Asset Based Long Term Care Product Comparison Table

The below table provides a quick comparison of the asset based long term care products we’ll be discussing in this guide.

 HOW IT WORKSFUNDING METHODSMINIMUMISSUE AGESKEY FEATURESUNDERWRITING
Global Atlantic
ForeCare
Annuity that provides three times leveraging for
clients in good to average health, and two times
leveraging for clients in below average health
Non-Qualified Only$35,000 Deposit50-80Joint life annuity with simple
benefit leveraging formula; most
applicants qualify for coverage
Simplified Issue
Lincoln Financial
MoneyGuard II
Simplified Issue Guaranteed Universal Life
product with below average death benefit
leveraging, but great leveraging for long term
care benefits
Non-Qualified Only$50,000
specified amount
40-79No distinction between smokers
and non-smokers; all clients
through table 4 qualify for
standard rates
Simplified Issue
Nationwide
Care Matters
Simplified Issue Life product with great
leveraging for LTC
Non-Qualified Only
Lump Sum, 5-pay,
10-pay
$60,000 deposit40-75Cash indemnity benefits; 20%
guaranteed minimum residual
DB; informal caregivers allowed;
90 day elimination period; ROP
Simplified Issue
OneAmerica
Asset Care I - IV
Survivorship Whole Life
product with below average death benefit
leveraging, but great leveraging for long-term
care benefits; Lifetime benefits available
Asset Care I:
NQ lump sum
Asset Care I:
$10,000 deposit
Asset Care I:
40-80
Variety of funding methods
accepted, including qualified
transfers and annuity 1035
exchanges; survivorship with
benefits for life
Begins as simplified
issue; becomes
fully underwritten
if client has not
seen a doctor in 12
months, has a history
of severe health
impairments, or if
net amount at risk
exceeds $250,000
Asset Care II:
Annuity 1035 exchanges
Asset Care II:
$20,000 deposit
Asset Care II:
59.5-80
Asset Care III:
Qualified funds
Asset Care III:
$20,000 deposit
Asset Care III:
59.5-80
Asset Care IV:
10-pay, 20-pay, life-pay
Asset Care IV:
$50,000 face
amount
Asset Care IV:
20-80
OneAmerica
Annuity Care I & II
Individual and joint life fixed annuities with
extended benefits for long-term care.
Annuity Care I:
Non-Qualified or
Qualified funds
$10,000 depositAnnuity Care I:
50-85
Joint life annuity with benefits
for life
Simplified Issue
Annuity care II:
Non-Qualified Only
Annuity Care
II: 40-80
Securian
SecureCare
Simplified Issue Universal Life with great
leveraging for LTC
Non-Qualified Only,
Lump Sum
5-pay, 7-pay, 10-pay,
15-pay
$50,000Lump 40-75
5pay 40-70
7pay 40-68
10pay 40-65
15pay 40-60
Cash Indemnity, 100% ROP, 10%
residual DB or $10k, whichever
is less, 3% or 5% Simple or
Compound Inflation options, 90
day EP
Simplified Issue, But
APS can be ordered
for cause

Definition: Asset Based Long Term Care

Asset Based Long Term Care is specific products issued by Insurance Companies that can provide long-term care benefits in the event you need care. They are alternatives to long term care insurance.

However, if you never require care, your asset passes to the next generation and becomes part of your legacy to your beneficiaries. The marketplace has proved this is a welcomed change from the “use it or loose it” benefits provided by traditional long term care.

When you purchase an Asset Based Long Term Care product you are essentially leveraging a portion of your assets to fund your long term care insurance. In this way, the cost for the long term care insurance you receive is the opportunity cost of what your asset could have earned had it was invested elsewhere.

What is Long Term Care Insurance?

Long term care is advanced and costly care that must be administered over a long period of time due to some type of debilitating illness. It is often referred to as (LTC) and traditional long term care insurance is many times abbreviated as (LTCI).

Long Term Care doesn’t just mean the nursing home. In fact,  LTC needs may arise sooner than you think. Short-term access to long-term care can help you recover from a sudden illness or injury. For example, while recovering from hip surgery you may need rehabilitation therapy that requires several weeks or a few months at a nursing facility.

This risk is a source of anxiety for retirees, yet most are unwilling to accept the variable costs and potential loss of premiums paid under conventional health-based long-term care insurance products. And few have taken steps to understand the complete range of long-term care insurance product features and options available to them.

No one wants to think, “This could be me” and no one can predict the future. But, according to the U.S. Department of Health and Human Services (1):

  • More than half of those 65 today will need some type of long-term care services and support. The average cost of those services and support is $138,000.
  • Women generally need care for longer periods than men. As a result, the average cost of long-term services and support for men is $91,100 and doubles ($182,200) for women

There are more options than ever to help you maintain comfort and dignity during a care need, including receiving care in your own home. All types of quality Long Term Care are costly especially In- Home Health Care. 

Long Term Care Qualifying Expenses

Aging, accidents, illnesses and chronic conditions may limit your ability to care for yourself. When this happens, you need access to quality care. You also may need assistance with everyday, personal tasks. Licensed long-term care providers and long-term care facilities can help with these and other types of “activities of daily living:” 

Asset based long term care insurance benefits become available when you are either confined to an assisted living or nursing home facility, or, when you are no longer able to complete 2 out of the 6 activities of daily living.

3 glass jars filled with coins, one labeled savings, 2nd labeled vacation and the 3rd medical asset based long term care guide

Activities of Daily Living

  • Bathing
  • Continence
  • Dressing
  • Eating
  • Toileting
  • Transferring (moving in and out of bed)

There are other everyday tasks that you may need assistance with, including:

  • Housework
  • Managing money
  • Taking medication
  • Preparing and cleaning up after meals
  • Shopping for groceries or clothes
  • Using the telephone or other communication devices
  • Caring for pets
  • Responding to emergency alerts such as fire alarms

 

Asset Based Long Term Care Helps Mitigate Longevity Risk 

 Retirement income planning involves three important unknown factors:
 

1. How long people will live
2. How their investments will perform over time
3. How much they will spend each year in retirement

Our Retirement Income Planning Worksheet is a fillable PDF that simplifies some of the calculations required to create a basic income plan.

The unknown cost of health care is among the most significant risks to any retirement plan. This risk amplified even further by the greatest risk we all must face in retirement, Longevity Risk. Advancements in modern medicine and healthcare American’s Life Expectancies continue to increase. All retirees face the possibility of a debilitating illness that will require advanced and costly care over a long period of time.

This risk is a source of anxiety for retirees, yet most are unwilling to accept the variable costs and potential loss of premiums paid under conventional health-based long-term care insurance products. And few have taken steps to understand the complete range of long-term care insurance product features and options available to them.

Will you need long-term care? The statistics say more than likely. With the life expectancy continuing to grow, those statistics will grow stronger.

Currently more than 70 percent of people over the age of 65 will need long-term care in their lifetime. 

Who would take care of you? How would you pay for long-term care?

While the numbers say you should prepare for long-term care, how you will pay for it is becoming complex. Medicare, Medicaid, health or disability insurance, long-term care insurance, reverse mortgages, and life insurance are just some of the possible sources.

Older retired gentleman pushing great grandson on the swing

HIPPA Makes Asset Based Long Term Care Possible

The chaos in the traditional health based long term care insurance led many middle-income retirees to throw up their hands in frustration and decide to simply take their chances on not needing assistance in old age.

Understanding this frustration, Congress has passed laws that provide incentives for taxpayers to purchase LTC coverage but in a manner different from traditional, stand-alone, health based LTCI. 

In 1996, with the:

  • Health Insurance Portability and Accountability Act (HIPAA), the federal government set forth the requirements for tax qualified LTC policies. Until that time, the tax status of benefits paid under LTC policies was uncertain. HIPAA provides that, if the policy meets certain triggering events for payment of benefits, then the benefits paid will be received free of income tax. 

These provisions are codified in:

  • Internal Revenue Code (IRC) Section 7702B.18 HIPAA also provides for the first type of “combination contract” or what is known as a hybrid or asset based LTC policy
 

Asset Based Long Term Care – Alternative to Traditional LTC

Life Insurance Combined with LTC Benefits

HIPAA stated that life insurance and LTC benefits could be combined in one policy. If the provisions for payment of LTC benefits comply with the law, those benefits will be received income tax free.(6) Additionally, if the policy pays no LTC benefits and the policy pays its life insurance death benefit on the insured’s death, then that benefit will also be received free from income tax. (7) 

The typical configuration of a life insurance asset-based contract involves what is basically an acceleration of the life insurance policy’s death benefit for qualified LTC claims. 

For example, a policy may provide that the maximum monthly LTC benefit is 2 percent of the policy’s death benefit. Hence, if the policy had a $250,000 death benefit, the maximum monthly LTC benefit would be $5,000 per month for 50 months. Each payment of LTC benefits would correspondingly reduce the policy death benefit. If the full payment of $5,000 were to be paid for 50 months, the policy death benefit would likewise be exhausted.

Benefits of Asset Based Long Term Care

#1.  If there are no LTC claims the insured’s beneficiaries receive the policy death benefit, and receive it income tax free.

#2.  Pricing Stability – It is fair to say that the mortality of the U.S. population has been one of the most studied of any in history, and it is fair to say that the actuarial profession has the mortality risk of the general population pretty well figured out. Risks associated with Long Term Care Insurance, a relative newcomer, have proven difficult to accurately predict. Asset Based Products combine the uncertainty of LTC underwriting with the relatively stable assumptions used in life insurance.

 

#3.  They permit the individual who is willing to partially self-insure his or her LTC risk the ability to do so and to do so in a manner that is generally more tax efficient than with any other method of investment. Setting aside funds in an asset-based life insurance LTC policy can free up other funds to use as the insured desires in his or her retirement and estate planning.

 

Long Term Care Annuity

A long term care annuity is an annuity with a qualified long term care rider attached.

The second of the two laws passed by Congress that had a positive impact on the LTC marketplace, specifically long term care annuities, is the:

  • Pension Protection Act of 2006 (PPA). The PPA extended the preferential treatment of life insurance LTC combination contracts to deferred annuity LTC combination contracts.(3)

With a traditional (non-LTC) fixed annuity, withdrawals are taxed as ordinary income to the extent there is gain in the contract, and gain is deemed to be distributed first.(4)  However, the payments made from an asset-based annuity for qualified LTC expenses are income tax free. Amounts remaining in the contract at the annuitant’s death are ordinary income to the annuitant’s beneficiaries to the extent there is taxable gain remaining in the contract.

  • IRC Sec. 1035 Exchanges to Asset-Based Policies – If you own an existing non-qualified annuity with gains that have accumulated tax-deferred for years – you will be required to pay ordinary income tax on those gains at the time you withdraw them from the annuity contract (LIFO).

However, if you 1035 (commonly called transfer) your existing annuity to an Annuity with LTC Benefits; your gains will come out income tax free if used to cover qualified LTC expenses. 

This is one of the very few examples when the IRS allows you to go from tax-deffered to tax-free. If you pass the annuity on to your beneficiaries or withdraw your funds for any other purpose, gains will be taxed just like they would on a traditional non qualified deferred annuity.

Long Term Care Annuity Example

The below chart is an example of how an annuity with a long term care benefit works. This sample illustration shows the benefits provided to a 60 year old female purchasing a One America Annuity Care II with $100,000.

As you see the Single Premium is $100,000 (purchase premium) and the LTC Balance is $250,176. The $250,176 is the total amount of LTC Benefit this annuity will provide over a 60 month period. 

  1. 100,000 / 24= $4,169 monthly benefit
  2. $4,169 x 36 =$150,084 COB Benefit (additional 36 months)
  3. Premium + COB Benefit = Total LTC Balance $250,084.

 (I realize this number is almost $100 off the illustration below – that is because there is a small amount of interest being credited and I used simple math)

As you can see we’ve added a 36 month COB Rider (continuation of benefits). This annuity is very simple to understand. You take your account value and divide it by 24 to get your monthly LTC Benefit. Your money pays for the first 2 years of benefit and once your annuity account value reaches zero – the COB Rider kicks in to pay the same monthly benefit for another 36 months. 

Asset based long term care illustration using one america annuity care for $100k female

One America Long Term Care Annuity 

The table below lists the Accumulated value, cash surrender value, LTC total Balance and COB Annual Benefit for ages 65 thru 100 (using One America’s Annuity Care II).

You’ll notice the account value and LTC balance are barely increasing and that is because interest rates are so low right now that the cost of the LTC rider is essentially using all of the interest that is earned.

I think of it as paying an intererst rat commencurate with a short term certificate of depost. The only reason to purchase this annuity is to leverage your asset two and a half times for LTC and favorable tax treatment.

If your goal is more geared towards accumulation you can view and compare current fixed annuity rates at our online fixed annuity store.

Long term care annuity with ltc benefit rider table of cash, ltc and surrender value for 100k one american annuity care ii policy

At the time this article was written, there were 14 carriers that market some form of either asset-based life insurance LTC benefits, asset-based annuity LTC benefits, or both (8) and several more carriers are planning to enter the market. While specifics of the various policies may differ, the general methodology for most of them is based on the same concepts described above.

In a nation with an aging population and a volatile economy, and where end-of-life care and the cost
of that care is an ever-increasing concern, understanding the role that asset-based LTC products can play in retirement income planning should be the cost of admission for a financial advisor.

Attorneys, accountants, and financial advisors who work with the elderly often encounter clients who are concerned and confused about LTC. A complete exploration of assets and a thorough knowledge of the options available is required if the advisor is to provide competent advice. 

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