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Long Term Care
Coverage
Presented By:
Will Stover
SDMEA Benefits
wstover@integratedlabor.com
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Agenda
▪ What is Long Term Care?
▪ Key facts
▪ Why MEA and Unum?
▪ Who is Eligible?
▪ How does the plan work and what options do I have?
▪ How much does it cost?
▪ Why now?
▪ How to enroll
▪ What happens when I retire?
What is Long Term Care?
Long term care is received either at home or in a facility when someone needs assistance safely completing the 6 major activities of daily living which are:
-Eating -Continence
-Bathing -Transferring-Dressing -Toileting
The inability to complete these activities can be caused by injury, illness, or advancing age.
3 Key facts about
Long Term Care
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▪ There is a greater probability of a person needing to stay at a nursing home than of premature death while being employed.1
▪ Every 40 seconds someone in America has a stroke.2
▪ Every 67 seconds, someone develops Alzheimer’s.3
▪ More than one quarter of the US population are family caregivers.4
▪ 26 million caregivers are full time employees.5
1. The Need is Extensive
1 Milliman, “True Group Long-Term Care Insight Long-Term Care and
Employer Contributions,” March 2006.
Sources: Assist Guide Informational Services: www.agis.com
2 Centers for Disease Control and Prevention: www.cdc.gov
3 Alzheimer’s Association: www.alz.org
4 AARP: www.aarp.org
5. AssistGuide Information Services: www.agis.com
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$250,000
200,000
150,000
100,000
50,000
01 2 3 4
years
2. The Cost is Enormous
Based on today’s costs, a $250,000 nest egg would last less than four years:
With the U.S. personal savings rate near or even below zero, most employees have little or no savings to rely on.3
Average home health aide care in CA =
$50,222 – 57,200 per year1
Average nursing home care in CA =
$74,460 - $91,250 per year2
1,2 Data Source: Genworth Cost of Care Study 2013: www.longtermcare.gov
3 U.S. Department of Commerce, Bureau of Economic Analysis Release, “Personal Income and Outlays,” December 21, 2007.
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■ Health/Medical Insurance
– will not pay for long term care
■ Medicare (only over age 65)
– only in very limited situations
■ Medicaid
– will not help until financial assets are almost depleted
3. Not Covered by Other Insurance
Why Get Long Term Care
Insurance through MEA and
Unum?
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Group Long Term Care Insurance (“LTCI”)
• SDMEA has offered Multiple Unum LTCI plans since 1996.
• Throughout this time numerous members and their families have utilized these benefits. The SDMEA has never heard of any problems or had any complaints about our plans.
• Unum and most of the insurance world has stopped offering LTCI due to “economic conditions” and “an unpredictable market”. The remainder of the world pays individual rates that are much more expensive, and only guaranteed for 5 years.
• This plan has been in place for over 10 years and is currently still allowed to be offered as it was 10 years ago.
• Our plans have never had a rate increase, but Unum did ask for one in 2015. The CA Department of Insurance denied the request. Future increase requests may be submitted at a later time.
Who’s Eligible?
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Who’s Eligible?
▪ All City of San Diego Employees
▪ Working 20 hours per week
▪ You do not need to be a SDMEA member to enroll
▪ Family members (natural, adoptive, or step) between ages of 18-80
▪ Spouse, Siblings and Children
▪ Parents of Employee or Spouse
▪ Grandparents of Employee and Spouse
How does the plan work
and what options are
available?
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Plan Highlights
Elimination Period: 90 days
Benefit Duration: (How long benefits are paid to you) choose between:
3 years, 6 years or unlimited.
Monthly Benefit Amount: $3,000 up to $8,000 in $1,000 increments
Nursing Facility Benefit = 100% of selected amount
Residential Facility Benefit= 70% of selected amount
Home Care Benefit = 50% of selected amount
Family member Care option: Homecare provider does not need to be certified)
Compound Inflation Option: Benefit increases by 5% annual every Jan 1st
**Your rates do not increase just your benefits**
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Benefit Payout Options
How the Benefits are Paid:$6,000/mo. for 3 years = $216,000 in your bucket of
money
Full Nursing Home 100% of selected amount; $6,000 per month, and bucket will be empty in 3 years.
Residential Facility 70% of selected amount; $4,200 per month, and bucket will be empty in 4.5 years.
At Home Care 50% of selected amount; $3,000 per month and bucket would be empty in 6 years.
▪Can choose to switch back and forth between types of care at any time.
▪Either way, you are still going to receive the $216,000 of benefits.
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Contract
■ No receipts necessary
■ Excellent Rates - Group Discounts- GLTC 95 contract - Age lock at purchase- **rates can only change if Dept. of Insurance approves**
■ Retirement Option C eligible
How Much Does it cost?
Rate Sheet
SDMEA – LTC Website Homepage
SDMEA – LTC Website Calculator
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Voluntary Long Term Care Sample Benefits/Premium
AgePayroll Deduction Per Pay Period,
Based on Basic $5,000 Plan
30 $7.50
40 $10.00
50 $15.75
60 $29.75
70 $81.00
Minimum Basic Plan
▪ Monthly Nursing Facility: $3,000▪ Elimination Period: 90 Days (Amount of time that must pass before an individual is eligible for
benefits)▪ Lifetime Maximum: $108,000▪ Facility Benefit Duration: 3 years▪ Home Care Level: 50% of Facility Benefit is paid when care is received in home
Buy Up Options
▪ 6 Year and unlimited duration
▪ Additional monthly Facility Benefit amounts up to $8,000 in $1,000 increments▪ Home, community based and immediate family member home care▪ Compound inflation 5% uncapped
Why Now?
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Unique Opportunity
▪ Group discounted rates may not be available tomorrow
▪ Level premiums based on age at purchase
▪ Portability: Keep the plan if you leave the city or retire
▪ Family Members can get the rates too
▪ You’re Healthy now!
What happens when
I retire?
Pension deductions are available with
SDMEA retiree membership
Get reimbursed for your premiums from
your Option C benefits.
Travel anywhere in the USA and receive
the benefits.
How do I enroll?
Questions?
Website:
http://w3.unum.com/enroll/sdmea/index.aspx
Informational Phone Number:
Will Stover: 619-535-7240
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