The Long Term Care benefit is an optional benefit program which provides insurance coverage to pay some or all of the costs of assisted living when a person is unable to take care of their daily living needs. Covered services can be received in a nursing home, an assisted living center, through community care or at home. Participants can continue their plan when they retire or leave state service. Who is Eligible Employees, retirees, and spouses, parents and in-laws of active employees or retirees, as well as dependent children under the age of 18 may participate in the program. Active employees are guaranteed acceptance into the plan.
Spouses have limited underwriting criteria to meet to participate.
All others are subject to full underwriting for participation. The employee or retiree does not need to participate for their spouse, parents, in-laws and dependent children to participate. Activities of daily living include bathing, dressing, toileting, transferring, eating and continence. Deductible Period There is a 90-day deductible period which needs to be satisfied only once per lifetime. The deductible period must be 90 consecutive calendar days.