FLTCIP Frequently Asked Questions - New Contract

Read the Federal Register Notice of the Enrollee Decision Period for Current Enrollees.

Select a question below:

  • Why was a premium increase needed?
  • Because long term care insurance is a complex, experience-based product, many factors are considered at the time premium rates are established. Examples include the frequency and severity of particular medical conditions, expected lifespan of enrollees, length of time an enrollee is expected to keep his or her coverage, cost of care, estimated returns on investment, and overall program expenses. As the program matures, these factors can change over time. Unfortunately, analysis of the Federal Long Term Care Insurance Program (FLTCIP), using updated assumptions based on identified trends and actual claims experience, indicated that the FLTCIP premiums were not sufficient to meet the program's future, projected claims costs. As a result, there was a need to increase premiums.
  • Does the 2016 enrollee premium increase have anything to do with the new contract award?
  • The FLTCIP law requires that premiums must reasonably and equitably reflect the cost of benefits and limits the U.S. Office of Personnel Management's (OPM's) contracts with insurance carriers to seven years. OPM went through a full and open competitive bidding process for the third seven-year FLTCIP contract term and awarded the contract to John Hancock Life & Health Insurance Company (John Hancock), the prior carrier and single bidder. John Hancock proposed significantly higher premiums because analysis of the program, using updated assumptions based on identified trends and actual claims experience, indicated that the FLTCIP premiums would not be sufficient to meet the future, projected costs of the benefits. The new premium rates are those established as a result of this competitive process.
  • Are you planning to raise premium rates again in the future?
  • John Hancock Life & Health Insurance Company, the insurer of the FLTCIP, continuously monitors the experience (e.g., the severity of certain medical conditions, expected lifespans, returns on investment, and overall program expenses) of the FLTCIP's inforce policies to ensure that premium rates are adequate. Based on our considered analysis, we believe at this time that the increased premium should be sufficient to meet the program's future, projected claims costs. However, new information could affect future conclusions about the FLTCIP's premium sufficiency. We cannot guarantee that there will be no future premium increases.

    Premiums are not guaranteed and could increase again in the future. Your premium will not change because you get older or your health changes or for any other reason related solely to you. Premiums may only increase if you are among a group of enrollees whose premium is determined to be inadequate and OPM approves the change.
  • What is the policy provision that allows you to increase my premium?
  • In the FLTCIP Benefit Booklet, there is a section titled "When We May Increase Your Premium," which states that we reserve the right to increase your premium in the future. However, we cannot single you out for a premium increase and may only increase your premium if you are among a group of enrollees whose premium is determined to be inadequate and OPM approves the change.
  • Who was impacted by the 2016 enrollee premium increase?
  • Most FLTCIP enrollees were impacted by the premium increase. The premium increase was effective on November 1, 2016, and those impacted included:
    • enrollees whose age at purchase was 79 years or younger
    • enrollees who had standard FLTCIP coverage and were not enrolled in the FLTCIP’s Alternative Insurance Plan
    • enrollees who applied for coverage before new application rates were raised on August 1, 2015
    • enrollees who were not eligible for benefits or awaiting a decision on a pending claim
  • Who was not impacted by the 2016 enrollee premium increase?
  • The following FLTCIP enrollees were not impacted by the 2016 premium increase:
    • enrollees whose age at purchase was 80 years or older
    • enrollees who were currently enrolled in the FLTCIP's Alternative Insurance Plan
    • enrollees who applied for coverage on or after new application rates were raised on August 1, 2015
    • enrollees who were eligible for benefits or awaiting a decision on a pending claim*
    * In the event your condition improves so that you are no longer eligible for benefits, or your pending claim is not approved, then your coverage, if you have not exhausted your maximum lifetime benefit, will be subject to a premium increase.

    Note: You may not have been impacted by the 2016 enrollee premium increase; however, this does not mean your premiums are guaranteed. Your premium will not change because you get older or your health changes, or for any other reason related solely to you. Premiums may only change if you are among a group of enrollees whose premium is determined to be inadequate and OPM approves the change.
  • I was eligible for benefits during the 2016 Enrollee Decision Period. Will my premium increase?
  • If you were eligible for benefits during the 2016 Enrollee Decision Period and are currently still eligible for benefits or awaiting a decision on a pending claim, you are not impacted by the premium increase at this time.

    In the event that your condition improves so that you are no longer eligible for benefits, or your pending claim is not approved, then your coverage, if you have not exhausted your maximum lifetime benefit, will be subject to a premium increase. At that time, we will send you detailed information about any changes to your premium, including personalized options to help reduce the impact of the premium increase.

    If you have questions about your coverage, please call our Customer Service Center at 1-800-LTC-FEDS (1-800-582-3337) TTY 1-800-843-3557 or use our secure email form to contact us by email.
  • I am awaiting a decision on a pending coverage change, submitted prior to the 2016 Enrollee Decision Period. Will my premium increase?
  • Once a decision on your pending coverage change is made, either your current coverage or new coverage, if approved, will be subject to a premium increase. At that time, we will send you an offer package with detailed information about any changes to your premium and personalized options to help reduce the impact of any premium increase.

    If you have questions about your coverage, please call our Customer Service Center at 1-800-LTC-FEDS (1-800-582-3337) TTY 1-800-843-3557 or use our secure email form to contact us by email.
  • Why didn't you advise me that the long term care insurance premium rates would increase when I originally enrolled?
  • In the FLTCIP Benefit Booklet sent to you when you originally enrolled, there is a section titled "When We May Increase Your Premium," which states that we reserve the right to increase your premium in the future. However, we cannot single you out and raise your premium because of your advancing age, declining health, claim status, or for any other reason related solely to you. We may only increase your premium if you are among a group of enrollees whose premium is determined to be inadequate and OPM approves the change.
  • If I selected an option to change my coverage during the 2016 Enrollee Decision Period, can I change back to my previous coverage after the effective date?
  • If you selected an option to change your coverage and you are not satisfied with your new coverage, you may return to your prior coverage within 30 days after you receive your new schedule of benefits. To do this, we must receive your notification in writing within 30 days at Long Term Care Partners, LLC, P.O. Box 797, Greenland, NH 03840-0797. After 30 days, you must submit a request to change your coverage, which may require additional underwriting and/or a higher premium.

    If you have questions about your coverage, please call our Customer Service Center at 1-800-LTC-FEDS (1-800-582-3337) TTY 1-800-843-3557 or use our secure email form to contact us by email.
  • Can I make changes to my coverage not provided in my 2016 Enrollee Decision Period offer package?
  • You may request changes not provided in your 2016 Enrollee Decision Period offer package, but some changes may require underwriting and/or a higher premium.

    If you request a decrease to your coverage, your new coverage and premium will be effective the first day of the month following your request. If you request an increase to your coverage, you must submit an application and undergo medical underwriting, answering questions about your health. If we approve your request for an increase, your new coverage and premium will be effective the first day of the month following our approval.

    If you wish to make changes to your coverage outside of the personalized options in your offer package, please call our Customer Service Center at 1-800-LTC-FEDS (1-800-582-3337) TTY 1-800-843-3557 or use our secure email form to contact us by email.
  • What happens if I did not respond by the 2016 Enrollee Decision Period deadline?
  • If you did not respond by September 30, 2016, your coverage remains the same and your premium increased, effective November 1, 2016.

    If you would still like to select an option provided in your 2016 Enrollee Decision Period offer package, you may do so as long as you notify us in writing within 30 days after you receive your new schedule of benefits. Please send your written notification to Long Term Care Partners, LLC, and P.O. Box 797, Greenland, NH 03840-0797. After 30 days, you must submit a request to change your coverage, which may require additional underwriting and/or a higher premium.

    If you have questions about your coverage, please call our Customer Service Center at 1-800-LTC-FEDS (1-800-582-3337) TTY 1-800-843-3557 or use our secure email form to contact us by email.
  • What happens if I missed the 2016 Enrollee Decision Period deadline for reasons beyond my control?
  • Please notify us immediately if you were unable to meet the deadline by calling our Customer Service Center at 1-800-LTC-FEDS (1-800-582-3337) TTY 1-800-843-3557 or using our secure email form to contact us by email.
  • Can I make changes to my coverage now that the deadline for submitting my personalized option selection has passed?
  • If you would still like to select an option or change to a different option provided in your 2016 Enrollee Decision Period offer package, you may do so as long as you notify us in writing within 30 days after you receive your new schedule of benefits. Please send your written notification to Long Term Care Partners, LLC, P.O. Box 797, Greenland, NH 03840-0797. After 30 days, you must submit a request to change your coverage, which may require additional underwriting and/or a higher premium.

    If you have questions about your coverage, please call our Customer Service Center at 1-800-LTC-FEDS (1-800-582-3337) TTY 1-800-843-3557 or use our secure email form to contact us by email.
  • If I cancel my coverage, can I request to have it reinstated as a later date?
  • Yes. If your coverage ends because you did not pay your premium when due, your coverage will be reinstated as of the date it ended if, within six months of the date your coverage ended, you:
    • submit evidence satisfactory to us that you suffered a cognitive impairment or loss of functional capacity before the expiration of the 30-day grace period for payment of your premium, and
    • submit all past due premiums
    If your coverage ends because you canceled it more than 30 days after your 30-day cancellation period or did not pay your premium when it was due, your coverage may be reinstated as of the date it ended if, within 12 months of the date coverage ended, you

    • request reinstatement, and
    • submit, at your expense, evidence of your good health that is satisfactory to us, and
    • submit all past due premiums
    If your coverage is reinstated, your premium will be based on your age as if your coverage had continued without interruption. After 12 months from the date coverage ended, you must reapply for coverage and, if you are eligible for coverage, your premium will be based on your age at the time you submit your application.
  • What is the contingent benefit upon lapse?
  • The contingent benefit upon lapse is a paid-up, limited benefit that is a consumer protection feature built in to your FLTCIP coverage. If your premium increases beyond a certain percentage as specified by the National Association of Insurance Commissioners, this benefit allows you to stop paying premiums and provides paid-up coverage with a reduced level of benefits. If you are eligible to exercise the contingent benefit upon lapse, it was included in your 2016 Enrollee Decision Period offer package as one of your personalized options. If you did not select this benefit during the decision period, it is still available to you if you stop paying premiums, but only for up to 120 days after the premium increase effective date. By exercising the contingent benefit upon lapse, you could significantly reduce the benefits of your coverage, so please give this option careful consideration.
  • How are benefits determined under the paid-up, limited benefit (referred to as the contingent benefit upon lapse)?
  • If you exercise the contingent benefit upon lapse, you will keep your daily (or weekly) benefit amount as of the date your paid-up coverage is effective, but your maximum lifetime benefit will be reduced to an amount equal to your total premiums paid, or 30 times your daily benefit amount, whichever is greater.

    Note: If claims have been previously paid from your coverage, no benefits will be paid in excess of your remaining maximum lifetime benefit.
  • If my premium is increasing or changing, when will I pay the new premium amount?
  • Any change in premium for selections made during the 2016 Enrollee Decision Period will be effective on November 1, 2016, and will appear in your November billing cycle.

    Direct bill
    If you pay your premiums through direct bill, you will receive a bill for the new amount in October.

    Automatic Bank Withdrawal
    If your premiums are automatically withdrawn from your checking or savings account each month, the new amount will be withdrawn in the first week of November.

    Payroll Deduction
    If you pay premiums through payroll deduction, the new amount will be deducted from the paycheck that covers the first full pay period that begins on or after November 1, 2016. For civilian employees, this will occur in paychecks received in mid-November to mid-December, depending on the pay date for your agency, with the majority of pay dates occurring in the first week of December.

    Annuity Deduction
    If you pay premiums through annuity/pension deduction, the new amount will be deducted from the annuity/pension check received during the first week of December that covers November.

    For billing questions, call 1-877-888-FEDS (1-877-888-3337) TTY 1-877-889-5680.
  • I pay my premiums through automatic bank withdrawal. Do I need to do anything?
  • No. Whether you decided to keep your current coverage and pay the premium increase or selected an option to reduce your coverage, we will continue to deduct your premiums from your bank account and adjust the premium amount accordingly.

    For billing questions, call 1-877-888-FEDS (1-877-888-3337) TTY 1-877-889-5680.
  • I pay my premiums through payroll or annuity/pension deduction. Do I need to do anything?
  • No. Whether you decided to keep your current coverage and pay the premium increase or selected an option to reduce your coverage, we will continue to deduct your premiums from your payroll or annuity/pension and adjust the premium amount accordingly.

    For billing questions, call 1-877-888-FEDS (1-877-888-3337) TTY 1-877-889-5680.
  • What if I do not have sufficient funds in my pay check, annuity/pension check, or bank account to cover my premium?
  • If your pay check, annuity/pension check, or bank account does not have sufficient funds to cover your premium amount, your billing method will switch to direct bill.

    For billing questions, call 1-877-888-FEDS (1-877-888-3337) TTY 1-877-889-5680.
  • What happens if I stop paying premiums?
  • If you stop paying premiums, your coverage under the FLTCIP will be canceled unless you are eligible for a paid-up, limited benefit, referred to as the contingent benefit upon lapse in your FLTCIP Benefit Booklet. The contingent benefit upon lapse is a consumer protection feature that is built in to your FLTCIP coverage. If your premium increases beyond a certain percentage as specified by the National Association of Insurance Commissioners, it allows you to stop paying premiums and provides paid-up coverage with a reduced level of benefits. If you are eligible to exercise the contingent benefit upon lapse, it was included in your 2016 Enrollee Decision Period offer package as one of your personalized options. If you did not select this benefit during the decision period, it is still available to you if you stop paying premiums, but only for up to 120 days after the premium increase effective date. By exercising the contingent benefit upon lapse, you could significantly reduce the benefits of your coverage, so please give this option careful consideration.
  • If I was due a credit or refund because of the selection I made during the 2016 Enrollee Decision Period, when will I receive it?
  • If you have the future purchase option (FPO) as the inflation protection for your coverage, and are due a credit or refund because you selected an option during the decision period that removed the 2016 FPO increase from your benefit amount, we will begin processing it during the November billing cycle.

    Direct bill
    If you pay your premiums through direct bill, you will receive a credit in your October bill.

    Automatic Bank Withdrawal
    If your premiums are automatically withdrawn from your checking or savings account each month, you will receive a credit in the first week of November.

    Payroll Deduction
    If you pay premiums through payroll deduction, your refund will be mailed during the first full pay period that begins on or after November 1, 2016.

    Annuity Deduction
    If you pay premiums through annuity/pension deduction, your refund will be mailed during your December pay period that covers November.

    All other enrollees, please call 1-877-888-FEDS (1-877-888-3337) TTY 1-877-889-5680 for questions about your billing.

 


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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.

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