Print-Friendly Page Version

Change Type Sizes

• U.S. Office of Personnel Management Sponsorship
• Backed by John Hancock & MetLife
• Designed for the Federal Family
• Competitive Group Rates
• Personalized Assistance
• Convenient Payment Options
• Other Features

Features of the Federal Long Term Care Insurance Program

Sponsorship by the U.S. Office of Personnel Management (OPM)

The Long-Term Care Security Act (P.L.106-265) was signed into law on September 19, 2000. The Act authorized OPM to offer a long term care insurance program designed exclusively for members of the Federal Family. The result is the Federal Long Term Care Insurance Program (FLTCIP).

OPM regulates this Program and plays an important role in ensuring that the FLTCIP remains up-to-date and competitive.

[ Back to Features ]
 

Backed by the Strength and Stability of John Hancock and MetLife

OPM selected John Hancock Life Insurance Company (John Hancock) and Metropolitan Life Insurance Company (MetLife) as the companies most qualified to offer insurance under the FLTCIP.

They have experience - offering long term care insurance for more than 15 years - and they provide the stability you need from an insurer. John Hancock and MetLife have consistently earned high ratings for financial strength and operating performance.

This Program is administered by Long Term Care Partners, LLC, a jointly held subsidiary of John Hancock and MetLife created exclusively for the Program.

 [ Back to Features ]
 

Designed Specifically for Federal Family Members

OPM has worked closely with John Hancock and MetLife to ensure this insurance coverage offers the kind of benefits and features that are most valuable to members of the Federal Family — today and tomorrow. For example:

• With the Comprehensive Option, you can choose your care setting, whether at home, in a nursing home, in an assisted living facility, or in a variety of other settings.
   
• Unlike many long term care insurance plans, the Comprehensive Option in the Program can provide benefits for approved care given at home by friends, family members, and other non-licensed caregivers. This informal care gives you added flexibility in determining where and from whom you receive long term care.
   
• Once you have coverage, it is portable. You can keep it as long as you continue to pay the required premium and have not exhausted your Maximum Lifetime Benefit. Even if you are no longer a member of an eligible group (e.g., you leave government employment), your premiums and coverage will not change because you left the group.
   
• Your insurance coverage is guaranteed renewable. It can never be canceled as long as you pay your premiums. It cannot be canceled due to your age or a change in your health. In addition, premiums can only increase if you are among a group of enrollees whose premium is determined to be inadequate and this increase must be approved by OPM.
   
• Your coverage includes a waiver of premium. Once you have completed your Waiting Period, the waiver of premium feature allows you to stop paying premiums while you are receiving benefits.

Get more information on benefits and options.

[ Back to Features ]
 

Competitive Group Rates

Thanks to negotiations on your behalf by OPM and the enormous buying power of a group as large as the Federal Family, you’ll find the premiums very competitive and the coverage among the most comprehensive available at any price. The Program does not pay commissions to sales agents.

Your premiums can change only with OPM’s approval and only on a group basis.

[ Back to Features ]
 

Personalized Assistance

The FLTCIP offers one-on-one assistance from our Certified Long Term Care Insurance Consultants (CLTCs).

Whether you’re requesting information, reviewing benefit options available under the Program or completing an application, these highly trained employees (who do not work on commission) can help you decide on a plan that will best meet your individual needs.

We adhere to the strictest service levels set forth by OPM. Our CLTCs take pride in providing the highest level of quality service to the Federal Family. Should you have any questions, please call us at the number below or email our Program Consultants.

In addition to personal assistance from our CLTCs, if you are approved for coverage and enroll, you will have unlimited access to the Program’s Care Coordinators.

Our Care Coordinators are registered nurses (RNs) who have worked extensively in the field of long term care. You can contact them to ask any questions you may have about long term care (even if you are not receiving benefits).

If you initiate a claim and are approved for benefits, Care Coordinators will work with you and/or your family members to develop a plan of care to meet your individual care needs.

They can also help you find high quality care providers in your area and communicate the results of state survey reports regarding service availability, quality, costs, and licensing.

Care Coordinators can also arrange for discounted services, monitor the care you’re receiving, and assist with changing your plan of care as your needs change. This service is personal because you can talk to the same nurse who knows your particular situation each time you call.

Unlike most long term care insurance plans, the FLTCIP also provides certain care coordination services to qualified relatives of enrollees at no cost. This can be invaluable in helping reduce the stress that may develop when a relative needs long term care, especially one who lives far away.

[ Back to Features ]
 

Convenient Payment Options

The Program offers the convenience of payroll and annuity/pension deductions for employees and annuitants, for themselves and/or their qualified relatives. These automatic premium deductions can ensure that your premiums will be paid on time. (This service is available to most enrollees.)

[ Back to Features ]
 

Other Features of the FLTCIP

• The FLTCIP was one of the first programs to use the National Association of Insurance Commissioners' (NAIC) rating guidelines, which are designed to produce stable premiums.
   
• The FLTCIP provides access to alternate plans of care. In certain circumstances, our Care Coordinators can authorize customized benefits for services that are not specifically covered under this Program. For example, if you select the Comprehensive Option, the Program may cover making your home wheelchair-accessible. This flexibility provides you with the cost-effective care and services you want and need.
   
• The Federal Program covers care provided by informal caregivers - those not licensed or employed by a home care agency. Unlike some other plans, the Comprehensive Option available under this Program also covers approved care provided at home by friends, family members, and other non-licensed caregivers.
   
• With the caregiver training benefit, the Federal Program pays up to seven times your Daily Benefit Amount (DBA) (with no Waiting Period) to train a family member or other informal caregiver to care for you.
   
• The Federal Program features international benefits that provide coverage for those who may require care outside the U.S. The Program will calculate benefits in the usual way except that it will pay benefits up to 80% of your DBA/Maximum Lifetime Benefit Amount.
   
• The Federal Program pays for bed reservations. If you are in an assisted living facility, nursing home or hospice facility and need to leave that facility for any reason (e.g., you need to be hospitalized), the bed reservations feature in your coverage will pay to hold your space for up to 30 days per calendar year.
   
• The Federal Program provides a respite care benefit. This provides you with temporary care if your caregiver (such as a family member) needs to take some time off.
   
• Unlike coverage under most long term care insurance plans, your coverage under the FLTCIP does not have a war exclusion. As a result, benefits may be payable for conditions due to war or acts of war, declared or undeclared, or service in the armed forces or auxiliary units.
  
  However, benefits are subject to a Catastrophic Coverage Limitation; if a Catastrophic Event (e.g., a war or act of terrorism) should occur, your Daily Benefit Amount would remain the same but the Benefit Period could be shortened if such a significant number of enrollees were impacted by this event that it threatened the financial security of the Federal Program. This provision will apply only if we determine that a Catastrophic Event has occurred. It will apply only to enrollees affected by the Catastrophic Event and to claims related to that Catastrophic Event.
   
• The Federal Program allows a third-party review of claims. If you disagree with a claims decision, and your appeal has been denied, you may request an independent third-party review. A third party, mutually agreed to by OPM and Long Term Care Partners, will provide a final and binding determination within 60 days of receiving all relevant information.
   
• If you select the Comprehensive Option and select (at an additional cost) the Weekly Benefit Amount option, you will have benefits for covered services calculated on a weekly basis. With this option, if your costs exceed your DBA on any particular day but the total of that week’s reimbursable long term care expenses does not exceed your Weekly Benefit Amount, then your expenses will be fully reimbursed. The Weekly Benefit Amount is equal to seven times your DBA.

[ Back to Features ]