Below are some frequently asked questions about Long-Term Care with Life Insurance.
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What is long-term care (LTC)?
Long-term care is the personal care and/or supervision (custodial, supervisory, or skilled care) needed by persons of any age for an extended period.
Often this is because of conditions associated with the effects of aging, but LTC may be needed at any time due to an accident or illness. It is estimated that more than 60 percent of us will need assistance with things like getting dressed, driving to appointments, or making meals.
Long-term Care + Life Insurance can help defray the cost of such care.
Is LTC covered by health or disability insurance?
It is a common misconception that LTC is covered by health or disability insurance. LTC services are typically not covered by Medicare,Medicaid, private health or disability insurance.
Should I consider this if I already have LTC insurance?
If you already have LTC insurance, great! It is often recommended to keep your existing coverage because of the value it provides. This enrollment presents an opportunity to review your existing coverage and consider if purchasing additional LTC coverage is right for you. Consider meeting with an LTC insurance specialist to review your existing coverage and your options under this special enrollment offer.
Are there different types of coverage available depending on age?
There are two types of Universal Life policies available, depending on your age at the time of enrollment:
Trustmark’s Universal LifeEvents® plan applies to enrollees ages 18-64. It pays a higher death benefit during the working years when expenses are typically higher, and families need maximum protection. The death benefit reduces to one-third at age 70 or the beginning of the 15th policy year, whichever occurs last. (The death benefit reduction does not impact premiums or LTC benefits.)
Trustmark’s Standard Universal Life plan applies to enrollees ages 65 – 70. It is important to note LTC is not available for applicants over age 70.
Can you explain how I might use the Long-term Care + Life policy?
This insurance is a Universal Life Insurance Policy with Long-Term Care (LTC) Benefits. It provides dual protection for the cost of LTC and financial support for your beneficiaries after you are gone.
There are generally two ways you might use the policy:
If you need long-term care , you may receive a monthly benefit of 4% of the total amount of Life Insurance you buy once you qualify for benefits. As an example, if you buy $100,000 in Life Insurance coverage, you will receive $4,000 a month for up to 50 months (about 4 years) for a total potential benefit of $200,000*.
Whether you need long-term care in your lifetime or not, there is still a death benefit available to your beneficiary. Using the same example, if you buy $100,000 of life insurance your beneficiary would be able to receive up to $100,000 in death benefits*.
*Death benefits reduce to one-third at age 70 or on the 15th policy year, whichever is later.
How does this insurance help pay for the cost of long-term care?
The monthly LTC benefit amount is 4% percent of the Life insurance amount you purchase. Once your LTC benefit is approved you will receive a monthly benefit until the earlier of your recovery or the expiration of the benefit. You can collect the monthly amount for up to 50 months, to a maximum of two times your Life insurance amount.
The full monthly benefit amount is paid regardless of the actual professional care expenses incurred. If the monthly benefit amount is not entirely consumed by professional LTC expenses, any remaining benefit can be used at your discretion.
How do I qualify to receive LTC benefits?
To qualify for LTC benefits, you must be receiving assistance with two (2) or more activities of daily living (transferring, continence, bathing, dressing, eating, toileting) or you have cognitive impairment expected to last more than 90 days. You also need to be receiving care from a licensed professional in a LTC facility, nursing facility or receiving home health care. Benefits are payable after you meet your 90-day elimination period, meaning, benefit payments will start 90 days (about 3 months) after your LTC needs begin.
A qualified health professional will need to certify that you meet the activity of daily living or cognitive impairment requirement.
What if I have a pre-existing condition?
The plan includes a 6/6 pre-existing condition exclusion, meaning if a claim is filed within the first 6 months from the enrollment date due to a pre-existing condition which was diagnosed within the 6 months immediately prior to the enrollment date, the claim would not be paid. If a claim is filed after 6 months from the enrollment date, the pre-existing condition clause is void. Refer to your policy for the pre-existing condition definition.
Does family-provided care qualify me to receive LTC benefits?
No, you must be receiving care from a qualified, licensed professional in order to receive LTC benefits under the plan.
Are there any limitations on where care is received?
If you qualify for LTC benefits, where you receive care is up to you (at home, assisted living, adult day care, nursing home). However, the policy will only pay LTC benefits for care received in the United States and Canada.
Death benefits can be paid regardless of where your death occurs or where your beneficiary resides.
Are LTC benefits taxable?
Benefits paid may or may not be taxable. Whether or not you or your beneficiary incur a tax liability when benefits are paid depends on how the IRS interprets applicable portions of the Tax Code. As with all tax matters, you should consult your personal tax advisor to assess the impact of this benefit. The insurance company has no responsibility for any tax consequences of any benefits paid under this policy. The rider for LTC insurance is not intended to be a federally qualified LTC insurance contract.
How much does LTC with Life coverage cost?
The premium is based on how much death benefit you select, the age that you are at the time of application and your smoking status.
The best way to see your pricing is to click "Check Your Rate." You are under no obligation to purchase once you start the enrollment process and can exit anytime.
You will enter some personal information and choose a death benefit from $25,000 - $300,000, in increments of $25,000.
Can I obtain coverage without providing evidence of good health?
Yes, if you elect coverage during a special enrollment period, your elected Life insurance amount is within the program’s Guaranteed Issue amount (up to $200,000), and you are between the ages of 18 and 64. Coverage elected outside of these parameters will be subject to evidence of good health. Guaranteed issuance is unique to special enrollment periods and does not re-occur every year.
Why does the application require my SSN, height, and weight?
The insurance company requires SSN to set up the policy as it is used for tax purposes and claims. Height and weight are used in underwriting if you are ineligible for Guarantee Issue underwriting and are required to answer health questions.
If I apply for coverage beyond the available Guaranteed Issue amount for my age, what medical questions are asked?
There are two sets of potential questions you will be asked if you apply for coverage beyond your available Guaranteed Issue amount:
Within a certain benefit range (called the Modified Guaranteed Issue) you need to answer a shortened health questionnaire consisting of two questions:
If either of these questions is answered “yes” or you select a death benefit amount above the Modified Guaranteed Issue range, additional health questions will be asked which includes a full health questionnaire, height/weight evaluation, Medical Information Bureau (MIB) screen, and a prescription drug screen. Additional medical questions may be asked based on findings.
This is called simplified issue - here are some examples of the types of questions asked at this stage:
Has any person to be insured:
Questions may vary depending on your state and the benefit amount selected. The best way to see the questions specific to your coverage is to begin the enrollment process.
If I apply for more than the Guaranteed Issue amount of benefit and am denied, do I still receive the amount up to my Guaranteed Issue limit, up to $200,000?
Yes. If you do not qualify for an amount beyond the Guaranteed Issue limit of $200,000, you will still be able to receive a policy up to the amount of the Guaranteed Issue.
What is the duration of this insurance policy?
Coverage is designed to mature at age 100. If you are living and the coverage is in force on that date, the cash value will be payable, and the coverage will terminate.
The illustration provided when you receive your coverage certificate will demonstrate the projected coverage period at the selected planned premium rate under both the current and guaranteed scenarios.
You will also receive an annual statement on the anniversary date of your policy to review your coverage period.
How do I pay my premium?
The premium will be deducted from your paycheck based on your pay schedule (monthly, bi-weekly…etc.) while you are employed by SSMHealth.
Are premiums paid on a pre-tax or post-tax basis?
The premiums are paid on a post-tax basis.
Are my premiums guaranteed or will the cost increase with age?
Your premium will be based on your age at the time of issue and will not increase as you age. You will receive an annual statement on the anniversary date of your policy that will explain the details of your coverage and your policy activity.
If I am receiving LTC benefits under the plan, do I continue to pay premiums?
No, premium payments will be waived while you are receiving payments under the LTC benefit.
What happens if I stop paying my premium?
Coverage will remain in force as long as there is sufficient cash value to cover the monthly expense, rider and cost of insurance charges. If insufficient, the coverage will lapse. You will be notified of the potential lapse and will be given the opportunity to pay outstanding premium.
Can policyholders take a loan from the cash value? If yes, what are the terms?
Yes, the interest rate is 8% on policy loans.
Who do I contact when my address changes?
For address changes, follow your normal process to change your address with SSMHealth. That change will follow through to Trustmark. You can always review your personal information, including your address via the Trustmark policy service portal at https://myvb.trustmarkbenefits.com/login.
Who do I contact to update my beneficiary?
You may initiate the beneficiary change process through Trustmark’s Customer Care team at 800-918-8877 (M-F, 7a-6p CR), or by email at customercare@trustmarkbenefits.com, or via the policy service portal at https://myvb.trustmarkbenefits.com/login. Currently, you are required to complete and return a beneficiary change form to Trustmark.
Can I increase my Universal Life Insurance policy at a later date?
Yes, you can request to increase your existing Universal Life Insurance policy at a later date (after your 30-Day Free Look Period) with medical underwriting. If approved, the increase in coverage will be based on your current (attained) age.
What if I leave my employer or retire?
This policy is completely portable – meaning you take the coverage with you if you change jobs or retire from your current employer. You should contact Trustmark to arrange for direct billing, and you can continue coverage without any change in premium or benefit amounts.
How do I cancel my policy and what happens when I do so?
To cancel, contact Trustmark directly at 800-918-8877 or customercare@trustmarkbenefits.com
If you cancel the policy after the 30-Day Free Look Period, you will receive any Cash Value minus any applicable policy surrender fees.
This a brief description of the benefits under forms GTL 121 C MET and applicable riders CTR 121, LTC.121 and STR.121. This is a life insurance benefit that also gives you the option to accelerate some of the death benefit in the event that you meet the criteria for a qualifying event. This is not a long-term care partnership policy or a Medicare supplement certificate. The accelerated death benefit for terminal illness is designed with the intent to qualify for favorable tax treatment under Section 101(g) of the Internal Revenue Code. The accelerated death benefit for long- term care is designed with the intent to qualify for favorable tax treatment under Section 7702B(b) of the Internal Revenue Code and is subject to long-term care insurance law. Unlike the benefits provided by traditional or stand-alone long-term care insurance, the benefits provided do not include coverage for the reimbursement of long-term care services. A maximum issue age applies to certain benefits; coverage issued at age 70 or later may differ from what is described here. Limitations on pre-existing conditions may apply. Benefits, definitions, exclusions and limitations and form numbers may vary by state. Please consult your certificate for complete information. For costs, coverage details and terms, see your agent or write the company. Underwriting conditions may vary, and determine eligibility for the offer of insurance. Trustmark® and Trustmark Life + Care® are registered trademarks of Trustmark Insurance Company. In California, review “A Consumer’s Guide to Long-term Care from the Department of Aging” at: http://www.aging.ca.gov/aboutcda/publications/Taking_Care_of_Tomorrow_English/. All other states, please refer to publication https://content.naic.org/sites/default/files/publication-ltc-lp-shoppers-guide-long-term.pdf