Long-Term Care Administered by Unum

If you are not a current participant, you may apply for coverage at any time with medical underwriting.

Today, Long Term Care (LTC) insurance is important for people of all ages if they want to reserve financial security and independence in the event of an extended disability. And despite popular misconceptions, the need for longer-term care isn’t restricted to the elderly, because many working-age adults have disabling injuries and illnesses as well

• More than half of long-term care claims submitted to UNUM are for people under age 65
• 20 million Americans are expected to need long term care services by 2030
• The demand for long term care services is projected to double by 2040
• Because women generally outlive men by several years, they face a 50 percent greater likelihood than men of entering a nursing home after age 65

Americans who need long-term care have more choice today. Many are able to remain in their homes and still receive the care they need. If you become disabled for any reason and could not live independently, how would you pay for the care you need? The financial impact of long-term care is significant, no matter where it is provided, and government programs don’t always pay for services:

• The national average cost of a private room in a nursing home is about $70,000 a year and an average stay is 24 to 26 months.
• The average hourly rate for a home health aide is $25. Based on this rate, four hours of home health aide services would total about $36,000 a year.
• The average base rate for a private room in assisted living care is about $33,000 per year.
• Medical insurance does not cover most long-term care cost. Medicare only covers short termed, skilled nursing home care following hospitalization, and only pays for short term assistance for care at home. Medicaid only pays after you have depleted your personal assets.

Eligibility

Any active employee of LSU AgCenter is eligible for benefits provided the following:

• Employed at 75% of full-time effort per pay period (avg. of 30 hours/week) or greater, and
• Appointed for a duration of at least one semester or 120 days or greater.

Enrollment and Effective Date of Coverage

Timely Applicant: If you enroll within your first 30 days of full-time employment, your coverage will be effective the first of the month following your first full calendar month of employment. This benefit is guaranteed for employee and spouse if it’s elected within first 30 days of eligibility of benefits.

Late Applicant: If an employee did not enroll into Long Term Care insurance within 30 days of their eligibility to obtain benefits, the employee can enroll at any time, but must complete the Evidence of Insurability Application before approval of coverage. Benefits will be effective once Unum approves their coverage.

Who Can I Cover?

Yourself as the Employee or Retiree, your spouse, your parents and/or grandparents and your spouse’s parents and/or grandparents may enroll in this plan. Coverage for retirees, your parents or grandparents is contingent upon them completing an Evidence of Insurability application and being approved by underwriting.

How is Eligibility for Benefits Determined?

The plan specifies two measures of functional capacity to determine eligibility for benefits. The first is the ability to perform routine day-to-day activities on your own. The second is based on cognitive skills. Benefits are payable if you are under the care of a physician and you lose the ability to perform at least 2 of the 6 specified “Activities of Daily Living” (ADL) or when you suffer a cognitive impairment that requires stand-by assistance or verbal cuing to ensure your own protection or the protection of others. The specified ADLs are bathing, dressing, toileting, moving from place to place, continence, and eating. ADL loss must occur while you are insured.

Terminating Employment

If the employee leaves LSU employment or the employee/family member becomes ineligible for coverage, the employee/family member will be able to port their coverage through UNUM and convert their Long Term Care insurance. Benefits and premiums will remain the same. The employee has 30 days from when they lose coverage to port their coverage.