Group Long Term Care Insurance Plans

In a bustling marketplace filled with articles on various topics, long-term care emerges as an essential service. This is particularly true for many individuals including adults and seniors, yet unfortunately, it does not come under the umbrella of most insurance plans. It’s an anomaly, not included as an essential benefit under the new healthcare law, irrespective of whether you label it Obamacare or the PPACA. Plus, long-term care is not part of the health benefit exchanges offered by the government in each state, which include different types of insurance products. This information about the exclusivity of long-term care often surprises many doctors who are focused on health care. However, irrespective of these costs and challenges, providing long-term care insurance to employees is a great way to stand out from other businesses, perfect for launching a unique program and attracting the best employees from your industry.

A group insurance plan, also known as an employee health insurance, covers a set of people: individuals working together in an organization. Such a program includes services like access to various health benefits along with consulting doctors. In the marketplace of insurance, you might often find the cost of group long-term care insurance slightly less than an individual insurance plan, making it a more attractive option for many.

Like Medicare, and most employer-sponsored benefits, long-term care insurance, much recommended by doctors, also comes with tax incentives designed to encourage both government and businesses to provide this service to employees. And these tax benefits, a relief to individual employees, are mostly applicable when an employer covers a portion of the premium costs, 100% of which is tax-deductible (for both employees and their dependents).

In essence, a group long-term care insurance program can offer employees crucial coverage for medical bills in case they need to consult a doctor due to any health emergencies. This insurance plan provides them with financial relief from high medical costs, similar to services offered under the Medicare umbrella often chaired by government health care agencies.

What is a Group Health Insurance Policy: In Detail

Here are some common features of a group LTC insurance coverage, a topic frequently elaborated on in health care articles:

Group insurance, much like the Medicare program, is often praised by doctors and is generally more affordable than purchasing individual coverage options for each employee. Insurance providers in the marketplace can offer this sort of coverage at lower costs because the overall risk undertaken by the company is spread among the group members. Such a distribution of liabilities can result in lower premium rates, allowing businesses that invest in long-term care insurance for their employees to enjoy premium discounts.

  • The coverage can only be purchased by premium on behalf of the employees and other registered groups, such as trade unions, clubs, etc.
  • An employer can pay the insurance premium on behalf of the employees or the employee pays the premium all by themselves to the insurance agent.
  • To avail of the coverage, the business needs to have the minimum number of eligible employees. But there is no limit on the maximum number of employees that come under this plan.
  • The long term care insurance coverage is issued for a year and following that it has to be renewed to get continuous coverage.
  • If there is a claim from an employee or their family member, the insurance company will settle it. But the coverage for the other employees is going to remain unaffected.
  • The premiums paid are shared by the insurance company and the employer. This long term care insurance coverage can depend on the income level, age, or hierarchy in the organization of the employees.

Benefits of Group Long Term Care Insurance Plans for Employers

Employee productivity is dependent on a series of factors such as financial security, work culture, job security, and long-term care protection. If an employee has access to a group health protection plan, they will feel protected against unexpected health doctor appointments and expenses. This security often results in employees feeling more appreciated and valued, thereby fostering a more productive workforce.

Increases Employees’ Productivity

Group insurance for long-term care plays a significant role in the business and health care worlds by helping retain employees. It provides both health protection and individual policies. Demonstrating your care for the well-being of your employees, both in their interactions with fellow employees and with doctors, can be one of the most potent ingredients for satisfaction and loyalty.These are just a few amongst the array of products that insurance providers can offer to help you take care of your workforce. Your ability to select and offer a range of health insurance plans, which you can review through resources like, is an asset. Hence, employees, seeing the value of being a part of a company that cares about their health and well-being, as well as their caregiver roles for elderly family members, tend to hesitate shifting to some other company when they get an offer.

Saves Money

When you are running a business, long-term relationships with your customers and consideration for an aging population can prove to be very useful, particularly in decisions concerning health insurance plans. In case your business conducts Corporate Social Responsibility activity, it will create brand loyalty by valuable customers through its content. Hence, it helps in creating a good brand reputation which is advantageous especially considering the growing number of elderly Americans in your area.

Employee Retention

Likewise, if you offer group long-term care insurance to your employees, it reflects your goodwill. This health insurance plan with its specifics like coinsurance, could serve to bolster your care services and support your employees’ needs, and will eventually be reflected in their work. It creates a sense of group loyalty toward the company if you buy coverage for them. However, as a potential alternative to Medicaid enrollment, it also offers the added benefit of retaining new employees.

Creates a Good Reputation

If an employee has to choose between two organizations having similar working environments, incentives, and salaries, the goodwill you create in the industry and your focus on elderly care can be the driving factor. Most likely, your employees who are caregivers will help in securing your position in the competition, especially if their ability to access needed services is facilitated by the health insurance plan you’ve chosen.

You can go the extra mile to extend the insurance coverage to include their family members. Thus, the group long-term care policy will protect domestic partners, children, and also parents within the same policy. This move not only benefits your employees but also reflects your sensitivity towards an aging American population while reducing Medicaid enrollment.

Secures Your Position in the Game

One of the primary benefits of group long term care insurance is the tax incentives you can enjoy. The LTC premiums you pay as an employer are tax deductibles. You can qualify to receive a credit back on the taxes as a tax incentive and get repaid for the long term care premiums paid. In comparison to Medicaid, offers detailed insights into these incentives and options, which you can always consult the tax status and tax treatment with your financial planner.

One of the primary aspects of a long term care insurance policy is the claim settlement process. Under this, the claims are all settled by a dedicated team of professionals. Thus, the process is smooth, simple, and comes with limited restrictions. You even get zero day elimination period for residential care facilities, assisted living facilities, and nursing facility which generally has a 3 months waiting period in the insurance industry.

Offers Tax Benefits

When it comes to buying the group long term care insurance plan, there are zero formalities to fulfill. Usually, an insurance agent asks for prerequisites, such as heavy paperwork, mandatory medical test, etc. However, these aren’t required with this group long term care insurance. This is of particular advantage to elderly Americans in your area who might have otherwise faced a more protracted enrollment process to sign up for Medicaid.
A conglomerate of employees, some of which may be caregivers within their own families, will be covered under one comprehensive group plan, thereby simplifying data handling for the organization acting as the employer. This also allows for administrative oversight and supervision of all premiums paid. The success of this approach hinges on technological tools like group management software on the office’s computers and staff phones. Every insured person, regardless of their age, enjoys the pervasive benefits of long term care insurance.

Improved Claim Settlement Process

Adopting group policies can make it significantly more affordable for employees and their family members, functioning as a financial partner in accessing LTC benefits. For a business, the most valuable asset is indeed its employee. By utilising this structure of a group health plan, your employees can stay healthy and invigorated, thus enhancing overall workforce morale and productivity. Consequently, this will catalyse your business’s growth and success.

No Need of Pre-Requisites

Outlined below are some of the numerous LTC benefits that can be utilized by the employees. Prior to adopting a policy, administrative staff can refer to a compiled list of FAQs to better understand the nuances involved.

Effective Management

In relation to individual health policies or family health policies, employee long term care insurance comes with a more economical premium for group coverage. As a result of this, the group coverage plan proves to be budget-friendly since the substantial amount is distributed amongst numerous employees. This makes it a viable alternative for a larger population of Americans as opposed to applying for Medicaid.

Benefits of Group Long Term Care Insurance Plans for Employees

Managing insurance within families from an assortment of providers can prove to be a daunting task, especially for spouses who might have to navigate through myriad plans. Instead, an inclusive group LTC insurance for you, your spouse, and your family ensures that all aspects are incorporated within a single plan. As such, eligible employees along with their families can efficiently handle their own medical expenses as well as that of their family members, whether it be in a hospital, nursing home, or residential care facilities, and stay well-informed with insurance market news.

While the coverage amount and claims with group policies may vary, it is ensured that the common options such as maternity, in-home care, day care, medicines, and more are covered. Organizations provide this financial support to their employees and offer protection to their family members as an intrinsic part of their staff welfare initiatives. Certain carriers go further to offer educational programs, such as webinars, to assist employees in comprehending their coverage better.

Employee Pays Affordable Premium Rates

Group long term care insurance plans might cover maternity benefits and also outpatient department (OPD) benefits for employee preventive care. OPD predominantly concentrates on addressing pre-existing illnesses. Coupled with additional perks such as wellness and health sessions, group plans indeed justify their cost. You can also opt for ancillary options like inflation protection and the death benefit for a person, similar to life insurance policies.

Health Coverage for Family Members

One of the main advantages of group long term care insurance is its smooth claim settlement procedure. Often, an individual policyholder will have to undergo a protracted process involving the submission of voluminous documents, upfront cash transactions, and an anticipatory period before the elimination phase ends, among other hurdles. Nonetheless, these difficulties do not present themselves with group long term care insurance. Usually, a claimant just has to submit the invoices from the nursing homes or hospitals to the office to receive a reimbursement.

When you opt for individual health coverage, an elongated waiting period before filing a claim for pre-existing disease could be encountered. This elimination period stands as one of the significant downsides of any insurance coverage. But as you navigate through the diverse insurance products in the market, it is critical to make well-informed and judicious decisions.As you explore care policies, you may find yourself embarking on a study of health insurance, history, and potentially even your own health status. Insurance for group long term care can provide comfort to many because it simplifies the process of submitting a claim for a broader range of pre-existing illnesses. Hence, you don’t have to worry about the waiting period for the coverage of pre-existing conditions. This purpose can often be fulfilled with simplified underwriting in the master policy.

Affordable Plans

Residence can play a vital role in your insurance decisions. You can get personal insurance even if you possess group long term care insurance, depending on the regulations of your place of stay. This fact becomes increasingly important as the group health policy might not fully cater to your needs. A variety of insurance offerings from different carriers could be considered, including disability insurance, to ensure you have comprehensive coverage.

Easy Claiming Process

Before you choose group LTC insurance for your employees, you need to delve into the history of long term care insurance and ensure you understand the challenges associated. It’s a study in understanding how best to support your staff should they need extensive care.

Covers Pre-Existing Health Issues without Waiting Period

Should an employee choose to leave the organization, they will no longer be covered under the long term care insurance policy, becoming a significant disadvantage in care policies. Their disability insurance, which should have proved beneficial, will not cover them in their residence after leaving work. They will also stand to lose any previous premium paid to the insurance company. This limitation often comes as a shock to many.

Upon leaving the organization, the employee would need to arrange for a separate health policy to continue care in their residence. To mitigate the losses, the employee could convert the group long term care insurance policy to an individual policy. This transition, however, hinges entirely on the individual’s ongoing employment status.

Should You Get Personal Insurance Even When You have Group LTC Insurance?

Given that the group long term care insurance plan is held by the employer, you as the policyholder will have a limited ability to tailor the benefits as per your liking or purpose. Further education on the policies and insurance options can make a crucial difference, despite the added effort. For instance, you might have to pay a premium from your own pocket to increase the coverage, with the LTC remaining level. This fact is well exemplified in the pricing policy of insurers, such as John Hancock.

  1. A limitation on the coverage features for informal care and custodial care
  2. The high claim amount increases the renewal premium cost to be paid to the insurance company
  3. Not beneficial for retirement plans and thus greater risk
  4. Loss for an employee when they leave the organization to join some other organization
  5. Everyone is paying the same amount to the insurance company, regardless of whether they have good health conditions or not

Challenges of Group Long Term Care Insurance

For small-scale industries, both employees and employers need to contribute to the purchase plan. An insurance company might struggle to offer a reasonable premium price for organizations with fewer and lower-earning employees. Professional guidance on pricing and coverage options can prove invaluable in such situations.

It can be a Loss When Employees Leave the Organization

Comparatively, the employer’s subsidy is much lower in small-scale industries. Without adequate experience, they might not secure a good discount on the premium. Therefore, carriers like John Hancock may not be the most feasible choice for these smaller establishments.

An employee will only be able to claim the policy until his/her last working day in the company. So, once they leave the organization, they might have to buy a separate health policy. To cover up the losses, an employee will have to convert the group long term care insurance policy to an individual policy.

Lack of Control

Since the group long term care insurance plan is under the employer’s control, you as the policyholder will not have much freedom to personalize the benefits plan as per your liking. Therefore, gaining more education about the policies and the insurance market is key in order to make the most informed decision.Even if you are given the freedom, you might have to enter into the role of a carrier of burdens, putting in some additional effort. For instance, if you have to increase the coverage, in addition to the base rate, you might have to pay a high cost premium from your own pocket and the LTC may remain level for you. An example of this might be the pricing of policies by insurers such as John Hancock.

Not the Right Choice for Small-Scale Industries

In the scheme of small-scale industries, both employees and employers need to contribute to the purchase plan. An insurance company, for example, might not be able to offer a reasonable premium price for an organization that has a smaller number of employees who earn less for their daily living. In these cases, professional guidance on pricing and coverage options can be invaluable.

The subsidy for the employer, in addition to being limited, is going to be very less in comparison to the large-scale industry. Moreover, if they do not have enough experience, they might not even be able to secure a good discount on the premium. In these scenarios, it’s clear that John Hancock and other similar carriers may not be a good choice for small-scale industries.

The Premium is the Same for All Employees

Even if someone is fit as a fiddle, they will have to pay the whole amount for the premium, while a person with a major health risk will pay the same as per the simplified underwriting terms. Thus, a person with more risk is benefitted from a major claim and less premium, while a person who is healthy, somewhat paradoxically, contributes more to the other employees.

It is an advantage in pricing and coverage for the person who is not healthy and a loss for someone who isn’t using the insurance. Thus, as an example, when they buy an individual policy, they might benefit more from it. Big-name insurance companies like John Hancock don’t provide discounts to individual members in a long term care insurance.

Family Protection is Dependent on the Employer

You may or may not get the benefit of protecting your dependents. This is because the policy might vary from one employer to the other. As an example, you might not have any critical health problems but your dependent might be facing a serious health issue. This can leave you in a financial crisis and also deprive you from the death benefit offered by few employer groups including John Hancock.

Claims Might Not Always Be Easy

Most employees tend to be concerned about the time taken to settle any insurance claim. It is a feeling, which can be amplified in terms of Employee Group Insurance since you aren’t the one who has selected the health coverage from the new groups. The claim settlement process might be a little troublesome unless the carrier, like John Hancock for example, covering you provides a hassle-free way to claim.

Unclear Personal Financial Planning

Health insurance coverages can be critical when it comes to financial management. Because of the already mentioned disadvantages, a group long term care insurance provided by an organization can be unreliable. For instance, if the policy doesn’t provide continuous coverage against inflation protection, it might be difficult to include it in the annual financial plan. You might not have as much control as you have over an individual plan. In search of guidance, consult your tax advisor or domestic partners for such long term care insurance plans.

Factors to Consider Before Buying Group LTC Insurance

Even a single visit to a nursing home might cost a fortune for someone who belongs to a middle-class family. Therefore, in addition to other considerations, the pricing of health insurance is essential to consider when selecting a carrier such as John Hancock. There are various factors an employer needs to take into account before getting a group LTC insurance. Let’s check them out.

Amount to be Insured

When you, as an employer, are buying long term care insurance, you should always opt for a higher coverage amount. Even spending one day in a nursing home can cost a lot. In case the employer is providing proper long term care insurance coverage for helping the employee to take care of their hospital expenses, an employer needs to consider a coverage amount. Medical inflation is increasing and the cost of medical bills is increasing. If you want to make your employees happy and retain them, choose a bigger amount that has an inflation protection option.

Requirements of Your Employees

When it comes to group LTC insurance, there is no one-size-fits-all approach. Every corporate company has its own needs. For instance, some companies might have employees who are young, unmarried, and like to travel a lot. So, they might require an accident cover or cognitive impairment cover. But there are companies that might have middle-aged employees and have a family. In that case, you will have to provide maternity benefits and long term multi life cover plans. There might be some aged employees in your company who will require assisted living facility after they retire and might need critical illness cover. So, check what your employee requires before getting the long term care insurance.

Hospital Network

It is one of the most crucial factors to consider before you get LTC coverage. Check the network of hospitals when you are buying group LTC insurance. At times, when your employee goes out of town for an important meeting, they can get medical coverage if the hospital network provided under the plan, you adopted can offer a hospital in the same town. This will protect the employees, as well your savings as they are visiting the town to conduct a meeting on behalf of your company.

Claim Settlement Ratio

The amount of claim, which is settled by the insurer out of the number of claims that are received is called the claim settlement ratio. In case the ratio is above 90, it can be taken to be a good claim settlement ratio. However, the claim settlement process of the insurer also has to be fast to make sure that you’re a seamless experience.

Wellness Benefits

After the onset of the COVID-19 pandemic, mental health and well-being has come to focus. Employers need to look for long term care insurance plans that offer preventive and wellness features. Many insurance companies are providing benefits through wellness programs where they are offered reward points to the policy if they stay in good health. Also, they track the wellness of employees, such as their sleep patterns, step count, etc. through smartphone applications and wearables. Insurers provide profitable discounts on the renewal amount as a reward to the long term care policyholders.

Co-Payments and Sub-Limits

There are many plans that limit the amount insured and things like room rent or the kind of procedure performed when a person is hospitalized. This is known as the sublimit. While other policies require the policyholders to pay some amount of the hospital bills as a part of the insurance’s co-payment clause. Hence, before you finalize the plan for the employers, you as an employer need to check the clauses. Also, check the long term care insurance policies that don’t have these restrictions.

Hidden Clauses and Coverage Exclusions

Group long term care insurance might come with coverage exclusions where the public policy doesn’t cover the medical expenses. Hence, you need to check the exclusion list to get an idea about the scope of the policy coverage. Moreover, it is crucial to find out if the group insurance policy has any hidden clauses. For instance, some policies might not cover their employees and their family members after a certain age. Get to know the clauses before you get the long term care insurance coverage.

Who is Eligible for Group Long Term Care Insurance?

Usually, group long term care insurance is provided by an employer to an employee. But the non-employer to employee groups is also eligible.

No matter you are a large-scale organization or a small business owner, or a group with similar interests. The people who cater to the following group health plan requisites are eligible for group long term care insurance.

The Minimum Number of Employees

A minimum of 7 or more employees has to be present in an enterprise or organization to apply for the group LTC insurance. These employees can also be family members, such as a family business. However, there has to be an employer-to-employee relationship to get the long term care insurance benefits.

Registered Businesses

You have to register the business in your state. For this, you need proper paperwork.

Usually, group long term care insurance is inexpensive. Thus, you can’t form a business or group to buy the insurance. If you try to breach this, it might lead to a refusal by the insurance company. A business needs to be engaged in economic activities at all times and not start their work after they have inquired about the group LTC insurance.

Who is Not Eligible for Group Long Term Care Insurance?

Like other insurance policies, employee group long term care insurance coverage also comes with certain limitations. In case your business falls under any of the following categories, you won’t be eligible for health coverage.

Family Business

If the family business is made up of both non-members and members of the family, your spouse will be eligible for the group cover. But if the business group only has family members, the spouse will not be covered.

Single Entrepreneur

In case you are a single entrepreneur without full-time equivalent employees, you won’t be eligible for long term care insurance. But you can always apply for individual insurance to make sure you are protected.

Tips to Buy the Best Group Long Term Care Insurance Policy for Your Employees

A happy employee can be the biggest asset to your company. Thus, if you are a business owner, you should be straightforward to unlock higher growth to make sure your employees are happy.

Thus, here are some tips that will help you get the best group long term care insurance for your employees.

Learn About Your Budget and Basic Requirements

You can go about this in two different ways. Firstly, you need to the employees health requirements and then decide on a budget. When you have set a budget, you have to outline the requirements within the set budget.

When you are choosing health LTC insurance, there are many nuances to it. Here are some key questions that you need to answer.

  • What will be the coverage limit for long term care insurance?
  • What type of diseases and medical issues will the long term care insurance policy cover?
  • Will the long term care insurance policy include vision and dental care?
  • Which hospital networks will come under the policy?
  • Will the policy only include the employees or their family members, too?

Check the Industry Standards

Before you buy the long term care insurance policy, you should do some industry-wide research to find out the type of health plans your competitors are providing to their employees.

You should provide benefits as per industry standards. Thereafter, you can take a step or two to make sure your team enjoys more long term care insurance benefits. What’s better is if you outdo the industry standards.

Ask Them the Type of Plan They Prefer

You are getting the group LTC insurance for your employees. Hence, you should ask them the type of long term care plan they would prefer. One of the common mistakes that businesses tend to make is to get a group LTC insurance plan as an obligation. They might ignore all the benefits that it brings for the employers and the employees. Hence, they make the decision based on what they like. Avoid being the same.

You should discuss the type of LTC insurance plan you should get with your employees. No that doesn’t mean you have to listen to whatever they demand as you might not have much resources. But you can always ask for their opinions to understand what they need. It can help in choosing the best long term care plan for them.

Relevant Statistics

  • Over 60% of businesses offer group long term care insurance as part of their employee benefits package.
  • The average annual premium for group long term care insurance is $1,500 per employee.
  • More than 70% of individuals with group long term care insurance coverage feel more secure about their future healthcare needs.
  • Studies show that employees with access to group long term care insurance are 20% more likely to stay with the same employer for longer periods.
  • Group long term care insurance policies typically cover up to 80% of the cost of nursing home care, allowing individuals and families to better manage expenses.

General Facts

  • Group long term care insurance is a type of insurance coverage designed to help cover the costs of long-term care services.
  • It is typically offered as a benefit through an employer or an organization to a group of individuals.
  • This type of insurance can help cover expenses related to nursing homes, assisted living facilities, home healthcare, and other long-term care services.
  • Premiums for group long term care insurance are often lower compared to individual policies due to the larger risk pool.
  • Group long term care insurance may have eligibility requirements and waiting periods before benefits can be accessed.

Consult an Expert

There is only so much you can know by reading and watching. The insurance world can be complicated as there are many terms and conditions that have to be taken care of. Having an expert by your side can help. They will help you to choose the right long term care insurance policy and personalize it as per your requirements.

With an expert on your side, you will get to learn more about the group LTC insurance and the type of plan you need. For your employees, the group long term care insurance policy depicts the affordable way to get health insurance coverage. But for the employers, the policy is a way of promoting loyalty and efficiency among employees. It goes a long way in retaining employees. By paying the premiums, a business can easily reduce its tax liabilities. So, a group LTC coverage can be beneficial for the employer, as well as the employee.

Give a call to Taylor Benefits Insurance Agency and share your requirements. Ask questions and get your answers for recommendations and advice.

For employees, one of the big advantages of an employer-sponsored long-term care insurance plan is that it is significantly cheaper than an individual plan (as with most group plans). Since the premium is based on the group as a whole, and not each employee individually, the overall cost per person is reduced to a much more manageable price.

Get a FREE estimate for group long-term insurance plans by calling us at the number at the top of the page or completing the short online request form! All estimates and consultations are given FREE OF CHARGE and require no obligation on your part!

Written by Todd Taylor

Todd Taylor

Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.

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