LTC Bullet:  The 16th Annual Inter-Company Long-Term Care Insurance Conference:  A Virtual Visit

Friday, March 18, 2016


LTC Comment:  In case you couldn’t be there, today’s LTC Bullet provides a little glimpse and some of the flavor of an exceptional industry meeting convened earlier this week, after the ***news.***

*** TODAY'S LTC BULLET is sponsored by Claude Thau, a GA whose proprietary tools help advisors find clients and reduce the “Ping-Pong” in the LTCi sales process. Help clients make informed final decisions about buying LTCi in 15-20 minutes!  Gauge a client's true interest in a combo product immediately!  Change work-site LTCi sales from a series of proposal deliveries to a single interactive consultation!  Claude is the lead author of the Milliman Broker World LTCi Survey, one of Senior Market Advisor's 10 "Power People" in LTCi in 2007, a past Chair of the Center for Long-Term Care Financing. Test Claude by calling 800-999-3026, x2241 or email him at to ask questions or get references. ***

*** WE NEED YOU.  Every time I attend a major industry conference like the one described in today’s LTC Bullet, I’m gratified by the many expressions of appreciation I receive for our work at the Center for Long-Term Care Reform.  Thank you!  But let me make this appeal, if you are receiving our content forwarded by others, please consider joining the Center on your own.  The only thing that makes our contribution to improving long-term care financing policy possible, is the support we receive from our very special individual and corporate members.  So, please, if you get value from our publications and you appreciate our advocacy on behalf of responsible LTC public policy, lend us your support by joining and contributing to the Center and our common mission.  Contact Damon at 206-283-7036 or ***


LTC Comment:  The biggest and best LTC insurance industry conference wrapped up at the Hyatt Riverwalk in San Antonio, Texas on Wednesday.  Attendance approached 1000, slightly down from last year, but the quantity and quality of sessions as well as the opportunities for networking were as plentiful and rewarding as ever. 

It would have been virtually impossible to top last year’s event at The Broadmoor in Colorado Springs, and there were a few overcrowded sessions this year, but conference founder Jim Glickman told me that’s because a larger proportion of attendees actually went to the educational session than last year.  He also opined that this year’s meeting was more upbeat, thanks to a new entrant to the business (National Guardian), optimism about combo products, and a general sense that LTCI has passed its nadir and is on the way back up.

LifeHealthPRO reporter Alison Bell took away a less sanguine impression of the meeting’s mood as she reported from the conference on March 15 in “ILTCI attendees hope traditional LTCI gets better soon”:  “[T]he conversation is more somber than it was a year ago … with news of MedAmerica's departure from the long-term care insurance (LTCI) market still fresh.”  My impression:  It’s a “glass half full or half empty” quandary which pretty well describes the LTCI industry’s current condition.

What follows are some quick impressions of the sessions I attended.  They are not a representative sample as I visited almost exclusively the program’s “Alternative Solutions” track.  (Special thanks to Eileen Tell, John O’Leary, Brian Vestergaard, and Don Redfoot for the hard work they expended to put together the seven sessions comprising the Alternative Solutions Track.)  The other tracks were Actuarial; Claims & Underwriting; Combination Products; Finance, Management & Operations; Legal, Compliance & Regulatory; Marketing, Sales & Distribution; and Technology. 

To find a list and description of all the sessions in all the tracks including links to the slide decks for many of the presentations, click here and check out the conference’s web-based version of the smartphone app that guided participants to all the sessions.  You’ll be quickly impressed by the range and richness of the content.

Texas Insurance Commissioner David Mattax offered a welcome to San Antonio and delivered some remarks about regulation of the LTCI product in Texas.

This year’s keynote speaker, sponsored by Agent Review, was Ken Schmidt, brand visionary and former communications strategist for the Harley-Davidson Motor Company.  The eponymous motorcycle company famously reinvented itself, rising from sinking failure to market ascendancy under Schmidt’s guidance.  He urged the audience to ask and answer three questions:  What are people saying about you?  What do you want them to say?  And how do you get them to say it?  Drawing parallels between the motorcycle industry and long-term care insurance, spiced with humorous anecdotes, the speaker pointed to ways a company in the latter business might achieve extraordinary results like those he and Harley Davidson achieved.  I don’t think anyone who heard the talk will be able to see and hear a HOG (Harley Owners Group) member revving his bike’s engine at an intersection without laughing and contemplating “How can we get people to brag about owning a long-term care insurance policy the way Harley owners take pride and satisfaction in their purchase?”

The first break-out session I attended was What's on the Minds of Combo Product Thought Leaders?   Producer Linda Chow of Ernst & Young brought together panelists Barry Fisher – Broadtower; Dennis Martin – OneAmerica; Parag Shah - Pacific Life Insurance Company; Steve Schoonveld - Lincoln Financial Group and Anthony Vossenberg – Genworth.  Consensus quickly emerged that the combo market remains largely untapped, that many more players are needed and wanted in the market, and that while combo products do not replace traditional LTC insurance, they do fill a critical space that fulfills and expands the mission of LTC insurance protection.  All in all, a very positive panel enthusiastic about the future prospects for their niche of the market.  Refreshing.

Next came the two-part “Alternative Finance Proposals” sessions.  Together the two sessions provided a review and summary of work recently reported by the SCAN Foundation, Leading Age, the LTC Collaborative, and the Bipartisan Policy Center. Click here for details on Part 1.  Part 1 focused on the “Economic and Actuarial Modeling Results” that formed the basis for analysis and recommendations reported by these groups and the policy implications explained in Part 2 of the program.  Independent consultant Anne Tumlinson described the “Top Ten Lessons from LTC Financing Research.”  Milliman actuary and mathematician Al Schmitz greeted the audience with “Happy Pi-Day” (3.14.16) and proceeded to explain how Milliman brought actual industry data to bear in the review and analysis of policy options and proposals.

Part 2 ( covered “the policy implications of the results and potential next steps from the study funders and from the perspectives of other interested parties.” The presenters said, in a nutshell, that private long-term care insurance on its own is too expensive to make much of a difference so it should be targeted toward a two-year front end role while a mandatory, government program paid for by an extra payroll tax should pick up the back-end, catastrophic risk.  I wanted to ask this question, but could not get recognized:  “You’ve put a lot of effort into showing why private, voluntary LTCI won’t work, which leaves you with a mandatory public program by default.  What effort have you put into considering that the mandatory public programs we already have--Social Security, Medicare and Medicaid--face trillions in unfunded liabilities and become insolvent in the 2030s just as the first baby boomers turn 85 and start needing LTC in skyrocketing numbers?”  I always wonder why private market options are scrutinized thoroughly but public funding alternatives get a casual pass—at least until they become law like CLASS and then blow up in the face of hard reality.

The next session I attended was New Research on LTCI (  Susan Coronel and Marc Cohen shared insights coming out of two important new studies, one of which looked at 25 years of buyer and nonbuyer research and general population surveys on LTCI.  The other updated critical work on claimant satisfaction, needs, experiences and the role of insurance.  Here are a few highlights, but watch for the full results in forthcoming reports.  Average age of LTCI purchase is down from 68 in 1995 to 64 in 2015 but up from 63 in 2010.  Only 26% think it’s the federal government’s responsibility to finance LTC for everyone.  Nursing-home-only policies have disappeared, but they were 60% of all LTCI policies in 1990.  Consumers who bought early underpriced polices were getting a very good deal.  LTCI claims are predominantly for home care (36%) and assisted living (30%).  Claims paid to date are a little less than $100,000 on average, a fairly high level of benefit with the vast majority of benefits way above premiums paid.  Very high, 96%, satisfaction with LTCI policies reported.  Summary:  Insurers are performing well for claimants regarding the claim filing process.  Insurance is achieving multiple goals :  affordability of services, ability to access high quality care, reducing burden on families, receiving care timely and not delaying, supporting choice regarding services. 

What Role Should Informal Caregivers Play in Alternative Solutions
Click for details and access to presentation slides:  Unpaid (don’t call them “informal”) caregivers are the unsung heroes of long-term care.  The statistics are alarming:  60% of caregivers are women averaging 49 years old (1 in ten is 75 years plus).  They provide 24.4 hours per week of care; a quarter give 41 or more hours of care.  Duration averages 4 years, but a quarter provide care for more than 5 years.  Worst of all, we’re  living in the halcyon days now because typical caregivers are boomers.  The supply of caregivers will decline radically just as the number of people needing care explodes in the 2030s.  The value of unpaid care is $470 billion, which exceeds the entire cost of the Medicaid program.

Thought Leaders Forum (  LTCI industry veterans (Jodi Anatole - Independent Consultant; Malcolm Cheung - Cheung Consulting, LLC; Laura Moore - TriPlus Services, Inc.; and Karen Smyth – Prudential) opined about “the successes, failures, hits and misses of our industry.  If we knew then what we know now, what would they have done differently?  What are the key lessons of the past and how do they or should they inform the future?”  The reflections of these experts were too many and varied to summarize, but I’ll share one that especially struck me.  When asked “what role should the public sector play?,” Laura Moore said we’re no closer to “cracking the nut of LTC risk;” there won’t be enough caregivers; there is no way Medicaid can cover the LTC need; and we’re going to see a “financial tsunami to make the current challenges we face look like a mere blip.”  So there has to be a public/private solution, but her biggest fear is that we’ll wait until the crisis happens to deal with it.  Hear, hear!

The conference’s closing general session was It's Not Me, It's You; A Consumer View on LTCI (  Behavioral economist Jeremy Pincus and consumer insight expert Luisa Uriarte delivered new information about how our current approach and sales and marketing techniques are actually standing in the way a broader appeal for long-term care insurance.  These fascinating presentations challenged everything we thought we knew about LTCI marketing, such as--explain the problem, price the risk, scare the pants off ‘em and they’ll buy.  Well, no, turns out that just drives people away.  What’s needed is an approach that generates good feelings and makes people positive about preparing for what’s coming.  Interestingly, this session was a perfect bookend for the conference, by providing evidence from behavioral research for some of the same insights about human behavior shared by the opening general session speaker about the turnaround he led at Harley Davidson.

The last full day of the conference ended with a closing exhibit hall session capped by a prize drawing and leading into a “casino night” featuring Texas hold ‘em and Blackjack tables.

That was not the end, however.  Wednesday morning’s offering was Alzheimer’s Association Session:  Advancements in Research, Current Breakthroughs and a Personal Story.  Details:  James A. Hendrix, Ph.D., Director, Global Science Initiatives, at the Alzheimer’s Association, opened the program by acknowledging that, yes, he is Jimmy Hendrix, followed by delivering a summary of the current status and recent findings of Alzheimer’s research.  The numbers are staggering:  Alzheimer’s cost is $226 billion growing to $1.1 trillion by 2050; 50.1% of boomers will have the disease by 2050; it will consume a quarter of Medicare funding by then.  In the meantime, NIH spends $586 million on research, less than for other major illnesses.  Research has made progress against other diseases and other diseases are declining as causes of death, but Alzheimer’s continues to increase.

Numbers are scary, but nothing moves an audience like a personal story.  Barb Cole shared the saga of early onset Alzheimer’s Disease experienced by “someone she knows very well.”  She talked about the confusion, the exclusion, the frustration, the expense, on and on as you can imagine from hearing so many similar stories.  What brought the audience to its feet in a standing ovation was when Ms. Cole acknowledged that the “Annie” of her story was actually she, herself.  Barb Cole reinvented herself after her devastating diagnosis by telling her story, opening others’ eyes, and advocating on behalf of the Alzheimer’s Association for the past six years.

See what you missed this year?  Mark your calendars now:  The 17th Annual ILTCI Conference will be held March 26-29, 2017 at the Hyatt Regency Jacksonville Riverfront in Jacksonville, FL. 

P.S.  The last time the ILTCI conference convened in Jacksonville, Florida was 2008 during the Center for Long-Term Care Reform’s “National LTC Consciousness Tour.”  We parked the “Silver Bullet of Long-Term Care” right in front of the Hyatt Regency venue, stocked the fridge with refreshments, and opened the little Airstream trailer as a “hospitality suite” for all visitors.  Check out our review of that year’s conference:  “LTC Bullet:  The Jacksonville LTCI Conference,” Thursday, March 20, 2008.