UNITED LTCi SOLUTIONS
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- Griffin Byrd
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1 UNITE LTCi OLUTION Assured olutios GOL M CA$H-FIRT WORKPLACE OLUTION Uited of Omaha Life Isurace Compay A Mutual of Omaha Compay Log-Term Care Isurace M FEATURING THE CA$H-FIRT AVANTAGE GC575 G819 AGENT ad UNERWRITING GUIE For producer use oly. Not for use with the geeral public.
2 Table of Cotets Cotact Iformatio... ectio 1 Assured olutios Gold & CAH-First M... ectio 2 Product etails Referece Grid Beefit escriptios Applicatio Requiremets Premium Allowaces Billig Iformatio Uderwritig Rules for Cash Beefits Uderwritig Rules for Optioal Beefits Workplace olutios... 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 ample Marketig Pla 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 G819_0312
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4 Cotact Iformatio Assured olutios & CAH-First M Mailig Addresses Workplace olutios Mailig Addresses Geeral Mail Expedited Mail Uited of Omaha Life Isurace Compay Log-Term Care ervice Office Log-Term Care ervice Office LTC Multi-Life Uderwritig 6th Floor P.O. Box Hudso Rd., uite 180 Mutual of Omaha Plaza t. Paul, MN Woodbury, MN Omaha, NE ectio 1 LTC ervice Office Claims Phoe: Hours: 7 a.m. to 5 p.m. Cetral time Moday Friday Customer ervice Phoe: Hours: 7 a.m. to 5 p.m. Cetral time Moday Friday New Busiess ervice Policy Issue Billig ad Collectio Fax Numbers Applicatio Requiremets Medical Iformatio elivery Requiremets Policy Chage Requests Correspodece Workplace olutios Multi-Life Uderwritig Coordiator Phoe: Fax: Hours: 8 a.m. to 4:30 p.m. Cetral time Moday Friday LTC.Multi.Life@mutualofomaha.com Case Quotig Group Approval Multi-Life Iquiries 1
5 Geeral Cotact Iformatio Premium ubmissio (o premium should be submitted with the applicatio) Geeral Mail Expedited Mail Uited of Omaha 1st Natioal Bak P.O. Box Att: top 2203 Omaha, NE Box odge t. Omaha, NE Licesig Phoe: Hours: 8 a.m. to 4:30 p.m. Cetral time Moday Friday ales upport Phoe: or Hours: 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: Hours: 8 a.m. to 4:30 p.m. Cetral time Moday Friday ltcuderwritig@mutualofomaha.com Prequalificatio Risk electio To Iitiate the Persoal Health Iterview Phoe:
6 Assured olutios Gold & CAH-First M Product etails There are two plas available. CAH-First M Assured olutios GOL CA$H-First M The CAH-First M log-term care isurace policy provides a mothly cash beefit to the cliet, based o the first day of qualified eed, with o elimiatio period to satisfy. The mothly cash beefit ca be used ay way the cliet chooses without havig to submit receipts for reimbursemet. The CAH-First M policy also icludes the flexibility to receive traditioal log-term care beefits as the eed for care icreases. This allows the cliet to be reimbursed for actual services redered icludig basic or professioal home health care, assisted livig facility care, or ursig home care. The cliet has the flexibility of choosig cash beefits oe moth ad reimbursemet beefits the ext, depedig o their curret eed for care. The CAH-First M log-term care isurace policy provides a mothly cash beefit as well as a maximum lifetime beefit pool of dollars. Cliets have the flexibility of both the cash beefit ad the pool of dollar amouts based o their eed. ectio 2 Assured olutios GOL The Assured olutios GOL log-term care isurace policy also provides the cliet with the flexibility to decide how they wat to receive their log-term care beefits. It combies mothly cash beefit that ca be used to pay for ay type of care the cliet chooses o the first day of qualified eed as well as traditioal log-term care beefits that reimburse for actual expeses icurred through a home health care agecy, assisted livig facility or ursig home. The Assured olutios GOL log-term care isurace policy provides a mothly maximum beefit ad a maximum lifetime beefit that is calculated based o the umber of moths selected as a beefit multiplier. The Basics Where? Care ettigs Both plas cover Home Health Care (HHC), Adult ay Care (AC), Assisted Livig Facility (ALF), Nursig Home (NH) & Hospice Care There is oe Maximum Lifetime Beefit for all coverages How Much? Maximum Mothly Beefit CA$H-First M Cash Beefit 40 percet of the Basic Home Health Care Beefit ($600 - $3,600) with a optioal icrease to 50 percet of the Basic Home Health Care Beefit Nursig Home Beefit up to 100 percet of the Maximum Mothly Beefit Assisted Livig Facility up to 50 percet of the Maximum Mothly Beefit; Optioal icreases: 60 percet, 70 percet, 75 percet, 80 percet, 100 percet Basic Home Health Care Beefit up to 100 percet of the Maximum Mothly Beefit Professioal Home Health Care additioal beefit is up to 100 percet of the Basic Home Health Care Beefit 3
7 Assured olutios GOL Maximum Mothly Beefit* $1,500 to $15,000 (i $500 icremets) Maximum: $15,000 Nursig Home Beefit up to 100 percet of the Maximum Mothly Beefit Maximum: $15,000 Home Health Care up to 100 percet of the Maximum Mothly Beefit Maximum: $15,000; Optioal reductios: 75 percet or 50 percet Assisted Livig Facility: up to 100 percet of Maximum Mothly Beefit Maximum: $15,000; Optioal reductios: 75 percet or 50 percet Cash Beefit is 40 percet of Home Health Care Beefit with a optioal icrease to 50 percet of the Home Health Care Beefit *Total beefits for all LTC policies i force (icludig policies from other compaies) caot exceed $15,000 mothly or $500 daily at time of issue. How Log? Maximum Lifetime Beefit CAH-First M The Maximum Lifetime Beefit is determied by choosig a Cash Beefit/Mothly Maximum Beefit amout with a valid Maximum Lifetime Beefit based o the grid or Lifetime. ee Referece Grid o Page 5 Assured olutios GOL The Maximum Lifetime Beefit is determied by multiplyig the umber of moths selected by the Maximum Mothly Beefit amout Choices are 2 Year (24 Moths), 3 Year (36 Moths), 4 Year (48 Moths), 5 Year (60 Moths), 6 Year (72 Moths), 8 Year (96 Moths) or Lifetime How oo? Elimiatio Period 0, 30, 60, 90, 180 or 365 caledar days The Elimiatio Period is cumulative ad eeds to be satisfied oly oce i a lifetime The Elimiatio Period applies to all coverages. However, if the 30, 60, 90, 180 or 365 ay Elimiatio Period is chose, the applicat has the optio to select the Waiver of Elimiatio Period for Home Health Care (ot available for Class I or II risks) The Elimiatio Period does ot eed to be satisfied i order to obtai a Cash Beefit 4
8 Referece Grid 40% Cash Beefit / MMB $600 $800 $1,000 $1,200 $1,400 $1,600 $1,800 $2,000 Maximum Lifetime Beefit 50K 75K 100K 125K 150K 175K $1, K 225K $2, K 275K 300K $2, K 350K $3, K 400K $3, K 450K 475K $4, K ELIGIBLE COMBINATION $2,200 $2,400 $2,600 $2,800 $4,500 $5,000 $5,500 NOT AVAILABLE $3,000 $3,200 $6,000 $6,500 $7,000 $7,500 $8,000 $3,400 $8,500 $3,600 $9,000 ectio 2 5
9 Beefit escriptios The followig charts idicate built-i features ad optioal beefits for Assured olutios GOL ad CAH-First. Beefits may vary by state. 6 Built-I Features: Maximum Lifetime Beefit Assured olutios GOL 2 yrs, 3 yrs, 4 yrs, 5 yrs, 6 yrs, 8 yrs & Lifetime CAH-First $50,000 to $500,000 (i $25,000 icremets) or Lifetime Maximum Mothly Beefit (MMB) Up to $15,000 per moth Up to $9,000 per moth Cash Beefit 40% of HHC 40% of HHC NH 100% ALF 100% 50% HHC 100% Elimiatio Period Bed Reservatio (NH ad ALF) Respite Care Hospice Care Iteratioal Beefit Waiver of Premium Alterate Care Care Coordiatio Caregiver Traiig urable Medical Equipmet Home Modificatio Medical Alert ystem 0, 30, 60, 90, 180 or 365 caledar days 30 days per caledar year 30 days per caledar year No limit MMB up to 1 year Whe beefits begi With care coordiatio Yes Pays up to 2x MMB with Care Coordiatio 5-Year Rate Guaratee Yes Yes Additioal Beefit for Prof HHC No Yes Additioal Beefit for Ijury No Yes Retur of Premium (less claims) if death before Age 65. (ee Optioal Beefits chart for other optios.) No Yes Additioal Rate Guaratee Yes Yes pousal Beefits: pouse ecurity Beefit pouse hared Beefit pouse Waiver of Premium pouse urvivorship Beefit Iflatio Optios: Up to 60% i additioal beefits for uisured spouse Allows a spouse to access the other spouses beefits upo their ow beefit exhaustio Waives premium for both spouses whe oe is o claim If death occurs after 10 years, o further premiums are due o survivig spouse. No Iflatio with Future Purchase Optio Yes Yes 5% Compoud Lifetime Yes Yes 5% imple Lifetime Yes Yes
10 5% Compoud 20 Year Yes Yes 5% Compoud 2X, 3X, 4X Maximum Icrease Yes Yes Compoud Iflatio with Guarateed Buy-up Optio 4.5%, 4%, 3.5%, 3%* * Isured ca icrease to ay other compoud lifetime Yes Yes iflatio optio prior to age 85 without uderwritig (multiple icreases ok). Other Optios: Waiver of Elimiatio Period for Home Health Care Yes Yes Restoratio of Beefits Yes Yes Cash Beefit Icrease from 40% to 50% Yes Yes ALF Reductio/Icrease 50% or 75% 60%, 70%, 75%, 80%, 100% HHC Reductio 50% or 75% No Additioal Years of Rate Guaratee 6 yrs to 10 yrs 6 yrs to 10 yrs Retur of Premium at eath (Less Claims Paid) Yes Yes Full Retur of Premium No Yes Noforfeiture horteed Beefit Period Yes Yes Cotiget Noforfeiture efault efault Premium Optios: Lifetime efault efault 10-Year Pay Yes Yes 20-Year Pay Yes Yes To-Age-65 Yes Yes Flex To-Age-85 Yes Yes ectio 2 7
11 Applicatio Requiremets Thigs to Remember The applicatio packet cotais the applicatio plus ay vital forms required by the cliet s residet state Note: No-residet state applicatios or forms will ot be accepted If the applicatio is take i perso the aget must be licesed i the state where the applicatio is siged. For mailed-i applicatios, the aget must be licesed i the state where the applicatio was mailed ad completed 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 Although may log-term care sales are made to married couples, each applicat is uderwritte idividually ad, upo approval, is issued his or her ow policy Note: Oly the applicat for isurace may complete ad sig the applicatio Please be certai all aswers are legible. 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 ot a acceptable aswer. Istead the questio should be aswered o or oe Agets are asked to iclude a copy of their quote with the applicatio packet How to Complete the Applicatio Geeral Iformatio All questios must be aswered icludig best time to call. Uless you call i to have the iterview completed at time of applicatio, please be certai to tell the applicat that a represetative will call to arrage a Telephoe Iterview or a Face-to-Face Examiatio. Allowaces All questios must be aswered. The applicat(s) may be eligible for premium allowaces based o their aswers. Replacemet Coverage Complete all iformatio requested, as applicable. If a Uited of Omaha policy will replace a existig log-term care policy, replacemet form(s) required i the applicat s state must be completed. Log-term care laws are strict regardig replacemet compliace. Health Isurability Questios (ee Uderwritig Requiremets ectio for assistace.) (Physicia ad Medicatio Iformatio Health Questios) Please provide complete ad accurate iformatio, icludig the Primary Physicia s address ad telephoe umber. While aswers are verified via Medical Records ad/or durig the Telephoe Iterview or Face-to-Face Examiatio, failure to disclose a existig coditio ca result i deial of a future claim related to that coditio. Importat Note: Please see the Uderwritig Guidelies sectio for pertiet iformatio about the Telephoe Iterview ad Face-to-Face Examiatio. 8
12 Beefit electio Check or fill-i all appropriate sectios. The total mothly beefit for Nursig Home/Assisted Livig or Home Health Care, icludig all log-term care policies i force, caot exceed $15,000 mothly or $500 daily at time of issue The 5 percet Compoud Lifetime Iflatio Beefit must be offered to all applicats. If the 5 percet Compoud Lifetime Iflatio Beefit is ot elected, the applicat must check the No box i the Iflatio Protectio optios sectio of the applicatio. A iflatio optio must be selected The Noforfeiture Beefit horteed Beefit Period MUT be offered. If ot chose, the applicat must check the No box o the Noforfeiture horteed Beefit Period sectio of the applicatio ad the Cotiget Noforfeiture Beefit will be default Premium Optios Idicate the premium mode desired ad add the modal premium ad premium collected. If the applicat wishes to pay mothly premiums via pre-authorized bak draft, the Recurrig Premium Mode sectio must be completed. A voided check must accompay the applicatio if future premiums will be draw out of a accout other tha the accout used for the iitial premium. ectio 2 elect Effective ate Idicate whether the applicat wishes to have coverage (if approved) issued as of the ate of Applicatio, the ate Policy is Issued, or for Replacemets oly, Requested Effective ate of Coverage (up to 60 days from the applicatio sigig date). Notice Before Lapse or Termiatio This sectio must always be completed. However, if the applicat does ot wish to desigate a perso to receive lapse or termiatio otificatio, the applicat must check the appropriate box. Agreemets ad Ackowledgemets Have each applicat sig ad date this sectio ad iclude the city ad state where the applicatio was siged. Check the appropriate box, provide a explaatio, if idicated, alog with your sigature. Note: The applicatio used must be from the applicat s residet state ad you must be licesed ad appoited i the sigig state. Authorizatio to isclose Persoal Iformatio to Uited of Omaha Life Isurace Compay This sectio allows Uited of Omaha to get ecessary iformatio i cojuctio with the uderwritig process. Please be certai the applicat sigs ad dates this page. Failure to sig will result i a o-issued policy. Producer tatemet/coditioal Premium Receipt Agets must complete all sectios prior to applicatio submissio. teps for chedulig ad Completig the Telephoe Health Iterview Must be completed for all applicats age 64 ad uder. A face-to-face iterview is required for applicats ages After completig the applicatio, help your cliet collect ad record iformatio about physicias ad medicatios usig the Preparig for the Health iterview worksheet (GC577) located i the applicatio booklet. 2. Be sure to explai the health iterview process to the cliet as well as the importace of givig the iterviewer his or her full attetio. Also, prepare your cliet for the possibility that a cogitive iterview also may be eeded. 9
13 3. You may choose to call Natios Care Lik at at the time of applicatio ad idetify yourself as the writig aget ad advise the service represetative that you have a cliet who eeds a iterview. Or, you may submit the applicatio ad your cliet will cotacted to schedule a iterview. 10 Iform the health iterviewer or ote o the applicatio if the cliet has ay hearig problems or if he/she eeds a iterpreter for a laguage other tha Eglish. 4. If a urse is available at the time of your call, have your cliet coduct the iterview. Importat: YOU MUT NOT BE PREENT URING THE CLIENT HEALTH INTERVIEW. 5. If a urse is ot available or it is ot a coveiet time for the cliet, a appoitmet ca be made for a future date. ee Udewritig Guidelies ectio for additioal iformatio regardig the Health Iterview. Premium Allowaces pouse/parter 35 percet each if both the isured ad the isured s spouse or domestic parter purchase log-term care isurace from Uited 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 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 isured s spouse or domestic parter does ot purchase log-term care isurace from Uited 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 isured s household for a cotiuous 12 moths (ot the isured s spouse or domestic parter) purchase log-term care isurace from Uited 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 is a member, or a eligible family member of a qualifyig associatio group Not available with limited pay optios, except To-Age-65 ad Flex To-Age-85 Not available with Producer Allowace Medicare upplemet 5 percet for a Mutual of Omaha Isurace Compay or Uited of Omaha Life Isurace Compay or Uited World Life Isurace Compay Medicare upplemet policyholder Not available with Producer Allowace Producer 5 percet if coverage is writte o Producer ad/or spouse or domestic parter All available allowaces will apply* *Oly oe household allowace ca be selected. Producer allowace caot be combied with Associatio Group or Medicare upplemet allowace. Preferred health allowace ca be combied with ay other allowace. Allowaces are multiplicative, ot additive. Billig Iformatio Please use the followig modal factors to calculate premium. Mothly Bak raft.09 Quarterly.26 emiaual.51 Aual 1.00
14 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: Uited of Omaha Life Isurace Compay. Uderwritig Rules for Cash Beefit A Cash Beefit, if elected, will be paid i advace each moth that the cliet is eligible for a Cash Beefit. If we determie that they are eligible for a Cash Beefit for less tha a etire moth, we will adjust the Cash Beefit for that moth. The Cash Beefit will be prorated based o the actual umber of days they are eligible for a Cash Beefit i such moth. We will assume that such moth cosists of 30 days regardless of the actual umber of days i such moth. If i ay moth they receive a Cash Beefit i excess of the amout for which they are eligible, we will reduce ay future beefits paid to them uder the policy by the amout of the ueared Cash Beefit. ectio 2 While receivig Cash Beefits, o other beefits are payable uder the policy. If the cliet decides to discotiue to receive the Cash Beefit, this may be doe by providig writte otice to us. After Cash Beefits have bee discotiued, other eligible beefits offered uder the policy would be payable. If your cliet later decides ot to receive other beefits uder the policy, they may agai elect to receive Cash Beefits. Please ote, days i which Cash Beefits are utilized do ot cout toward the elimiatio period for reimbursemet beefits. Other Iformatio: The Elimiatio Period does ot eed to be satisfied to receive Cash Beefits. We reserve the right to require submissio of a ew Pla of Care at least oce every 60 days while receivig Cash Beefits. Uderwritig Rules for Optioal Beefits All available optios may be added to the Pla selected, uless a specific combiatio of optios is ot allowed by uderwritig rules Uderwritig will be the same for the base policy ad selected optioal beefits Additioal premium will be required for all optioal beefits Optios may be added at time of sale or withi 60 days of policy issue with Uderwriter approval ee Class I ad Class II Health Risks (Page 15) for list of uavailable optios 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%, 4.5%, 4%, 3.5%, 3% Five Percet Compoud 20-Year Your curret maximum mothly beefit ad maximum lifetime beefit amouts will icrease by 5 percet o each policy aiversary date for 20 years. 11
15 Five Percet Compoud with Maximum Icrease Your curret maximum mothly beefit ad maximum lifetime beefit amouts will icrease by 5 percet o each policy aiversary date util the beefit amouts have: Optios: oubled, Tripled, Quadrupled Guarateed Buy-Up Optio If you select a compoud lifetime iflatio protectio optio less tha 5 percet, you may icrease your selected optio to ay higher compoud lifetime optio at ay time prior to age 85 with o additioal uderwritig required.* Premiums for ay icreases i iflatio beefit percetages will be based o your age at the time you elect the icrease. You may elect multiple icreases over the life of your policy but ot more tha oce per year. Optios: 4.5%, 4%, 3.5%, 3% imple Iflatio Protectio: Five Percet imple Lifetime O each policy aiversary date, your maximum mothly beefit will icrease by 5 percet of its origial value. I additio, the maximum lifetime beefit will icrease by 5 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 5 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.* 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. Compoud Lifetime with Buy Up is ot available with 10-pay, 20-pay or To-Age-65 Compoud Lifetime with Maximum Icrease is ot available with Flex-to-Age 85 M *ubject to the followig limitatios: Your premiums are ot waived o the policy You are ot curretly eligible to receive policy beefits or have you received policy beefits i the two years prior to electig the icrease 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 t receive home care both cout toward satisfyig this elimiatio period. Note: This beefit is ot available for Class I or II risks pousal Beefits The spousal beefits listed below are oly available whe both spouses or domestic parters apply at the same time ad both policies are issued. pouse Waiver of Premium this optioal beefit waives the paymet of premium for the policy whe ad so log as the premium for the pouse s policy is waived uder the terms of his or her policy. Whe the waiver period uder the pouse s policy eds, premium paymets will resume for the policy ad must be paid to keep it i force. 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. 12
16 Note: If pouse Waiver of Premium is selected, the pouse ecurity Beefit is ot available This optio is ot available with the 10-year, 20-year, To-Age-65 or Flex To-Age-85 paymet optios Not available with Married or Two-Perso Household Allowaces Not available o Class I ad Class II risks pouse urvivorship If the policy has bee i-force for 10 or more years, this optioal beefit provides that o further premiums are due ad payable for the policy from ad after the date the pouse dies. Note: If pouse urvivorship is selected, the pouse ecurity Beefit is ot available This optio is ot available with the 10-year, 20-year, To-Age-65 or Flex To-Age-85 paymet optios Not available with Married or Two-Perso Household Allowaces Not available o Class I ad Class II risks ectio 2 pouse hared Care Beefit This optioal rider allows the cliet, oce beefits have bee exhausted uder his or her policy ad care cotiues, the ability to access beefits uder their spouse s idetical policy util a miimum of 12 times the curret mothly beefit remais. I additio, if either 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. Oly available whe both spouses or domestic parters apply at the same time ad both policies are issued with idetical beefits. Note: pouse hared Care is ot available: for Class II risks for Class I risks with a Maximum Lifetime Beefit greater tha 3 years with pouse ecurity Beefit with Full Retur of Premium at eath (Less Claims) or Full Retur of Premium at eath with Lifetime Beefits if Uderwritig determies oe or both applicats poses a greater tha ormal risk of premature death with Married or Two-Perso Household Allowaces pouse ecurity Beefit The pouse ecurity Beefit is equal to 60 percet of the reimbursemet beefits payable each moth (excludig the Cash Beefit, if ay). pouse ecurity Beefits will ot reduce the Maximum Lifetime Beefit. Note: pouse ecurity is ot available: for Class I or II risks with pouse Waiver of Premium, pouse urvivorship, or pouse hared Care with pouse or Two Perso Household Allowace for issues ages over 69 13
17 Restoratio of Beefits If beefits have bee paid uder the policy ad your cliet later becomes eligible for Restoratio of Beefits, we will restore the Maximum Lifetime Beefit oe time durig the term of the policy. Except for ay beefits paid for the spouse uder ay shared beefit to the policy, the Maximum Lifetime Beefit will be restored to the amout that would have applied if o beefits had bee paid uder the policy. Note: Not available with Lifetime Beefits Additioal Beefit for Ijury The Additioal Beefit for Ijury pays a beefit if your cliet sustais a Ijury, which results i cofiemet to a Nursig Home or Assisted Livig Facility or receivig Home Health Care Beefits. The Ijury must be sustaied while the policy is i force, ad the isured is ot chroically ill. We will pay a Additioal Beefit for Ijury ay moth the isured icurs eligible expeses i excess of the Nursig Home Beefits, Assisted Livig Facility Beefits or Home Health Care Beefits paid that moth, up to the Maximum Mothly Beefit. Note: Not available for issue ages over 60 Retur of Premium at eath Beefits Retur of Premium (Less Claims Paid) if eath Occurs Before Age 65 If cliet dies while the policy is i force, but prior to the Policy Aiversary ate coicidig with or ext followig their 65 th birthday, we will retur the total amout of premiums paid for the policy, less the amout of claims paid uder the policy. Note: Retur of Premium (Less Claims Paid) if eath Occurs before Age 65 is ot available for issue ages over 64 Retur of Premium at eath (Less Claims Paid) If your cliet dies while the policy is i force, we will retur the total amout of premiums paid for the policy, less the amout of claims paid uder the policy. Note: Retur of Premium at eath (Less Claims Paid) is ot available: with pouse hared Care for issue ages over 64 Full Retur of Premium at eath If your cliet dies while the policy is i force, we will retur the total amout of premiums paid for the policy. Note: Retur of Premium at eath (Less Claims Paid) is ot available: with pouse hared Care for issue ages over 64 Additioal Years of Rate Guaratee Optio Class I or II health risks are ot eligible for this Optio. The policy icludes a built-i 5-Year Rate Guaratee. Applicats may choose to add up to 5 more years for a total rate guaratee period of 6, 7, 8, 9 or 10 years. Note: This Optio may be removed at the request of the isured. Upo removal, the policy will revert to the built-i 5-Year Rate Guaratee. hould a rate icrease occur durig the additioal years of rate guaratee period (prior to its removal) the icreased premium amout will take effect oce the additioal years of rate guaratee is removed. No premium credit (refud or advace of the paid-to-date) will be give. 14
18 Premium Optios Lifetime premium paymets are level ad made over the life of the policyholder Is default optio if o other premium optio is chose 10-year Pay premium paymets are made over a 10-year period Oly available at issue A limited pay optio may be removed at the request of the isured. The premium after removal will be based o the origial issue age. No premium credit (refud or a advace of the paid-to-date) will be give Not available with Class I or II risks Not available o Associatio/posored Group policies Not available with pouse Waiver of Premium or pouse urvivorship Not available with Compoud Iflatio with buy-up optios or No Iflatio with Future Purchase Optio (FPO) ectio 2 20-year Pay premium paymets are made over a 20-year period Oly available at issue A limited pay optio may be removed at the request of the isured. The premium after removal will be based o the origial issue age. No premium credit (refud or a advace of the paid-to-date) will be give Not available with Class I or II risks Not available o Associatio/posored Group policies Not available with pouse Waiver of Premium or pouse urvivorship Not available with Compoud Iflatio with buy-up optios or No Iflatio with Future Purchase Optio (FPO) To-Age-65 premium paymets are made util Age 65 Oly available at issue Maximum issue age is through Age 54 A limited pay optio may be removed at the request of the isured. The premium after removal will be based o the origial issue age. No premium credit (refud or a advace of the paid-to-date) will be give Not available with Class I or II risks Available for Associatio/posored Group policies Not available with pouse Waiver of Premium or pouse urvivorship Not available with Compoud Iflatio with buy-up optios or No Iflatio with Future Purchase Optio (FPO) Flex-to-Age-85 premium paymets begi as a percetage of the fixed premium ad icrease each year util Age 65, where premiums become fixed. The policy is paid up at Age 85. Oly available at issue Maximum issue age is through Age 60 Premium icreases may be discotiued at the request of the isured. Aual premiums will remai fixed from the date of the request ad the Compoud Lifetime Iflatio Protectio will termiate Not available with Class I or II risks Not available with pouse Waiver of Premium or pouse urvivorship Oly available with Compoud Lifetime (with or without buy-up optio) Iflatio Optios Available for Associatio/posored Group policies 15
19 Class I ad Class II Health Risks Maximum allowable beefits: 5-Year (60 Moths) Maximum Lifetime Beefit ad a miimum 90-day elimiatio period. The followig optios are ot available: pouse ecurity Beefit pouse hared Care Beefit is available for Class I risks with a Maximum Lifetime Beefit of 3 Years (36 Moths) or less pouse Waiver of Premium Beefit pouse urvivorship Beefit 10- ad 20-Year Premium Optio To-Age-65 Premium Optio Additioal Years of Rate Guaratee Flex-to-Age-85 Premium Optio Waiver of Elimiatio Period for Home Health Care 16
20 Workplace olutios Program Overview What is Uited of Omaha s Workplace olutios? Workplace olutios is a multi-life program for busiesses with three or more employees. 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 17
21 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 Workplace olutios 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 18
22 Exteded family members are eligible for full uderwritig with a 5 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 5 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 5 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 5 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 19
23 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 20 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)
24 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% 21
25 Product etails Workplace olutios The followig charts cotai the built-i ad optioal beefits of Uited of Omaha s Workplace olutios, which vary by state. Pre-packaged Plas tadard Beefits Base Broze ilver Gold Platium Nursig Home, Assisted Livig Facility ad Home Health Care up to 100% of Maximum Mothly Beefit Cash Beefit is 40% of Home Health Care 90 Caledar ay Elimiatio Additioal Beefit for Ijury 5 Year Rate Guaratee Lifetime Premium Maximum Mothly Beefit $2,000 $3,000 $4,000 $5,000 $6,000 Maximum Lifetime Beefit $50,000 $100,000 $150,000 $200,000 $250,000 Iflatio Protectio Noforfeiture Beefit horteed Beefit Period 5% Compoud Lifetime 4.5% Compoud Lifetime with Buy Up 4% Compoud Lifetime with Buy Up 3.5% Compoud Lifetime with Buy Up 3% Compoud Lifetime with Buy Up No Iflatio (Future Purchase Optio is available i OH oly) Optio Optio Optio Optio Optio pouse hared Care Optio Optio Optio Optio Optio *Please see Program Optios Grids i ectio 3 for program limits based o uderwritig program. 22
26 Flex Pla tadard Beefits Maximum Mothly Beefit Maximum Lifetime Beefit Caledar ay Elimiatio Iflatio Protectio Mothly Beefit Optios pousal Beefits Retur of Premium Additioal Years of Rate Guaratee Other Optioal Beefits Flex Pla Nursig Home, Assisted Livig Facility ad Home Health Care are each up to 100% of the Maximum Mothly Beefit Cash Beefit is 40% of Home Health Care Beefit Additioal Beefit for Ijury 5 Year Rate Guaratee $1,500 to $15,000 $50,000 to $500,000 i $25,000 icremets 90, 180 or 365 caledar days 5% Compoud Lifetime 5% imple Lifetime 5% Compoud (20-year) 5% Compoud Lifetime (2x Maximum Icrease) 5% Compoud Lifetime (3x Maximum Icrease) 5% Compoud Lifetime (4x Maximum Icrease) 4.5% Compoud Lifetime with Buy Up 4% Compoud Lifetime with Buy Up 3.5% Compoud Lifetime with Buy Up 3% Compoud Lifetime with Buy Up No Iflatio (Future Purchase Optio is available i OH oly) Assisted Livig Facility 75%, or 50% pouse hared Care pouse urvivorship pouse Waiver of Premium Retur of Premium at eath (Less Claims) Full Retur of Premium at eath Home Health Care 75% or 50% 6, 7, 8, 9 or 10 years Noforfeiture Beefit horteed Beefit Period Waiver of Elimiatio Period Home Health Care Cash Beefit Icrease 40% to 50% pouse ecurity Beefit Restoratio of Beefits *Please see Program Optios Grids i ectio 3 for program limits based o uderwritig program. Nursig Home 100% Beefit escriptios This sectio cotais a explaatio of the built-i ad optioal beefits of Uited of Omaha s Workplace olutios. 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 ectio 3 Additioal Years of Rate Guaratee Guaratees the iitial rate for additioal years. Available optios are 6, 7, 8, 9 or 10 years. Not available with Class I or II risks 23
27 Cash Beefit Whe elected, pays a cash beefit (equal to 40 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. 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: ays i which the cash beefits are utilized do ot cout toward the elimiatio period for reimbursemet beefits. Cash Beefit Icrease Whe elected, Cash Beefit amout icreases from 40 percet of the home health care maximum mothly beefit to 50 percet of the home health care maximum mothly beefit. 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 icreases the isured s curret maximum mothly beefit ad maximum lifetime beefit o each policy aiversary date to help keep pace with iflatio. Iflatio Protectio Optios The isured has the choice of the followig iflatio protectio optios: Prepacked Plas 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%, 4.5%, 4%, 3.5%, 3% Guarateed Buy-Up Optio If you select a compoud lifetime iflatio protectio optio less tha 5 percet, you may icrease your selected optio to ay higher compoud lifetime optio at ay time prior to age 85 with o additioal uderwritig required.* Premiums for ay icreases i iflatio beefit percetages will be based o your age at the time you elect the icrease. You may elect multiple icreases over the life of your policy but ot more tha oce per year. Optios: 4.5%, 4%, 3.5%, 3% 24
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