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Outline of Coverage

Group Policyholder: United States Office of Personnel Management (OPM)
Insurer: John Hancock Life & Health Insurance Company
Federal Long Term Care Insurance Program (FLTCIP) Administrator: Long Term Care Partners, LLC
Group Policy Number: 900-003

1. NOTICES
2. PURPOSE OF THE OUTLINE OF COVERAGE
3. LONG TERM CARE INSURANCE COVERAGE
4. EFFECTIVE DATE OF COVERAGE and ACTIVELY AT WORK REQUIREMENT
5. BENEFITS PROVIDED BY THE FLTCIP
   • Covered Services
   • Benefit Amounts
   • Maximum Lifetime Benefit
   • Schedule of Benefits
   • Stay-at-Home Benefit
   • International Benefits
   • Alternate Plan of Care
   • Payment of Benefits
   • Eligibility for Benefits
   • Activities of Daily Living
   • Waiting Period
   • Waiver of Premium
   • Care Coordination Services
      
6. EXCLUSIONS AND LIMITATIONS
   • Exclusions
   • This Coverage Does Not Have a War Exclusion
   • Limitations
   • Coordination of Benefits
      
7. RELATIONSHIP OF COST OF CARE AND BENEFITS
   • Automatic Compound Inflation (ACI) option
   • Comparing 4% and 5% Automatic Compound Inflation
   • Future Purchase Option (FPO)
   • The Future Purchase Option and the Consumer Price Index
   • Comparisons of ACI and FPO
     • Purchase Age 50 - Examples
     • Purchase Age 65 - Examples
   • Other Benefits Changes (Upgrades and Downgrades)
      
8. WHEN YOUR PREMIUM MAY CHANGE
    
9. WHEN YOU MAY RECEIVE A PREMIUM REFUND
   • 30 Day Free Look / Cancellation of Coverage
   • Other Refunds of Premium
      
10. WHEN COVERAGE MAY BE CONTINUED OR ENDED
    • When Your Coverage Will End
    • Reinstatement of coverage
    • Late Payment Grace Period
    • Portability
    • Continuation of Coverage
       
11. PREMIUM
     
12. APPLYING FOR COVERAGE UNDER THE FLTCIP

Call: 1-800-LTC-FEDS (1-800-582-3337) (TTY: 1-800-843-3557)

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