Long-Term Care
Long-term care is the assistance received when someone needs help with two or more Activities of Daily Living - such as dressing, bathing, going to the bathroom, eating, or moving about - or when someone suffers a severe cognitive impairment. This care could be provided in the home, in an assisted living or residential care facility, or in a skilled nursing facility such as a nursing home. The long-term care insurance program is administered by Unum Life Insurance Company of America.
Quick Information Links
Plan Highlights
- Elimination Period - Your plan’s Elimination Period of 90 days is the amount of time you must wait before benefits become payable. This time period must be satisfied only once during the life of your plan.
- Newly Hired Employees - once eligible for the plan, you have 30 days to sign up for Guarantee Issue coverage.
- All Active Employees & Newly Hired Employees who enroll after the Guarantee Issue enrollment period or choose benefits over the Guarantee Issue limits will be required to fill out Evidence of Insurability (EOI), proof of good health.
- Medical Underwriting Effective Date – The effective date for all those needing medical underwriting is the first of the month following approval into the plan. Medical underwriting means that you must answer all questions on the EOI. In some cases, an interview may be necessary.
- Delayed Effective Date – If you are absent from work at the time your coverage is approved because you are injured, sick, temporarily laid off, or on a leave of absence, your coverage will not begin on your otherwise expected effective date.
- Medical Underwriting for Employees and Family - Completion of the Benefit Election Form is required for enrollment. As an employee you are eligible for benefit amounts on a Guarantee Issue basis of up to and including $4,000 and a facility benefit duration of 3 or 6 years. This does not require completion of the Long-Term Care Insurance Application (EOI/medical questionnaire) if you apply during your initial eligibility period. The Long-Term Care Insurance Application (EOI/medical questionnaire) is required if enrolling after your initial eligibility period or if you choose to buy $5,000, $6,000, or the unlimited duration coverage. Retirees and all family members must complete the Long-Term Care Insurance Application (EOI/medical questionnaire) and must be approved for coverage in order to enroll in the Long-term care plan. All medical questionnaires/EOI forms must accompany a signed authorization to request medical information form #6720-03 (located in the enrollment kit).
- Lifetime Maximum - The lifetime maximum is the maximum benefit dollar amount that will be paid over the life of your coverage. The amount is calculated on the facility benefit amount and benefit duration. For example, if you choose $3,000 facility monthly benefit amount and 3 year duration, your lifetime maximum is calculated as follows, $3,000 per month times 12 months times 3 years equals $108,000 lifetime maximum.
- Insurance Age - Insurance age is used to determine the cost of your coverage. Insurance age is your age on the plan effective date if you enroll for coverage prior to the plan effective date. If you enroll for coverage on or after the plan effective date, insurance age is your age on the date you sign the enrollment form.
Eligibility
Employees, legislators, retirees, spouses, parents, parents-in-law, grandparents, and grandparents-in-law are eligible for the long-term care insurance plan. This plan may be elected, changed, or dropped at anytime.
Enrollment
You can request an enrollment kit by calling the Health Care and Benefits Division at (800) 287-8266; (406) 444-7462; TTY (406) 444-1421; or via e-mail at benefitsquestions@mt.gov. You can also request a kit through the SABHRS Self Service application. To request a kit through Self Service:
- Log into mine.mt.gov
- Select the Employee Self Service link on the Enterprise Menu
- Select the Benefits link
- Select the Long-Term Care Requests link
- Select the address you would like the packet to be sent
- Click Submit
Long-Term Care Options
The long-term care insurance plan offers a variety of options, all of which affect the monthly contribution. These options are:
- Care types
- Monthly benefit amounts
- Care durations
- Inflation protections
Types of Care
Monthly Benefit Amounts
- Nursing home monthly benefit amounts of $1,000, $2,000, $3,000, $4,000, $5,000 or $6,000 are available.
- Assisted living facility monthly benefit amounts total 60 percent of the selected nursing home amount.
- Home care monthly benefit amounts total 50 percent of the selected nursing home amount.
Care Duration
Three Years: Provides 3 years nursing home care, 5 years assisted living facility care, or 6 years home care.
Six Years: Provides 6 years nursing home care, 10 years assisted living facility care, or 12 years home care.
Unlimited: Provides an unlimited amount of care at a nursing home, assisted living facility, or a home.
Inflation Protection
You can elect to participant in the inflation protection provision. This provision increases your monthly benefit amount each year on January 1 by 5% of the monthly benefit in effect on that January 1. Increases will be automatic and will occur regardless of your health and whether or not you are disabled. Your contribu will not increase due to automatic increases in your monthly benefit amount.
The benefit paid is subject to the lifetime maximum benefit amount.
Payment for Benefits
Contributions/benefit payment rates listed are for a $1,000 monthly facility benefit. You may choose from $1,000 - $6,000 in facility monthly benefit.
Questions?
Please call (800) 227-4165 to contact Unum with questions regarding long-term care insurance.
