Long-term Care - Voluntary Insurance

SWARTHMORE COLLEGE VOLUNTARY GROUP LONG TERM CARE INSURANCE PROGRAM

 

FREQUENTLY ASKED QUESTIONS

(This material is intended for use by eligible Swarthmore College employees).

 

1. What is long term care insurance?

Long term care insurance is designed to help reimburse charges for the care you may need if you are chronically ill--that is, you need help with some of the everyday activities we often take for granted (like eating, bathing or dressing). It also pays for care, if you need supervision due to a cognitive impairment like Alzheimer’s disease.

People often confuse long term care insurance with long term disability insurance. Such long term disability coverage provides income protection to help you cover daily expenses such as rent, utilities, and food. It is not intended to pay for your care if you have a long term care situation.

Long term care insurance is not medical insurance. It will not cover doctor visits, hospital costs, pharmacy costs or any other cost to treat an injury or illness.

 

2. What does long term care insurance cover?

Long term care insurance covers care received in a nursing or assisted living facility, at home, or in community settings like adult day care centers, The plan also has features that may help you stay in your own home, such as benefits that help reimburse the costs for informal care, home modifications, caregiver training and in home monitoring systems, as well as a respite care benefit.

 

3. Who should consider long term care insurance?

Regardless of age, anyone could suddenly be in a situation where long term care services are needed. A broken bone, a chronic disease, or a cognitive impairment such as Alzheimer’s disease could mean months or even years of on-going care. Long term care insurance is specifically designed to help pay for this kind of care.

 

4. Is long term care insurance affordable?

The cost of long term care insurance varies depending on your age and the options you choose. Many people find the group premiums more affordable than expected. You can tailor this benefit to meet your needs.

 

5. Should I wait until I am older to buy it?

Long term care insurance premiums are based on your age when you apply; so typically, the younger you are the lower your premiums will be. A second reason not to wait is that an accident or illness requiring long term care services could happen at any time. If this happens, it may not be possible to meet the underwriting requirements for coverage in the future.

 

6. Who is eligible to apply for coverage?

The Swarthmore College Voluntary Group Long Term Care Insurance Program is available to full-time benefits eligible employees, their spouses/partners, and other family members.

Specifically, you are eligible for this program if you are:

A. An actively at work employee working full time. There is no age limit for employees.

B. Family members of an eligible employee who are between ages 18 and 75, including:

  • Spouses/Partners
  • Adult Children and their spouses/partners
  • Parents, Parents-in-law, Step Parents, Step Parents-in-law
  • Grandparents, Grandparents-in-law, Step Grandparents and Step Grandparents-in-law
  • Siblings and their spouses/partners

All applicants must maintain a permanent US residence and have a valid Social Security number or Tax Identification number.

 

7. How do I learn more about the Program?

a) Visiting the Genworth Life Insurance Company website. Beginning September 19, 2016 go to:

  • Enter the Group Name: swmore
  • Enter the Access Code: groupltc

b) Calling 800-416-3624 toll free, to speak to a Genworth program expert, or order a printed information kit that contains full details of the Program including important disclosures as well as applications you can fill out, sign and mail.

 

8. What happens to my coverage if I leave Swarthmore College?

Your coverage is fully portable which means that it continues according to its terms as long as you pay your premium on time.

 

9. Do I have to apply in order for my spouse or other family members to get coverage?

No, eligible family members can apply for coverage whether or not the eligible employee applies.

 

10. Do I have choices in how I pay for this plan?

Yes, you have three ways you can pay your premiums. Premiums can be paid via direct bill: electronic funds transfer or you can be billed directly on a quarterly, semi-annual, or annual basis. Your premiums will be paid directly to the Genworth Life Insurance Company.

 

11. Can premiums go up in the future? If so, under what circumstances?

No insurance company can guarantee that premiums will never increase. Genworth Life Insurance Company has priced this coverage conservatively to help avoid future rate increases; however, it does retain the right to raise premiums in the future. Such an increase would have to be reviewed and approved by the Pennsylvania Department of Insurance, and it would have to be for an entire class of individuals, not for you as an individual. You cannot be singled out for a rate increase and your premiums will never be increased based on your age, claim, or health status.

 

12. Who is the insurance carrier offering this LTC coverage?

Genworth Life Insurance Company is a leader in the long term care insurance industry, with over 39 years of experience with this type of coverage. Genworth Life was selected by Swarthmore College to be the carrier for its Group long Term Care Insurance Program.

Genworth Life’s experience includes:

  • Being a leading provider of Long Term Care insurance with over a million policyholders
  • A proven claim servicing capability, including paying out more than $9.1 billion in claims to over 180,000 claimants
  • A conservative approach to pricing and reserving for claims
  • A multi-year alliance with the Alzheimer’s Association
  • The annual cost of care survey, which tracks the costs of long term care throughout the nation
  • The Genworth Financial Annual Long Term Care Symposium, which brings together elected officials, researchers, caregivers, media observers, and business leaders to discuss the costs and challenges of long term care

 

13. If age 75 is the oldest age for a family member to apply for this Program, does that mean the program ends when I (or they) reach age 76?

No. This program will continue as long as you continue to pay your premiums, or when your pool of money (Total Coverage Amount) is exhausted.

 

14. Will my Group Long Term Care Insurance plan pay for care provided by family members, friends, neighbors, etc.? If so, how much will it pay for?

When you become eligible to receive benefits, your plan will pay a limited amount each year for care provided by “informal caregivers” such as family members (who do not live with the insured), friends, neighbors, etc. via the Informal Care Benefit only. The Informal Care benefit will pay each year for informal care provided in accordance with your plan of care.

So for example, if you selected a $3,000 monthly benefit, the annual Informal Care benefit would be: 1% x $3,000 = $30

$30 x 30 days = $900 per year

The benefit available to help pay for this type of care will be up to $900 per year.

 

15. How long do I need to pay my premiums?

You will continue to pay your premiums as long as you want to keep your insurance in-force. Premium payments will stop if you lapse coverage or exhaust the benefits or “pool of money” available under the plan.

 

16. Once I am receiving benefits under the plan, do I continue to pay premiums?

No. Premium payments will be waived while you are receiving benefits under the Nursing Facility or Assisted Living Facility Benefit, Bed Reservation Benefit, Home and Community Care Benefit or Hospice Care Benefit.

When will this Program pay benefits?

Benefits become payable under this program when:

  • You need help with at least two “activities of daily living” and will likely need it for at least 90 days, OR
  • You are diagnosed with a cognitive impairment that requires supervision, AND
  • A medically licensed healthcare professional certifies that your condition qualifies you

 

The Activities of Daily Living are eating, dressing, continence, transferring, bathing, and toileting.

In addition, the elimination period (also known as a “waiting period”) must be satisfied, and you must be receiving covered services under a plan of care.

 

17. What is an “elimination or waiting period” and how does it work for this program?

Once you qualify for benefits, a “waiting period” of 90 calendar days starts on the first day you receive care and continues for 90 calendar days while you remain chronically ill. You are not required to receive services during these 90 days. Once the elimination period is satisfied, benefits for covered services become payable.

 

18. Can I cancel my coverage at any time?

Yes, you can cancel you coverage at any time by notifying Genworth in writing.