Long Term Care (LTC) Insurance is one of the ways you or your family members can pay for long term personal care which can be very expensive. Long term care is not one service but many different services available to help people with chronic conditions compensate for limitations in their ability to function independently. Long term care services may include help with the activities of daily living, home health care, respite care, adult care, care in a nursing home and care in an assisted living facility. Long term care is different from medical care in that it may not help to improve or correct medical problems. People with physical disabilities often need help with the activities of daily living and people with cognitive impairments may need supervision, protection, or reminders to do everyday activities.
You can enroll in LTC within the first 60 days you are in a benefit eligible position. If you elect one of the guaranteed levels of coverage, referred to as Guarantee Issue, and submit your enrollment forms within the first 60 days, a medical questionnaire (evidence of insurability) is not following submission of the form. If you elect a higher level of coverage or your family members elect any level of coverage, evidence of insurability is the first of the month after it is approved by UNUM.
Unlike the medical and dental plans, there will never be an open enrollment for LTC insurance. This is your only chance to obtain the guaranteed coverage.
Yes. You can apply for LTC Insurance anytime after your first 60 days, but you will not be eligible for the guaranteed coverage. You will be required to answer medical questions and your coverage (any amount) will have to be approved by UNUM. If UNUM denies you coverage based on your health, you will not be able to obtain the LTC Insurance.
Unlike the medical and dental insurance, you do not have to experience a family status change to apply for LTC insurance. You can apply any time, but your application might be denied because of your health.
Benefit-eligible employees who are full-time, part-time or seasonal and their family members who are between the ages of 18 and 84 can enroll in LTC Insurance.
An employee may cover a spouse or domestic partner. In addition, the following family members of the employee or the employee's spouse or domestic partner may be covered:
parents and grandparents
adult children
adult siblings
You may contact the Office of Human Resources at 346-3086 to obtain a packet. We have a limited supply of enrollment packets (they're very expensive) so will be able to give them only to employees who actually plan to enroll in the LTC plan.
If you are an employee or employee's spouse or partner, return the Long Term Care Insurance Enrollment Form to the Office of Human Resources, 463 Oregon Hall. If you need to complete the Evidence of Insurability Form, mail it directly to UNUM in the envelope provided in your packet. All other applicants must complete and mail the Long Term Care Insurance Enrollment Form and Evidence of Insurability directly to UNUM in the envelope provided.
If you elect coverage for yourself or your spouse or domestic partner, the premiums will be deducted from your paycheck. Premiums will not be deducted from your paycheck for parents and grandparents, adult children and adult siblings. These family members will need to tell UNUM on the enrollment form how they want to be billed. UNUM will bill quarterly, semi-annually or annually. There is no administrative charge for the direct billing.
No. Premiums are paid with after-tax dollars. However, your benefit will not be taxed when you receive it.
You can take a tax credit on you state income tax and can claim a deduction for health care premium amounts (includes LTC premiums) in excess of 7.5% of adjusted gross income on your federal income tax. Check with your tax advisor or the Department of Revenue to determine the amount of your state income tax credit. Your tax advisor or the IRS can help you determine whether you can claim a deduction on your federal income taxes if you are not sure.
You can call UNUM at 1-800-227-4165. Because they are located on the East Coast, you will have to call them between 5:00 a.m. and 2:00 p.m. PDT. You may also contact the Office of Human Resources with general questions.
Your Long Term Disability plan provides income replacement if you are unable to work because of an illness or accident. The plan replaces 60% or 66 2/3% of your pay, depending on the option elected. If you need to be placed in a Nursing Home Facility, an Assisted Living Facility, or need home care, the Long Term Care Insurance would pay you a set amount that you could use to help cover these costs. The plan pays benefits when your doctor certifies that you can no longer perform at least two of the six Activities of Daily Living (ADLs) for at least 90 days. The ADLs are bathing, dressing, toileting, transferring, continence and eating. Both policies will pay as long as you meet the definition of "disability" under both policies.
Four. Each plan offers different options so you can choose a plan that meets your needs. All of the plans include Long Term Care/Nursing Home Facility and Professional Home Care as their base.
Plan 1
Long Term Care/Nursing Home Facility
Professional Home Care
Plan 2
Long Term Care/Nursing Home Facility
Professional Home Care
Total Home Care
Plan 3
Long Term Care/Nursing Home Facility
Professional Home Care
Simple Inflation Uncapped
Plan 4
Long Term Care/Nursing Home Facility
Professional Home Care
Total Home Care
Simple Inflation Uncapped
If you enroll during your first 60 days, you can automatically elect $1,000, $2,000, $3000, or $4,000 for your Monthly Facility Benefit. If you choose $5,000 or $6,000, you will be required to complete evidence of insurability and be approved by UNUM. Until we receive approval from UNUM, the Payroll Office will deduct the premium for the $4,000 level of coverage. This premium will be adjusted the first of the month after approval is received. If the level of coverage you requested is denied, you will automatically receive $4,000. If you enroll after your first 60 days, you will have to submit evidence of insurability for any level of coverage. Please refer to the rate sheet in your packet for the monthly premiums.
UNUM will pay you a flat amount each month. The full Monthly Facility Benefit is paid for the Long Term Care/Nursing Home Facility. Adult Foster Care and Assisted Living benefits are paid at 60% and Professional Home care and Total Home Care are paid at 50%.
You decide how long you want your monthly benefit to continue from three choices. You can automatically elect to have benefits continue for three years or six years. If you choose to have benefits continue for an unlimited duration, you will be required to complete evidence of insurability to be approved by UNUM. Until we receive approval from UNUM for the unlimited duration, the Payroll Office will deduct the premium for the six year benefit duration. This premium will be adjusted the first of the month after approval is received from UNUM. If the unlimited duration benefit is not approved, you will automatically receive the six year benefit. If you enroll after your first 60 days, you will have to submit evidence of insurability for any level of coverage. Please refer to the rate sheet in your packet for the monthly premiums.
The Long Term Care guaranteed coverage is only available to employees. The guaranteed coverage includes enrollment in Plans 1, 2, 3, or 4, a monthly benefit of $1000.00, $2000.00, $3000.00 or $4000.00 and for a benefit duration of 3 or 6 years.
Use the rate sheet in your LTC information packet. Please note the rate shown is per $1,000 benefit.
To calculate your premium follow these four steps:
1) Determine what your age will be as of the date you apply for coverage
(the date you sign the LTC Insurance Enrollment Form).
2) Follow your age across to the column that shows the plan you selected (Plan
1, 2, 3 or 4.)
3) Go to the rate for the benefit duration you want (3 years, 6 years or
unlimited).
4) Multiply this rate by 1 if you want a $1,000 Monthly Facility Benefit, 2 if
you want a $2,000 Monthly Facility Benefit, etc.
Example:
If you are age 40 and you elect Plan 2 with a $4,000 benefit payable for six
years, your monthly premium will be $6.10 x 4 or $24.40 per month.
Yes. However, if you are increasing your level of coverage you will need to submit evidence of insurability and be approved by UNUM. Your premium will change based on the age you applied for the new coverage. You can decrease your level of coverage without approval from UNUM.
Yes.
You can continue your LTC coverage at the same rates on a direct pay basis with UNUM. You must complete an Election For Conversion Coverage form available from Human Resources.