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• Sponsored by OPM
• Supported by John Hancock
• Designed for the Federal Family
• Knowledgeable program representatives
• Convenient payment options
• Other Features

Features of the Federal Long Term Care Insurance Program

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

The Long-Term Care Security Act (P.L.106-265) authorizes OPM to offer a long term care insurance program designed exclusively for members of the Federal Family.

OPM regulates the Federal Long Term Care Insurance Program (FLTCIP) and plays an important role in ensuring that the FLTCIP remains up-to-date and competitive—a valuable benefit not found in other long term care insurance programs.

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Supported by the strength and stability of John Hancock Life & Health Insurance Company

OPM selected John Hancock Life & Health Insurance Company (John Hancock) to provide the group policy for the FLTCIP’s second 7-year contract term starting in 2009.

John Hancock Life & Health Insurance Company has experience offering long term care insurance for more than 20 years and provides the stability you need from an insurer. John Hancock consistently earns high ratings for financial strength and operating performance.

Long Term Care Partners, LLC, administers the FLTCIP on behalf of John Hancock Life & Health Insurance Company.

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Benefits designed specifically for the Federal Family

OPM has worked closely with John Hancock Life & Health Insurance Company to ensure this insurance coverage offers the kind of benefits and features that are most valuable to members of the Federal Family today and in the future.

Features and services

• Home, assisted living and nursing home care
  
  You can choose your care setting, whether at home, in an assisted living facility, in a nursing home, or in a variety of other settings. Additionally, the FLTCIP covers care provided in the home by friends, family members, and other unlicensed caregivers.
   
• Stay-at-home benefit
  
  The FLTCIP offers a stay-at-home benefit which can pay benefits for numerous options that support care in a home environment such as care planning visits, home modifications, an emergency medical response system, durable medical equipment, caregiver training, and home safety checks.
  
  
• Portable coverage
  
  Once you have coverage, it is portable. You can keep it as long as you continue to pay the required premiums and have not exhausted your maximum lifetime benefit, even if you are no longer a member of an eligible group (for example, if you leave government employment).
   
• Guaranteed renewable
  
  Your insurance coverage is guaranteed renewable. It can never be canceled by the insurance carrier as long as you pay your premiums. It cannot be canceled due to your age or a change in your health.
   
• Waiver of premium
  
  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 the benefits and options under the FLTCIP.

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Access to knowledgeable program representatives

Program Consultants can assist you at every step

The FLTCIP has extremely knowledgeable program consultants who can help you every step of the way. Whether you’re requesting information, reviewing benefits, or completing an application, these highly trained employees can help you decide on a plan that will best meet your individual needs.

One very popular service requested from the FLTCIP consultants is a personalized rate quote. Using the rate quote, program consultants can demonstrate the wide range of benefits available and the costs associated with each.

Our program consultants take pride in providing the highest level of quality service to the Federal Family and adhere to the strictest service levels set forth by OPM. Should you have any questions, please call us or email our program consultants.

Care coordinators understand your individual care needs

If you are approved for coverage and enroll, you will have unlimited access to the FLTCIP’s care coordinators. They 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 relay the results of state survey reports regarding service availability, quality, costs, and licensing. Gaining access to this level of detailed information allows you to make a knowledgeable decision about which provider is best for you.

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 care coordinator 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.

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Convenient payment options

The FLTCIP offers the convenience of payroll and annuity/pension deductions to 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.)

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Other features of the FLTCIP

• Alternate plan of care
  
  In certain circumstances, our care coordinators can authorize customized benefits for services that are not specifically covered under the FLTCIP. For example, under an alternate plan of care, we will consider a facility that is not normally covered under the FLTCIP if it meets your needs. The flexibility of an alternate plan of care allows the FLTCIP to provide you with benefits for cost-effective care and the services you want and need.
   
• Generous informal caregiver provisions
  
  The FLTCIP covers approved care provided at home by informal caregivers such as friends, family members, and other non-licensed caregivers. When informal care is provided by non-family members, it is covered for the benefit period you’ve selected. When informal care is provided by family members, it is covered for up to 500 days of care in your lifetime. Informal caregivers cannot have lived with you at the time you became eligible for benefits, but they can live in your home after you become eligible for benefits.
   
• Caregiver training
  
  With the caregiver training benefit, the FLTCIP pays up to seven times the daily benefit amount (DBA) (with no waiting period) to train a family member or other informal caregiver to care for you.
   
• International benefits
  
  Because the FLTCIP was designed exclusively for the Federal Family, it features international benefits that provide coverage for those who may require care outside the United States. When you receive such services, the FLTCIP pays benefits up to 80% of the benefit amounts shown on your Schedule of Benefits. If your Schedule of Benefits shows that you have an unlimited maximum lifetime benefit, benefits payable for any covered services you receive outside the United States will be limited to 10 years.
  
  
• Bed reservations
  
  If you are in an assisted living facility, nursing home or hospice facility and need to leave that facility for any reason (for example, you need to be hospitalized), the bed reservations feature in your coverage will pay up to 100% of the daily benefit amount for up to 60 days per calendar year to hold your space.
   
• Respite care
  
  This benefit provides you with temporary care if your caregiver (such as a family member) needs to take some time off. Respite care is covered up to 30 times the daily benefit amount per calendar year and there is no waiting period requirement.
   
• No war exclusion
  
  Unlike coverage under most long term care insurance plans, 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.
   
• Third-party review of claims
  
  If we deny your appeal of benefits eligibility or of a claims decision, you may request an independent third-party review. A third party, mutually agreed to by OPM and Long Term Care Partners, will review our evaluation of your medical condition or functional capacity and will provide a final and binding determination within 60 days after we receive your request for appeal.
   

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