LTC insurance premium "surprise"

Its not my forecast; its a fact probably known only to the insiders in the LTC industry!
Which would mean you are one of those insiders, right? :)

The reason I started this thread was the years of discussion/news/rumors/facts regarding huge rate increases on LTC policies led me to expect a big jump in rates once my 10 year guarantee expired. As the thread title states, I was (pleasantly) surprised when my premium remained unchanged. I'm keeping the thread updated for no other reason than to share my personal experience with our LTC rates.
 
Which would mean you are one of those insiders, right? :)

The reason I started this thread was the years of discussion/news/rumors/facts regarding huge rate increases on LTC policies led me to expect a big jump in rates once my 10 year guarantee expired. As the thread title states, I was (pleasantly) surprised when my premium remained unchanged. I'm keeping the thread updated for no other reason than to share my personal experience with our LTC rates.

:)...If I were an insider, I wouldn't have let this secret out!

It is a good thread and is worth keeping it updated!!
 
Yes, of course I alerted them! Sorry, I can't reveal their response - it's a secret... :)


When you bought the policies....Were there other products with the same or similar features to compare against? Were they priced similarly?


The devil is always in the details. Aside from the basic coverage amount... Some products have broad flexibility and other have many restrictions.
 
Whether the premiums for your LTC policy has increased so far or not, it is bound to increase multiple times in the near future (during the next 2 to 20 years).

Here is why I say so. When LTC insurance product was being designed and priced by the Actuaries, they had assumed some of the ratios (don't want to get too technical here, feel free to ask me if you want to know more) from their experience with Life Insurance products however later they realized that their assumptions were 100% incorrect. So much so that within 20 to 30 years of launching the product in the market, the premiums collected turned out to be insufficient to pay off the cost of claims. This was the case with all the insurance companies who offer LTC insurance in the US. As a result all LTC insurance companies had to apply for rate increase with the Department of Insurance (DOI).

The DOI does not approve the total increase requested by the insurance company straight away keeping in mind the interest of the insured. So the DOI approves only a fraction of the rate increase demanded by the insurance company which compels the insurance company to go back to the DOI in a couple of years.

This vicious circle will continue till such time the LTC insurance providers are able to increase the rates to an extent where the premiums not only cover the cost of claims but also make some profit!

So whether your rates have gone up or not, be prepared to receive at least 2 to 4 letters from your LTC insurance provider in the next 2 to 20 years asking you to either pay higher premiums to keep the same coverage or choose a lower coverage to keep the same premiums or a combination of both!

Maybe you could get more technical. The only ratio I can think of that would have come over from life insurance was lapse rates. They can't keep getting lower and lower because zero is the lower bound.

If it's a matter of requested rate increases aren't getting approved, do you have numbers on what percent of the typical request goes through? (Company names would help here.)
 
Yes, I did this calculation at the time. I don't recall the specifics, but the required rate of return on the side fund was very high, and totally unobtainable given the level of risk one would want to take for a fund with this purpose.


Well, not quite. Since I wrote the initial post, the insurance company significantly increased their rates on policies with the included inflation protection, so even the "big boys" weren't able to make it work. This was because their investments weren't producing the expected returns, not because the cost of care had gone up (they pay out a set daily dollar rate, so the LTC insurers are largely insulated from rising care costs, that risk is left to the policyholder). In addition, insurers have some advantages that we'd lack-they get the benefit of all the policies that lapse or are abandoned early, and each policy doesn't need to cover that specific patient's costs (as long as all the policies written, in aggregate, cover all costs, in aggregate).

As I said, I think these FPO policies may make some sense as part of a complete package. It's "cheap" coverage against a very early need for LTC, and one can still retain the flat benefit (without buying additional coverage to keep up with inflation) at moderate cost if additional insurance is declined starting at about age 65-70. But this requires a good understanding of the risks one is taking, especially with regard to inflation.

So if I understand this: Andy bought a policy with the intention of taking the FPO and paying increasing premiums. Bob bought one with a higher premium which was expected to be constant and included an increasing benefit.

Bob did the math on the original premium schedule and felt that the company must be including a higher interest rate than he could get in their calculation, so that's why he took the level premium. Later, the company discovered they couldn't hit their interest target and had to raise Bob's premium (they didn't have to do as much with Andy's because interest wasn't as big a deal on his policy). Correct?

It looks like we agree that one of the reasons the insurer can provide a higher apparent interest rate is that policies cancel due to death or voluntary termination. I intended to say an Andy can partially match the mortality gain by moving the fund to an immediate annuity at some appropriate age. He can view the voluntary termination angle as an option that he's buying. The insurer is giving Bob a better deal if they both stay, but Andy gets the better deal if they both leave.

I'm not claiming those facts make Andy's choice the "right" one. But they are relevant to me. Given the uncertainty of management and future premiums, I would want at least consider minimizing the money I put in up front.
 
Even though I have a technical background, I don't think of LTC insurance in primarily techincal terms. Seeing my MIL in LTC facilities for many years made DH and I realize we would want the best of care for each other - and options such as in home care to avoid ending up in one of those places. Plus, we wouldn't want the burden of bankrupting the survivor.

That's the thing about LTC insurance - it's both a complex financial decision yet very personal. No right or wrong decision. Yes, we're under the federal employee plan and got hit with that big increase, but we're hanging in...for now. Who knows what the future will bring? Both in terms of DH and I and the LTC insurance biz. Thinking about it is such a major bummer! Yet we need to think about it.
 
The insurer is giving Bob a better deal if they both stay, but Andy gets the better deal if they both leave.

I'm not claiming those facts make Andy's choice the "right" one. But they are relevant to me. Given the uncertainty of management and future premiums, I would want at least consider minimizing the money I put in up front.
Yes. And, reducing the money given to the insurer up front could prove really smart. These are multi-decade gaps between buying and needing the insurance, the requirement for insurance might well go down: there's every possibility that a broad federal LTC program will come along, Medicare might be expanded to carry the load, a broad national health care program might take over, or better private products could come along as insurers figure out how to price these products and make them attractive. Even the cost of providing LTC might go up more slowly than inflation--it's fundamentally low-skill labor, and if our economic trends continue we'll have a large number of people qualified to do it and needing work.
 
Heard today that JH is discontinuing their current LTC product and introducing a new one with lesser benefits and higher rates....remains to be seen what will happen to current insureds. JH raised their rates big time last year on compound inflation policies and really isn't competitive anymore. Looks like Genworth is going to take an even bigger market share...
 
... and options such as in home care to avoid ending up in one of those places.
In one of "those places" it's a lot easier to be social, to have access to more activities, to easily be seen by a doctor or a nurse.

I know home caregivers for whom just getting to the doctor is an all-day affair. They're also responsible for entertainment, socializing, activities...
 
Yes. And, reducing the money given to the insurer up front could prove really smart. These are multi-decade gaps between buying and needing the insurance, the requirement for insurance might well go down: there's every possibility that a broad federal LTC program will come along, Medicare might be expanded to carry the load, a broad national health care program might take over, or better private products could come along as insurers figure out how to price these products and make them attractive. Even the cost of providing LTC might go up more slowly than inflation--it's fundamentally low-skill labor, and if our economic trends continue we'll have a large number of people qualified to do it and needing work.

Yes.
 
I thought this was interesting:

According to the study, the respondents’ greatest fear regarding the possibility of a long-term illness is not
- running out of money (10 percent), or
- dying (11 percent), or
- ending up in a nursing home (26 percent).

The overwhelming fear is “being a burden on my family” (53 percent).
 
My father's premium went up repeatedly. The older he became the higher the increase and they eventually became astronomical. He would be offered an opportunity to apply for a "new plan" at a lower rate but it required a "physical" from a company nurse. This was essentially a way to price out people that were becoming close to actually needing the coverage.

Anyone who knows me knows I essentially hate all insurance companies, insurance salespeople and insurance products except for the traditional "risk sharing" products involving liability, auto and home type insurance (ie. immediate protection for a short, defined coverage). I have a self-funded LTC approach. If I don't need it, my heirs will be much happier.
 
This article may explain some of it.

“While increasing lifespan is a good thing, for the long-term-care industry it means that people are living longer and reaching the age where frailty and dementia are more likely to occur, and [insurance] carriers are consequently paying far more claims than originally priced for,” she says.

In other words, when the product was being created, actuaries made an educated guess about how many claims there would be, and didn’t come close.
 
This article may explain some of it.
Of course, these were the same companies that therefore made more money on their life insurance business because folks lived longer. Don't hold your breath waiting for a refund of premiums. "That line of products has nothing to do with this line of products".

In addition to a larger amount of claims paid, folks who had the early policies figured out they had a good deal and didn't abandon the policies at the rate expected. That was another surprise.
 
@kumquat. Yes I read that article on the weekend. I did that as a shareholder in Manulife(by far the worst performer in my portfolio) not as a LTC consumer. You can blame the insurance co's for much that is wrong with US healthcare but not everything. When considering these issues, I am happy to be a Canadian. MFC sure is a dog though. It seemed at the time that their John Hancock purchase was brilliant. Not any more. I personally knew the previous CEO and CFO and they were very arrogant and smug. I wonder if they still are?
 
It definitely happens. Healthy lifestyle (not obese, non-smoker, etc)... live long and eventually need LTC.

It makes sense if one equates the longer one live (in old age), the greater the probability of some debilitating disease brings on the need for LTC.


Center for Retirement Research Finds Healthy Pay Higher Costs than Unhealthy in Retirement | Advisor One

I looked at the CRR paper here: http://crr.bc.edu/images/stories/Briefs/ib_10-8.pdf

They are looking at out-of-pocket expenses from the individual's view. So a longer lived individual pays Medicare parts B and D and Medigap insurance premiums for more years. If those premiums go up at about the same rate as the discount rate, they are just adding up the total number of years that people pay premiums and, surprise, healthy people pay premiums for more years.

It's not clear from the brief description on LTC costs that they are any higher for the healthier group. Healthier people presumably enter nursing homes at older ages, but it's not clear that they have any experience to claim that the healthier have longer stays in the nursing homes. That is, does a healthy person who enters a nursing home at 85 stay in the nursing home any longer than a less healthy person who enters a nursing home at 80?
 
I looked at the CRR paper here: http://crr.bc.edu/images/stories/Briefs/ib_10-8.pdf

They are looking at out-of-pocket expenses from the individual's view. So a longer lived individual pays Medicare parts B and D and Medigap insurance premiums for more years. If those premiums go up at about the same rate as the discount rate, they are just adding up the total number of years that people pay premiums and, surprise, healthy people pay premiums for more years.

It's not clear from the brief description on LTC costs that they are any higher for the healthier group. Healthier people presumably enter nursing homes at older ages, but it's not clear that they have any experience to claim that the healthier have longer stays in the nursing homes. That is, does a healthy person who enters a nursing home at 85 stay in the nursing home any longer than a less healthy person who enters a nursing home at 80?

Anyone entering a nursing home with LTC paying a benefit has to have lost 2 of the 6 ADL's anyway, so there are no "healthy" people going into a nursing home that are on LTC claim.
 
Anyone entering a nursing home with LTC paying a benefit has to have lost 2 of the 6 ADL's anyway, so there are no "healthy" people going into a nursing home that are on LTC claim.



It looks to me like the paper concludes: Just because one is healthy now, does not mean they will experience lower health care costs during their lifetime.... therefore, plan adequately.

But they did not supply data on LTC.

They were just pointing out that people sometimes draw the wrong conclusions because they are healthy.


Households planning for retirement need to decide how much to set aside for health care costs and whether to purchase Medigap and/or long-term care insurance. Those currently in good health would be unwise to infer that they will continue to enjoy lower than average health care costs. The reality is that even the currently healthy can expect to eventually suffer from one or more chronic diseases, which often results in high out-of-pocket and long-term care costs.
If one is already unhealthy or has serious health care problems.... it may be too late to get LTCi. Insurance companies may not offer insurance to them or it may be so expensive that it is not practical.
 
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