Welcome To The Alera Group Long-Term Care Solution

Here you will find information on what is Long-Term Care, why Long-Term Care insurance is so important today, and a Long-Term Care insurance solution available for you to enroll requiring no medical underwriting.

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What is Long-Term Care?

Long-Term Care encompasses a form of medical assistance that becomes necessary as we age and require assistance with fundamental daily tasks. The primary objective of Long-Term Care is to support individuals in maintaining as much independence as possible when they can no longer manage on their own.

This assistance can manifest in various ways, such as residing in a nursing home, residing in an assisted living facility, or receiving continuous care from a nurse in the comfort of one's home. Such care is often essential for individuals grappling with chronic health conditions, disabilities, or impairments.

These services are available across diverse settings, including:

  • Nursing homes
  • Assisted living facilities
  • Adult day care centers
  • Home health care
  • Community-based services

My Grandpa Pappy was in a nursing home for 4 years before passing away. He lost his eyesite and needed full time care.

primary reasons to consider

Protect your family, future and finances with Life Insurance & Long-Term Care protection.

National Data Shows:

  • Nearly 70% of people turning age 65 can expect to use some form of Long-Term Care during their lives.
  • Average stay in a nursing home – 2.25 years
  • Average duration of care needed at home - 4 years
  • Recipients who suffer from Alzheimer’s disease or dementia may require care for 10+ years
  • Caregivers provide care for 3-4 years

Rising Cost of Long-Term Care

Year Nursing Home Home Care
2023 $119,517 $130,024
2033 $194,680 $211,796
2043 $317,113 $344,994
2053 $516,543 $561,958

* (https://acl.gov/ltc/basic-needs/how-much-care-will-you-need).

* Median Cost for Average Stay, assuming an inflation rate of 5% and 84 hours of weekly Home Care - Genworth Cost of Care Survey (https://www.genworth.com/aging-and-you/finances/cost-of-care.html).

Pricing Calculator

Monthly Price Death Benefit LTC Benefit

Potential Tax Increase on All Employees

An additional tax may be approved in your state to cover a state run Long-Term Care plan. Employees may be able to OPT out of this potential tax if a private Long-Term Care insurance policy is owned prior to the legislation becoming law.

Currently 20+ states are looking into Long-Term Care benefits. Washington was the first state to implement a payroll tax of .58% on all W2 employees to cover a small $36,000 LTC Benefit. CA could approve Long-Term Care payroll tax as soon as 2024.

WA Cares Act of 2021

  • First LTC tax in U.S.
  • Mandatory employee payroll tax, .58%, earnings, no cap on income
  • $36,500 LTC benefits, $100/day (1 year)
  • Tax “optout“ if you owned LTCI before November 1, 2021
  • 500,00 people purchased LTCI, lost 39% of wage base

CA LTC Task Force Proposals

  • Payroll tax split between employees and employer
  • Proposed tax rates are .64% up to 2.4%
  • Proposed benefit amounts: 36K to just over 100K
  • Employers and Employees may have the ability to opt out of the tax if private Long-Term Care insurance is owned prior to the legislation being signed.

Lets compare a potential state run Long-Term Care program vs. a private insurance offering

Income Annual Tax (.70%) State Benefit LTC Benefit LTC Plan Cost Savings increased Benefit
$50,000 $350 $36,000 $50,000 $288 $62 $14,000
$70,000 $490 $36,000 $50,000 $288 $202 $14,000
$100,000 $700 $36,000 $50,000 $288 $412 $14,000
$150,000 $1,050 $36,000 $50,000 $288 $762 $14,000
$200,000 $1,400 $36,000 $50,000 $288 $1,112 $14,000
$250.000 $1,750 $36,000 $50,000 $288 $1,462 $14,000

* based upon a 40 year old male non-smoker

A private Long-Term Care plan can offer lower costs and superior benefits. Additionally, it’s worth noting that state-run programs might potentially raise tax rates, or your income could see an increase over time.

Introducing a Long-Term Care Insurance Solution that offers both Long-Term Care and Life Insurance.

A Long-Term Care and Life Insurance plan that can:

  • Alleviate the future burden on your family
  • Protect your wealth and assets
  • Let’s you age comfortably in a location of your choice

Long-Term Care + Life Insurance PLAN HIGHLIGHTS

Chubb One-Time Guarantee Issue

Employees (ages 19 through 70) & spouse/domestic partners (ages 19 through 60) enrolling during their initial enrollment period and within the guarantee issue limits cannot be turned down (no medical questions). Employees 71 through 80 and spouse/domestic partners 61 through 70 are eligible with medical questions.

Term Insurance

Provides Life Insurance protection with rates that don’t change as you age. The policy will NEVER expire.

Long-Term Care (LTC) Protection (Included)

Provides a monthly LTC benefit equal to 4% of your death benefit. E.g., a $100,000 policy will pay a $4,000 monthly LTC benefit for up to 25 months, with $100,000 total LTC benefits.

Extension of Benefits (Included*)

Provides an additional 50 months of LTC benefits totaling 75 months; tripling your LTC coverage. E.g., $100,000 Life Insurance policy / $300,000 LTC benefits. *This feature is not available to applicants who are ages 71-80 on the effective date of coverage.

Death Benefit Restoration (Included)

Restores the Life Insurance to 50% of the death benefit up to a maximum of $50,000, assuring a death benefit available up to the insured’s age of 121. *Not available in CA and PA

Benefit for Terminal Illness

After coverage has been in force for two years, employees can receive up to 50% of the death benefit immediately (not to exceed $100,000), if they are diagnosed as terminally ill.

PORTABLE COVERAGE

Take this policy with you when you leave employment or retire, at the same cost and same benefits!

Paid-Up Benefits

After 10 years, paid-up benefits begin to accrue. At any point thereafter, if you stop paying premium, a reduced paid-up benefit is issued and can never lapse.

Recommendations

  • Take advantage of this one time offering through your company.
  • Owning a qualified Life & LTC product prior to the end of 2024 will likely allow you to opt out of any future tax. The Chubb product is a tax qualified 7702(b) Long-Term Care product.
  • This is a meaningful benefit to consider as apart of your overall financial portfolio.
  • Qualifying for Long-Term Care insurance can be difficult. This offering includes Guaranteed Issue, which means coverage can be placed with no medical questions asked.

Average monthly premium

Age Monthly Premium
30 $16.48
40 $26.12
50 $46.10
60 $89.50

Frequently Asked Questions

What does this policy provide for coverage?

This coverage combines the benefits of both Life Insurance protection for your family along with Long-Term Care benefits, which can be utilized to help pay for services 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 insurance 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. It pays for your lost income. Unlike disability insurance, Long-Term Care insurance does not end when one retires – it remains active into retirement, provided premiums are paid.

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

The insurance company requires social security number to set up your coverage for tax purposes and claims. Height and weight are needed only when applicants are required to answer the Simplified Issue health questions.

Can I add my spouse to this employer's offering?

Yes, spouses/domestic partners are eligible if the employee applies for coverage. If the employee does not apply for coverage, the spouse is ineligible. Spouse/domestic partner coverage is limited to no more than 50% of the coverage amount elected by the employee, up to a maximum of $75,000.

If your spouse/domestic partner also works for this employer, they should apply for coverage as an “employee” (not as a spouse) to qualify for Guarantee Issue underwriting (no health questions).

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

The employee Life Insurance options are $20,000, $40,000, $50,000, $75,000, $100,000, $125,000, and $150,000.

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 75 months. For example, a $50,000 policy provides a $2,000 monthly Long-Term Care benefit up to $150,000 in total Long-Term Care benefits.

Is the death benefit guaranteed to remain the same?

Your death benefit is guaranteed when it is needed the most – during the working years when a family is relying on income. The death benefit is 100% guaranteed for the longer of 25 years or age 70. Any reduction in death benefit (after age 70 or 25 years, the longer of) will result in a corresponding decrease in the monthly Long-Term Care benefit.

Can I take my coverage with me if I were to leave work or retire and, if so, do the rates change?

This is permanent Life Insurance designed to last a lifetime. Should you leave your employer or retire, you can keep your coverage at the same cost and benefit levels.

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, so 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.

Does my policy provide a way to “replenish” or restore my Death Benefit as LTC benefits are paid?

Yes, all coverage includes 50% Restoration of Death Benefits. Once the death benefit falls below 50% of its original value, it is restored to 50% of its original value up to a maximum of $50,000.

For Example: $100,000 in coverage would pay $4,000 per month in LTC benefits ($100,000 x 4%). If the insured received $24,000 or 6 months of LTC benefits ($4,000 per month x 6 months = $24,000), the net death benefit would be $76,000. If the insured then died, $76,000 in Life Insurance proceeds would be paid to the beneficiary. Alternatively, if the insured had received $52,000 or 13 months of LTC benefits ($4,000 per month x 13 months = $52,000), the death benefit would be restored to 50% of its value or $50,000. If the insured were to die, the policy would pay $50,000 in Life Insurance benefits.

*Not available in CA and PA

How is my rate determined?

This insurance offers unisex rates based on your age (as of the effective date), nicotine usage, and coverage level selected.

How will I pay my monthly premiums?

Your premiums will be paid monthly 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 are receiving LTC benefits, all premiums are waived.

Am I able to review my plan and return it to the insurance company if I am not 100% satisfied?

The Certificate holder may, within 30 days after the Certificate is delivered, return the Certificate to the Carrier’s Administrative Office, and receive a full refund of any premiums that have been paid. Once returned, the Certificate will be void from the effective date.

Can my rates increase?

Life Insurance premiums are guaranteed and cannot increase. LTC rates are subject to change.

What are the health questions employees need to answer for underwriting?

Employee Guaranteed Issue (No Health Questions)

Guarantee Issue is available for employees ages 19 through 70. Employee Guarantee Issue Limits are $20,000 up to $150,000. There is just one “Actively at Work” question (below).

“Is the employee actively at work performing the regular duties of the job in the usual manner and at the usual place of employment?”

Employees who answer “No” to the above Actively at Work question are ineligible to enroll but may apply for coverage upon their return to work and during the next enrollment period.

Employee Simplified Issue

Employee Simplified Issue is available for employees ages 71 through 80. The Simplified Issue Limit is $50,000.

Employee Simplified Issue Health Questions

Has the Employee missed more than 5 consecutive days of active work due to an illness or injury in the past 3 months?

Has any proposed Insured been treated in a medical facility, hospitalized, or disabled in the past 6 months, excluding flu or cold? Hospitalized means in-patient or outpatient, whether or not confined. Treated in a medical facility does NOT include a regular physician’s office visit.

Has any Proposed Insured, within the last 10 years, been tested positive for exposure to the Human Immunodeficiency Virus (HIV) infection, been diagnosed by a physician as having Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC) caused by the HIV or other sickness, or condition derived from such infection?

Note: Employees who answer “Yes” to the above HIV/AIDS question are ineligible for coverage.

Has any person/Spouse proposed for coverage been seen or treated by a licensed physician or other medical practitioner within the past 6 months, excluding flu, cold or routine physical?

Height: Weight:

Within the past 5 years, has any proposed Insured been admitted or advised to be admitted to a hospital or received medical advice or treatment by a licensed member of the medical profession for: Inquiries are specific as to treatment or diagnosis as provided by a licensed health care practitioner.

Any chest pain, heart disease, stroke or paralysis, lung or respiratory disease, blood disease or high blood pressure? If yes, provide most recent blood pressure reading and date.

Any cancer, tumor, disorder of the kidney, liver disease or hepatitis?

Any mental or psychiatric disorder, stomach or intestinal disorder or reproductive organ disorder?

Received or been advised to have, by a licensed member of the medical profession, counseling, or treatment for the use of alcohol, drugs, illegal drugs, or used any illegal drug or controlled substance?

Taken any prescription medication in the past 6 months (If “Yes”, state name of medication, reason for taking frequency and dosage)?

Had or been advised to have, by a licensed member of the medical profession, an electrocardiogram, x-ray, blood study, urinalysis, or any other diagnostic study, operation, or treatment?

Other than stated above, within the past 5 years, had any other illness, operation, or treatment?

What are the health questions Spouse/Domestic Partners need to answer for underwriting?

Guarantee Issue (no health questions) is available for spouses/domestic partners ages 19 through 60. Spouse Guarantee Issue Limits are the lesser of 50% of the employee amount or $20,000. For example, if the employee applies for $20,000, the maximum Guarantee Issue amount the spouse could apply for would be $10,000.

Spouse Conditional Guarantee Issue

Conditional Guarantee Issue (some health questions) is available for spouses/domestic partners ages 19 through 70. Spouse/domestic partner Conditional Guarantee Issue Limits are 50% of the employee amount up to $75,000.

For spouses/domestic partners ages 19 through 60 who apply for amounts of $20,001 up to $75,000, the Conditional Guarantee Issue health questions are required.

Spouse Conditional Guarantee Issue Health Questions

Has any proposed Insured been treated in a medical facility, hospitalized or disabled in the past 6 months, excluding flu or cold? Hospitalized means in-patient or outpatient, whether or not confined. Treated in a medical facility does NOT include a regular physician’s office visit.

Has any Proposed Insured, within the last 10 years, been tested positive for exposure to the Human Immunodeficiency Virus (HIV) infection, been diagnosed by a physician as having Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC) caused by the HIV or other sickness, or condition derived from such infection?

Note: Applicants who answer “Yes” to the above HIV/AIDS question are ineligible for coverage.

Has any person/Spouse proposed for coverage been seen or treated by a licensed physician or other medical practitioner within the past 6 months, excluding flu, cold or routine physical?

NOTE: Spouse/domestic partners who answer “Yes” to any Conditional Guarantee Issue questions (excluding the HIV/AIDS question) are required to answer the Simplified Issue health questions (below).

Spouse/Domestic Partners Simplified Issue Health Questions:

Height: Weight:

Within the past 5 years, has any proposed Insured been admitted or advised to be admitted to a hospital or received medical advice or treatment by a licensed member of the medical profession for: Inquiries are specific as to treatment or diagnosis as provided by a licensed health care practitioner.

Any chest pain, heart disease, stroke or paralysis, lung or respiratory disease, blood disease or high blood pressure? If yes, provide most recent blood pressure reading and date?

Any cancer, tumor, disorder of the kidney, liver disease or hepatitis?

Any mental or psychiatric disorder, stomach or intestinal disorder or reproductive organ disorder?

Received or been advised to have, by a licensed member of the medical profession, counseling or treatment for the use of alcohol, drugs, illegal drugs, or used any illegal drug or controlled substance?

Taken any prescription medication in the past 6 months (If “Yes”, state name of medication, reason for taking frequency and dosage)?

Had or been advised to have, by a licensed member of the medical profession, an electrocardiogram, x-ray, blood study, urinalysis, or any other diagnostic study, operation, or treatment?

Other than stated above, within the past 5 years, had any other illness, operation, or treatment?

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

Employees who answer “No” to the “Actively at Work” Guarantee Issue question will be ineligible for coverage but may enroll for coverage upon return to work and during the next enrollment period. Applicants who answer “Yes” to the HIV/AIDS will be ineligible for coverage.

Can I increase my coverage later?

You can request to increase your coverage later with Simplified Issue underwriting. If approved, you will be issued a second Life Insurance policy based on your current (attained) age.

What if I enroll in the plan and I change my mind?

The Certificate holder may, within 30 days after the Certificate is delivered, return the Certificate to the Carrier’s Administrative Office, and receive a full refund of any premiums that have been paid. Once returned, the Certificate will be void from its beginning.

What is the Elimination Period Under The Long-Term Care Benefit?

Means the number of days at the beginning of a Period of Care for which benefits are not payable under this Rider. In order for a day to count as a day in the Elimination Period, the following requirements must be met:

  • The Insured must be Chronically Ill; and
  • Charges must be incurred for the care and services of the Insured.

The elimination period needs to be satisfied only once during the Insured’s lifetime.

What are the Long-Term Care Benefit Triggers?

You must satisfy the Elimination Period before benefits are paid. Each day the Insured is Chronically Ill, and charges are incurred for the care and service of the insured, one day of the Elimination Period will be satisfied.

Chronically Ill means certified by Licensed Health Care Practitioner as:

  • being unable to perform, without substantial assistance from another individual, at least 2 Activities of Daily Living (ADLs) for at least 90 days due to a loss of functional capacity or
  • requiring substantial supervision for protection from threats to health and safety due to Severe Cognitive Impairment.

Activities of Daily Living (ADLs) include: Bathing, Dressing, Continence, Eating, Toileting and Transferring

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

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 (e.g., Home Care, Assisted Living/Memory Care, Adult Day Care or Skilled Nursing Homes).

Will the plan pay for care outside of the US?

The plan will pay LTC benefits for care or services received in the United States or its territories only. Death benefits are paid anywhere in the world.

What are the Policy Exclusions and Limitations?

If the insured commits suicide, while sane or insane, within two years (one year in some states) from the Date of Issue, and while this Coverage is in force, the Carrier will pay in one sum to the Beneficiary, the amount of premiums paid for this Coverage.

Long-Term Care Exclusions

The Carrier will not pay Long-Term Care benefits for care that is received, or loss incurred as a result of:

  • Any Pre-Existing Conditions; See Pre-Existing Condition Limitation noted below;
  • Mental or nervous condirtions except Alzheimer’s Disease;
  • Alcoholism and drug addiction;
  • Illness, treatment or medical conditions arising out of:
    • War or act of war (whether declared or undeclared);
    • Participation in a felony, riot or insurrection;
    • Service in the armed forces or units auxiliary thereto;
    • Suicide (sane or insane), attempted suicide, or intentionally self-inflicted injury;
    • or Aviation (non-fare-paying passengers);
  • Treatment provided in a government facility (unless otherwise required by law), services for which benefits are available under Medicare or other Governmental program (except Medicaid), any state or federal workers’ compensation, employers’ liability or occupational disease law, or any motor vehicle no-fault law, services provided by a member of the covered person’s immediate family, and services for which no charge is normally made in the absence of insurance.
  • Expenses for services or items available or paid under another Long-Term Care insurance or health insurance policy.
  • In the case of a Long-Term Care contract, expenses for services or items to the extent that the expenses are reimbursable under Title XVIII of the Social Security Act or would be so reimbursable but for the application of a deductible or coinsurance amount; or
  • Care or services received outside the United States or its territories.
What is the Pre-Existing Condition Limitation for LTC?

LTC benefits are not payable for care received in the first 6 months after the coverage issue date if a Pre-Existing Condition causes an insured to be Chronically Ill. Care received 6 months or more after the issue date caused by a Pre-Existing Condition will be covered.

LPre-Existing Conditions means a condition for which medical advice or treatment was recommended by or received from a provider of health care services within 6 months preceding the date of issue.

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Tippett Moorhead & Haden LLC, an Alera Group Agency will be your consultant on the plan

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