LTC Flashcards
1
Q
LTC Benefits
Factors that Drive Product Growth
A
- Increasing life expectancies
- Aging of baby boomers
- Concern about outliving retirement savings
2
Q
LTC Benefits
Sales and Marketing Process
A
- First Sale = Plan Sponsor selection of LTC insurer
- Second Sale = Education and Marketing campaign to EEs to convince them to enroll
3
Q
LTC Benefits
Types of Plans (List and Define)
A
- Service Reimbursement
- Service Indemnity = Fixed benefit for day when LTC services are received
- Disability/Cash = Fixed benefit for each day insured is eligible
4
Q
LTC Benefits
Underwriting
A
- Guaranteed issue basis
- Accept or Decline coverage
5
Q
LTC Benefits
Premiums
A
- Based on initial age
- Level over lifetime on policy (unless increase is approved)
6
Q
LTC Benefits
Benefit Triggers
A
Inability to perform at least 2 ADLs or cognitive impairment
7
Q
LTC Benefits
Covered Services
A
- Nursing home/assisted living
- Home/Community-based care
- Hospice
- Caregiver training
- Respite care
- Independence support services
- Care management services
8
Q
LTC Benefits
Inflation Protection
A
- Periodic offers to purchase additional coverage
- Automatic inflation protection
9
Q
LTC Benefits
Nonforfeiture benefits
A
- Shortened Benefit Period = Lifetime max reduces to (Premiums Paid - Claims Paid)
- Reduced Paid-up Benefit = Daily and lifetime max reduce and extend for lifetime of insured
10
Q
LTC Benefits
Other Plan Features
A
- Death benefit
- Cash alternative benefit
- Bed reservation benefit
- Spousal riders
- Restoration of benefits
11
Q
LTC Benefits
Policy Exclusions
A
- Preexisting conditions
- Mental disorders
- Alcoholism/Drug Addiction
- Conditions from war, attempted suicide, felony
12
Q
LTC Benefits
Claim Administration
A
- Benefit Eligibility Assessment = Insurer determines if benefit trigger is satisfied
- Care Management = Provider and Insurer determine care plan
13
Q
LTC Benefits
Tax
A
- Premiums paid by ER and EE = deductible
- Benefit is not taxable income
- ER contributions are not taxable to EEs
14
Q
LTC Benefits
Group vs. Individual Coverage (Differences)
A
Individual =
- larger market
- more in-depth sales and underwriting process
- Target market = older
