Program Benefits

Please explain the choices I'll need to make when designing my plan.

1st Choice to be made: Your monthly benefit of $4,500, $6,000 or $7,500

2nd Choice to be made: Your total "pool of money" to be available to you. Use the chart below to see your choices. Remember this is the initial "pool of money" you are purchasing. Assuming you select one of the inflation protection options, the "pool of money" will increase over time.

If monthly benefit selected is: Then you can choose from one of these three "total pools of money":
$4,500 $108,000, $162,000 OR $270,000
$6,000 $144,000, $216,000 OR $360,000
$7,500 $180,000, $270,000 OR $450,000

3rd Choice to be made: Choose from one of the three "benefit increase options" to protect against inflation. The choices are listed below. The default, if no choice is made, is the FPO.

  • Buy Additional Coverage as you need it (FPO)
  • Automatic increase of 3%
  • Automatic increase of 5%

And finally, you will accept or reject the non-forfeiture rider. The question is written as a negative so do be careful. "Do you reject the non-forfeiture benefit rider?" So if you do not want the rider, answer yes. If you do want the rider, answer no.

Please explain the non-forfeiture rider.

The non-forfeiture benefit provides for a reduced benefit if coverage lapses after it has been in effect for at least 3 years. Under this rider you would receive the greater of: (a) one hundred percent (100%) of the sum of all premiums paid for your coverage, excluding any waived premiums; or (b) the maximum amount in effect at the time of lapse applicable to one month (30 days) of Nursing Facility Confinement. (typically your monthly benefit, adjusted for inflation increases and/or benefits paid out)

Benefits can be used for in-home care, assisted living, nursing home and "other care support." What's included in "other care support"?

Other care support includes caregiver training, adult day care, necessary home modifications to make at-home stays possible and necessary emergency monitoring systems. There is also an alternate care benefit that allows coverage for qualified long term care services that are not specifically identified in your certificate of insurance.

This insurance pays the same benefit for in-home care as for in-facility care. If a family member is the one providing the in-home care, how much can the care provider be paid?

A family member (who doesn't normally live in the home) can provide in-home care for the insured person based on the plan of care; however the benefit, for this informal care is one percent (1%) of the monthly benefit amount in effect for the covered participant for up to 30 days per calendar year.

What benefit do I receive if I choose to receive care outside of the United States?

If you receive care outside of the United States for which benefits would be payable, the maximum benefit available is 75% of your monthly benefit for up to four years, as reimbursement for covered long term care services received in a nursing facility. In home care is not covered by the International Benefit.