Unit 21 Flashcards
What is the main consideration for underwriting a Long Term Care policy
Ability to preform activities of daily living
What are the activities of daily living
Bathing, Dressing, Toileting, Transferring, Continence, Eating
How many ADLs does someone need to be unable to preform to qualify for benefits
Usually 2
What is another qualifier for benefits for a Long Term care
Cognitively Impaired
What are the levels of long term care
Skilled nursing care, Intermediate care, Custodial care
What are the types of long term care
Home health, Adult day care, Respite care, Assisted Living
What is the minimum and typical benefit period for a long term care policy
12 months mim, typically 2-5 years
How are the benefit amounts for a long term care policy expressed
$/ day
What percentage is covered for home health care in comprehensive long term policy
50% of facility benefit
What is the elimination period for a long term care policy
The amount of time an individual must be insured before qualifying for benefits
What are the optional benefits for a long term care policy
Guaranteed Insurability, Nonforteiture Benefits, Inflation Protection
What types of mental illness are exclusions from long term care
Non organic-based mental illness
If a long term care policy meets the rules set forth by HIPAA what is it considered and what does it receive
Qualified and favorable tax treatment
Premiums on a long term policy are what for self employers subscribers
Tax deductible up to an age limit
Employers who pay for their employees long term care policy are able to
Deduct as a business expense
What is a long term care policy that doesn’t meet HIPAA’s rule considered
Non-qualified
What is different about a Qualified/ Non qualified long term care policy
Tax treatment
What did the Deficit Reduction Act of 2005 (DRA) introduce
Qualified State Longterm Care Partnership Program
What 3 agencies participate in the State long term care partnership plans
Insurers, State’s insurance department, and state medicaid agency
What is the Dollar for Dollar approach
Its a method used in the Long term care partnership plans making it possible for participants to keep assets equal to the benefits they’ve received from a partnership plan and exempt those assets from Medicaid estate recovery
What grade of renewability is a long term care policy
At least Guaranteed renewable
