FAQs

What is Whole Life Insurance with Long Term Care (LTC) benefits and what does it cover?

Whole Life Insurance with a Long Term Care rider is permanent Life Insurance (not term insurance) that combines the benefits of both Life Insurance protection for your family along with living benefits, which can be utilized to help pay for long term care such as home healthcare, adult day care, assisted living facilities and nursing home expenses. Long Term Care is personal care - help with everyday activities such as bathing and dressing (also known as "Activities of Daily Living”) and/or care for severe cognitive impairments like Alzheimer’s Disease.

What is the difference between Long Term Care and Long Term Disability insurance?

Long Term Care benefits helps cover the cost of a nursing home, assisted living, adult day care or home health care if you become unable to care for yourself. Long Term Disability insurance replaces a portion of the income you will lose if you are unable to work because of an injury or illness.

Why does the application require my SSN, height, and weight?

The insurance company requires SSN to set up the policy as it is used for tax purposes and claims. Height and weight are used in underwriting if you are ineligible for Guarantee Issue underwriting and are required to answer health questions.

Can I add my spouse or domestic partner?

Yes, spouses and domestic partners are eligible to apply. If your spouse/domestic partner also works for this employer they should apply as an “employee”, to qualify for Guarantee Issue underwriting (no health questions). Guarantee issue is available for employees aged 18-70.

How does this Whole Life Insurance with Long Term Care (LTC) work?

• Applicants ages 18-70 will be issued Whole Life Insurance that provides a higher death benefit during your working years, when your needs, responsibilities and expenses are at their greatest.
• This policy also includes a Long Term Care benefit that can help you pay for LTC services in your home and/or a facility at any age. This LTC benefit never reduces due to age, so the full amount is always available when you most need it.

How much Whole Life Insurance can I purchase and how is my monthly Long Term Care benefit calculated?

• The policy options for employees guarantee issue is up to $100,000 (in $10,000 increments). ($100,000 – $250,000 is simplified issue)
• Working spouse/domestic partners guarantee issue up to $50,000 ($30,000 – $150,000 is simplified issue)
• Non-working spouse/domestic partners guarantee issue up to $10,000 ($15,000 – $50,000 is simplified issue).
• The monthly Long Term Care benefit is 4% of the death benefit and can be used for homecare and/or facility care for up to 25 months. For example, a $50,000 policy provides a $2,000 monthly LTC benefit. A $300,000 policy provides a $12,000 monthly LTC benefit.

When I start receiving LTC benefits, does the death benefit decrease as each monthly LTC benefit is paid out?

Yes, the death benefit is accelerated (reduced) to pay each monthly LTC benefit. For example, a $50,000 policy provides a $2,000 monthly LTC benefit. After the first monthly LTC benefit is paid, the net death benefit would be $48,000. This depletion of the death benefit continues as LTC benefits are paid out. The policy includes a death benefit restoration, see below for details.

Does the plan provide a way to “replenish” or restore my death benefit as LTC benefits are paid?

• Yes, it includes a monthly dollar-for-dollar restoration of the death benefit as each monthly LTC benefit is paid out. Here is how it works. A $50,000 policy provides a $2,000 monthly LTC benefit. After the first monthly LTC benefit is paid, the net death benefit would be reduced to $48,000 - only to be restored back to the original $50,000 death benefit.
• The total maximum benefit of your policy could double with this death benefit restoration feature. For example, with a $50,000 policy, you can receive up to $50,000 in LTC benefits + $50,000 in death benefits paid to your beneficiary(s) for a total maximum benefit of $100,000.

How is my rate determined?

This insurance offers unisex rates based on your age as of the policy effective date, tobacco usage (cigarettes, cigar, smokeless tobacco, e-cigarettes) and coverage selected.

Can I pay the monthly premium with a credit card?

Credit cards are not accepted.

When will my first premium payment occur?

Employee and spouse premiums are paid via payroll deduction.

Are the premiums pre-tax or post-tax?

The premiums are paid post tax.

Do premiums continue when on LTC claim?

The plan has Waiver of Premium, which means that while you receive LTC benefits, all premiums are waived once the elimination period is met and as long as LTC premiums are paid.

What if I cancel my plan outside of the 30-Day Free Look Period? Do I get my money back?

If an insured cancels the policy after the 30-Day Free Look Period, they will receive any Cash Value minus any applicable policy surrender fees.

If I answer “Yes” to any Simplified Issue health questions, will I be declined coverage?

A “Yes” answer to any of the health questions will NOT preclude the applicant from continuing the application process.

Can I increase my Whole Life Insurance policy at a later date?

Yes, you can request to increase your existing Whole Life Insurance policy at a later date (after your 30-Day Free Look Period) with Simplified Issue underwriting. If approved, the increase in coverage will be based on your current (attained) age.

What are the LTC Benefit Triggers with the plan?

• You become eligible for Long Term Care benefits once you have satisfied the 90 Day Elimination Period, your physician has submitted a Plan of Care stating LTC services are medically necessary and certifies that you require assistance with at least two of the Activities of Daily Living (ADLs) or have a Cognitive Impairment.
• To satisfy the Elimination Period, 90 days of LTC services must be rendered within six (6) months or else a new 90 Day Elimination Period begins.
• Activities of Daily Living (ADLs) are Eating, Dressing, Bathing, Going to the Toilet, Continence, and Transferring. Note: Under the plan, Cognitive Impairment can be the only benefit trigger needed for benefits to begin to pay. This is extremely important because most people with Alzheimer’s or Dementia can still bathe, dress, and feed themselves but need supervision and might need to be in a facility.

How does the plan pay LTC benefits?

Long Term Care Facility and Assisted Living Facility Benefit:

• Once eligible for LTC benefits, the insurance company will pay the Long Term Care facility or the assisted living benefit for each month the insured remains confined in a Long Term Care or assisted living facility, following the Elimination Period, for up to 25 months for all Benefit Periods combined. For a partial month of confinement, benefits are payable on a pro-rata basis; One thirtieth (1/30) of the monthly benefit will be paid for each 24-hour day of confinement. If a new confinement is within the same Benefit Period as a previous confinement, benefits are resumed at the previous amount of monthly benefit.

Home Health Care and Adult Day Care Benefit:

• The insurance company will pay a benefit for home health care (by a licensed professional) or adult day care for each month the insured receives such care, following the Elimination Period, for up to 25 months for all Benefit Periods combined. Benefits are payable on a pro-rata basis. One thirtieth (1/30) of the monthly benefit will be paid for each day of home health care or adult day care.

Can the plan provide LTC benefits for care provided by unlicensed/informal caregivers such as family or friends?

No. Care must be provided by licensed professional providers.

Where does the plan pay for care?

If you qualify for LTC benefits, where you receive care is up to you (at home, assisted living, adult day care, nursing home).

Will the plan pay for care outside of the US?

The Whole Life Insurance policy will only pay LTC benefits for care received in the United States or U.S. territories. Death benefits can be paid internationally.

Are my LTC benefits taxable?

Benefits paid may or may not be taxable. Whether or not You or Your Beneficiary incur a tax liability when benefits are paid depends on how the IRS interprets applicable portions of the Tax Code. As with all tax matters, you should consult Your personal tax advisor to assess the impact of this benefit. The insurance company has no responsibility for any tax consequences of any benefits paid under this policy. The rider for long-term care insurance is not intended to be a federally qualified long-term care insurance contract.