transamerica trans care ii product

25
The Basics For Producer Information Only. Not for public distribution. ICC10 TLC A PROD

Upload: kmpurnell

Post on 26-May-2015

1.851 views

Category:

Documents


0 download

DESCRIPTION

Long Term Care Product information. Agent Use Only

TRANSCRIPT

Page 1: Transamerica Trans Care II Product

The Basics

For Producer Information Only. Not for public distribution.

ICC10 TLC A PROD

Page 3: Transamerica Trans Care II Product

Our Financial Strength*Long Term Care insurance is only as good as the company behind it.

A+

AA-

A1

AA-

94

Superior A.M. Best

Very Strong Standard & Poor’s

Good Moody’s

Very Strong Fitch

Composite Comdex Index Score (out of 100)

*Ratings shown represent current and independent opinions from the leading providers of ratings of insurance companies. After evaluating a company’s financial condition and operating performance, these agencies assign ratings of a company’s financial strength and ability to meet obligations to Policyholders. A.M. Best, second highest of 16 ratings. Standard & Poor’s, fourth highest of 21 ratings. Moody’s, fifth highest of 21 ratings. Fitch’sfourth highest of 19 ratings. Agency Ratings and Analysis April 2011. The Comdex is a composite index. It provides a company’s standing in relationto other insurance providers that have been rated by the independent rating agencies. The standing is based on the number or percentage of companiesreceiving each letter rating, based on a percentile score on a scale of 1 to 100.

Page 4: Transamerica Trans Care II Product

TransCare II Rate StructurePreferred Health Discount•15% off standard premium rates•May be offered in addition to other discounts

available

Couples*•30% Discount Both Issued Identical Coverage•15% Discount if One Applies or if Different Benefits

Issued

Underwriting Flexibility•6 classes available•Rated Class 1 and 2, Maximum Daily Benefit $150

and Maximum Pool of Money $273,750•Rated Class 3 and 4, Maximum Daily Benefit $100

and Maximum Pool of Money $109,500

* Couples and spouse/partner may include married persons, domestic partners and/or civil union partners.

Page 5: Transamerica Trans Care II Product

New Benefits Available

Return of Premium to Age 67Issued if Under Age 67 Returns Premiums Paid (excluding waived premiums) less Claims

Paid

Global Coverage Benefit

Maximum Daily Benefit = 75% of Facility MDB

Monthly Cash Benefit = 10 x Facility MDB

Maximum Benefit = 75% of Facility MDB x 365

Alternate Plan of Care

Ability to cover new and evolving long term care services not expressly covered in the Policy

Accident Benefit

Issued if Under Age 67 Pays 2 x MDB* and only 1 x MDB subtracted from Policy Maximum

Page 6: Transamerica Trans Care II Product

Accident* Benefit Endorsement

Endorsement

•Included if under age 67 at issue (unless substandard-rated)

•Benefit ends on 67th birthday (or the date the policy ends)

•All benefits of the policy (up to the Policy Maximum Amount) are available except: Cash Benefit, Global Coverage Benefit, Remain at Home Benefit, and the Extension of the Long Term Care Facility Benefit

BENEFIT

ELIGIBILIT

Y

•Injury must occur before 67th birthday

•Were not eligible for benefits under policy prior to the injury

•Must be eligible for benefits under policy including certification, within 90 days of the injury, that Insured is a Chronically Ill Individual as a result of the injury

•Elimination Period applies if applicable to benefits received

BENEFIT

•Reimburses up to two times Maximum Daily Benefit for covered out-of-pocket expenses

•Reduces Policy Maximum Amount by no more than one times the Maximum Daily Benefit

*Accidental injury is an unexpected and unintentional physical event. It isindependent of and unrelated to any and all existing medical conditions. Amedical event such as a stroke, heart attack or seizure is not an injury.

Page 7: Transamerica Trans Care II Product

Alternate Plan of Care*

Eligibility

•Currently receiving benefits under Policy

•Receipt of written request to consider benefits not identified in Policy

•Eligibility for Payment of Benefits satisfied

•Cost for services under Alternate Plan of Care are less than Transamerica would otherwise pay for Qualified LTC Services

Plan of

Care

•Services are clearly specified in the Plan of Care

•Services to be included are not described in the General Exclusions and Limitations or Nonduplication of Coverage provisions of the policy

•Days of alternative Qualified Long Term Care Services on or after the effective date of the Plan of Care count toward satisfaction of the Elimination Period (if applicable to alternative services)

Agreeme

nt

•May not extend any benefit listed in the Policy that has been exhausted

•Benefits not paid when any other benefits for care or services are being provided under Policy

•May not be used to pay for services at any facility that is excluded from coverage under Policy

•Written agreement with effective date and termination date

*Gives Transamerica the ability to consider whether we coveralternate Qualified Long Term Care Services not otherwise expresslycovered under the policy.

Page 8: Transamerica Trans Care II Product

Global Coverage Benefit*

Benefits

Available

•Long Term Care Facility Benefit

•Home Care and Adult Day Care Benefit

•Cash Benefit

•Hospice Care Benefit

Benefit

Amounts

•Maximum Daily Benefit – 75% of Facility Benefit elected

•Monthly Cash Benefit – 10 times Facility Benefit elected

•Maximum Benefit Amount – 75% of Facility Benefit x 365 days

•All benefits paid reduce the Policy Maximum Amount

Benefit

Eligibility

•Meet the Eligibility for Payment of Benefits provision

•Meet the Elimination Period (the Global Monthly Cash Benefit is not subject to and will not be applied to satisfaction of the elimination period)

•Provide a written Plan of Care (in English with any updates to it), completed claim forms, and proof of loss documents

Benefit

Limitation

s

•Global Coverage Benefit paid in lieu of all other benefits under the policy

•Premiums will not be waived when receiving the Global Coverage Benefit

*Coverage outside 50 United States, District of Columbia or Canada

Page 9: Transamerica Trans Care II Product

Global Coverage Example

Facility Maximum Benefit = $100• Global Coverage Maximum Daily Benefit = $75• Global Monthly Cash Benefit = $1,000• Global Coverage Maximum Benefit = $27,375

If Global Coverage exhausted• Policy remains in force• Any remaining benefits are available if care and services are

received in the 50 United States, DC, or Canada (subject to the Policy Maximum Amount)

Page 10: Transamerica Trans Care II Product

Return of Premium to Age 67

Endorsement

•Included if under age 67 at issue

Benefit

•Paid if Insured is under age 67 at time of death

•Sum of all premiums paid (excluding any waived premiums) minus any claims paid

Page 11: Transamerica Trans Care II Product

We Kept What Was GOOD

POLICY MAXIMUM is POOL OF MONEY (e.g. $500,000 instead of Benefit Period)

CASH BENEFIT ( “Cash” instead of Alternative Payment Benefit)

REMAIN AT HOME (Home Modification, Therapeutic Device, Caregiver Training,

Medical Alert Systems bundled)

SHARED CARE (Optional Rider); available only to couples who are both issued and maintain identical policies. Not available

with ROP or Unlimited Pool of Money

5 YEAR RATE GUARANTEE

Page 12: Transamerica Trans Care II Product

Enhancements

Pool of

Money*

•Describe the Policy Maximum Amount as a Pool of Money rather than Benefit Period to more accurately reflect the policy maximum.

•Policy Maximum Amounts *available from $18,250 to unlimited ($18,250 is the minimum Maximum Daily Benefit** in most states x 365; 1 year benefit available in most states)

•All benefits (except the Optional Care Coordination Benefit ) when paid reduce the Pool of Money

Cash Bene

fit

•Renamed the Alternate Payment Benefit to Cash Benefit

•Monthly benefit equal to 10 times the Facility Benefit

Eliminatio

n Perio

d

•0, 30, 60, 90 and 180 ***day Elimination Periods available

•The LTC Facility Benefit, Facility Bed Reservation Benefit, Global Benefit and Alternate Plan of Care are subject to the Elimination Period

* Pool of Money in MD and MA is between $29, 200 and unlimited**Maximum Daily Benefit in VT ranges from $75 to $400; in WI from $60 to $400; in MA from $40 to $400 unlessA Mass Health participant, then from $125 to $500*** Not available in VT

Page 13: Transamerica Trans Care II Product

Enhancements

Remain At

Home Benef

it

•Bundles Therapeutic Device, Medical Alert, Home Modification and Caregiver Training into one benefit

•Maximum benefit equal to 60 x Facility Benefit

Rate Guarantees

•5 year rate guarantee included (no option to buy additional rate guarantee periods); rate guarantee available in more states*

BIO

•Deferred BIO included (previously added 1 % extra to premium)

•Changed to the industry standard of inflating the pool of money, less any claims paid (compound inflation is less expensive)

*GA, IL, KY, MD, PA, TN, WI now have a 5 year rate guarantee

Page 14: Transamerica Trans Care II Product

Some Good Benefits Got Better

Nursing Home and Assisted Living combined into a Facility Benefit

Compound Inflation less expensive – move to the industry standard of inflating the pool of money less claims already paid

Monthly Benefit includes Facility in addition to Home Care and Adult Day Care

3% Step Rated Compound Benefit Increase Option Available

Page 15: Transamerica Trans Care II Product

DRA Partnership Certification• TransCare II has been certified as a Partnership policy

in the following states:– CO, GA, IA, ID, KS, KY, LA, MD, ME, MN, MO, MT,

NE, NH, NC, ND, OH, OK, PA, RI, SC, TN, TX, WV, WI, WY

• TransCare II has been filed for partnership certification in the other DRA states (and we are hopeful to receive approval by product launch)– VA

Page 16: Transamerica Trans Care II Product

Robert Woods Johnson Partnership

• CA – TC II product filed, pending approval• CT – TC II product approved for CT Partnership• IN – TC II product, pending implementation

Page 17: Transamerica Trans Care II Product

Multi-Life Selling Just Got Easier with theBusiness Advantage Program*

Executive Advantage (EPA- Employer Pay All)• 20% Discount

Corporate Advantage (EPS-Employer Pay Some)• 15% Discount (Employer must pay for a minimum pool of benefits equal to $50,000.

The maximum pool of benefits that can be purchased by any individual is $250,000.)

Employee Advantage (VOL- Voluntary)• 10% Discount

Affinity Advantage (Association)• 5% Discount

New

*Discounts are available at issue only. Single Pay policies will not receive multi-life or affinity discounts

Page 18: Transamerica Trans Care II Product

Worksite Underwriting TypesUnderwriting Type Minimum Group Size Participation

Requirement

Modified Guaranteed Issue (MGI)

15 Employees Greater of 15 employee applications or 10% of HPE*

Simplified Issue (SI) 10 Employees Greater of 10 employee applications or 5% of HPE*

Abbreviated Application (AA)

10 Employees 5 employee applications

Full None None

*HPE = High Potential Employee; employees between the ages of 45 and 65and with annual incomes greater than $35,000

Page 19: Transamerica Trans Care II Product

Underwriting Evidence

MGI

•Application Section A – 3 questions

•Up to age 65

•Standard rates

SI

•Application Sections A & B – 9 questions (may have state variation in number of questions)

•Rx Database, MIB

•Up to age 65

•Standard rates

AA

•Application Sections A & B

•Telephone interview, APS “for cause”, Rx Database, MIB

•Up to age 65

•All rate classes available

Page 20: Transamerica Trans Care II Product

Full Underwriting Evidence

Full Application (ABC Sections)

Ages < 65• MIB, Prescription History, Telephone Interview, Face-to-Face “for cause”,

Medical Records “for cause”

Ages 66 -69• MIB, Prescription History, Telephone Interview, Medical Records, Face-to-Face

Assessment “for cause”

Ages 70-79• MIB, Prescription History, Face-to-Face Assessment, Medical Records

Page 21: Transamerica Trans Care II Product

Service You Can Count On

• How committed is Transamerica Long Term Care to the LTC marketplace? – COMPLETELY – we are building new distribution– Never exited the LTC industry. Continued to

administer more than 322,000 in- force policies– Core Product for AEGON Life & Protection Division

Page 22: Transamerica Trans Care II Product

Support You Can Trust

• Home Office Support• Tools: ARC www.taltc.com

TransQuote: Illustration SoftwareStatus of Pending Business (nightly update)Supplies- order or download PDF’s

Page 23: Transamerica Trans Care II Product

Support You Can Trust• Sales & Marketing: [Regional Vice Presidents,

Internal Wholesalers, National Sales Desk]• Underwriting:

• Underwriting Pre-qualification:

Phone: 1-866-297-7412

Email : [email protected]

• Agent Resource Center: www.taltc.comIllustration SoftwareStatus of Pending Business (nightly update)Supplies- order or download PDF’s

Page 24: Transamerica Trans Care II Product

Good Tools Just Got Better

Agent Resource Center

TransQuote TQ Mobile Web-Based Application Supplies Real Time

U/W Status

New Look

Coming Soon

Page 25: Transamerica Trans Care II Product

Questions

ContactKim Purnell, Regional Vice President

Transamerica Long Term Care800 514 0982

[email protected]