LTC

Overweight Americans More Prone To Cognitive Decline

According to new research published in the latest issue of The Journals of Gerontology Series A: Biological and Medical Sciences, individuals with higher midlife body mass index (BMI) scores had significantly lower general cognitive ability and significantly steeper decline than their thinner counterparts over time.

Why Advisors Need To Compare LTC Provisions

Understanding long term care insurance terminology is often the cause of great confusion and frustration for advisors as well as consumers.

Much of the benefits terminology was derived from the long term disability industry, where it also bewildered applicants. Today, many LTC policies use simpler and more understandable concepts, but assessing the terms carefully is still essential, because terms differ between contracts and they may involve tradeoffs from traditional comprehensive LTC insurance.

The MetLife Study of Boomers in the Middle

The study provides an in-depth look at Americans born 1952 - 1958. The Baby Boomer generation, typically, has been characterized as a bloc of people who think and act as one monolithic generation, when it actually comprises three separate cohorts. This study found that there are distinct differences between these Middle Boomers and their older and younger generation mates.

NAIC Panels Discuss LTC Morbidity Project, PBR Valuation Manual Section

The American Academy of Actuaries told state regulators it will be developing long term care morbidity tables.

Members of the Accident and Health Working Group at the National Association of Insurance Commissioners, Kansas City, Mo., heard about the LTC insurance valuation morbidity tables project early this week during a working group teleconference.

LTC Insurance Costs Up Slightly: Study

Premiums for long term care insurance rose about 2% to $723 a year for a base plan for a 55-year-old married individual, according to a study by the American Association for Long Term Care Insurance.

For a single individual in that age range, base protection would cost $1,060 annually, according to the annual Long Term Care Insurance Price Index published by the AALTCI, Westlake Village, Calif.

Reforming Long-Term Care in the United States: Findings from a National Survey of Specialists

Long-term care specialists—including consumer advocates, providers, public officials, and policy experts—who participated in a national survey generally agreed on the need for long-term care reform. Despite some differences, key constituent groups supported the establishment of government-sponsored financing strategies, a shift toward home- and community-based care, offering payment incentives to improve quality, and more effective regulation of nursing homes, home health care agencies, and assisted living facilities.

Adverse Selection and the CLASS Act

A proposal in the House and Senate healthcare reform bills, the CLASS Act, establishes a federal long-term care (LTC) program financed from participant premiums without any federal subsidy. The new LTC program is subject to guaranteed issue, and that, combined with its voluntary nature, subjects the CLASS Act to considerable adverse selection risk. This paper by Al Schmitz examines this risk while considering other likely consequences.

Long-Term Care Financing Reform: Lessons from the U.S. and Abroad (The Commonwealth Fund)

Broad health care reform legislation being considered by Congress would effect a major change in the way the United States finances long-term care. The Community Living Assistance Services and Supports (CLASS) Act would create a voluntary national long-term care insurance program. As lawmakers debate the potentially far-reaching proposal, they may learn from the experiences of other developed nations and from recent experiments in the U.S.

The future of long term care insurance is …

Industry insider Jesse Slome opines on LTCI's future - good and bad.

Metlife Mature Market Instute: Demographic Profiles

A series of publications provide a history of the generations born since the early 1900s. The profiles provide a snapshot of four generations. They look at demographics and, perhaps more importantly, the events occurring during their teen and young adult years that influenced their values and their viewpoints.

Milliman: Quite the combination: Hybrid products offer more effective safety net for seniors

From 2000 through the first half of 2009, sales of long-term care (LTC) insurance plunged—a phenomenon that would seem to defy demographic trends that show an increasing number of Americans turning 60 each year. Rate hikes, product uncertainties, and an intractable reluctance by consumers have made LTC insurance a difficult sale. But a number of market and regulatory factors have come together to spur innovation in combination products that pair LTC with an annuity or life insurance. Could this next generation of hybrid products be the solution that consumers and insurers have been seeking?

Long–Term Care News–December 2009

Newsletter of the SOA's Long Term Care section.

LTC Awareness Month Finds Americans Still in Dark About Long-Term Care

Survey shows while vast majority are aware of the significant likelihood of needing long-term care, 83% have no plan for dealing with it.

Executive Long-Term Care In Today’s Challenging Economic Environment

Stock prices have reduced retirement funds by nearly 50 percent for the Baby Boomer Generation. With tens of millions approaching retirement, can long-term care provide a cost effective solution?

LTC Rates Continue To Rise

The recession may be depressing prices for some goods and services, but the cost of nursing home care, home health care aides and assisted living services is still going up.

Risk Matters: LTC Quarterly (Gen Re)

This edition looks at recent evidence concerning the frequency and burden of falls, the value of exercise programmes and the prediction of future falls.

Percentage of Adults ≥65 Yrs Limited in Activities of Daily Living (ADLs), by Poverty Ratio/Number of Limitations National Health Interview Survey

During 2003-07, among adults aged ≥65 years, the poorest (<100% of the poverty threshold) were approximately twice as likely to need help with ADLs as the least poor (≥300% of the poverty threshold). Older adults were more likely to have 3-6 ADLs than 1-2 ADLs, except for the poorest group where the difference was not statistically significant.

Milliman: Combo LTC annuities: Here they come

The Pension Protection Act of 2006 included some key provisions that addressed for the first time the taxation of combination annuity plans featuring long-term care insurance (LTCI). The rules apply only to nonqualified annuities coupled with tax-qualified long-term care riders.

Gen Re Risk Insights: August 2009

The latest issue looks at:

  • Underwriting the Elderly - Findings From a U.S. Survey
  • Beyond Containment but Well Into the Guessing Game - The Novel A/H1N1 Influenza Pandemic
  • Evidence-based Underwriting - Rheumatoid Arthritis

NEW STUDY EXAMINES LONG-TERM CARE INSURANCE CLAIMS

The largest open long-term care insurance claim has surpassed $1.2 million in paid benefits, according to a just-released report from the American Association for Long-Term Care Insurance. The claimant, a woman, purchased coverage at age 43, paying an annual premium of $1,800. Three years later her claim began and has continued for almost 12 years. [Note: Payment of policy premiums ceases when an individual is receiving policy benefits.]

2009 LONG TERM CARE INSURANCE PRICE INDEX

A 55-year-old individual considering long-term care insurance protection can expect to pay $723-per-year for a base level of protection if they are married or $1,060 if they are single according to the 2009 Long-Term Care Insurance Price Index published by the American Association for Long-Term Care Insurance. Across various age groups, costs for coverage increased about two percent from the prior year.

Actuaries Urge Need for Risk Management and Continuity Planning With H1N1 Pandemic

With the H1N1 flu spreading globally, the World Health Organization (WHO) has declared it a pandemic. This marks the first global flu epidemic in 41 years with reports of the flu coming from Mexico, U.S., Australia and many more locations. In response to this development, members from the Society of Actuaries (SOA) are advising businesses to revisit and/or create business continuity and preparedness plans.

Health and Ageing

The Geneva Association's April 2009 Information Newsletter spotlights long-term care and aging issues from a global perspective. The guest editorial by Christopher Ball and Ross Campbell discusses instruments that produce the right information for underwriters and claim managers to better insure long-term care risks. Housing, Medicare and long-term care insurance are also examined.

Faster, Friendlier Older-Age Underwriting On The Way

With the flowering of “financial services,” life insurers are now seriously questioning the appropriateness of cumbersome, time-consuming and blatantly customer-unfriendly screening tests.

Group Long-Term Care Insurance Employer Long-Term Care Insurance Study Data

When it comes to buying long-term care insurance protection, there are some significant differences between those purchasing group (employer-sponsored) coverage with those purchasing on an individual basis (typically through an insurance professional).

180,000 Americans Receive LTCi Benefits

Some 400,000 individuals purchased long-term care insurance protection in 2008 according to a just-released report. The overwhelming majority (84%) of individual buyers in 2008 were younger than age 65 and three-fourths (76%) selected a more affordable approach to this protection by opting for coverage for a specific number of years.

The annual study conducted by the American Association for Long-Term Care Insurance, the industry's professional trade organization, analyzed data on 215,000 buyers of individual long-term care insurance protection.

Ageing Health Costs

Presentation at Institute of Actuaries Australia 2009. (Audio, slides and synopsis available.)

The Economics of Long Term Care

Presentations made at the 5th Geneva Association Health & Aging Conference No: 348 November 2008.

Long-Term Care Insurance Tax-Deductibility Rules

Recognizing that government can't pay the bill for long-term care, federal and a growing number of state tax codes now offer tax incentives to encourage Americans to take personal responsibility for their future long-term care needs. (The American Association for Long-Term Care Insurance)

Penn Treaty Aside, LTC Reinsurance Market Is Viable - Companies/Financial - Life and Health Insurance News

Despite the experience of Penn Treaty Network America in Allentown, Pa., which was recently put into rehabilitation, experts say reinsurance is available for long term care carriers.

The Older Age Insurance Market: Cognitive Function Mortality Results

Presentation by Transamerica Reinsurance's David Wylde at the 2009 MUD Group meeting.

2009 Long-Term Care Insurance Sourcebook Published

The 2009 Long-Term Care Insurance Sourcebook, a compendium of the most current relevant research and data regarding long-term care and insurance products, has been published by the American Association for Long-Term Care Insurance (http://www.aaltci.org).

Individual Long Term Care Insurance Premium Falls 23 Percent in the Fourth Quarter, LIMRA Reports

After a promising start in 2008, individual long-term care insurance (LTCI) premium fell 23 percent in the fourth quarter, ending 2008 down seven percent, according to LIMRA’s Individual Long-Term Care Sales survey.

Economic Uncertainty Will Affect LTC Insurance This Year

As 2008 came to an end, many of us found ourselves wondering what the adjective 'long-term' means in the context of wildly gyrating stock markets and the day-to-day uncertainty this turbulence has created for countries around the globe."

Understanding the Underwriting Challenges of the Age 65-Plus Market

When working with an older client in the planning process, the individual’s health may be a critical component of the underwriting equation. Right from the start, there are certain issues that should be taken into consideration.

Health Risk Appraisal (The Merck Manual of Geriatrics)

A form of screening to identify persons who are likely to need complex health care, who are at risk of adverse health outcomes, and who will benefit from care management programs.

John Hancock Announces Results of National Long -Term Care Cost of Care Study

John Hancock has announced the results of an in-depth study of the 2008 costs of long-term care (LTC), which found that LTC costs have been increasing in line with inflation in recent years.

LTC Claims Management of the Future

Presentation at the SOA Annual Meeting & Exhibit, October 2008.

Aging Population: Opportunities and Risks

Presentation from SOA Annual Meeting in Orlando, October 2008.

Follow-up: Comfort Food for an Actuary: Cognitive Testing in Underwriting the Elderly

A follow-up to the article originally published in the May 2006 edition of Product Matters!, the newsletter of the SOA Product Development Section.

Pricing and Underwriting of New Combination Products—Will We Get It Right?

The Pension Protection Act of 2006 includes some important tax rules affecting combination plans that feature life or annuity plans coupled with long-term care insurance (LTCI). Many of these rules will become effective Jan. 1, 2010. In some cases, the rules will be applicable to policies on the books prior to that time. Among the benefits resulting from these new rules, the most notable would seem to be the clarification of tax treatment of annuity/LTCI combination products.

Highlights from the 2008 Living to 100 Symposium

Changes in longevity, biological perspectives, mortality trends and more.

2009 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services and Home Care Costs

Price rollbacks throughout the U.S. economy during the past year did not apply to long-term care service providers, according to the 2009 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs. Private room nursing home rates rose 3.3% to $219 per day or $79,935 per year, while assisted living also rose 3.3% on average to $3,131 per month. Home health care aides now cost an average of $21 per hour, a 5% increase; adult day services run $67 per day, a 4.7% increase.

Older-Age Screening Tests Coming Into Focus For Life Underwriters

Potential testing options in underwriting people over age 65 are on the move. (link updated)

Mild Cognitive Impairment (MCI) Teleconference

...from the Long Term Care International Forum.

Living to 100: Survival to Advanced Ages International Symposium

Handouts from the Living to 100: Survival to Advanced Ages International Symposium for sessions such as:

  • Distinguishing Health Status For Advanced Ages - Faye S. Albert, John M. Bragg, James C. Brooks, Dr. Bob Gleeson, Steven K. Holland, Ashely Thomas
  • Demographic Implications of Aging Populations Internationally - Robert L. Brown, Roberto Ham–Chande, Steven G. Prus, N. V. Subramanyan
  • Quality of Life of Elderly - Beverly J. Orth, Anna M. Rappaport,Eric Stallard

Milliman - Healthcare - True Group Long-Term Care Advisor - Overcoming LTC barriers

It is no secret that the long-term care insurance (LTCI) industry is having trouble offering products with a convincing and an attractive value proposition. In a recently released report, Conning Research & Consulting, Inc. reminds us that from an economics point of view, in order for a consumer to purchase a product, the product must 1) satisfy a perceived need or a want for which the consumer is personally responsible and 2) have an acceptable price. It appears that there are large gaps between LTCI consumers and insurers in both of these areas. (link updated)

Gen Re LTC Quarterly Digest Summer 2008

There are threee major strands to the review of the last quarter (April - June 2008) papers with relevance to long term care insurance, which are discussed in this issue. (link updated)

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