The optional Long-Term Care Insurance plan available through the Board, underwritten and administered by CNA, provides coverage when the subscribing member has a physical illness, disability, or cognitive impairment that makes it impossible for him or her to perform at least two of the basic Activities of Daily Living (ADLs) independently for at least 90 days. The ADLs include:

• bathing
• dressing
• using the toilet
• transferring to or from a bed or chair
• incontinence
• eating

These needs are not covered over the long term by health benefit plans like the Board of Pensions Medical Plan, the Board of Pensions Medicare Supplement program, or Medicare.

Four daily benefits rates are available: $100, $150, $200, and $250. This includes coverage for:

• nursing facilities
• home healthcare
• adult daycare
• an assisted living facility

These daily benefits are guaranteed for a total of five years, allowing for non-consecutive care. However, if the amount paid daily is not equal to the benefits rate selected by the subscriber, the coverage may extend beyond five years. For example, if the average daily room rate at a nursing home in Ohio is $200, but the covered member selected a daily benefit rate of $250, there is an excess of $50 per day. This amount will be applied to charges that extend beyond the five-year mark.

Eligibility

New Plan members who are employed by participating employing organizations may elect to enroll for coverage with guaranteed issue (not subject to medical underwriting) within 60 days of initial Benefits Plan enrollment. (This guaranteed issue provision does not apply at the start of a new service.) If you apply anytime thereafter, enrollment is subject to medical underwriting.

The following active Plan members' relatives up to age 90 are also eligible, subject to medical underwriting:

• spouses
• parents
• step-parents
• grandparents

Spouses and in-laws may maintain their coverage after a divorce from or death of the member as long as the coverage was purchased prior to the divorce or death.

Additional Information

• The premium depends on the member's age and the amount of coverage chosen. The premium remains level, so it will not increase as you age (unless you elect to buy-up).
• Most Plan members are direct billed for their premiums on a quarterly, semiannual, or annual basis (as determined by the member).
• Members enrolled for Long-Term Care Insurance coverage through CNA will be notified by CNA when they are holding a periodic buy-up option.
• The coverage is portable, meaning members can continue their policy even if they leave their current employer or retire.
• The policy includes coverage for an alternate plan of care. This program provides for non-standard benefits in place of covered services if the treatments are recommended by your physician or another authorized representative, such as a home health agency.

There are a number of considerations when evaluating whether or not to enroll for this Long-Term Care Insurance coverage. One of these is whether or not your budget will allow for the annual premium. Please talk with your financial advisor to determine if you are able to cover the premium.

Questions

For additional details about long-term care and long-term care insurance, please see the replay of our Long-Term Care Insurance Webinar.

Contact the Board of Pensions at 800-773-7752 (800-PRESPLAN) with eligibility questions.

Contact CNA at 800-528-4582 with questions about coverage options, premiums, and underwriting requirements or to request an enrollment packet.