What is Long-Term Care Insurance?
Long-term care is ongoing personal assistance for an individual who, as the result of an accident, illness or age, needs help preforming daily activities of maintaining their health.
Here are some reasons why you should consider Long-Term Care Insurance:
- Protect your assets
- Minimize dependence on family members and others
- Control how, where, and from whom you receive care
LONG-TERM CARE INSURANCE
This plan provides coverage in the form of a fixed dollar indemnity monthly benefit if you become disabled and you are receiving care while confined in a Long-Term Care Facility or Assisted Living Facility.
If you purchase Total Home Care or Professional Home Care Services coverage, UNUM will pay you a benefit if you elect to receive care other than in a Long-Term Care Facility or Assisted Living Facility.
Coverage is subject to policy limitations, benefit maximums and elimination periods.
- Be an Active or Associate HSTA Member, and
- Be enrolled and continuously covered as an eligible participant under one or more of the Trust’s benefit plans, other than Long-Term Care Insurance Plan.
Base Coverage for Active Participants
The Base Coverage is as follows:
Elimination (Waiting) Period: 90 consecutive days
Monthly Benefit Maximums*
Long Term Care Facility: $1,000
Assisted Living Facility: $600
Professional Home Care Services: $500
Lifetime Maximum Amount*: $36,000
In addition to the Base Coverage, you may also apply for Additional Buy-Up Coverage described in the Outline of Coverage. However, you are responsible for the cost of all Additional Buy-Up Coverage. If you are applying outside of the guaranteed issue period, you must submit information on your health status and the insurance company has the right to decide whether to accept or deny your request for coverage.
- MEMBER BENEFIT ELECTION ENROLLMENT FORM
- GROUP LTC EVIDENCE OF INSURABILITY FORM/HIPPA AUTHORIZATION FORM
- ACKNOWLEDGEMENT OF DISCLOSURE OF RATING PRACTICES – Includes the following documents:
- LTC insurance Personal Worksheet
- Group LTC insurance potential rate increase disclosure form
- Things you should know before you buy LTC insurance
How to File Claim:
- Contact the HSTA VEBA Trust office for Long Term Care Claim forms, complete the forms and send it to UNUM. You must send UNUM the claim forms no later than 90 days after the date you become disabled or as soon as it is reasonably possible to do so, but in no event more than one year after the time this proof is required.
- You will be required to give UNUM information on your continued Disability, when requested. UNUM may also require a claims assessment, which is a review done by UNUM to help in evaluating the Disability. A face-to-face interview or examination by a Physician may also be required. If required, however, UNUM will pay for the cost of the interview or examination.
SCHEDULE OF BENEFITS/PLAN HIGHLIGHTS
OUTLINE OF COVERAGE/GROUP MASTER POLICY/CERTIFICATE FORM 536134
In order to sign up for Long Term Care, you would need to be enrolled in another HSTA VEBA TRUST plan like Short- or Long-Term Income Protection Insurance, Basic Life or Basic Plus Life Insurance, Critical Illness, or Accident Insurance.
The Long-Term Care Base plan covers $1,000.00 a month if you are receiving care in a Long-Term Care Facility. The facility benefit duration is 3 years. The base plan also covers professional home care at 50% of your monthly facility benefit ($500.00). The maximum lifetime coverage is for $36,000.*
*This plan overview is a summary provided to help you understand your insurance coverage from UNUM. Please refer to your certificate booklet for your complete plan description. If the terms of this plan highlighted summary or your certificate differs from your policy, the policy will govern.
Zero; no cost to you, the HSTA VEBA Trust subsidizes 100% of your monthly premium.
If I currently have the Long-Term Care Base Plan, can I increase my coverage? And if I do, will the HSTA VEBA TRUST continue to subsidize the Base Plan?
Yes, you can increase your Long-Term Care coverage. You would need to complete an application along with the Evidence of Insurability form. The HSTA VEBA TRUST will continue to subsidize, but only up to the amount of the Long-Term Care Base Plan. You can call the HSTA VEBA TRUST office at 808-440-6940 or 1-800-637-4926 (neighbor islands) to request for the required forms.
Then you would just continue to have the Long-Term Care Base Plan and the HSTA VEBA TRUST would continue to subsidize it. Denial of additional coverage will not change your current coverage.
Your new premium will be calculated at your current age and the amount that was subsidized by the HSTA VEBA TRUST will reduce your monthly premium.