Long Term Care Insurance

Question 1

Reinstatement of Coverage Through Unintentional Lapse

Answer 1

Reinstatement much more lenient with LTCI because of cognitive impairment. LTCI contracts must include provision that if insurer is provided proof of the insured being cognitively impaired, policy can be reinstate within 5 months.

Question 2

Community Based Care

Answer 2

LTCI that covers care in the home, adult health care centers, assisted living facilities; but not nursing some or skilled nursing.

Question 3

Levels of Nursing Care

Answer 3

Skilled - 24 hour supervision by skilled medical personnel. Intermediate - skilled medicare professional, but not 24 hour. Custodial: no skilled medical care, help with ADLs

Question 4

Deficit Reduction Act

Answer 4

Expanded state long term care partnership programs by allowing states to include Medicaid asset disregarding. This encourages members to buy partnership policies as opposed to “spending down” assets so that they qualify for Medicaid. Partnership policies are collaborations between Medicaid and private LTCI.

Question 5

Nonforfiture Benefits

Answer 5

Given when a LTC policy lapses and the insured does not accept significant rate increase from insurer. Member generally goes to a shortened benefit period and same benefits are paid despite policy lapsing - benefits are not reduced; only the period of time the benefit is payable. Must be offered if rate increase goes beyond 58%