150 likes | 173 Views
Continental Casualty Company Policy GLTC-3-C-TX-01. What is Long Term Care - LTC?. Long Term Care is a variety of services provided to those unable to take care of themselves.
E N D
What is Long Term Care - LTC? Long Term Care is a variety of services provided to those unable to take care of themselves. Services can range from simple help with meal preparation, to assistance with daily living activities, to 24-hour monitored care. What is Long Term Care Insurance? It pays for the costs of long term care services. • It is not health insurance. It does not pay hospital or doctor bills. • It is not disability insurance. It does not replace lost income.
Long Term Care (LTC) Facts • Nationwide the Facility Care cost can average $50,000 to $110,000 dollars per year.1 • Average nursing home cost in Texas is $142 per day, or over $51,000 per year. 1 • Home Health Services can cost up to $36,000 per year.2 • Medicare generally only pays for limited care following hospitalization.3 • LTC is not just for the elderly. • Almost 40% of all people needing long term care services are working age adults. 4 • Many financial planners today recommend a LTC policy as part of a sound financial plan. • 2011 CNA Nursing Home Cost Survey • A Shopper’s Guide to Long-Term Care Insurance, 2008. National Association of Insurance Commissioners. • U.S. Department of Health and Human Services, National Clearinghouse for Long-Term Care Information. 2008 • CNA Claim Data as of January 1, 2009.
Special Enrollment Opportunity for all Active Employees Guarantee Issue for Active Employees during the annual enrollment period from July 15 to July 31, 2013 • No medical questions. • No underwriting. • All eligible employees will be approved during this time period. • The effective date will be September 1, 2013. • You must still be actively at work on the effective date. If on LOA the effective date will be the first of the month after your return to work. • Normal underwriting rules apply to all other applicants (spouses, parents, etc..)
Facility Care Daily Benefit / Lifetime Maximums • The choices available will be: • $100 per day, $109,500 Lifetime Maximum • $125 per day, $136,875 Lifetime Maximum • $150 per day, $164,250 Lifetime Maximum • $200 per day, $219,000 Lifetime Maximum • $250 per day, $273,750 Lifetime Maximum • Daily Maximum for Home Based Care is 50% of the daily maximum for Nursing Home Care shown above
What’s in the Plan? Inflation protection (Choice #1) • Guaranteed benefit increase (GBO) • Opportunity to purchase additional coverage at routine intervals (3 to 5 years). • Increases daily maximums and lifetime maximum pools. • Premiums for increased coverage based on your attained age.
Buy-up Opportunity for Current Enrollees For those who are already insured with Guaranteed Benefit Increase Option (GBO) Offer letters mailed July 10th No medical questions (EOI) or underwriting for employees and their spouses, or anyone else who either is getting an offer for the first time, or who accepted the last offer in 2009. Enrollment period is through the end of July The effective date for the coverage increase will be September 1, 2013 Your premium will be adjusted for the cost of the additional benefit you are adding.
What’s in the Plan? Inflation protection (Choice #2) • Automatic Benefit Increase (ABI) • Automatically keeps up with inflation. • Both daily benefits and lifetime maximum increase by 5% compounded each year. • Premiums remain level.
How do you qualify for coverage? • One of two ways to receive benefits. • Certification as “chronically ill” by a licensed health care practitioner. Must be unable to perform 2 of the 6 activities of daily living (eating, dressing ,toileting, bathing, continence, and transferring). • Have a cognitive impairment such as Alzheimer’s. • Must incur expenses for LTC services. • Must satisfy the 90 day waiting period. Only once per lifetime. • Premium is waived once benefits begin
Some Additional Features • Worldwide Coverage – Coverage outside the USA is standard. Paid at the Home Care benefit amount. • Bed Reservation – Will hold a bed in a nursing home for up to 60 days per year while temporarily away. • Respite Care Benefit – Up to 14 days per year to relieve a caregiver. • Future Benefit Guarantee – Provides a reduced benefit for cancellation after 3 years of coverage. • Home Medical Technology – Will pay of to $1,000 per year for assistive devices in the home
Who Is Eligible? • All actively-at-work, benefits eligible employees • Guaranteed acceptance during this special enrollment period • Must be approved for coverage with Evidence of Insurability (EOI) after the special enrollment period ends • Spouses – EOI is required • Parents (Parents-In-Law) – EOI is required • Grandparents (Grandparents-In-Law) – EOI is required • Retirees (and Spouses) – EOI is required • Adult Children over age 25 – EOI is required
Enrollment • Only the new plan is available for enrollment • Effective date is Sept 1, 2013 • During the special enrollment, Active Employees are guaranteed issuance if they enroll between July 15 to July 31, 2013 • Employees can enroll online at www.ltcbenefits.com/uts • No EOI is required • BID is required to enroll online • Information is available at: • www.ltcbenefits.com/uts • Information and applications are available in the enrollment packets
Enrollment Spouses can apply during the annual enrollment period by completing a Short Form Application – EOI Required Parents, Grandparents, and Retirees can apply at any time by completing a Long Form Enrollment Application – EOI Required Earliest effective date is September 1, 2013 Information is available at: www.ltcbenefits.com/uts Information and applications are available in the enrollment packets
Premiums • Premiums are based on the enrollee’s age as of the effective date of coverage and plan selected • Premiums are level which mean they do not go up each year as you get older • Payroll Deduction • Employees and Spouses • Direct Bill • Parents, Grandparents, In- laws, Adult Children
Questions? • Call Customer Service toll free at: 1-888-825-0353 • Hours • Monday through Friday • 7 AM to 5 PM (Central Time)