Some LTC Blips Show Up On NAIC Radar Screen

By

Chicago

Long term care came up on the radar screen several times during the winter meeting of the National Association of Insurance Commissioners last month.

During a meeting of consumer representatives and regulators, Bonnie Burns, director of consumer education with California Health Advocates in Scotts Valley, Calif., described what she said could be a growing problem in the LTC market.

Burns told regulators how consumers who buy LTC insurance in one state and then make use of it in another may find they are not able to get the same kind of care they had previously received.

The rub is the way states license providers of LTC, she continued. For example, if a consumer purchases a policy in Florida and then moves to California to be near family, California’s licensing may result in some companies denying coverage.

States like California, according to Burns, license facilities that care for both those who need assisted living facilities and for those who do not. Burns explained that some companies have said that the person is living in an institutional setting and cannot collect home care benefits. However, according to Burns, the person is indeed living in an independent living apartment and can buy personal care services at additional cost from the building’s personnel or from a contractor to the building.

Another instance Burns cited is specialized care offered to patients with Alzheimer’s disease. Although, according to Burns, some LTC policyholders qualify for nursing home benefits, they may be denied such benefits because the facility they are in is not licensed as a nursing home.

Separately, LTC actuarial work is proceeding, Burt Jay, a representative for the American Academy of Actuaries in Washington, told regulators of the life risk-based capital working group. Work should be presented to regulators during the spring NAIC meeting, he added.

Among the points that will be examined are the impact of policy termination experience and the use of industrywide data and individual company data for claim variability, a progress report from the Academy stated.


Reproduced from National Underwriter Life & Health/Financial Services Edition, January 14, 2002. Copyright 2002 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.


Copyright 2002 by The National Underwriter Company. All rights reserved. Contact Webmaster