Long Term Care Insurance with UNUM
Voluntary coverage is available for the employee and certain extended family members to provide a variety of services, such as community-based care, nursing home care and/or hospice care, for subscribers who are unable to care for themselves. If the benefits eligible employee elects to purchase this coverage during the first 31 days of eligibility there is a “guaranteed issue” provision for up to $6,000 and 6 years. Benefits eligible employees may also apply for long term care insurance during the fall open enrollment period of each year. Please consult with benefits staff for details.
- Eligible employees
- include full-time and part-time: Faculty*, Classified, Managerial, Academic Professionals, Confidentials. (*Part-time Faculty must be eligible for medical insurance through PCC. See eligibility rules on the Part-time Faculty Eligibility Requirements web page.)
UNUM Long Term Care (LTC) is insurance that pays benefits for providing people disabled by illness or accident with care such as nursing home or community based care when the subscriber is certified as chronically ill, and is unable to perform at least two of the adult daily living activities, or has severe cognitive impairment.
This benefit is one that permits "guaranteed issue" if you apply within the first thirty-one (31) days of employment in a benefited position with PCC. That means that even if you have pre-existing health conditions that might otherwise jeopardize your eligibility for this insurance, such as a heart condition, multiple sclerosis, or a family history of Alzheimer’s Disease, you cannot be refused coverage for yourself only up to $6,000 and 6 years. If this insurance is not elected during the first 31 days of eligibility, employees can apply for long term care insurance at open enrollment each year, but such applications are subject to approval by the underwriting department of UNUM.
As long as you continuously pay premiums on this policy, the premium cost will always be charged to you based upon your age at the time you purchased the policy. In other words, if you purchased this policy at age 30, you will always be charged the same rate as all other 30 year-olds for your coverage. So while the cost of coverage may increase, your premiums do not increase as you grow older or as your health changes.
The LTC with UNUM has the following plan features:
- Available benefits are between $2,000-$9,000 per month (in $1,000 increments).
- The duration of coverage can be for 3 years, 6 years or unlimited.
- The levels of coverage run from 100% for care from nursing homes and assisted living facilities, to 50% for services such as in-home professional care and/or adult day care.
- There are provisions for International coverage.
- UNUM LTC is completely portable should your employment with the college terminate.
- Certain family members are also eligible to receive these group rates on a self-pay basis. Contact UNUM at 1-800-227-4165 for more information.
If you want LTC insurance, then you must decide the following:
- Your monthly coverage amount from $2,000 to $9,000.
- Your coverage duration of 3 years, 6 years or unlimited years.
- If you want a 5% inflation feature which provides an automatic annual benefit increase to help offset the increases in the cost of care due to inflation.
- If you want Professional Care (care must be provided by licensed professionals) or Total Choice Home Care which provides a 50% benefit to cover the cost of in-home care provided in your home by anyone, including the use of a family member as the care provider.
UNUM Long Term Care Plan
|Pre-existing conditions||No pre-existing conditions exclusions will apply, but chronic illness* must occur on or after the coverage effective date.|
|Basic Plan Provisions|
|Available Monthly Benefit Amounts||$2,000 to $9,000 (in $1,000 increments)|
|Benefit duration options||3 years, 6 years or unlimited|
|Guarantee issue||Employees up to $6,000 monthly benefit for 6 years|
|Elimination period||90 days (cumulative within 730 days)|
|Lifetime maximum benefit||Monthly benefit x 12 months x benefit duration|
|Benefit payment eligibility||Inability to perform 2 out of 6 activities of daily living or severe cognitive impairment.|
|Issue ages||18+ for employees, 18 – 80 for family members|
|Covered Facilities||Nursing home, assisted living, hospice, rehabilitations, Alzheimer’s and residential care|
|International benefit||Coverage at 75% of the home care benefit for care received outside the U.S or Canada.|
|Nursing Home and Assisted Living||100% of monthly benefit|
|Professional Home Care and Community Care (provided by a licensed Home Health Care Agency, a licensed Home Health Care Professional, or in a Adult Day Care Facility)||50% of monthly benefit**|
|Adult Date Care, Adult Foster Care, Hospice Care and up to 21 days of Respite Care per year||50% of monthly benefit** Respite care benefits can be paid while a person is satisfying the elimination period – the days that a respite care benefit is paid apply towards the elimination period.|
|Home care by Relative||Available through Total Home Care Provision|
|Additional care benefit||A separate pool of $5,000 to cover services such as equipment and caregiver training to assist the insured living at home or in other residential housing. Pool will not reduce the insured’s lifetime maximum benefit and is payable during the elimination period.|
|5% simple inflation, uncapped||Provides an annual automatic increase in benefit amount to help offset the rising cost of care due to inflation|
|Total Choice Home Care||50% of monthly benefit and covers care provided in your home by anyone, including a Family Member.|
|Limitations and Exclusions|
|Waiver of premium||Yes|
* "Chronic illness" and "Chronically ill" mean:
- Members are unable to perform, without substantial assistance from another individual, two or more activities of daily living; or
- Members require substantial supervision by another individual to protect members from threats to member’s health and safety due to severe cognitive impairment.
** Benefits are payable on a pro-rated basis equal to 1/30th of the professional home care monthly benefit amount for each day care is received.
Monthly Premium Rate Information
See Long Term Care rates.
If you are interested in additional information about this self-pay long term care benefit, please contact the benefits team and/or fill out the Benefit Material Request form to have materials mailed to you.