Portland Community College | Portland, Oregon

Long Term Care Insurance with UNUM

You may purchase voluntary coverage for yourself and/or your spouse or domestic partner that helps to pay for  care when you are no longer able to care for yourself. This includes  community-based care, nursing home care and/or hospice care. If you elect to purchase this coverage for yourself during the first 31 days of benefits eligibility, there is a guaranteed issue provision for up to $6,000 per month for 6 years. Benefits eligible employees may also apply for long term care insurance during annual Open Enrollment, subject to underwriting. Please consult with benefits staff for details.

• Eligible employees include Full-Time and Part-Time: Faculty*, Classified, Managerial, Academic Professionals, and Confidentials. (*Part-time Faculty must be eligible for medical insurance through PCC. See eligibility rules on the Part-time Faculty Eligibility Requirements web page.)

PCC contracts with UNUM to provide voluntary Long Term Care (LTC) coverage. It pays a monthly benefit for care provided to people disabled by illness or accident when the subscriber is certified as chronically ill, and is unable to perform at least two activities of daily living or has severe cognitive impairment.

This benefit offers a guaranteed issue of $6,000 per month for 6 years for the employee only if you apply within the first thirty-one (31) days of benefits eligibility. 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 during this period. If you do not enroll during the guaranteed issue period, you may apply during annual Open Enrollment, but such applications are subject to approval by the underwriting department of UNUM. All LTC applications for your spouse or domestic partner are subject to underwriting.

As long as you continuously pay premiums on this policy, the premium cost will always be based on your age at the time you purchased the policy. In other words, if you purchase 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.

UNUM LTC offers the following plan features:

• Choose a monthly amount between $2,000 and $9,000 per month.
• Choose coverage for 3 years, 6 years or lifetime.
• Coverage levels range from 100% for nursing homes and assisted living facilities, to 50% for 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.

Before you enroll in LTC insurance, you must decide the following:

• Your monthly coverage amount from $2,000 to $9,000.
• Your coverage duration of 3 years, 6 years or lifetime.
• Whether you want a 5% inflation feature which provides an automatic annual benefit increase to help offset increases in the cost of care due to inflation.
• Whether you want Professional Care (provided by a licensed professional) or Total Home Care which provides a 50% benefit to cover the cost of in-home care provided in your home by anyone, including a family member.

UNUM Long Term Care Plan

Long term plan coverage information

Coverage Information
Pre-existing conditions	No pre-existing condition 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 lifetime
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, rehabilitation, 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 an Adult Day Care Facility)	50% of monthly benefit**
Adult Day 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.
Optional Choices
5% simple inflation, uncapped	Provides an annual automatic increase in benefit amount to help offset the rising cost of care due to inflation
Total Home Care	50% of monthly benefit and covers care provided in your home by anyone, including a family member.
General Provisions
Limitations and Exclusions	War or act of war, whether declared or undeclared Chronic illness caused by intentionally self-inflicted injuries or attempted suicide, while sane. Chronic illness caused by the commission of a crime for which the insured has been convicted under law, or caused by the insured’s attempt to commit a crime under law. Chronic illness caused by alcoholism, alcohol abuse, drug addiction or drug abuse. Any period of time while the insured is chronically ill and confined in a hospital, other than if the insured is confined to a long term care facility that is a distinctly separate part of a hospital – does not apply to bed reservation benefit. Any period of time while the insured is chronically ill and outside of the U.S., its territories or possessions or Canada for 30 consecutive days or longer if home benefits are not selected.
Portable coverage	Yes
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.

For more information, please contact the benefits team.