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General Description
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Long-term Care is optional insurance, administered by
the Program Administrator, which provides benefits to
help cover the expenses of personal and medical care for
individuals needing help with functional abilities such
as eating, bathing and dressing.
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Overview
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Eligibility
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Eligibility
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Eligibility for Family Members
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Eligible family members, with some restrictions,
include spouses, domestic partners, parents, and
grandparents.
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Eligibility
for Family Members
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Amount of Benefit
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If the Program Administrator finds that you are
eligible, benefits will be paid for services provided to
you as stated in your approved Service
Plan.
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Benefit
Maximums
Alternative
Care Benefits
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How Benefits Are Paid
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The Program Administrator will pay benefits directly
to you on a monthly basis, unless you assign your
benefits to the provider of care.
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How
and When Payment Received
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How do I...
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Contact the Program Administrator to change your
coverage. You can increase your coverage every three
years by choosing a higher Plan Option and providing Proof
of Good Health. You can decrease your coverage one
year after your coverage effective date, by choosing a
lower Plan Option. In addition, under certain
circumstances, you can increase the maximum benefit your
option pays.
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How
to Change Coverage
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Complete a Group Long-term Care Plan Enrollment Form.
If you enroll after 30 days of becoming eligible, you
will also need to provide proof of good health. If you
are enrolling a domestic partner, you will need to have
a Declaration of Domestic Partnership on file.
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How
to Enroll
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The claims filing procedure will differ, depending on
whether you are already receiving care, or are planning
to receive care.
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Filing
a Claim
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Cost
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Premium rates vary depending on the Long-term Care
coverage option you select and your age at the time you
enroll.
Premiums are paid through payroll deductions.
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Long-term
Care Costs
Premiums
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Approvals
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The covered person must have a Qualifying Impairment
and satisfy the wait period. In addition, if you are
enrolling after 30 days of becoming eligible, or if you
want to increase your coverage, approval is subject to
evidence of good health.
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Limitations
and Exclusions
Qualifying
Impairment
Evidence
(Proof) of Good Health
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For additional information:
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Contact the Program
Administrator . |
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