Tag Archives: Policyholder

2013 HSA Contribution Limits

2013 HSA Contribution Limits

The IRS has recently announced the new contribution limits for HSA’s (Health Savings Accounts).

HSA contribution limits: 

  • Individuals (self-only coverage) – $3,250 (up $150 from 2012)
  • Family coverage – $6,450 (up $200 from 2012)

HDHP minimum required deductibles:

  • $1,250 for self-only coverage
  • $2,500 for family coverage

Out-of-pocket maximum:

(Out-of-pocket expenses include deductibles, co-payments, and other amounts, but not premiums)

  • $6,250 for self-only coverage
  • $12,500 for family coverage

Under guidelines implemented in the Patient Protection and Affordable Care Act, over-the-counter drugs may only be reimbursed if they have a prescription. If a policyholder uses an HSA to pay for items or services that aren’t qualified medical expenses, the tax penalty is 20 percent of the HSA distribution.

Exploring the Lesser Known Features of Long-Term Care Insurance

Exploring the Lesser Known Features of Long-Term Care Insurance

Buyers of long-term care insurance often focus on just the coverage basics, such as the level of daily benefits, length of coverage, and under what conditions the policy will pay a claim. While these basics form the chassis of the policy, long-term care policies offer a host of other options that may prove beneficial to the policyholder.

Let’s take a look at some of these available options:

Survivorship Premium Waiver– If both spouses obtain long-term care policies from one insurer, some policies will provide a waiver of all remaining premiums if one spouse dies within a certain number of years after the policy is issued. For example, the policy may provide a premium waiver if the policies have been in effect for 10 years before one spouse passes away. The policy might also stipulate that no claims could have been paid during the period.

This feature may be included with the policy automatically or it may be offered as a rider to the base policy for an extra premium.

Shared Pool of Benefits- Instead of each spouse having an individual policy with separate benefits, they can elect to share each other’s benefits if needed. For example, each spouse might have a policy with a 3-year benefit period. Once one spouse has expired 3 years of benefits they have no further coverage, but the other spouse may still have 3 years of coverage remaining. With the shared pool of benefits rider, the spouse receiving care could also access the other spouse’s benefits.

This feature is most commonly offered as rider to the base policy for an extra premium.

Alternate Plan of Care– With our population continuing to age, new ways of delivering long-term care will continue to be developed. Not too long ago, no one had ever heard of adult day care or assisted living facilities.

With the alternate plan of care feature, you can ensure that your policy will never grow obsolete. You, your physician, and the insurance company will develop a plan of care which best serves your needs based on currently available options.

Look for this feature to be included in the policy with no additional cost.

Accelerated Premium Payment Options– Many insureds worry about their ability to afford premium payments during retirement when their income is reduced. Some insurers offer policyholders an option to pay accelerated premiums for a shorter period of time with the benefit of a contractually paid up policy after a certain period. For example, a 10- or 20-year accelerated payment period with no further premiums due afterwards.

This option has several benefits. Business owners may be able to deduct premiums from their taxes during their working years with no further premiums due in retirement. Additionally, with the cost of long-term care increasing rapidly, a contractually paid up policy means no exposure to premium adjustments made by insurers in future years to account for higher than expected claims experience.

Enhanced Elimination Periods– While all policies provide several elimination period options ranging from a 0 day to a 180 day elimination, it’s important to understand how the elimination period can be satisfied.

For example, some policies may credit a week towards your elimination period with just one day of home care received per week. Still another policy may have no elimination period for home care benefits while nursing home or assisted living facility care may require an elimination period.

These are just a few of the lesser-known features of long-term care insurance. There are many other options to consider when selecting a policy, but be sure to compare not only the basics of each policy but the included features and available riders.

Home Health Care – Another Option for Your Long-Term Care Needs

Home Health Care – Another Option for Your Long-Term Care Needs

You’ve decided that the purchase of a long-term care policy for yourself and your spouse would be advisable.   The figures, however, are daunting and the premiums exceed your budget.  If you are considering the idea of long-term care insurance, the option to receive necessary assistance in your own home may be more preferable to living in a nursing home.  Because the vast majority of the middle aged and senior population are in favor of this option, the insurance industry has responded.

The assisted living and home health care industry is growing along with the desire to receive care in your own home.  Most long-term care insurance providers are now offering the consumer the opportunity to purchase insurance that provides coverage for community health services and home health care at much lower rates than a full blown long-term care policy.

For example, using the guidelines of one “A” rated provider, full coverage for a 55-year old married couple, both in good health, with a $150.00 per day policy featuring inflation protection and a 30-day waiting period, would require an annual premium of about $2600.00.

The same provider also offers a policy covering home health care and community care coverage for an annual premium of just under $1,000.00, a considerable savings over the full coverage policy, while still offering protection for the most commonly required assistance.

While some policies will restrict the care to be offered by licensed providers, there are policies now available which also offer coverage for services performed by non-licensed personnel, allowing the opportunity for care to be provided by people known to the policyholder, such as a family friend or a neighbor.  This raises the comfort level of the care provided, since allowing strangers into their home is something of which most seniors are wary.

In order to prevent fraud or abuse of the coverage, family is excluded from providing services in most cases, unless the family member happens to be a licensed provider.

As the baby boomer population ages, and home health services are seeing increased effectiveness and popularity, the purchase of this type of coverage can be an affordable, attractive alternative to the more traditional long-term care insurance.

Lifewise of Oregon March 1st effective date


The online application tool is not available for applicants requesting a March 1, 2011 effective date. To apply for a March 1 effective date, please submit a paper application based on the timeframes described below. Please note that applicants under the age of 19 can only apply during the two Oregon state-defined open enrollment periods. The first open enrollment period is February 1-28, 2011.

Applicants age 19 and older who are not enrolling any dependents under age 19:

We must receive your paper application by February 21 for a March 1 effective date.
Applications received after February 21 will only be eligible for an effective date of March 15 or later.

Applicants age 19 and older who are enrolling dependents under age 19 OR applicants under age 19 that are enrolling as a policyholder:

We must receive your paper application by February 28 for a March 1 effective date. For February 2011 only, we will allow applicants age 19 and older to submit their applications up to February 28th for a March 1 effective date if applying on the same paper application as their under age 19 dependents.

Applicants under age 19 will not be accepted if we receive the application after February 28. However, applicants age 19 and older on the same application will still be eligible for an effective date of March 15 or later.

If you have further questions, please  call Brian at 800-240-3390.

Lifewise of Oregon

Home Care Equals One-Third of All Long-Term Care Claims Paid in 2006

Home Care Equals One-Third of All Long-Term Care Claims Paid in 2006

A recent American Association for Long-Term Care Insurance study revealed that total long-term care insurance claims rose to $3.3 billion for 2006.1 This figure represents the highest amount of benefit payments to Americans for a one-year period ever.

Of the total, 34 percent of the insurance benefit payments made by eight of the nation’s largest insurers covered home care expenses. Additionally, 30 percent of benefits paid were for assisted living costs and the remainder, 36 percent, was allocated toward nursing home care. The largest single claim paid to date was more than $875,000. In fact, the largest claims paid by leading insurers ranged from well over $350,000 to one approaching $900,000.

The data also revealed that approximately eight million Americans now own long-term care insurance obtained individually or through their employer. The researchers concluded that the increasing amount of benefits paid to policyholders is proof of the growing need for long-term care insurance.

To encourage more consumers to buy long-term care insurance, The National Association of Insurance Commissioners has developed the following consumer guidelines to help you select the right policy:

·   The policy should cover at least one year of nursing home or home health care, including intermediate and custodial care. Nursing home or home health care benefits should not be limited primarily to skilled care.

·   The policy should also provide coverage for Alzheimer’s disease if the policyholder develops it after purchasing the policy.

·   Inflation protection is critically important. The policy should offer a choice between:

o   Automatically increasing the initial benefit level on an annual basis.

o   A guaranteed right to increase benefit levels periodically without providing evidence of insurability.

·   Your insurer should offer you a coverage summary that describes the policy’s benefits, limitations, and exclusions, and also allows you to compare it with others. They should also provide a long-term care insurance shopper’s guide that helps you decide whether long-term care insurance is appropriate for you.

·   There should be a guarantee that the policy cannot be canceled, non-renewed, or otherwise terminated because you get older or suffer deterioration in physical or mental health.

·   The insurer should permit you to return the policy within 30 days of purchasing to receive a full premium refund.

·   No requirements should exist that policyholders:

o   First be hospitalized in order to receive nursing home benefits or home health care benefits

o   First receive skilled nursing home care before receiving intermediate or custodial nursing home care

o   First receive nursing home care before receiving benefits for home health care

1 2007 LTCi Sourcebook published by the American Association for Long-Term Care Insurance

How Likely Are You to Need Long-Term Care Services?

How Likely Are You to Need Long-Term Care Services?

The phrase “long-term care” refers to a number of medical and non-medical services provided to people suffering from a chronic illness or disability. Such services help these individuals to maintain their health and personal needs. Most long-term care providers assist people with daily activities like dressing, bathing, and using the bathroom. Long-term care can be provided at home, in an assisted living facility or in a nursing home.

According to the U.S. Department of Health and Human Services, in 2007, about nine million men and women over the age of 65 will need long-term care services. By 2020, 12 million older Americans will need long-term care. Most will be cared for at home. In fact, an agency study revealed that family and friends are the sole caregivers for 70 percent of all elderly Americans needing long-term care. The research also showed that people who reach age 65 have a 40 percent chance of entering a nursing home during their lifetime. About 10 percent of the people who enter a nursing home will stay for five years or more.

Another research project concerning the likelihood of needing long-term care services was conducted by Milliman USA, an actuarial consulting firm. The results of the study were published in the December 2005 edition of LTCi Sales Strategies magazine:

Out of every 1,000 65-year-old policyholders:

– 449 will need LTC services
– 106 will need LTC for > 2 years
– 59 will need LTC for > 3 years
– 34 will need LTC for > 4 years
– 20 will need LTC for > 5 years

The length of stay also varies significantly depending on the policyholder’s gender and whether the policyholder is married or single. The two “extremes” for a 65-year old are shown (that for a married male (lowest) and a single female (highest)):

Out of every 1,000 married 65-year-old males:

– 302 will need LTC services
– 20 will need LTC for > 2 years
– 12 will need LTC for > 3 years
– 7 will need LTC for > 4 years
– 4 will need LTC for > 5 years

Out of every 1,000 single 65-year-old females:

– 555 will need LTC services
– 70 will need LTC for > 2 years
– 51 will need LTC for > 3 years
– 35 will need LTC for > 4 years
– 23 will need LTC for > 5 years