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Long-term care (LTC) refers to a broad range of medical, personal, and social services provided to people who are unable to care for themselves over a relatively long period of time. Although most people think long-term care refers to care in a nursing home, care can also be provided at home by home health care workers, nurses, or therapists, or in a community-based adult day care center.
The vendor for the Public Employee Benefits Board (PEBB) for LTC insurance is John Hancock Mutual Life Company.
You are eligible to apply for group LTC insurance if you are:
You qualify for benefits when a licensed health care practitioner certifies that, due to a covered condition, you are dependent in at least two of six Significant Activities of Daily Living (SADLs) or you are cognitively impaired. A John Hancock patient advocate will verify this information.
You qualify for benefits when a licensed health care practitioner certifies that, due to a covered condition, you are dependent in at least two of six Significant Activities of Daily Living (SADLs) or you are cognitively impaired. A John Hancock patient advocate will verify this information.
The six SADLs are:
Three coverage options are available:
The Daily Maximum Benefit is the most the insurance will pay for covered services received on any given day. The Lifetime Maximum benefit is the total pool of money payable for covered long-term care services received while you are insured.
| Plan | Daily Maximum Benefit (DMB) | Lifetime Maximum Benefit (LMB) |
|---|---|---|
| Bronze | $100 | $109,500 |
| Silver | $130 | $237,250 |
| Gold | $160 | $292,000 |
You may receive up to :
Future Purchase Option - Included in your coverage is a Future Purchase Option (FPO) inflation protection provision. You may be offered additional amounts of coverage every three years to keep up with inflation. The amount of each adjustment will reflect a benefit increase of at least 5% compounded annually for the applicable period.
Automatic Benefit Increase - For an additional cost, you have the choice of replacing the FPO with an Automatic Benefit Increase (ABI) inflation protection provision. Instead of offering inflation amounts every three years at additional cost, the price is already calculated into your premium rate. Your benefit amounts will automatically increase every year at a rate of 5% of the Nursing Home DMB when in effect, while your premium remains level. no inflation will be offered under the ABI if your coverage is being continued in effect in a Reduced Paid Up basis as described below.
Reduced paid-up option allows you to stop making premium payments after paying premiums for at least three years. If you elect this option, you will retain a portion of the original coverage. When you exercise this benefit, you keep your full DMB amount, but the LMB is reduced.
There are some important exclusions to consider when applying for LTC insurance coverage, including:
Read your enrollment packet carefully to ensure that you understand the limits of this coverage.
Premiums are specific to the individual. For an individual rate packet and enrollment form, contact the John Hancock Mutual Life Company at 1-800-399-7271.
Contact the John Hancock Mutual Life Company directly at 1-800-399-7271 to request an enrollment form.
See also LTC Information & Resources.
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