Long Term Care Policy Worksheet Instructions

Index ID is the identifier you assigned to the policy in the earlier exercise.

Annual Premium is the total amount you pay for the policy in a year. If you make monthly payments, multiply your monthly premium by 12; if quarterly, multiply by 4; if biweekly, by 26.

Level Premium is a premium that does not change over time.

Waiver of Premium is a policy provision that guarantees that the insurance will continue in force without the payment of premiums after you have established that you are disabled, as defined by the policy, and continue during the entire term of disability.

Insurer’s Financial Strength Rating must be obtained by either telephone or the Internet. You may use any of the raters listed in there, but make sure you obtain the rating for the actual company that underwrites your policy.

Contact information for the insurance company should be located on the policy. If not, call your agent and obtain it for your records.

Contact information for your agent or group affiliates, if any, should be stored with your policy. If not, write it down and store it with your policy.

Policy or Identification Numbers: The number used by the company to identify your particular insurance contract to the insurance company.

Identity and Birth date(s) of Insured(s): Name all persons insured, and list their birthdates.

Noncancellable and guaranteed renewable: Examine your policy to see if you have the right to renew your policy despite claims made, and circle yes/no on the worksheet; also see if you have protection against cancellation by the insurance company despite claims made, and circle yes/no on the worksheet (which, by the way, also protects against premium increases).

Nonforfeiture Benefits: examine your policy to see if a form of a cash value is paid up during the life of the policy, and if it is available if you surrender the policy. If your policy accrues such values, it has a nonforfeiture benefit. Circle yes/no on the worksheet.

Adult Day Care Benefit: This is a benefit for a special community-based adult day care center. Adult day care provides a structured, supervised, social environment to support care needs. The adult day care center must be state-licensed or certified. Circle yes/no on the worksheet.

Inflation Benefit: This is a benefit that will allow your insurance policy to keep up with increasing costs over time. Check you policy to see if it has an annual percentage increase in the benefits to keep up with increasing long-term care costs (circle yes/no) and, if so, note what the annual increase percentage is, and whether it is tied to an index (and, if so, what index).

Daily Home Care Benefits: These are benefits that are provided in your home, as opposed to a facility such as a nursing home. Note the amount of the benefits and whether there are any limitations on the type of services covered or conditions under which such services will be provided.

Home Care Requiring Hospital Stay First: Note (yes/no) whether your policy requires as a condition for eligibility for home care benefits whether you must commence long-term service upon discharge from a hospital or nursing home. Daily Nursing Home Benefits: Note the amount of the benefits and whether the policy fails to include coverage for (1) skilled care, (2) intermediate care, (3) custodial care, (4) sheltered care, or (5) assisted living.

Waiting Period: Note whether your policy has a waiting period and, if so for how long.

Maximum Benefits: Note whether your policy has a maximum benefit limitation for a single covered period of care; also whether there is a maximum lifetime benefit for all covered periods of care.