The history of America's long term care insurance industry.

1. Long Term Care:
Beyond the Nursing Home
International Claim Association
2012 Annual Education Conference
Orlando, FL
October 2, 2012
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2. Robert R. Pohls, Esq.
Pohls & Associates
Walnut Creek, California
Peter K. Burke
AVP, LTC Claims Operations
John Hancock Financial Services
Boston, Massachusetts
Rita Bennett, RN, BSN, LTCP
Director, LTC Operations
Bankers Life and Casualty
Chicago, Illinois
Lori M. Watson
Director, LTC Claims
Genworth Life
San Rafael, California
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3. Session Agenda
• Goal of session
• Interactive session – audience participation!
• Long Term Care
• Past
• Present
• Future
• Wrap up
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4. The Early Years:
1970’s – Early 1980’s
A Walk Down Memory Lane…
LTC Options
• Nursing Homes
• Slow emergence of Assisted Living Facilities
• Concept of “graduated care” emerges
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5. LTC Insurance
• Traditional health insurance generally did not cover LTC
options
• LTC offered by only a few companies
• Medical Necessity trigger determined by admitting
physician
• Indemnity-based benefit structure
• Prior hospital stay requirement
The Early Years:
1970’s – Early 1980’s
A Walk Down Memory Lane…
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6. The Early Years:
1980’s – Early 1990’s
A Walk Down Memory Lane…
LTC Options
• Nursing Homes
• Assisted Living Facilities
• CCRCs/Life Care Communities
• Home Health Care, Adult Day Care, etc
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7. LTC Insurance
• Comprehensive policies
• HIPAA impact and NAIC influence
– Chronically Ill trigger
– Qualified Long Term Care Services defined
– Non-duplication of Coverage
The Early Years:
1980’s – Early 1990’s
A Walk Down Memory Lane…
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8. The Early Years:
Mid 1990’s – Present
A Walk Down Memory Lane…
LTC Options
• Nursing Homes
• Assisted Living Facilities
• CCRCs/Life Care Communities
• Home Health Care
• Adult Day Care
• Supportive Equipment
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9. LTC Insurance
• Comprehensive policies
• More insurers enter the market
• Expense reimbursement benefit
• Popular and sought out coverage
• Growing media, Departments of Insurance and consumer
interest
The Early Years:
Mid 1990’s – Present
A Walk Down Memory Lane…
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10. Lessons Learned
and the Future of LTC
• Lessons learned?
• Gaps - what are they and how do we address them?
• Alternate Plans of Care – what are they being used for?
• Long term care delivery – what are the expectations?
A Few Thought Provoking Questions…
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11. Wrap up – Questions?!?!
Robert R. Pohls
Managing Attorney
Pohls & Associates
1550 Parkside Drive
Suite 260
Walnut Creek, CA 94596
Ph: (925) 973-0300
rpohls@califehealth.com
www.califehealth.com
Peter K. Burke
Assistant Vice President
LTC Claims Operations
John Hancock Financial Services
200 Berkeley Street, B5
Boston, MA 02117
Ph: (617) 572-1979
pkburke@jhancock.com
Rita Bennett, BSN, RN, LTCP
Director, LTC Consumer Relations,
Risk Management
Banker’s Life
111 E. Wacker Drive
Chicago, IL 60654
Ph: (312) 396-6747
r.bennett@banklife.com
Lori M. Watson, CLTC, LTCP
Director, LTC Claims
Genworth Life
1650 Los Gamos Drive
San Rafael, CA 94903
Ph: (415) 492-7916
lori.watson@genworth.com
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