Group Long Term Care (LTC)

The fully insured Group Long-Term Care (LTC) insurance is offered to you through CNA. For the 2009-2010 plan year, there are no premium or benefit changes. Individuals already enrolled in the CNA Guaranteed Benefit Increase Option (GBO) will have an opportunity during this 2009 Annual Enrollment to increase their coverage to keep pace with the rising costs for long term care services. Please read this section for more information.

The LTC plan is available to you, your spouse, adult children (25 years and older), parents, grandparents, parents-in-law and grandparents-in-law. Your eligible family members may apply without you having applied for coverage; however, only the premiums for you and your spouse may be deducted from your UT paycheck. Other enrolled family members will be set up for direct billing from CNA.

LTC insurance provides funds for necessary services when an individual becomes incapable of caring for himself or herself. Covered services can vary depending on the individual’s condition and can range from assistance in the home with day-to-day activities to care provided in a nursing home. It is important to note the need for long-term care does not just affect the elderly. The need for long-term care can occur at any age. Also, keep in mind this type of care is not covered by disability insurance. In addition, health insurance and Medicare will only pay for limited amounts of care. Medicaid does pay for LTC but only after you spend most of your financial assets.

LTC coverage is portable, so if you leave your employment with UT System, you can keep your LTC coverage, and your premium will remain the same.

 

Long-Term Care Benefit Summary

Daily Maximum Nursing Home Benefit	$100	$125	$150	$200
Daily Max for Community Based Care	$50	$72.50	$75	$100
Lifetime Maximum Benefit	$182,500	$228,125	$273,750	$365,000

The four choices for the maximum daily nursing home benefit are $100, $125, $150 and $200. This is the most that would be payable for each day of care in a nursing home. The Lifetime Maximum is equal to 1,825 times the Daily Maximum Nursing Home Benefit selected. (This is also the number of days in a 5 year time period.)

Inflation causes everything to cost more in the future than it may today. To help counter the effects of inflation, you may elect either the Guaranteed Benefit Increase Option, which will offer periodic opportunities to increase your existing coverage, or the optional Lifetime Automatic Benefit Increase (ABI). If ABI is chosen, on each anniversary of your coverage effective date CNA will increase each benefit amount in effect by 5%.

If you chose the GBO inflation protection when you first enrolled in the LTC plan, CNA will be notifying you during the 2009 Annual Enrollment period of this opportunity to increase your coverage to keep pace with the rising costs for long term care. For all currently insured employees and their spouses with the GBO, no Evidence of Insurability (EOI) is required. For retirees and all other participants with the GBO, no EOI is required if this is their first buy-up offer or if they accepted the last buy-up offer. If you would like to take advantage of the increase in coverage, you must complete and return the election form that will be included with the CNA letter. Your premium will be adjusted only for the cost of the additional benefit being added.

A person becomes eligible for LTC benefits when they are certified chronically ill by a licensed healthcare practitioner. Chronically ill means the person is unable to perform two or more activities of daily living (bathing, continence, dressing, eating, toileting, transferring) for at least 90 days without substantial assistance or supervision. Chronically ill can also mean that an individual has a severe cognitive impairment that can cause threats to the individual's health and safety without a great deal of supervision. The waiting period for benefits is 90 days, starting on the first day of chronic illness and ending 90 calendar days later.  Premiums are waived once a person begins to receive benefits.

For additional information, or to order a complete package of information including enrollment materials, please call CNA Customer Service at (888) 825-0353. Additional information is also available at www.ltcbenefits.com/uts.