USC Benefits Voluntary Group Long Term Care Insurance Program

Transcription

1 USC Benefits Voluntary Group Long Term Care Insurance Program Employee Presentation for Enrollment Period September 26 to November 14, VCA 05/07/15 Underwritten by Genworth Life Insurance Company Genworth Financial, Inc. All rights reserved.

2 Today s topics An introduction to Long Term Care Insurance (LTCI) Three Key Decisions Additional Benefits & Eligibility Summary & Next Steps 2

3 Why purchase LTCI? Protect Savings Helps protect the money you ve been saving for retirement, education, etc. Protect Family Helps protect your family and friends from the effects of caregiving. Maintain Choice & Control Helps keep your options open about how you receive care. Stay At Home Helps reimburse expenses to make home modifications and receive home care where you re most comfortable. 3

4 Myths & realities It won t happen to me. 7 out of 10 people over 65 will need long term care services and support at some point in their lives.* My insurance will cover me. Neither disability income nor health insurance are designed to cover long term care expenses. The government will pay for the care I need. Medicare & Medi-Cal benefits are very limited and you may not qualify. I can pay for this out of my savings. It can take years to accumulate an amount equal to the insurance coverage you could have today. * 2015 Medicare & You National Medicare Handbook, Center for Medicare and Medicaid Services, Revised September

5 Can you pay for LTC out of your savings? Example: A 50-year old invests $76.71 per 5% to age 80 This monthly investment is equal to premiums for a 50-year old with $150 Daily Benefit, and $164,250 Total Coverage and the Buy More Coverage Over Time/Future Purchase Option (FPO). It assumes no FPO elections are exercised and no premium increases occur. $200,000 $160,000 $120,000 $80,000 $64,180 Total Coverage Available TODAY $164, cost for a year in California for a private room in a Nursing Facility $112,055 $40,000 $0 Age 80 Invest 5% LTCI Benefit All references to cost of care are based on Genworth s 2016 Cost of Care Survey, conducted by CareScout 04/2016 You may not be able to save enough to pay for the care you need. Additional options are available at different costs. 5

6 More myths & realities I can rely on my family & friends. Caregiving is difficult and requires significant physical and emotional commitment Long term care insurance is too expensive. You can customize a plan to fit your needs and your budget 6

7 Premiums vary by age Premiums vary by age. Coverage for a 50-year old under this insurance program can be as low as $76.71 per month about $2.56 a day. Purchase Age Initial Cost Per Month Age 55 $ Age 60 $ Age 65 $ Age 70 $ This displays example premiums for a $150 Daily Benefit, and $164,250 Total Coverage and the FPO Benefit Increase Option at a variety of ages. It assumes no FPO elections are exercised and no premium increases occur. Actual premiums depend on the age, plan design and options selected. Premiums are not guaranteed, but this example assumes they do not change over the life of the policy. 7

8 How do you qualify for benefits? Need for care may arise from: Bathing Dressing Eating Injuries caused by accidents Illnesses like Multiple Sclerosis Diseases like Alzheimer's or Parkinson s Continence Toileting Transferring Strokes or other chronic conditions If you Need help with at least 2 of the 6 Activities of Daily Living (ADLs), and help is expected to last at least 90 days. Have a severe cognitive impairment that requires substantial supervision. When you need long term care, the elimination period is the time period during which you must pay for your own care without being reimbursed under the policy. LTCI can help reimburse the cost of covered services 8

9 How does LTCI work? Home & Community Care Adult Day Care Nurse and Therapist Services Home Health Care Homemaker Services Total Living Coverage LTCI provides a pool of benefits that can reimburse long term care services when and where needed Personal Care Services Residential Care Facility Allows you to live independently with on-site support for daily basics Nursing Facility Care Provides more skilled care, supervision, medication, therapies and rehabilitation 9

10 Three Key Decisions Basic choices to customize your plan The examples that follow reflect plan design options and premiums available to your group. Your actual premiums will depend on your age and the plan design you choose. Examples assume no premium increases occur, except as anticipated with acceptances of the FPO Benefit Increase Option. All cost of care information shown is based on Genworth s 2016 Cost of Care Survey, conducted by CareScout 4/

11 Three Key Decisions 1 Daily Benefit Amount $100 $150 $200 $250 Total Coverage Maximum 2 Daily Benefit Amount Total Coverage Maximum $73,000 $109,500 $146,000 $182,500 $109,500 $164,250 $219,000 $273,750 3 Benefit Increase Option Buy More Coverage Over Time Automatic 3% Compound for Life Automatic 5% Compound for Life Benefit Increase Option 11

12 Three Key Decisions 1 Daily Benefit Amount $100 $150 $200 $250 Cover the daily cost of care in the area where you might retire 100% for nursing home & residential care 100% for home & community care Total Coverage Maximum 2 $73,000 $109,500 $146,000 $182,500 $109,500 $164,250 $219,000 $273,750 3 Benefit Increase Option Buy More Coverage Over Time Automatic 3% Compound for Life Automatic 5% Compound for Life Group ID: Standard Code: groupltc 12

13 Step 1: Choose a Daily Benefit Select a Daily Benefit to cover the monthly cost of care in your area Annual Cost of Care Home Health Aide Median Annual Rate Oregon $51,480 California $52,624 Colorado $50,336 Illinois $49,192 Michigan $46,904 Massachusetts $57,200 New York $52,624 Virginia $43,472 Texas $42,603 Florida $43,472 Low (up to $122, per day) Average (up to $138/per day) High (over $150/per day) Group ID: Standard Code: groupltc 13

14 Step 1: Choose a Daily Benefit Select a Daily benefit to cover the monthly cost of care in your area National Median Annual Rate Home Health Aide $45,760year Adult Day Care $17,904/year Assisted Living Facility Private Room $43,200/year Nursing Home Private Room $91,250/year 14

15 Three Key Decisions 1 Daily Benefit Amount $100 $150 $200 $250 Total Coverage Maximum $73,000 $109,500 $146,000 $182,500 $109,500 $164,250 $219,000 $273,750 2 Cover the daily cost of care in the area where you might retire 100% for nursing home & residential care 100% for home & community care Have enough coverage to last ~3 years 3 Benefit Increase Option Buy More Coverage Over Time Automatic 3% Compound for Life Automatic 5% Compound for Life 15

16 Step 2: Choose your total coverage Select a Total Coverage Maximum that will cover ~3 years of care Cost for 1 Year of Care x Years of Care = Target Total Coverage Maximum Residential Care Facility (A private room) $48,000 $144,000 Home Health Care (44 hours with a licensed home health $23 per hour) Nursing Home (A semi-private room) x3 $54,912 $164,736 $112,055 $336,165 16

17 Three Key Decisions 1 Daily Benefit Amount $100 $150 $200 $250 Total Coverage Maximum $73,000 $109,500 $146,000 $182,500 $109,500 $164,250 $219,000 $273,750 2 Cover the daily cost of care in the area where you might retire 100% for nursing home & residential care 100% for home & community care Have enough coverage to last ~3 years 3 Benefit Increase Option Buy More Coverage Over Time Automatic 3% Compound for Life Automatic 5% Compound for Life Keep up with the cost of care in the future 17

18 Step 3: Choose a benefit increase option Select an option to help your coverage keep up with inflation 900, , , ,000 Projected cost for 3 years of care for a 50-year old Assumes cost of care increases by 3% until age , , ,000 3 Years of Care Today In 30 Years 200, ,000 0 Residential Care Facility Home Health Care (44 hours/week) Nursing Facility LEARN MORE GET A QUOTE APPLY ONLINE 18

19 Step 3: Choose a benefit increase option Select an option to help your coverage keep up with inflation 5% Compound Automatic Increase for Life Available for an additional premium. Premiums stay level but costs most at issue 3% Compound Automatic Increase for Life Available for an additional premium. Premiums stay level but costs more than FPO at issue Buy More Coverage Over Time (FPO) Coverage can increase every 3 years Built into each plan. Costs less at issue but increases with each additional purchase Premiums for additional coverage under the FPO option are based on your age at the time of each increase. 19

20 Additional benefits Available with your insurance program 20

21 Additional benefits included in your plan That may help you stay at home available during the waiting period Hospice Care Reimburses charges up to the applicable Monthly Benefit. Respite Care Reimburses charges up to the applicable Monthly Benefit to give an unpaid caregiver short term relief. Home Assistance Reimburses up to 90 times the Daily Benefit Amount for home modifications, support equipment and caregiver training. 21

22 Additional benefits included in your plan Informal Family Care Reimburses cost of services provided by a friend or family member Bed Reservation Reimburses charges to reserve your accommodations in a nursing or residential care facility while you are away for any reason. International Coverage Reimburses covered nursing facility care services received outside the United States. 22

23 Eligibility You and your family are eligible to apply 23

24 Who is eligible to apply? To be eligible, each applicant must maintain a permanent U.S. residence, and have a valid Social Security Number or Tax Identification Number from the U.S. government. Actively at work, benefit-eligible employees working hours/week Employee Spouse or Domestic Partner under age 76 Surviving Spouses and Surviving Domestic Partners of eligible employees Parents, Parents-in-law and Step-Parents under age 76 of eligible employees Grandparents, Grandparents-in-law and Step-Grandparents under age 76 of eligible employees Adult Children and Siblings under age 76 of eligible employees Each person must apply separately. [24] 25

25 Enrollment medical underwriting Applicant Application Eligible Full-time Employees and New Hires up to and including age 65 during initial enrollment/new hire period Eligible Full-time Employees and New Hires over age 65 during initial enrollment/new hire period All Other Applicants ages Modified Guarantee Issue Comprehensive (MGIC) 2 question form Height / weight parameters Pre-Existing Conditions Limitation applies* Long Form Medical records are requested Full medical underwriting, which may include: - Paramedical exam - Functional/Cognitive Assessment - Phone Health Interview * Pre-Existing Conditions Limitation: We will not pay for Covered Expenses incurred for any care or confinement that is a result of a Pre-Existing Condition when the care or Confinement begins within six (6) months following Your initial Certificate Effective Date. A Pre-Existing Condition means a condition for which medical advice or treatment was recommended by, or received from, a provider of health care services within six (6) months prior to Your initial Certificate Effective Date. 25

26 Summary & next steps Program advantages & how to apply 26

27 Why act now? If you postpone the decision to buy Underwriting requirements may change. You may not qualify due to future health issues. Your premiums will be established at your older age & higher rate. Buy Today (Age 50) $51 EXAMPLE BASED ON $100 Daily Benefit $109,500 Total Coverage Maximum FPO Benefit Increase Wait 10 Years $101 This example is case specific and presents one of the plan designs available. It assumes no FPO elections are exercised and no premium increases occur. Additional options are available at different costs. Premiums are not guaranteed, but this example assumes they do not change over the life of the policy. Wait 20 Years $258 LEARN MORE GET A QUOTE APPLY ONLINE 27

28 Key advantages of this insurance program Spouses and other family members can also apply with these customized group rates & underwriting A 30 day free look is available Care coordination and other additional benefits are included at no additional cost Coverage is portable - you can take it with you if you leave your job or retire Flexible choices to match your needs and your budget Easy enrollment by web or paper Available Billing Options Payroll Deduction is available Direct bill on quarterly, semi-annual or annual basis or monthly electronic funds transfer 28

29 About Genworth Industry Leading Experience* 40+ Years of Claims Experience Providing Unparalleled Service Alzheimer s Association Annual Cost of Care Survey Genworth is a leading provider of LTCI * LIMRA 2014 Individual Long Term Care Report 29

30 Three Key Decisions Daily Benefit Amount Total Coverage Maximum Benefit Increase Option

31 Next steps Take advantage of this opportunity for reduced underwriting during the enrollment period / Review your coverage options now: September 26 - November 14, 2016 Apply Online Group Name: USC Code: groupltc OR Call Customer Service Talk to your spouse, parents, parents-in-law, and grandparents about this insurance program. They are also eligible to apply up to age Group ID: USC Code: groupltc 31

32 Details you should know There is no Return of Premium if you don t use the benefits. Rates are designed and priced for long term stability, however they could increase. There is an elimination or waiting period. Care not covered includes: Care by an Immediate Family Member (unless covered by the Informal Family Care Benefit or other benefit under the Group Policy) Care when no charge is made in the absence of insurance Care by a Veteran s Administration or federal government facility, unless a valid charge is made Care outside the USA, its territories or possessions (unless covered by the International Coverage Benefit) Provided for your alcoholism or addiction to drugs or narcotics (except for an addiction to a prescription medication when administered in accordance with the advice of a Physician). Care that results from: war, act of war; participation in a felony, riot or insurrection; attempted suicide, or intentional self-inflicted injury Care for which you receive or are eligible to receive benefits under worker s compensation, an occupational disease act, or similar acts or laws. View important details in the Outline of Coverage at 32

33 Other limitations Non-Duplication of Medicare Benefits: The program reimburses covered expenses that exceed what Medicare or other governmental health care programs (other than Medi-Cal or Medicaid) pay. Deductibles and co-insurance under Medicare are not covered by this long term care insurance. Coordination of Benefits: The program coordinates its benefits with all other long term care insurance coverage that you have. Pre-existing Conditions Limitation: The program includes a Pre-Existing Conditions Limitation. View important details in the Outline of Coverage at 33