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Important Legal Information
Please read the information in each link below carefully. Your application for insurance coverage under the Federal Long Term Care Insurance Program (FLTCIP) - received either online or via downloading, completing, and mailing a paper application - confirms that you have read and understand the information below.
- Applying and underwriting
- Authorization to use and disclose health information
- Authorization for automatic bank withdrawal or payroll/annuity deduction
- Agreement and acknowledgment
- Upon signing the section titled "Agreement and Acknowledgment" on your application, you acknowledge you are applying for insurance coverage under the Federal Long Term Care Insurance Program. All of the answers and explanations
you have given on your application, including your status as an eligible individual, are true and complete. You understand that the decision to approve your application will be based on your answers and explanations on your application. If
required, your medical records or answers to interview questions will also be considered.
You agree to immediately inform Long Term Care Partners in writing, if between the date you sign your application and the date your insurance coverage is effective (1) your health changes in a way that would cause any answer you have given
on your application to no longer be correct, or (2) you receive any medical advice or treatment from a physician or other health care practitioner for a condition that would affect an answer to any question on your application. You understand
that Long Term Care Partners may use information about such health changes or medical advice or treatment, whether provided by you or otherwise obtained, to reevaluate your application for coverage. You further understand that your coverage
will not go into effect as scheduled or will be voided if the information, if known previously, would have caused the carrier not to issue your coverage.
You understand you have the right to request a copy of this application at any time, but you also understand you will receive one automatically.
The company's right to increase premiums: You understand that your premium will not change because you get older or your health changes or for any other reason related solely to you. Premiums are not guaranteed. Premiums may only increase
if you are among a group of enrollees whose premium is determined to be inadequate. You understand that while the group policy is in effect, the U.S. Office of Personnel Management (OPM) must approve the change.
Caution: If you are approved for coverage, but you should not have been because one or more of your answers or explanations are incorrect or untrue, or fails to include all material information requested, we may have the
right to deny benefits or void your insurance. This is true even if you did not knowingly misrepresent the facts as shown in your medical records. We may also void your insurance at any time if we find that at the time of application,
you misrepresented your status as a member of an eligible group.
Note: Signing the section titled "Agreement and Acknowledgment" also confirms the elections you made in the sections titled "Plan Options," "Billing Options," and "Protection Against Unintended Lapse."
- If you rejected an automatic compound inflation option in the section titled "Plan Options" by choosing the future purchase option, you are confirming that you reviewed the descriptions and graphs of the inflation protection options in the
FLTCIP 2.0 Outline of Coverage. You also understand that if you elect an automatic compound inflation option, you may switch to the future purchase option at any time. And if you elect the future purchase option, you may request to change from the future
purchase option to the automatic compound inflation option, and should you make such a request:
- you will be required to provide, at your expense, evidence of your good health that is satisfactory to us; and
- the effective date of all future automatic compound benefit increases will be the anniversary of the first day of the month that next follows the date of our approval of your request.
- If you elected automatic bank withdrawal in the section titled "Billing Options," you are authorizing your bank to charge your account for such withdrawals, payable to Long Term Care Partners. This authorization will remain in effect until you,
your bank, or Long Term Care Partners terminates it by a 30-day written notice to the others. You will not receive any bills or other notices of the withdrawals from Long Term Care Partners. You agree that if the automatic bank withdrawal is not honored by
your bank, for whatever reason, Long Term Care Partners will have no liability for the payments.
- If you elected payroll or annuity/pension deduction from your own pay or annuity/pension in the section titled "Billing Options," you are authorizing Long Term Care Partners to deduct from your pay or annuity/pension the amount necessary to
pay the premiums for the FLTCIP coverage issued to you. If you elect payroll deduction, then we reserve the right to deduct from your annuity/pension or direct bill you the amount necessary to pay the premiums on your retirement. You can cancel your payroll
or annuity/pension deduction by contacting Long Term Care Partners to choose a different billing option.
- If you did not name someone in the section titled "Protection Against Unintended Lapse" to receive a notice if your coverage is about to lapse, you are confirming that you understand that such notices do not obligate such person in any way and
are not sent until 45 days after your premium was due but unpaid. You also understand that you may identify a person (and/or name a different person) to receive notice of pending lapse at any time in the future.
- Online application consent (online applications only)
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Federal family members can apply for coverage anytime—you do not have to wait for the next open season. Premiums are based on your age and the premium rates in effect at the time we receive your application—the younger you are when you apply, the lower your premium will be.