Bahr Advisory Services

Pooled Benefits: There is more than one type of Pooled Benefit. Keep the following information in mind when reviewing the different types of Long-Term Care Policies Available.

• Scenario 1: When purchasing LTC, you create your initial pool of money with your choice of daily benefit and benefit period. This pool of money is used for most of the services and care available in the LTC policy. Some benefits do not reduce the pool of money, but have their only separate amount/pool available. All benefits taken from one pool of money. For Example: If you have a 3 year benefit period at $150.00 a day and you are only using $75.00 a day for home care, assuming you continue to use the same $ amount, your policy benefits should last for 6 years.

  The first long-term care policies made available had separate pools of money for Home Health Care and Nursing Home Care. When you depleted your Home Care portion of your benefit, your benefit would stop until you entered a Nursing Home. At that time, you would start receiving benefits again.

• Scenario 2: A single pool of money can be available for more than one person. This could be a husband and wife sharing a policy or a rider on their individual policies combining their pools of money to be shared between them. You can also have a pool of money shared by several family members under one contract.

Types of Long-Term Care Policies Available

Private insurance companies sell long-term care insurance policies. You can obtain these policies in many different ways:

• Individual Long-Term Care Policies: One insured and one pool of money

• Individual Long-Term Care (National Partnership) Policies: One insured and one pool of money. Provides Dollar for Dollar Asset Protection. This policy is exactly the same as the individual LTC policy listed above, but it meets certain guidelines:

  • Approved by the state and launched by the carrier as a Partnership Approved policy, and

  • The policy meets the age-based / inflation guidelines mandated by the National Partnership Program. See program details...

• Individual Long-Term Care with Shared Benefit Riders: Two LTC insurance policies (husband & wife or partners) that have their own individual policies but have purchased a benefit rider that combines their pools of money. Example: Husband purchases a 2 year benefit ($100 a day) = $87600 (pool of money), spouse purchases a 2 year benefit ($100 a day) = $87,600 (pool of money) and they both purchase the Shared Rider. Now they have created a total pool of money of $175,200 to be used by one of them, both of them at the same time, or one of them and then the other until the pool is deleted. The benefit of this type of plan is you have a greater chance of using the benefit if it’s covering two people. If the husband goes on claim and uses 3 years, passes, then the spouse would have the remaining year for her use. Each carrier runs their program a little different, so you need to determine exactly how the rider works before purchasing. There is an additional cost for this rider because the carrier is at greater risk for paying a claim.

• Joint Long-Term Care Policies: This is one policy with more than one insured. This can be a husband and wife or partners. It can also be several people from one family sharing one plan. The guidelines of the available plans are dictated by the carriers. They all vary to some degree.

• Individual Long-Term Care Offered Through Employers: These are individual LTC policies offered by an employer as either an employer paid or voluntary benefit. There is usually a 5 or 10% discount involved depending on the program offered. These discounts are usually in addition to any other discounts available (spousal or preferred) depending again on program being offered.

• Individual Long-Term Care Offered Through Associations: These are individual LTC policies offered by an Association on a voluntary basis. There is usually a 5% discount involved depending on carrier's discount program. These discounts are usually in addition to any other discounts available (spousal or preferred) depending again on carrier.

• Group Long Term Care (Certificate Policies): When an Employer offers long-term care insurance to their employees either as an employer-paid benefit or on a voluntary basis, the employer chooses which benefits are being offered. The employer also owns the Contract and the Participating Employees all obtain a certificate of coverage. These policies are usually portable…meaning if you leave the company, you can keep the insurance but you must begin paying the premiums. In many cases, an individual long-term care policy can compete with this type of plan on home care benefits and for the individual that could be issued a regular policy with a preferred health discount. Group plans have a rate chart based on the ages of the eligible group, which can work against a preferred health individual.

• Life Insurance Policies: Some companies let you use your life insurance death benefit to pay for specific conditions such as terminal illness or for qualified long-term care expenses such as home health care, assisted living, or nursing home care. A life insurance death benefit that you can use while you are alive is known as an accelerated death benefit.