Group Long Term Care. 2 WHAT IS LONG TERM CARE? Skilled, intermediate and/or custodial care provided to individuals who are unable to care for themselves,

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Presentation transcript:

Group Long Term Care

2 WHAT IS LONG TERM CARE? Skilled, intermediate and/or custodial care provided to individuals who are unable to care for themselves, including: Institutional Based Care Nursing Home Facility Alternate Care Facility Hospice Care Facility Community Based Care Home Health Care Adult Day Care / Adult Foster Care Assisted Living Facility Home Hospice Care

3 DON’T ASSUME YOU’RE COVERED Medical Insurance and HMOs Provides only limited coverage, if any, for skilled long term care Services must be medically necessary Designed to cover specific medical conditions Long term care needed for help with everyday activities - Custodial care is seldom covered Medicare Governmental programs are not adequate - Covers skilled care only Prior hospital stay is required Pays limited benefits Medicaid Individuals must “spend down” their assets Meet the states’ definition of poverty Long Term Disability Only replaces a portion of lost wages - Designed to cover ordinary and normal living expenses

4 WHY CONSIDER LONG TERM CARE INSURANCE? Long term care services are expensive Protection of personal assets Inadequacy of medical coverage and Medicare Preservation of independence Flexibility and control of care

5 LONG TERM CARE PLAN HIGHLIGHTS Discounted group rates Guaranteed coverage if enrollment occurs within 31 days of eligibility. Premiums do not increase with age Rates are based on the plan, optional benefits selected and your age on the coverage effective date Continuation of Coverage Coverage can be continued if you retire or leave No change in benefits or rates CNA will bill you directly for future premiums You do not have to enroll in the plan for your eligible family members to apply for coverage

6 WHO IS ELIGIBLE FOR COVERAGE? Regular Full Time and Regular Part Time employees - Actively-at- work Eligible for coverage on a guaranteed issue basis - no evidence of insurability required during the open enrollment period only New hires that apply for coverage during the first 31 days are guaranteed issue - no evidence of insurability required After the eligibility period: You must provide evidence of insurability and be approved Coverage is not guaranteed

7 WHO IS ELIGIBLE FOR COVERAGE? Other Eligible Groups Spouse of an employee May apply for coverage via the short form application Coverage is not guaranteed Must provide evidence of insurability and be approved

8 WHO IS ELIGIBLE FOR COVERAGE? Other Eligible Groups Parents, Grandparents, In-Laws, Retirees May apply for coverage at any time Complete the long form application Coverage is not guaranteed Must provide evidence of insurability and be approved May request their own Enrollment Package from CNA

9 HOW TO ENROLL Employees Complete employee enrollment form Select Plan Design Spouses Complete short form application Select Plan Design Employees can request forms from customer service, or download them by going to mccs.org/emp_bene.html and clicking on the CNA logo. mccs.org/emp_bene.html Mail completed forms/applications to CNA before the 31 day eligibility period is up!

10 Cancellation of Coverage If employees call customer service, they will be directed to their local HR Office. Have the employee or spouse (if applicable) fill out the Authorization to Cancel Long-Term Care Insurance Form. Inform the employee that the effective date of cancellation will be the 1 st of the month following receipt of this form by CNA. If deductions continue after the 1 st of the next month, CNA will refund the deductions. Mail the form to CNA Long-Term Care at the address noted on the cancellation form.

11 Other Issues That May Arise: If an Employee goes into Leave Without Pay status, CNA will begin automatic billing after 2 months of missed premiums. If an Employee leaves the MCCS organization, they can continue the benefit. CNA will begin automatic billing after 2 months of missed premiums.

12 Questions? For All Other Issues Employees Contact CNA’s CUSTOMER SERVICE: HOURS OF OPERATION: Monday thru Friday 8:00 a.m. to 6:00 p.m. (EST) For Cancellations or Customer Service Issues, HR Offices only Contact: KAREN OEHLSCHLAGER mccs.org (703)