In this series of articles, I have walked you through the federal employee health benefits program, which applies to both employees and retirees, the decisions you need to make regarding your federal employee group life insurance, and the potential benefits of filing with the Federal Dental and Vision Insurance Program. This time I will close with an overview of the federal long-term care insurance.
There is one major difference with the FLTCIP: the program will not be accepting new applications for enrollment until the end of next year pending a review of the program’s funding. Also, requests to increase existing coverage will not be accepted, although such coverage will continue as long as current policyholders continue to pay premiums.
What is covered
FLTCIP covers services you may need if you are unable to take care of yourself due to a chronic mental or physical illness. These services include things like nursing home care, home health care, assisted living facilities, adult day care, and personal or home care. Coverage is provided by LTC Partners, LLC and underwritten by John Hancock Life & Health Insurance Company under contract with OPM.
Whether you choose to join this program or not is entirely up to you. When you sign up, you pay the full cost of the rewards. As long as you are paying these premiums, FLTCIP benefits cannot be changed because of aging, declining health, or other reasons unique to you, unless you apply for and receive a higher benefit level.
However, with the approval of OPM, premiums may be increased if it is determined that premiums for a particular group of insured will not be sufficient to cover the projected cost of those services. There is a good chance that the current review of the program will result in such an increase.
Those eligible to enroll in the program cover a much broader spectrum than other federal employee insurance programs:
• Federal employees, including the Postal Service and the Tennessee Valley Authority;
• federal retirees, surviving spouses of deceased federal or postal employees, and former employees who are eligible for a deferred pension, and retired federal employees who are in receipt of workers’ compensation;
• Members of the unformed service who have been on active duty or full-time duty with the National Guard for more than 30 days, active members of the selected reserve, former members of the uniformed service, and retired military reservists who are eligible for retirement or salary payments;
• current spouses of employees, pensioners and survivors’ pensioners, and cohabiting spouses recognized by the state in which they live;
• Civil partners of federal, postal, annuity, and retired uniformed service employees who submit a Civil Partnership Declaration Form;
• adult children, including birth children, adopted children and stepchildren, but not foster children;
• Parents, parents-in-law and step-parents of living workers and their spouses, but not of civil partners or pensioners.
While there is no upper age limit, there is a lower one. You must be at least 18 years old at the time of application.
If you meet the eligibility criteria, you may enroll in the program at any time, subject to underwriting, a series of health and other life questions.
The traditional policy has been that newly hired employees and their spouses have 60 days to apply under an abridged (“abbreviated”) form of underwriting, after which they must undergo standard (“full”) underwriting. This also applied to newly married spouses of employees. However, this will change when the program resumes accepting new applications, in all cases full risk assumption applies unless the OPM announces an exception.
Other beneficiaries have always been subject to full insurance.
As an insured you can choose a maximum benefit, the duration of the contract and the type of inflation protection. You can also choose between fully comprehensive insurance and health insurance. The premiums you pay depend on the coverage you choose and your age at the time of enrollment.
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