**GAO-08-1016T**                      Published: Jul 24, 2008. Publicly Released: Jul 24, 2008.                  

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## Highlights

As the baby boom generation ages, the demand for long-term care services is likely to grow and could strain state and federal resources. The increased use of long-term care insurance (LTCI) may be a way of reducing the share of long-term care paid by state and federal governments. Oversight of LTCI is primarily the responsibility of states, but over the past 12 years, there have been federal efforts to increase the use of LTCI while also ensuring that consumers purchasing LTCI are adequately protected. Despite this oversight, concerns have been raised about both premium increases and denials of claims that may leave consumers without LTCI coverage when they begin needing care. This statement focuses on oversight of the LTCI industry's (1) rate setting practices and (2) claims settlement practices. This statement is based on findings from GAO's June 2008 report entitled Long-Term Care Insurance: Oversight of Rate Setting and Claims Settlement Practices (GAO-08-712). For that report, GAO reviewed information from the National Association of Insurance Commissioners (NAIC) on all states' rate setting standards. GAO also completed 10 state case studies on oversight of rate setting and claims settlement practices, which included structured reviews of state laws and regulations, interviews with state regulators, and reviews of state complaint information. GAO also reviewed national data on rate increases implemented by companies.

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## Topics

Health Care

Baby boomersBest practicesClaims processingClaims settlementConsumer educationConsumer protectionElderly personsFederal regulationsstate relationsInsuranceInsurance claimsInsurance cost controlInsurance premiumsLong-term careLong-term care insurancePolicy evaluationPrices and pricingProgram evaluationRatesRisk managementStandardsStandards evaluationState governmentsStrategic planningPolicies and procedures