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Dissolving Myths about LTCi, Part 2

February 7, 2018 by Honey Leveen Leave a Comment

Previously, on Long Term Care Insurance Myths…

People with question marks over facesWe have seen multiple examples of the press misrepresenting the current state of the Long Term Care insurance (LTCi) industry. In my last blog post (you can read it here), I called out a specific article in the Wall Street Journal (Jan 2018) that predicted the imminent downfall of the industry. They cited financial instability and unexpected rate hikes as the central culprits.

Multiple experts from the LTCi industry penned their objections, offering well-sourced facts. Like me, they were compelled to present a number of articles in response. The status of long term care insurance is not only financially stable, but also more popular than ever.

More Answers to Long Term Care Insurance Myths

This blog focuses on the response from my colleague, Steve Moses, President of the Center for Long Term Care Reform. Moses is a noted expert on both state and national levels.

In a letter addressed to the author of the WSJ article, Moses highlighted the glaring omission from the article: the dominant role that Medicaid plays in the long term care solution*. He reminds the author that government policy is central in determining the financial stability of long term care.

He concludes: “It is a tragedy to blame private insurers and the dedicated people who’ve tried to make the LTC insurance product work for problems caused by poor public policy. Blame the culprits, not the victims.”

As we’ve recently discussed, people who own long term care insurance (LTCi) have necessary funds and are far more likely to be able to avoid Medicaid, stay at home, or access quality assisted living if they need long term care.

Click here to receive your personal quote for Long Term Care Insurance.


*In his monograph, “How to Fix Long Term Care Financing” (July 2017), Moses explains:

“Medicaid is not just a factor in long-term care financing; it is the critical factor. Since its founding in 1965, Medicaid has evolved from a minor funding source to the primary funder of formal paid care.”

 

Filed Under: Correcting Ignorant Public Figures, Helpful Information About LTC, Information About LTC Tagged With: Long Term Care insurance, LTCi, LTCi rate hikes, rate hikes

Myths about LTCi (No Thanks to the Press), Part 1

February 1, 2018 by Honey Leveen Leave a Comment

Two senior men reading newspaperIn my almost 30 years as a Long Term Care insurance (LTCi) specialist, I have seen and shared multiple articles with you on the subject of faulty journalism. Some LTCi articles are more accurate than others. The press tends to have a negative view of long term care insurance. I work hard to help you sort the facts from fiction.

We know that negative news sells more papers. The press covers LTCi rate hikes in an often uninformed, inflammatory fashion, making it falsely appear that policyholders have no satisfactory in-between options. Journalists pretend to be expert financial advisors. This can lead policyholders to the conclusion they have no other option than to cancel their LTCi coverage. It discourages people who should and can afford LTCi premiums from considering it. Such non-factual, misinformed reporting has devastating results! We’ll talk about this in greater detail, later.

Here’s the other thing:  LTCi is a complicated product with a lot of moving parts. One cannot become an expert overnight. These journalists (even at the more respected publications), in their zeal to bring you the story, get a lot of the information wrong.

Long Term Care Insurance Myths

Let’s talk about those rate hikes.

In January 2018, the Wall Street Journal published an alarming article that essentially reported the implosion of the LTCi industry. The journalist predicted that the increasing financial instability of the industry was going to result in massive rate hikes, for which most aging policy holders were unprepared. The fear over looming rate hikes is one of the prevailing Long Term Care Insurance myths.

FACT:  It is almost never necessary to drop a LTCi policy due to a rate hike. We normally downgrade the policy instead, which lowers premiums while conserving high LTCi policy function.

FACT:  Inciting panic over these policies results in dissuading people from acquiring this important coverage. It gives them one more excuse to avoid responsible and reasonable long term care planning in advance.

My colleague, Matt McCann, wrote a thoughtful piece to address the rate stability and affordability of LTCi:

“An insurance company can not ask for increases on current product series policy holders based on the mistakes of the older plans. This provides substantial peace-of-mind for those who are planning today.

“It is also not easy to raise premiums; the insurance company must show a substantial need based on actuarial data and have it based on a class basis only.”

FACT:  The sale of LTCi policies is increasing. The real financial risk comes from lack of coverage, providing asset protection and peace of mind to families.  McCann adds, “It safeguards their retirement accounts… while making their aging issues much easier on their family.”

Matt McCann’s complete article can be found here.

There are a number of well-intentioned articles providing misinformation. We’ll be addressing more of these in future blogs. Stay tuned!

In the meantime, if you’d like to get a free quote for your own LTCi policy, click here.

Filed Under: Correcting Ignorant Public Figures, Helpful Information About LTC, Information About LTC Tagged With: Long Term Care insurance, LTCi, LTCi rate hikes, rate hikes

Why & How Reputable Media Continues to “get” LTCi Wrong

January 18, 2018 by Honey Leveen 2 Comments

News cloud with how and whyThis blog has become my repository for correcting an error riddled, inflammatory Wall Street Journal article published last week.

Here’s a very accurate Forbes article refuting the WSJ article. It’s inately

My colleagues Steve Moses and Claude Thau wrote the following comments in response to this Wall Street Journal article titled “Millions Bought Insurance to Cover Retirement Health Costs. Now They Face an Awful Choice”.

Even a publication as credible and august as the Wall Street Journal can report things wrong.

I will add that in the nearly 30 years I’ve been a long-term care insurance (LTCi) specialist, faulty coverage like this still “gets to me”! LTCi has always been disparaged by the press, probably because it is a complex product that journalists don’t have time to properly research before deadlines. I also understand that inflammatory coverage attracts more readership.

This has led to widespread misinformation. My many long-term care insurance claimants will tell you LTCi is an extremely valuable, transformative, product. Articles like this one do the public a disservice by dissuading people and giving them one more excuse to avoid responsible and reasonable long-term care planning in advance.

By the way, it is almost never necessary to drop a LTCi policy due to a rate hike. We normally downgrade the policy instead, which lowers premiums yet conserves high LTCi policy function.

Here is a press release about this by my colleague Matt McCann.

Here are Steve Moses’s comments:

1/17/2018, “Millions Bought Insurance to Cover Retirement Health Costs. Now They Face an Awful Choice,” by Leslie Scism, Wall Street Journal

Quote: “Long-term-care insurance was supposed to help pay for nursing homes, assisted living and personal aides for tens of millions of Americans when they became unable to take care of themselves. Now, though, the industry is in financial turmoil, causing misery for many of the 7.3 million people who own a long-term-care policy, equal to about a fifth of the U.S. population at least 65 years old. Steep rate increases that many policyholders never saw coming are confronting them with an awful choice: Come up with the money to pay more—or walk away from their coverage.”

LTC Comment: Following is the letter I sent to the author of this front-page Wall Street Journal article:

Dear Ms. Scism,

There is a critical aspect of the LTC insurance issue that your otherwise fair and well-researched article missed entirely.

When LTC insurance carriers recognized their reserves were inadequate to pay future claims, they did the honorable thing. They raised premiums to ensure future claimants would receive full benefits.

Compare that with the federal government’s failure to fund Social Security and Medicare adequately, leaving those programs with upwards of $100 trillion dollars in unfunded liability. What’s more, government policy actually impaired private LTC insurance.

Beyond the reasons you cited for LTC insurance problems (actuaries’ errors regarding lapse rates and utilization, plus the Federal Reserve’s forcing interest rates to near zero, for which actuaries should not be blamed) there is another cause. Medicaid is the dominant payor of long-term care. Easy access to Medicaid for middle class and affluent people after they already needed care crowded out up to 90% of the potential market for LTC insurance, according to authors of peer-reviewed research published in the American Economic Review.

In other words, government policy impaired demand for and profitability of private long-term care insurance, while itself, leaving most aging Americans vulnerable to social insurance and public assistance programs that are hopelessly unprepared financially for the coming age wave.

It is a tragedy to blame private insurers and the dedicated people who’ve tried to make the LTC insurance product work for problems caused by poor public policy. Blame the culprits, not the victims.

For a full explanation, evidence and documentation of these facts and this analysis, please see my monograph “How to Fix Long-Term Care Financing,” published by the Foundation for Government Accountability (also the source of yesterday’s WSJ op-ed about millionaires on food stamps, a very similar problem.)

If you would like to follow up on these aspects of this complicated problem, please contact me.

Steve Moses

Stephen A. Moses, President
Center for Long-Term Care Reform
2212 Queen Anne Avenue North, #110
Seattle, WA  98109
Office: 206-283-7036
Fax: 206-283-6536
Email: smoses@centerltc.com
Web site: www.centerltc.com

Here are Claude Thau’s comments:

For the most part, Leslie Scism’s Wall Street Journal article  is accurate, however it leads readers to reach false conclusions.  From my perspective, it is clear that:

  1. Insurers are losing a lot of money on their old LTCi policies.  Although it was clear from the start that LTCi was a risky business, the “perfect storm” problems that the insurers are experiencing was unforeseeable.
  2. Both claimants and healthy policyholders cherish their policies (for good reason), hence will either stretch to pay the increased premiums or will reduce coverage to keep their policy in effect.
  3. Price increases are a big problem for people who bought LTCi policies long ago and don’t have the cash flow to pay the premium increases.
  4. People who can afford the price increases are getting a good deal, although they expected a much better deal.  I think it is appropriate that the burden of the adverse experience is being split between the insurers and the policyholders, but choosing the right balance is subjective.  I empathize with both sides, but more so with the policyholders.
  5. The industry is not meeting its potential in helping to solve the country’s LTC financing problems.  There are many reasons why the industry is not developing adequate market share.  Some people blame the industry; some people blame various levels of government.  However, human nature and other factors also contribute.
  6. Despite the problems, a good number of insurers have stayed in the market or entered the market, offering good ways that many people can insure their LTC risk.
  7. The price increases are taking a heavy toll on the industry, partly because media attention is focused on these older blocks, which causes people to be unduly wary of good opportunities to protect against LTC risk.
  8. The problems of existing policyholders, while severe, are significantly less common than Ms. Scism suggests.
  9. A key issue:  How do we encourage insurers to develop coverage for new risks, particularly distant future risks (long-term care is much more risky for insurers than annual property and casualty risks such as cyber risks).

The industry is losing money because the insurers ARE paying claims1.  Insurers sometimes erroneously fail to pay a claim, but failure to pay a claim appropriately is not necessarily bad faith.  I have generally succeeded in getting errors fixed or in explaining to the policyholder or family why the claim decision was right.  The Independent Review process, which protects against some wrongly-denied claims, is rarely used, which suggests that claims are resolved fairly.  To the degree that the July 2017 Milliman LTCi Survey was able to identify such appeals, independent reviewers supported insurers’ declines in nearly 90% of the cases2, which also suggests claims are resolved fairly.  A 2016 study3 found that 98% of LTCi claimants were satisfied with their claim payments and an earlier federally-funded study4 found large satisfaction as well.  (Footnotes are below my signature block.)

Our society spawns a significant number of fraudulent insurance claims in every line of insurance, including LTCi.  Insurers have a responsibility not to raise premiums in order to pay fraudulent claims.  Their efforts to avoid fraudulent claims can contribute to (but not fully explain) frustrating claims processes (16% of claimants do not consider the claims process to be easy.5)

Ms. Scism wrote “some policyholders complain that it [the industry] has nothing to lose by denying legitimate long-term-care claims”.  She failed to address that complaint appropriately.  One of the key risks of denying a LTCi claim is the huge risk of a (possibly class action) law suit.  In my view, insurers too often pay claims because the cost of defending a lawsuit would be expensive, even if successful.  Perhaps that contributed to a federally-funded study concluding that insurers overpaid LTCi claims by 3.4%6.

Ms. Scism’s title refers to “Millions… Face An Awful Choice” and her second paragraph starts “Now, though, the industry is in financial turmoil, causing misery for many of the 7.3 million people who own a long-term-care policy, equal to about a fifth of the U.S. population at least 65 years old.”  This sentence is inaccurate and misleading in several respects:

  1. There were 47.8 million above age 65 as of July 20157, obviously even more today.  Dividing the “7.3 million” by 47.8 million produces less than 15% (still overstated), not “about a fifth” as she wrote.
  2. She is including people below age 65 in the numerator but not in the denominator.  If she did an apples-to-apples comparison, the ratio would be significantly lower than even 15%.
  3. She is also including policyholders who no longer pay premiums (generally because they are on claim) and those who have purchased more recently-priced policies.
  4. She wrote “Credit Suisse analysts tallied more than 4,500 rate-increase requests nationwide from 2009 to early 2017 by 16 once-big sellers of long-term-care insurance. The proposed increases affected hundreds of thousands of policyholders.”  Even if all those “hundreds of thousands” are over age 65, the Credit Suisse data suggests probably less than 10% of people age 65+.  Did she make any effort to reconcile the conflict between her statements and her Credit Suisse source?

Policyholders getting huge price increases is worthy of attention and discussion, but focusing solely on the plight of policyholders who bought LTCi long ago leads readers to infer that LTCi is not a good alternative for them today.  The past problems have caused today’s products to be much more stably priced.  Furthermore, Ms. Scism dismisses the popular combo products (“But such products are often costlier”), without mentioning that many of those combo products are entirely guaranteed, which protects against the “misery” she cites.  By the way, of course it costs more if you add a potential death benefit to LTCi coverage.  I believe articles about price increases on old policies should make strong efforts to explain that the situation is tremendously better today.

Best wishes,

Claude Thau
Director of Long Term Care Insurance Funding Solutions, Target Insurance Services

Phone direct: 913-403-5824; WATS line: 800-999-3026, x2241
claudet@targetins.com

Click here to connect with Claude on LinkedIn

Claude’s Footnotes:

1  NAIC Experience Exhibit Reports through 2014 show LTCi claims compounded 12% per annum from 2001-2014.  The author did not seek more recent information; growth clearly has continued albeit at a rate that the author can’t quote. See also the subsequent proof that claimants are satisfied, etc..

2  Thau, Claude; Schmitz, Allan; and Giese, Christopher, Milliman LTCi Survey, Broker World Magazine, July 2017, p. 3 of the reprint.

3  LifePlans, “Experience and Satisfaction Levels of Long-Term Care Insurance Customers: A Study of Long-Term Care Insurance Claimants”, September 2016, p. 14.  “…only six percent of claimants had a disagreement with their insurance company about policy coverage, and the majority of these disagreements (65 percent) were resolved to the satisfaction of the claimant. Put another way, for every 100 people making claims under their insurance policy, only two are likely to have had a disagreement about coverage that was not solved to their satisfaction.”  A table on page 22 shows that 70% of claimants were “very satisfied” with their policy, 27% were somewhat satisfied, 2% were somewhat dissatisfied and 1% were very dissatisfied.  The lower satisfaction rate in this table appears to reflect the claims process as well as the amount paid, whereas the 98% statistic is related solely to the amount paid.

4  U.S. Department of Health and Human Services, Office of Disability, Aging, and Long-Term Care Policy (2006 and 2008). “Service Use and Transitions: Decisions, Choices, and Care Management Among an Admissions Cohort of Privately Insured Disabled Elders” (2006); “Following an Admission Cohort over 28 Months to Track Claim Experience, Service Use, and Transitions” (2008); “Care Management, Claim Experience, and Transitions Among an Admissions Cohort of Privately Insured Disabled Elders over a 28-Month Period” (2008).  This study found that 14% of home care claimants, 5% of assisted living facility (ALF) claimants and 11% of nursing home claimants were dissatisfied.  It differed from the 2016 study in that this older study dealt with people earlier in the claims process.  Satisfaction apparently increases with time on claim, perhaps because the paperwork hassle is concentrated at claim initiation and because the monthly payment tends to increase and cumulative payments definitely increase.

5  LifePlans, “Experience and Satisfaction Levels of Long-Term Care Insurance Customers: A Study of Long-Term Care Insurance Claimants”, September 2016, chart p. 15 shows that 78% said it was easy; 15% said it was difficult and 7% did not know.  Of those who expressed an opinion, 15/93=16.2% thought it was difficult)

6  National Long-Term Care Insurance Claims Decision Study: An Empirical Analysis of the Appropriateness of Claims Adjudication Decisions and Payments, April 2010; Figure 5; p. 11 Total Paid/Total that should have been paid = Total Paid/((Total paid – (Amount that auditors would have denied – amount that auditors would have approved)) = $155,925,300/(155,925,300 – ($5,905,708 -$719,999)) = 3.4%

7  See https://www.census.gov/newsroom/facts-for-features/2017/cb17-ff08.html

Filed Under: Correcting Ignorant Public Figures, Helpful Information About LTC, Information About LTC Tagged With: Long Term Care insurance, LTCi, LTCi rate hikes, rate hikes

Long-Term Care Insurance: Dave Ramsey is Just So Wrong!

May 11, 2017 by Honey Leveen Leave a Comment

image of man giving thumbs down to long-term care insuranceCelebrity and unlicensed financial advisor, Dave Ramsey, freely gives advice on when to buy long-term care insurance (LTCi) and he is wrong! For about 20 years, my colleagues and I have emailed, written, and called to offer him correct advice on when to buy LTCi. I’m still waiting for his reply.

Dave does not have an insurance license. He let his license lapse in 1996. Clearly, he does not have current knowledge of the LTCi marketplace. This does not stop him from giving advice on it. Worse, this does not stop many listeners from taking his erroneous advice!

Dave’s Advice on Long-term Care Insurance (so wrong!)

TheHere’s Dave’s advice on long-term care insurance: https://www.daveramsey.com/blog/long-term-care-why-age-60. He is a staunch LTCi advocate, but on his terms (he’s the expert, right?). Weirdly, he doesn’t think we need to plan for unexpected emergencies happening before we’re 60 years old. He recommends waiting until age 60 to buy LTCi. I guess he believes nothing adverse will happen to listeners’ health before then. There are additional flaws in his simplistic thinking. Dave admits and does a good job of explaining why people save money by buying LTCi at much younger ages; how puzzling!

I have new clients who recently attended Dave’s Financial Peace University. They are 56 and 61 years old. Based on Dave’s advice, they wanted to postpone applying for LTCi until Mrs. was 60.  I offered them correct information on why this is a bad idea. Armed with more accurate information, they went forward with their applications.

The High Cost of Waiting

Mrs. was declined long-term care insurance coverage because of a notation that was recently made to her medical records. She would be completely covered today if only she had applied for coverage 2 years earlier.

The LTCi company approved Mr’s. application, although his premiums are higher than than we expected. This is because after a lifetime of very stable, low prostate levels, his prostate levels have recently climbed. The LTCi carrier spotted this, even though the levels are still well within the normal range. He missed receiving Preferred Rate status by only one year.

The correct age to buy LTCi is age 50 or younger, if at all possible. Each passing year, long-term care insurance rates increase, regardless of health.

For many years, Suze Orman, another unlicensed, beloved celebrity financial pundit, proffered incorrect advice on when to buy LTCi.  But she learned firsthand why waiting until age 60 is wrong.  See  http://www.njltc.com/docs/Suze_Orman.pdf for her retraction of that advice.

The moral of this story is: Do not depend on the advice of popular celebrities!

If you want to take personal responsibility for your long-term care planning and make a confident, well-informed decision on the best plan of action, seek the advice of an experienced, ethical LTCi specialist. The best time to buy LTCi is in your 40’s or 50’s, but we’ll still find affordable rates for you in your 60’s.

Filed Under: Information About LTC, Uncategorized Tagged With: Long Term Care insurance, Long-Term Care Planning, LTCi rate hikes

Ding Dong the Wicked Witch of LTCi Rate Hikes is Dead

September 9, 2016 by Honey Leave a Comment

The following is a guest blog by my friend and highly respected LTCi colleague, Ron Hagelman, who can be reached at rhagelman@broadtowerinsurance.com, www.BroadtowerInsurance.com.

The article laments the undeserved, unintended ill-will earned by the LTCi industry. Ron’s sentiment matches my own and expresses the widespread confidence of LTCi actuaries that LTCi pricing is now extremely rate stable. Here are blogs I’ve written about rate hikes.

Here is info on the Society of Actuaries study Ron refers to.  Thanks, Ron, for allowing me to re-publish this.

Wicked Witch“There are simply those who, even after repeated exposure to the glare of the truth, are subsequently unable to admit they were wrong. Our industry suffers seriously from this flaw in human behavior. Far too many have conveniently pointed the finger of blame at those responsible for our lifeless interest environment (whoever those people are) and not taken sufficient responsibility for the “mistakes” that were made in our past pricing assumptions. “We” got it way wrong and the damage done to all concerned is much more extensive than many are willing to admit. Stand-alone LTCI sales are a shadow of their former selves. The destruction to new sales caused by repeated rate increases is pervasive and insidious. We have unfortunately created a general public malaise and aversion to all things LTCI both in terms of those who we said were the smart ones for leveraging their risk early and those prospective buyers considering the security of policy ownership. What is of course much worse is that we have successfully decimated the ranks of those willing to help sell the product. The age-old equation is now painfully obvious to all concerned: rising premium creating falling sales culminating in a drastically reduced field force. This artificially created sales spiral is much more than just a self-fulfilling prophecy. We must first admit that it is also a self-inflicted wound.

We must first freely admit and acknowledge our own culpability. Frankly, we over built benefits, underpriced mortality and morbidity, and overestimated potential sales in the initial rush to achieve market share. We completely missed the whole side of the barn in terms of persistency and honestly we were basing our future experience on far too little actual claims data.

That Has All Changed!

“Ding Dong the Wicked (Rate Increase) Witch is Dead!” The Society of Actuaries has recently completed a research project designed specifically to evaluate the historical potential for rate increases.   The research clearly indicates that products priced today are much less likely to have future rate increases. What is absolutely certain over the last 15 years is that the need for long term care services and support, the growth of assets and income needing protection, and the certainty of a need for expensive care is now greater than ever. We have also accumulated a substantial volume of claims information upon which to more accurately base current pricing.

The conclusion of the SOA analysis is that confidence in current pricing “should” be at an all-time high. Claims data is no longer scarce. We have an abundance of claims to evaluate at this time, meaning we have reduced the potential likelihood of future rate actions. According to the SOA, “Premium stability on today’s LTCI prod- ucts is at its highest.” The SOA identified a number of benefits of the new pricing stability as the study found that, “Claim experience nationwide in 2014 was 70 times more credible than in 2000.” The fact that we now have a history to evaluate has laid the groundwork for future carrier optimism concerning this market. Pricing stability contributes to:

  • Greater carrier confidence in assumptions concerning lapse, morbidity and mortality.
  • Less operational administrative risk translating into lower expenses. Constant change is expensive.
  • Less friction on the regulatory level and potential stress on reserves.

Restoration of consumer confidence at this point is a massive undertaking.

The Study also illuminated the validity of what we knew were serious contributing factors:

  • Long term investment return has fallen dramatically from 6.4 percent in 2000 to 4.6 percent in 2014.
  • Commissions have crept up during the same period of time, emphasizing first year compensation, and while administration expenses have declined.
  • Based on experience, allowable margins for error have also increased.

What is important is that we have learned from our experience and that the relative predictability of current premiums has risen from a low of a 40 percent chance of a future need to raise premiums to only 10 percent today. The study also pointed out that the regulatory environment has provided evolving strength by implementing the necessity of providing adequate margins for adverse circumstances under the NAIC Model Regulations beginning in 2000 and subsequently enhanced in 2009 and 2014.

The journey now standing before us must certainly begin by joining hands with those new friends willing to take that first step on the yellow brick road as we must ask the wizard to help us restore the faith of consumers and agents alike. Together we must recognize that we have indeed survived the flying monkeys and that our strength of purpose to find a home for the risk that will not be ignored was always built upon our brains, our heart and our courage.

Other than that I have no opinion on the subject.”

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: LTCi rate hikes, LTCi Rates, Ron Hagelman, Society of Actuaries

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