Stop-Loss Long-Term Care Insurance


Stop-Loss Long-Term Care Insurance

Stop-Loss LTCi was developed from a Hybrid LTCi policy chassis to create a partially self-insured LTCi policy.  The idea was to design a product option that would fit the LTCi needs of those couples who have a net-worth between $3.5mm to $10mm+.  This is a large range, but some argue that in this range one might be able to self-insure.  We know without a doubt $15mm+ should be able to self-insure most if not all their potential LTC costs.

There aren’t any Stop-Loss LTCi policies on the market for individuals so I wanted to see if I could put together partially self-insured stop-loss product with the available policies on the market.  This is to meet the needs of a couple who have a net-worth in this $3.5mm to $10mm+ range and can take on the extra risk of not being fully insured.

Product requirements:

-It needs to have a high deductible or in this case a long elimination period

-The benefit pool needs to be large once the stop-loss is triggered

-A low or no-loss product is preferred, meaning that a benefit was going to be paid out either via long-term care claim or at death.

-The product needs to make sense financially

Case Study: Husband and Wife both age 50.


In this scenario, we are assuming that the Traditional LTCi policy does not increase in premium although history shows it most likely will.  The Hybrid LTCi policies are the base for the Stop Loss LTCi chassis and have guaranteed premiums.  We typically will choose to go with an LTCi policy over a Traditional LTCi policy except in a few scenarios.  An example would be a single male in his early 60’s.  Traditional LTCi has priced this category very well.  It’s assumed the reasoning being the known the LTCi claims history of this demographic is in the carriers favor.  Traditional LTCi does not typically payout any death benefits.

The Stop Loss LTCi has an initial elimination period of 60 days of long-term care service.  Once this has been met, there is a small initial benefit that will start paying out for the first 50 months in Illustration A or 33 months in Illustration B.  Once that 2nd elimination period has been met (50 or 33 months) by one or a combination of the husband/wife couple then the larger benefit will be paid out.  In this example we used a benefit payout starting at age 88.

The couple can each take the full benefit amount.  In Illustration B, this is almost $40,000 tax-free if they are both on claim at the same time.  This benefit will continue for as long at they are both on claim without limit.

If neither husband or wife use the long term care benefit then a death benefit will be paid out after the 2nd spouse were to pass away.

If you look at the “Total Premium Paid by Age 88” column, in most cases the clients will pay about half as much in premium by partially self-insuring the first several months.  They are not fully self-insuring because they will still receive a small amount of benefit for the first 50 or 33 months of claim (combined).

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s