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October 28, 2002

Long-term care coverage now available

Wynell Lauver is communications consultant for Human Resources

Right now, the average American’s chances of spending two-and-a-half years in a nursing home are one in three. In Atlanta, the average annual cost for a nursing home is about $47,500.

Accidents and illnesses can happen at any time and at any age. In fact, about 40 percent of people needing long-term care are between the ages 18 and 64. If you needed long-term care and planned to rely on health insurance, Medicare or Medicaid to cover your costs, be aware that these plans do not cover many long-term care costs, so your assets could disappear quickly, along with your ability to make choices and maintain control over your life.

In 2003, Emory will offer a new long-term care policy, so now is an excellent time to consider the possible need for long-term care and the impact it can have on a family’s financial security. Long-term care insurance is designed specifically to help protect employees and their loved ones from the financial burden of nursing homes, assisted living facilities and home health care.

If you are a regular University employee or rehired retiree working 20 hours or more a week, you and your family members between the ages of 18 and 80 can enroll in long-term care insurance. Emory retirees also can participate. Family members include spouses, adult children, siblings, parents, parents-in-law, grandparents and grandparents-in-law.

Due to state regulations, same-sex domestic partners are not eligible for this group policy. However, individual long- term care policies are available from many insurance companies.

Employees who sign up for a policy during Open Enrollment (Oct. 21–Nov. 8) are guaranteed coverage without completing a medical questionnaire for benefits up to $4,000 for a six-year duration. Those who wait until later or buy $5,000, $6,000 or an unlimited duration period will have to go through medical underwriting and are not guaranteed coverage.

Family members are subject to completing a medical questionnaire regardless of the benefit amount they choose. Emory retirees must also complete a medical questionnaire.

Cost for long-term care insurance depends on the individual’s age on the plan’s effective date and the plan and/or options chosen. The younger you are when you purchase the insurance, the lower the cost, and rates will not increase as you grow older. If you change employers or retire, you can still keep your coverage at an affordable group rate.

Premiums for employees and their spouses will be handled through payroll deductions. Other family members will be responsible for paying for their own policies and will be billed directly by UnumProvident.

Call the benefits department at 404-727-7613 to request an enrollment kit for you and your spouse, or visit one of the Open Enrollment meetings. For enrollment kits for other family members, call UnumProvident at 1-800-227-4165.

When considering the plan that is best for you, ask yourself:

• Where do I want to receive care?

• How much money will I need for care?

• How long do I want the care to last?

Emory’s new group plan, provided by UnumProvident, allows for various levels of care, including long-term care facilities/nursing homes, assisted-living facilities and professional home care. Your policy would provide benefits when a physician certifies that you have lost the ability, for a period of 90 days, to perform at least two of six activities of daily living: toileting, transferring, bathing, dressing, eating and continence.

You can choose a long-term care/nursing home monthly benefit from $1,000 to $6,000. The assisted-living facility or professional home care benefit would be 75 percent of the long-term care facility monthly benefit. You can also choose a facility benefit duration of three, six or unlimited years. If you choose unlimited years and/or a monthly benefit of $5,000 or $6,000, you will need to complete a medical questionnaire. There also is an option to purchase inflation protection, whereby the monthly benefit amount will increase 5 percent annually.

Enrollees in the plan will have to wait 60 days before the benefits become payable. This 60-day “elimination period” will be incurred only once during the life of the plan.

For general information about long-term care, visit AARP’s website at For more information about Emory’s long-term care insurance, check out the UnumProvident web site at or call its long-term care services at 1-800-227-4165. Information also is available at Open Enrollment meetings.