states 15% higher on average than noncampaign states with weekly surges tied to campaign as high as 97% Sales impact over long term as awareness increased for ~10% of target population $7.5 million in Federal Funding

Keys To Success Understand Importance of Advisor in the Process Recognition of Different Market Segments Leverage Heightened Market Awareness www.longtermcare.gov Distribution of Information Consistent Accurate Relevant Understandable Current

Keys To Success LTC Educational Clearinghouse CMS supported programs SHIP Administration on Aging Disability Resource Centers Medicare.gov Four areas of Focus Consumer research Clearinghouse content Web Based LTC Initiative Design Tool LTC Initiative Call Center $3MM of Annual Funding Source: CMS LTC Initiative Report; Feb 2004

Keys To Success Advisor Education New Continuing Education Requirements State Specific Requirements Initial and Ongoing CE requirements Carrier management of Certification data Carrier commitment to market with product offering and Marketing Materials What is Medicaid Asset Protection How a Partnership-Qualified Policy Works Description of Carrier Solution

Opportunities for Advisors / Agencies Need for education will create speaking opportunities Agent CE Financial Planners Benefits Producers Life Insurance Groups General Licensed Agents AICPA / NAELA 2 hour, 4 hour, and 8 hour programs

Opportunities for Advisors / Agencies Need for education will create speaking opportunities to consumer groups Counseling Programs Client Appreciation Events Consumer Seminars Employer Groups AICPA / NAELA Partner with NAELA Attorneys

Opportunities for Advisors / Agencies Important Message for client letters and Newsletters Write articles for local publications, community newsletters, and religious group publications Component of Marketing Initiatives for 2008 Promotion of New Certification to Local Industry and Compatible Financial Professionals Review of Existing LTCi Contracts for Coverage Enhancements Limit Replacements

What Not to Do Do not split business with advisors who do not have state required CE Do not attempt to gauge Medicaid Eligibility Do not sell LTCi to individuals where LTCi is not suitable Do not commit to reciprocity across all states Do not suggest plan will be grandfathered, or that exchange is guaranteed Do not sell only carriers with LTCi Partnership Plans or Carriers without LTCi Partnership Plans Do not expect an employer to purchase coverage with COLA, but it should be available as a buy-up

What To Do Suggest Employers Commit to LTCi now that all employees have benefits which can match their needs Make Appropriate Plan Design Recommendations Reach out to all clients with some level of Coverage Make it work..