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Long-Term Care (LTC) Program
Program Information>Program Details

 
 


LTC insurance helps you pay for long term care services that are not usually covered under your health insurance plan.  These include services such as nursing home care and community-based care. 

How the Program Works
When enrolling, you must first select a Daily Benefit Amount (DBA). The DBA is the maximum amount of daily coverage available for nursing home, in-patient hospice care and respite services. Your DBA options are:

  • $100
  • $150
  • $200
  • $250
  • $300
  • $350

Next, you must select a Total Lifetime Benefit. The Total Lifetime Benefit is the maximum amount of benefits the Plan will pay to or on account of you. Your options are:

  • 730 days (2 years) times the daily benefit
  • 1,095 days (3 years) times the daily benefit
  • 1,825 days (5 years) times the daily benefit

Benefits can last longer than the duration selected based on the cost of your care, how frequently services are needed and what types of services are used. For example, if you select the $150 DBA and you enter a nursing home that only costs $125 per day, the difference of $25 remains toward your total lifetime maximum and extends the duration of your Plan benefit.
If you select the $150 DBA and you receive home health care costing $60 per day, $52.50 remains toward your total lifetime maximum and extends the duration of your Plan benefit (75% of $150, minus $60).

Nonforfeiture Option
When you enroll, you may also elect a Nonforfeiture feature for a higher premium cost. The Nonforfeiture feature allows you to stop paying premiums at a future date and still keep a portion
of your coverage. To qualify for Nonforfeiture, you must have paid premiums for at least three consecutive years. The feature provides the full DBA with a Total Lifetime Benefit based on the greater of the total amount of premium paid or 30 times the DBA. For example, if you elect the $150 DBA and pay $3,500 in premiums over three years and then decide to discontinue the policy, your Total Lifetime Benefit will be based on the greater of $3,500 (the total amount of premiums paid) or $4,500 (30 times the DBA). 

The last choice you will need to make in enrolling is choosing between the two Inflation options offered by MetLife.

Optional Inflation

  • Every three plan years you will be offered the opportunity to increase your Daily Benefit Amount (DBA)
  • 5% increase in DBA compounded annually
  • Premiums for the increase are based on attained age

Automatic Inflation Option

  • DBA automatically increases by 5% compounded annually
  • Pre-funded up front so premiums do not increase as benefits increase

Your premiums are calculated based on your age and the amount of benefits you select when you enroll in the Program.  For active employees and their spouses/domestic partners, premiums are automatically deducted from your paychecks. (Retirees and all other family members will be directly billed.)  If you have been determined as eligible to receive benefits, you will need to submit a claim to MetLife to begin receiving benefits.

See the FAQs

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