LTC Bullet: 2021 ILTCI Virtual Conference Wrap Up

Friday, April 30, 2021


LTC Comment: This virtual version of the annual Intercompany Long-Term Care Insurance conference was an extraordinary example of electronic legerdemain. Some comments and session reviews follow. This content will be added to our “History of LTC Insurance Conferences.”


LTC Comment: The 2021 Intercompany Long-Term Care Insurance (Virtual) Conference is history. Organizers Barry Fisher and Vince Bodnar eased potential participants into the idea of a virtual conference with weeks of advanced notice and guidelines. They recruited sponsors for the overall meeting, for each track and even for each session. Virtual exhibitors were encouraged to sign and pay up. Somehow, Fisher and Bodnar managed to fund the effort, because beginning Tuesday, April 13, 2021, it kicked off successfully.

After an Opening General Session on the 13th, two different educational sessions began on the hour each Tuesday and Thursday for three weeks from 12pm – 4pm EDT and ran for 50 minutes each, followed by 10-minute breaks. Find the agenda here. Sessions were recorded and are available to any and all through June 2021 using the password ILTCI*2021.

Here’s how to access those recordings: Open the screen. Click “Schedule” on the navigation bar at the top of the page. Click the track name of the session you want to watch. Then find and click the session you’re looking for in the list of track sessions. Find and click the “Access Recording” button at the bottom of the session description. Fill out the information to identify yourself, click “I am not a robot” and you’re in … hopefully.

As might be anticipated with a complicated virtual conference, the outcome was not electronically flawless. The opening session was to be a talk by futurist Anders Sörman-Nilsson, who was actually in Australia speaking at 2am local time the next day. Interruptions and sound difficulties caused that session to be cancelled in the middle, but organizers expect a recording of it, done without the long-distance complications, will be available.

As your humble reporter was preoccupied with other matters during three days of the program, I asked some LTCI experts to help me provide reviews of the sessions they attended. I thank Claude Thau, Stephen D. Forman, and Honey Leveen for sharing their comments on several of the sessions. We decided not to attach names to specific session reviews in order to encourage frank commentary. Those reviews follow.

Session Reviews

Week One

Tuesday, April 13, 2021

Opening General Session

After a slight delay, Conference Chairman Barry Fisher opened the conference with the National Anthem followed by announcements, thank you’s, and sponsor appreciations. He said the meeting had over 1500 unique attendees (which later increased to 1700, then 2000!). He recognized the advisory committee and program/education committee, the professional team, and spoke of other ILTCI initiatives.

Robert Eaton, immediate past Chairman and CEO, thanked sponsors and exhibitors, introduced the conference’s new logo and the new “aging in place track,” concluding that he is more positive about the LTCI industry now than in a long time. We are “fulfilling our responsibility.”

Dennis Martin of One America introduced the opening session speaker, “virtual futurist” Anders Sorman Nilsson. But, as already mentioned, that didn’t go smoothly. We’re assured, however, that “Anders will be back for 2022.”

Speaking of 2022, Steve Schoonveld, next year’s Conference Co-Chair, announced where we’ll meet, hopefully in person: the Raleigh, North Carolina Convention Center. Vince Bodnar will Chair next year’s event.


Session Title: Care Optimization and Best Practices to Streamline the Claims Process

Track: Management & Operations

Presenters: Adam Warner (UW Modernization for LTCi and DI at NYLIC, ex-Claims,, Lucy Beiter (Manager, NYLIC LTCi Claims,, Rita Bennett (, Char Hu, CEO (

Comment: 90% of the audience for whom the question was relevant used nurse assessments and 2/3 used video in 2020 and are definitely likely or somewhat likely to continue to use it.

Recommendation: Treat the 80% expecting recovery differently from the 20% not expecting recovery

BEA = Benefit Eligibility Assessments are becoming more varied and customized.

Recertifications can be simplified if recovery is unexpected.

With facilities, some of the electronic substitutions during the pandemic did not help much because facility staff were overwhelmed.

Recommendation (view recording or not?): Maybe; there were no slides.


Session Title: Seniors and Technology: A Paradigm Shift Toward Digitalization

Track: Management & Operations

Presenters: Laura Moore, Shannon Perschy, Becky Freeman, Christina Newbrough (Helper Bees;

Comment: Several sessions indicate that elders are embracing technology. John Hancock: authenticated, personalized website that allows a person to log on securely and upload a form which by ID is put directly into the queue. Electronic Visit Verification; electronic claims payments; consistent claims across lines; repatriated services that were done overseas. Start clients interacting digitally as soon as possible (premium, claim initiation). I can attest to JH’s excellent upgrade. A classmate’s wife told me how great it was that she could get on the system on the West Coast and work with an East Coast company so efficiently on her schedule. When I passed the compliment on to JH, they were elated because the system had just been released. Thrivent’s upgraded system sends alerts to staff and FUs to claimants during claim. Smart forms reduce displayed fields to those which are necessary. Thrivent learned (more quickly or wouldn’t have learned at all) about out-of-facility days, days paid by 3rd parties, deaths, no licensed health care professional on-site (so need to do another assessment), etc. Thrivent initiated some efforts jury-rigging existing resources in order to test viability before seeking IT resource. Very important to test on a subset of claims.

Recommendation (view recording or not?): Definitely yes!


Session Title: The Good and the Bad of The #1 Trend In The Life Insurance Industry

Track: Marketing

Presenters: Steve Cain (LTCI Partners), Ramona Neal (Living Benefit Review)

Summary: What You Don’t Know Can Hurt You And Your Clients.

– #1 Trend Life Insurance Industry: LTC-Life Insurance Solutions
o LTC-Life Insurance Continuum
o LTC Riders
o Chronic Illness Riders
o The Risks with some Riders
o Critical Illness Riders
– How to Fish: Understanding what You’ve Sold and are Selling
– Regulation and Litigation
– Best Practices
– What’s Good and What’s Bad?

Comment: All riders are good, but are we adequately disclosing how they work? We need to talk about the riders; sales applications; client fit. People are selling policies they don’t understand. Need to make a study of what we are selling. Sometimes the ones that illustrate the best don’t have the best benefit. All the riders are good; it’s about managing expectations. Are we adequately explaining how they work? Read the fine print.

Recommendation (view recording or not?): Yes, good session as no one left early.


Session Title: Existing Managed LTC Programs: What Makes Them Successful?

Track: Aging in Place

Presenters: Ali Ahmadi (Tcare), Sam Espinosa (Mercer), Mary Kaschack (National MLTSS Health Plan Assoc), Sanjit Puri (Moderator, Optum)

Comment: A panel of experts knowledgeable about LTSS programs shared their insights on what makes such programs successful. General overall view of benefits. Big changes in Medicare. What is health related? Benefits don’t have to be uniformly available. Medicare Advantage plans can choose to target benefits. But Medicare is still not LTC. Very limited. 72 hours per year. Title 19 not designed for this; Medicaid through waivers has had to adapt to provide these services. Expanded into categories of services not traditionally LTC. We are offering marriage counseling to a family about to break up. Far beyond traditional services. Pest control. Many MA plans starting to offer these new benefits. Driven by rebate dollars available to Medicare Advantage plans. Can they target these benefits to the people who need them most is critical question. These benefits are not short term, they’re chronic, permanent. Program pretty successful on the Medicaid side as compared to Medicare side. Very positive trend on the LTCI side, but not on the dual eligible side. Misaligned. Just because benefits available doesn’t mean they’re being used.

Recommendation (view recording or not?): Yes, very interesting. The government is moving more and more into providing LTC benefits and supportive benefits. For better or worse.


Session Title: Modeling a Public Long-Term Care Program

Track: Actuarial

Presenters: Eddie Armentrout (Actuarial Research Corporation) absent, had babyChris Giese (Moderator, Milliman), Annie Gunnlaugsson (Milliman), Matt Smith (State of WA)

Comment: This session compared and contrasted actuarial modeling of public LTSS programs to traditional private standalone and hybrid benefits. The panelists used Washington’s LTSS Trust Program as a case study, providing background on the program as a whole, as well as on the methodology and assumptions used in performing feasibility and actuarial studies for the program. Common features of public programs: insurance, premiums, mandatory participation, limited benefit, financing perspective considered a tax on wages, for example; must pay specified number of years to be vested; long time horizons, 75 years typically; not true pay as you go programs; mismatch over time. Methodology and assumptions to model these kinds of programs. Similar to any insurance program. Look at population and analyze income needed to cover costs. Similar to private LTCI. Demography, morbidity and economic assumptions. How differ between private and public. Brand new programs. Demographic: fertility rate, mortality, migration when benefits not portable. Benefit trigger, some states considering more liberal or restrictive triggers. Continuance tables, how long stay on benefit. WA covering first year. Economic assumptions: payroll tax or premiums; payroll tax tied to wages so have to estimate those. Vesting requirement. Interest rate, mismatch between revenue and expenses emerges over time. Prefunding from vesting period, collect revenue but people haven’t vested in program yet. Interest earned on fund balance very important. Social Security Trustees report publishes interest. Treasuries, bonds, equities?

Question: What is public reaction? They rejected advisory and constitutional change to allow investment in equities. But the program goes forward anyway.

Recommendation (view recording or not?): Yes, actuarial science 101. Incredibly complex even at the high level they addressed in this session. Prompts the question: what could possibly go wrong with an actuarially complex government program dreamed up by politicians that the public has rejected twice in referenda.

Same session; different reviewer:

Session Title: Modeling a Public Long-Term Care Program

Track: Actuarial

Presenters: Chris Giese, Milliman; Matt Smith (Department of the Actuary, State of Washington); Annie Gunnlaugsson (Milliman)

Comments: Very interesting session about issues related to pricing a public LTCi program, in particular the WA LTC Trust. Accessing Milliman’s report to the WA LTC Trust provides a lot more detail. Cost varies: CA feasibility range was .3% to 20% payroll taxes

WA average cost =.0058*median = $375/year. $64,655.

Recommendation (view recording or not?): Yes, but accessing the report may be more valuable, depending on your interest.


Thursday, April 15, 2021

Session Title: Industry Best Practices on Common Terminology

Track: Legal

Presenters: Rita Bennett (Lincoln), Allison Brown (Bankers/CNO), Matt Morton (LTCG), Mike Rafalko (Cozen O’Conner), moderator Josh Falco (Lincoln)

Comment: Thought-provoking presentation focusing on common words and phrases found in LTC contracts, viewed from various points of view (including claims, legal, and risk management). Among the most problematic terms have been “care,” “continual supervision,” and “approved.”

Recommendation (view recording or not?): Yes


Session Title: Changing Selling Techniques for Changing Times

Track: Advisors and Agents

Presenters: Bridget Collins, Denise Gott, Alecia Barnette, Angie Hughes

Comments: I noticed the following tips:

  • To protect your Zoom meeting from failure, have wireless back-up in case you lose network connection and be close to your router (if multiple people in the house are on-line, the one closest to the router is most likely to maintain connection).
  • For client convenience, provide webinars on demand and have an appointment-setting tool (I’d add for your convenience too!)

Recommendation (view recording or not?): Good vibrant speakers. If you want to hear more, sure, listen to the recording.


Session Title: The COVID-19 Effect: Claims and Underwriting Processes – Part 1

Track: Underwriting and Claims

Presenters: Karen Smyth, Break-Out session leaders: Allison Brown, CNO; Arlene Hendricks, Lincoln Financial Group; Charles Jenkins, CNA; Robyn Narveson, LTCG; Cassandra Prebis, OneAmerica; Natalie Schreiber, CNO; Joan Stear, Wilton Re; Jennifer Vey, LTCG

Comments: LTCi companies stepped up to the pandemic crisis, as 87% of the people answering a poll indicated that their company made claims administrative exceptions and most did so beyond regulatory mandates. Note that this is not the same as saying “87% of the insurers.”

They used Alternate Plan of care, extracontractual letters with Reservation of Rights, and other methods. They used virtual and telephonic assessments and a greater reliance on medical records, instead of on-site assessments

Recommendation (view recording or not?): It was a great session! Exciting that the insurers made such concessions! Definitely worth hearing.


Session Title: Adverse Decisions: Considerations for Determining Risk Tolerance

Track: Claims and Underwriting

Presenters: Steve Brogan (Moderator, Faegre Drinker), Drinker; Julie Belknap, Continental; Cassandra Prebis, OneAmerica; Jon McElhaney, Northwestern

Comments: Standard advice regarding managing the claims process and inherent risk therein.

The Chronic Illness certification is completed by a HO Licensed HealthCare Professional 50% of the time and by the insured’s physician 37% of the time, but PCPs often document the existence of a chronic condition rather than “chronically ill” as per §7702(b). 87% of the polled people responded that someone could need substantial activity if they needed the care a majority of the time or intermittently.

Recommendation (view recording or not?): Generally standard advice. If that is of value, this session is excellent.


Week 1 Wrapup (April 13 and 15) as reported by conference organizers

ILTCI attendee registrations are now over 1,700! The Opening Session kicked off with a welcome from the 2021 Conference Chair, Barry Fisher. He expressed appreciation to the 2020 Conference Chair, Robert Eaton, for his mentoring and leadership throughout the year. In case you missed the Opening Session, here are a few other highlights:

  • As a result of the technical issues during the keynote address, ANDERS SÖRMAN-NILSSON is recording his complete keynote address and it will be posted on the ILTCI website, hopefully next week.
  • The 2022 ILTCI Conference will be March 20-23, 2022 in Raleigh, NC. The Conference Chair is Vince Bodnar and Co-Chair is Steve Schoonveld.
  • We hosted 15 individual sessions this week which were recorded and are available at for on-demand viewing until July 1. Check the track pages on the website for recording links.


Week 2 

Tuesday, April 20, 2021

Session Title: Long Term Care Marketing, a 360 View

Track: Marketing

Sponsor: National Peace Officer and Firefighters Benefit Association

Presenters: Claire Akin (Indigo Marketing Agency), Monica Breeding (Fig Marketing), Tom Riekse (Moderator, LTCI Partners)

Comment: Very good, practical info on how to build and develop a LTCi practice – amazing how differently marketing is done today than when I started.

Recommendation (view recording or not?): Yes


Session Title: The Claims, Compliance and Legal Challenges of CCRCs, Continuing Care Retirement Communities

Track: Legal

Presenters: Gina Besz (Triplus Services), Angie Forsell (Moderator, LTCG), Daniel Lambert, Kenneth Pfaehler (Dentons)

Comment: It was actually “intelligible” and more engaging than I expected. They used interactive polling, which is always more fun. Definitely, some good information. I hope they’ll repeat both of the above sessions at our next in-person ILTCI – hopefully 2022.

Recommendation (view recording or not?): Yes


Session Title: Fraud: Emerging Trends and Innovative Solutions

Track: Legal

Presenters: Kim Martin, LFG; Kim Dionosio, KRM Legal Group, former environmental attorney who lives in FL; Jeff Ferrand, Attorney, LTCG VP Fraud; Christie Conway, Assuricare

Comments: Disasters create new opportunities for fraud; greater financial pressure makes people more desperate hence likely to commit fraud and justifications people can use to make themselves comfortable committing fraud and also make it harder to expose because of travel limitations, lack of access to medical documents, etc. Accommodations (mandatory or voluntary by insurer) opened up fraud and litigation risks. For example, Alaska required paying for family care; NJ made it easy for people to re-license after extended gap. It is good to have multiple vendors in case some vendors can’t perform.

Recommendation (view recording or not?): Yes.


Session Title: Tax Advantages of LTC Planning

Track: Marketing

Presenters: Rick Stewart (Crump); David Gresham (OneAmerica), Channing Schmidt (Securian Financial) 

Comments: Seemed standard but thorough for me.

Recommendation (view recording or not?): If you are expert, “No”. If you are not expert: “Absolutely.”


Session Title: Critical Tools for Crisis Planning

Track: Advisors & Agents

Presenters: Elizabeth Moss, Producer’s Choice Network; Cathy Sikorski (NAELA)

Comments: How likely to people think they, their spouse, their parents or people in general are to need LTC in the future?

Recommendation (view recording or not?): Could help you organize your thoughts about this topic. Very good speakers.


Session Title: The COVID-19 Effect: Claims and Underwriting Processes – Part 2

Track: Claims and Underwriting

Presenters: Karen Smyth; Joan Steer; Arlene Hendricks; Charles Jenkins; John McElhaney (NW); Allison Kusel (GNW, Claims)

Comments: Restoration of Benefits is being requested more now because of temporary discontinuation of service. Fewer visits to doctor during pandemic may mean less medical info available for future applications. What if insurer allowed [a neighbor] to provide care during pandemic and the care recipient is happy, doing well and not wanting to disrupt his/her caregiving situation. But the current care was covered only as a temporary accommodation? Now what?


Thursday, April 22, 2021

Session Title: LDTI and Regulatory Updates on LTC Standalone and Hybrid Products

Track: Actuarial and Finance

Presenters: Linda Chow, EY, FSA, MAAA, Kevin Healy, New York Life, FSA, MAAA, Doug Reilly, CNA, CFA, CPA

Comment: Broad review of half a dozen regulatory updates (e.g., PBR, 7702 changes), leading into discussion of “long duration targeted improvement” (LDTI) accounting standards, followed by discussion of management reporting with emphasis on “rollforwards” and “remeasurement.” (I can’t say more than that: this was so far over my head as to make me feel dumber after the hour. I’m normally able to keep up, but this was specialty stuff…)

Recommendation (view recording or not?): Honorably recuse myself.

Same presentation; different reviewer:

Session Title: LDTI and Regulatory Updates on LTC Standalone and Hybrid Products

Date and Time: Thursday, April 22, 2 pm

Track: Actuarial

Presenters: Linda Chow; Doug Reilly, CNA: Kevin Healy, NYLIC

Comments: Valuation discount rates are decreasing causing higher required reserves and cash values, hence higher prices (surrender charges higher at young ages, lower at old ages).

Principle-Based Reserving also increases reserves because must hold higher of:

Traditional type of reserves based on prescribed values for variables

  • Alternative future scenarios, using insurer experience if credible.
  • The interest rate for MEC and corridor calculations has dropped from greater of (4%, rate guaranteed in contract) to (2%, rate guaranteed in contract). If this lowers the interest rate in the calculation, the MEC premium cap increases and the Death Benefit factors go down, which are both good.

CA AB1209 requires notice of impact of taking ADB, loan or withdrawal.

MT lifted its unisex mandate, Kevin thinks.

Recommendation (view recording or not?): Very good content. Worthwhile.


Session Title: How to Communicate with Policyholders

Track: Management and Operations

Presenters:  Beth Acerbo (MetLife), Jodi Anatole (Moderator, Endeavour Consulting), Andy Freedman (Assured Allies), Jessica Loesing (Faegre Drinker), Sharon Reed (LTCG). I don’t remember Jodi having been there.

Comments: As a result of the pandemic, 62% would rather die than go to a nursing home.

Andy advises insurers to give gifts and wellness advice to policyholders to make their lives more comfortable. 95% still using paper based on poll taken.

Recommendation (view recording or not?): Depends on your needs, interest and knowledge of the subject.


Session Title: Look What You Made Me Do – The Dilemma with Mortality and Morbidity Trends

Track: Actuarial & Finance

Sponsor: Sutton Actuarial

Presenters: Bob Yee; Andrew Dalton; Laurel Kastrup, PWC

Comments: Many actuaries presume that active life mortality improvement is geometric (it is lumpy based on societal factors), will stop in 10-20 years, that there is no disabled life mortality improvement and that morbidity improvement will stop in 5-20 years. Disabled life mortality improvement or morbidity improvement could lengthen or shorten claims, particularly depending on the cause of claim). Using first principles (multiple decrement assumptions) rather than a cost curve is a superior technique with greater flexibility and imparts more understanding; it reflects that reduced current incidence creates more later incidence. Reserves should be conservative relative to improvements; otherwise booking profits too soon.

Recommendation (view recording or not?): Outstanding!


Session Title: Litigation Update

Track: Legal, Compliance, & Regulatory

Presenters: Sandy Jones (Moderator, Faegre Drinker), Amy Kline (Saul Ewing LLP), Angela Shire (MedAmerica)

Comments: Reviewed rate increase (Newman, DiRito, Gunn, Skochin, New Hampshire) and claims (Dallal) litigation. Explained types of claims issues and why difficult

Recommendation (view recording or not?): Yes! Super!


Week 2 Wrapup (April 20 and 22) as reported by conference organizers

We are now up to 2,000 individual people viewing our sessions! This week we had 15 more fantastic sessions, here are a few highlights:


Week Three

Tuesday, April 27, 2021

Session Title: Aging in Place – Applications of Remote and Virtual Services

Track: Aging in Place

Sponsor: Active Daily Living

Presenters: Deana Bell (Milliman), Char Hu (The Helper Bees), John Palmer (Moderator, CNA) Kelly Prchal (Allied Virtual Care)

Comments: This panel discussion explored innovative ways companies are providing services to their policyholders and claimants virtually. Topics included pre-claim initiatives and on claim programs that can be conducted remotely to improve the insureds quality of life. Panelists come from different organizations utilizing technology to change the way care is delivered to help insureds sustain their independence and improve their quality of life. Hearing loss; virtual care concierge; adoption rate; engagement; tele-medicine (internet, chat, video, remote patient monitoring, provider to provider). Make expansions permanent? Not clear; fraud risk. Stranger danger. People getting more familiar with virtual option. How do you market this? Glacial pace before pandemic. Post Covid adoption.

Recommendation (view recording or not?): Yes.


Session Title: Who is Selling What? To Whom, How, and Why? Results of the National Survey

Track: Marketing & Distribution

Sponsor: CLTC – Certification for-Long Term Care

Presenters: Barry Fisher (Ice Floe Consulting), Ronald Hagelman (Ice Floe Consulting), Liz Hoch (Oliver Wyman), Mike Smith (CPS Horizon)

Comments: This survey, “Who is Selling What? To Whom, How & Why?” illuminates the factors most relevant in selling LTC Insurance (Traditional & Hybrid Life + LTC) today. Over 600 Insurance and Financial Advisors shared their opinions and attitudes about the ideal client profile, product perceptions, best practices in starting the LTC planning conversation, what messages resonate with clients and more. Best source of respondents: broker, general agents. 85% over age 50; 80% over 15 years of experience. Majority focus on upscale markets. Most surveys focus on who buys and why, i.e. adverse selection. 2 or 3 key issues: advisors are aging out of the business. How to get younger agents involved? Only 12% called themselves LTCI specialists. Wider range of professionals selling LTCI now. What are they selling? Half, traditional; other half, combo products both suited. Over half said difficult to explain differences in products. Zero premium products were not usually a help to sell product. Need more training and education came through. Agents know what they sell but not necessarily what they don’t know. Who is the customer and why buying? 95% motivated by personal experience. Know cost don’t want to depend on family. Protecting income or leave legacy least important. Premium rate guarantees and inflation protection most important to consumers. Least important: return of premium and non-forfeiture benefits. Risk replacement or partial—partial more than ever. Who provides best training: general agents and insurance companies. High desire to go down market surprised surveyors. Products just not designed for that space. Key is enabling people to stay at home. Most important thing from survey: get in the door by including LTC planning in your retirement planning practice. Should be part of every conversation, individual or corporate. Always address risk mitigation. Go to for copies of the survey results.

Recommendation (view recording or not?): Yes


Session Title: Rate Increase Innovation: What’s Next in Mitigation, Communication & Implementation

Track: Legal, Compliance, & Regulatory

Presenters: Ralph Donato (LTCG), Afik Gal (Assured Allies), Nolan Tully (Moderator, Faegre Drinker), Amanda Weaver (John Hancock), Kristen Weil (Dentons)

Comments: Rate increases continue to be a necessary component of long term care insurance administration. As the need for rate increases has persisted, however, carriers and regulators have faced the continuing balancing act of servicing a primarily elderly client base while maintaining financial stability for blocks of long term care insurance. Increasingly, companies and regulators have looked at unusual and creative options that will permit rate increases, but allow policyholders mitigation options that might be suitable for them. This session examined the current regulatory environment around rate increases and the options offered by carriers as part of the regulatory approval process. Focus on the future, not the past. Many blocks will need premium relief in the future. Buyouts are an innovative option. Enhanced non-forfeiture. Freeze and drop. NAIC task force. 70% of individuals accept rate increases. Creative options, pushing limit of what accepted: cash buy out increasing interest. Lawyers cringe; actuaries like. Hybrid buy out, none so far. Policy reformation, structural change to the policy to mitigate rate increase. Annual re-rate option; push from some in industry; some regulatory interest, but supplanted by NAIC task force. Many complications. Need clear disclosures. Case study described to identify how a company might come up with a menu of mitigation options.

Recommendation (view recording or not?): Yes.


Session Title: The WISH Act: Addressing the Financing and Regulatory Needs Within LTC Public/Private Solutions

Track: Legal, Compliance, & Regulatory

Presenters: Peggy Hauser (PwC), Steve Schoonveld (Moderator, Lincoln Financial Group), Tom Suozzi (NY State)

Comments: This session discussed the implications of a proposed federal catastrophic long-term care program, the WISH Act. The session focused on the benefit to consumers, the financial soundness of the proposed program and the regulatory steps necessary to achieve the desired public/private insurance program goals. Average income of 65 year old; guessed $65,000. Median annual income for 65 year old: $55,000. Didn’t give actual until later; could not follow. Confusing what the point was of this query. Pick two ADLs and don’t do them. Can your spouse actually help you? Intense level of need requires personal care. Congressman Suozzi on WISH. Trained as lawyer and CPA; mayor; county position; ran for Governor; Congress, third term. His parents had LTCI but most people can’t afford it. Medicaid cannot support it; just not enough money. Fewer caregivers available: more older people, fewer adult children. Only have access to Medicaid if you are broke; cottage industry to qualify people artificially. Others really spend down. Need better solution. You pay .25% of income from employee and .25% from employer to create a LTC insurance fund, $30B a year for catastrophic insurance plan. You take care of your own needs for 1 to five years depending on your wealth. Fed gov’t provides catastrophic coverage, $3600 per month. Private sector will come in and provide insurance for shorter time up front. Either buy private insurance for first years or have family members take care of you or use your own funds. Willing to listen to others. Good news this is part of the conversation. Biden proposes $400B; he’d like to apply some of that to this program. Need to educate people. Dramatically reduce Medicaid costs. (NB: Be very dubious of that statement.) Heavy lift to create a payroll tax. Lots of demand for more payroll taxes. Nobody wants to pay for anything. Peggy Hauser: what could private sector do within WISH. Fill gaps. Cover costs over $3,600 per month. Could reinvigorate the group LTCI market. WISH Act would be mandatory, so very broad, but there will be people not covered, including those already retired. Suozzi: opt out option?

Recommendation (view recording or not?): Yes, but keep your eyes open and your skepticism sharp. Session offered zero critical perspective, only supportive comments on this important program.


Thursday, April 29, 2021

Session Title: Tools & Tech to Boost Productivity and Your Bottom Line

Track: Advisors & Agents

Presenters: Matt Essick (The Ensight “Tell A Story” Solution), Ken Leibow (InsurTech Express), Bill Nash (Lincoln Financial Group), Mike Pepe (Proformex)

Comments: Technology is advancing faster than we adapt. The latest apps, software and tech developments that can help you be more efficient, educate your clients, close business and run a more successful practice. Proformex presentation more an ad for company than objective information. Power of visuals through virtual compared to phone calls. Interactive marketing tools. Better experience, more efficiency, bring in new clients. Animated visuals. Tools to deliver LTC information critical now as people are ready to listen. How to reach out to existing clients about new products. All about visual story telling. Everything is online nowadays. Firms are delocalizing; following clients when they move; reaching out geographically. Need tools to tell product stories. Need a hybrid digital model; tools to become more effective; drive better client communication. Covid is changing LTCI distribution forever, hybrid in persona and virtual. Good content in the Q&A part of this session.

Recommendation (view recording or not?): Maybe, especially if you’re interested in the products of the presenters’ companies.


Session Title: Uninsurable Doesn't Mean the End of the Sale/Relationship

Track: Advisors & Agents

Presenters: Carroll Golden (Moderator, NAIFA), Tafa Jefferson (Amada Senior Care), Shelley Giordano (Mutual of Omaha), Dan Mangus (Senior Marketing Specialists)

Comments: Don’t lose a client, and by extension, the family of a client, who is uninsurable. There are services, products, and tools to use with clients at the point of need. Understand the options available for you to help your client see you as the problem solver and not as part of the problem. What role can Medicare play? Is the home the buffer asset to fund care and/or sustain premium and preserve the retirement portfolio? Is finding a service to help navigate necessary care needs the answer they want to hear? Options related to Medicare supplements and Special Needs Programs. Lots of programs available even up to quite a lot of income. Slimby. Alphabet soup means there’s more Medicare does than you may realize. Lots of noncountable resources allowing Medicaid eligibility. Email Dan Mangus for links to all these sources. Many free publications from Medicare. Hard to tell people “we charge for our home care.” Hate to say “I can’t help you.” So we try to find funding solutions to help people age in place. Huge believers in LTCI. Tools if uninsured and uninsurable. Care coordination. Need holistic approach. Focus during pandemic from institutions to home care. Transitions are challenging. Medicare pays for home health, very limited in scope, but not for assisted living or memory care. Home care not covered by Medicare; that’s a “pay for.” VA Aid and Attendance and homebound benefit. PACE program for dual eligibles. Do you own your own home? MoO does reverse mortgages; home as a LTC funding solution. HELOCs require monthly payment and were cancelled during the Great Recession. Use to buy LTCI. But if coverage denied, other options. HECM line of credit. Bad media, but problems fixed. FHA insured.

Recommendation (view recording or not?): Yes, but expect it will raise many more questions than can be answered without a lot of personal research.


Session Title: Legal and Regulatory Considerations for Aging in Place Programs

Track: Aging in Place

Presenters: Fred Andersen (Minnesota Department of Commerce), Hugh Barrett (Prudential), Charlie Philbrook (Moderator, John Hancock), Nolan Tully (Faegre Drinker)

Comments: Explored some of the key regulations that influence aging in place services and how regulators are reacting to the emergence of activity in this space. Lots of regulator interest in range of issues. State-specific regulation is complicated. Aging in Place industry changing fast, but measured approach within LTCI. Rebating is a regulatory concern more than any other. Rules recently changed. Insurers permitted to offer services not specified in the insurance contract if related to the coverage and fit into 9 specified categories. Exception to the anti-rebating law. Not meant to prohibit wellness programs. State by state adoption process. Discrimination. If have wellness program dependent on tech ability, is it unfair to less tech savvy beneficiaries. Could Aging in Place services compromise tax status? Many benefits to beneficiaries, but are there claims cost savings? That will decide the future of these benefits. These issues are complications but not show stoppers.

Recommendation (view recording or not?): Yes if you have a need to know and are new to this topic.


Session Title: Remote Work and Business as Usual

Track: Management and Operations

Presenters: Matt Capell (Moderator, LTCG), Paula Johnson (LTCG), Julie Kirby (sp?), John Hancock

Comments: How do you manage key LTC functions in a COVID environment? Many employees and key functions are now working and taking place in home offices and dining room tables across the world. We are working anywhere but the office. What did we learn in the shift? What will those key functions look like in the coming months or years? Series of polling questions allowing participants to vote. Work situation before pandemic? Full time in office, 60%; hybrid, 26%; all at home, 14%. If hybrid, how often in office each week? 3 to 4 days per week most prevalent answer. Q3: Has your company set a return to office date? If so, when? 54% still undetermined. Q4: How does company accommodate work from home equipment and supply? 72% computer monitor, etc. most common. John Hancock has a comprehensive program to train and support remote workers. Big question how people adapt and perform in remote environment. Need to adjust expectations? How to measure performance. Need consistent way to measure work wherever it is done. New metrics? Phone availability? Communication. Technology, JH provided basic equipment to employees; guidance and guidelines. Step by step instructions on how to set up. 20 megabits connectivity needed. Telephony cloud based. Wireless headsets. Digital transformation. 24 hour access; chat bots. Policies, wild, wild west. Working remotely, managing remotely. Work from home contract? What are working hours? Strict or flexible. Child care. Work force expectations. Privacy, security, avoid kitchen table.

Recommendation (view recording or not?): Yes, very interesting.