Short-Term Care Study Hall

Short-term care insurance is one of the fastest-growing segments in the LTCi market, but do you really understand what you're offering and who it's best for? The answer could reshape how you serve clients who fall outside traditional long-term care underwriting.

In this Short-Term Care Study Hall edition of the Buddy Study Podcast, the group digs into the short-term care landscape with a market-level overview, carrier comparisons, and candid conversation about where these products shine and where advisors need to proceed with caution. Featuring insights from Linda Thalheimer's premium-to-benefit analysis and real-world positioning strategies, this session equips advisors with the knowledge to use short-term care as a strategic tool, not just a fallback.

We explore:

• Why short-term care has emerged as both an affordability and underwriting solution for advisors
• How carriers like Aetna, Manhattan Life, Bankers Life, and Thrivent compare on benefits, underwriting, and value
• The rate increase reality: why advisors should set expectations early and sell responsibly
• Aetna's new Recovery Care Choice product and its $700/day maximum benefit
• Key underwriting sweet spots, including no build chart and insulin-dependent diabetic acceptance
• Using short-term care as a gap fill strategy to cover elimination periods on traditional or hybrid plans
• The growing synergy between short-term care and the Medicare supplement market
• Group and retiree market opportunities developing on the carrier side

This episode is designed to help advisors:

• Position short-term care appropriately based on client health, budget, and planning needs
• Compare carriers with confidence using benefit-per-premium-dollar analysis
• Set honest expectations around rate increase potential without undermining product value
• Identify new market opportunities in the senior, Medicare, and retiree group space

Chapter Markers

0:00 Welcome & Episode Overview
1:04 Why Short-Term Care Is Gaining Traction
3:18 Short-Term Care as a Starter Plan and Gap Filler
4:21 LTCi-Filed Products vs. Supplemental Health Filing
5:23 Product Design Levers and Rate Increase Risk
10:25 Carrier Comparison: Premium-to-Benefit Analysis
15:06 Underwriting Differences Across Carriers
18:04 Selling Responsibly: Buy What You Can Afford to Keep
20:15 Manhattan Life Age Range and Process Advantages
26:06 Aetna Recovery Care Choice Product Updates
33:15 Overcoming the "It's Only One Year" Objection
36:04 Short-Term Care as an Elimination Period Gap Fill
43:07 Group and Retiree Market Opportunities
47:17 Medicare Gaps and Final Advisor Takeaways

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🔎 About Buddy Study Podcast

The Buddy Study Podcast helps insurance professionals and financial planners master Long-Term Care Insurance through case studies, expert interviews, and carrier product updates. Our goal is to help advisors become more confident, efficient, and knowledgeable when helping clients plan for long-term care.

Transcript

Welcome & Episode Overview

SPEAKER_03 0:00

Of the Buddy Study Group, and we are resuming the study hall sessions today. So it is going to be a short-term care study hall. And uh as I was saying before we hit record, I think this is going to be very much uh market-oriented today, rather than talking about specific carriers. Of course, we'll talk about um the major players and we'll talk about what updates we've seen. But I think for today, a large part of the discussion is probably going to be an overview of the short-term care market, what we see developing, our thoughts on it. We'll talk through obviously ideal clients and all that good stuff. But I would love to hear uh your thoughts on whether it be specific carriers, whether it be the short-term care market in general, whether you have short-term care uh case studies that have really helped out a client that you think sharing would help. Um, I think we can all learn from each other. We do a really good job of that on these study hall sessions.

Why Short-Term Care Is Gaining Traction

SPEAKER_03 1:04

So feel free to speak up. But uh just to get us started, short-term care is I I mean, a lot of these solutions aren't new, right? But a newer kid on the block as as far as we're all concerned and with how long we've been doing this. Um, and it really started to emerge from you know needing a market, number one, that is a little bit easier on underwriting, but number two, I think short-term care is also a really good affordability play. So I think that's where we started to see these emerge. I think from uh a carrier perspective, from a product design perspective, this product can certainly make sense as well. Because since we're dealing with very limited benefit periods on these plans, we have a much more predictable exposure on the carrier side to um be able to work with at the worst possible claim. I know I'm going to be paying claims for a very short amount of time. Um, so I think it can be a relatively appetizing market to get into for carriers. We haven't seen too many new major players in the industry of late. Um, but I think just from uh a ground floor, that's how I kind of start by um laying out short-term care. Of course, one of the limitations being state availability, right? Um, many of you may not have worked with any short-term care products purely because short-term care as a product has not been approved in your state. Um, so that can be a limitation, but I think even if you're in one of those affected states, you're more than likely going to do a case out of state at one point or another. So it makes sense to have short-term care on your radar as an arrow in your quiver because it can fit a lot of uh holes that you may have with specific clients. Mark, do you have anything you wanted to add, discuss here?

Short-Term Care as a Starter Plan and Gap Filler

SPEAKER_02 3:18

Yeah, those are the biggies. Um, but yeah, I do want to add a couple of things. Uh, one is that I think it's really important to give clients an option to get a starter plan. We talk about this a lot on the work site side as well. But that's how I view short-term care is think about what getting the first year covered can do for a family to help them like plan further for the future instead of being like totally reactive in a crisis situation. I like that short-term care has a zero-day elimination period, for example.

SPEAKER_03 3:49

Gap filled, huge strategy.

SPEAKER_02 3:51

Cause you need to fill in the elimination period cap. I like that it goes up to certain ages. So, give you an example, my father-in-law, 85 years old, did not have any long-term care insurance, could not get any long-term care insurance, could get short-term care. And I'm thrilled, my wife is thrilled, that he has the one-year plan just uh just to help when when that time comes, get that professional care as a supplement. So, you know, there's just a lot of stories where I think it just makes a ton of sense. Um,

LTCi-Filed Products vs. Supplemental Health Filing

SPEAKER_02 4:21

also, um I like that there are now some carriers that are thinking about filing as long-term care, but building a one-year benefit and simplified underwriting. So I call it short-term care. I mean, it's it's essentially the same thing, but doesn't run into the regulatory issues of having a true supplemental health file product. So we can get, you know, Banker's Life is a great example. They kind of trailblaze this. And believe it or not, they're the number one traditional long-term care carrier in the country in terms of sales now, because there's a lot of demand for an affordable one-year, simplified, underwritten long-term care policy. So I think other carers are going to copy that model. Whether or not you're comfortable offering bankers, you know, is a different question. We decided, and and several people in this room decided to take the leap and to get you know access to their products, though, because it is so important to have this product, you know, in New York and in other states as well.

SPEAKER_03 5:22

So

Product Design Levers and Rate Increase Risk

SPEAKER_03 5:23

I would say please don't take this as literal, but I would I would characterize short-term care as kind of like a uh little cousin of traditional long-term care, if there was a way to characterize their relationships. I think they're the most closely related products.

SPEAKER_02 5:37

Well, and I'll take it one step further because there is a little bit more of a direct connection. Is originally when short-term care was uh approved, it was very non-inconsistent with the contract definitions, which is why certain states have not gotten comfortable with it. It used to be cancelable. You could buy a policy and the care could just cancel your coverage, you know, at their discretion. That is not the case anymore with these new policies because they've kind of mimicked, Jason, to your point, the long-term care contract language. And I would say that we do expect that it's likely they're going to have rate increases like traditional long-term care has had. So I think it's important to disclose that potential and not pretend that this time is different than what we saw in the past, you know, with long-term care. But despite that, there are clients that still are willing to kind of budget for that, you know, expectation. And they're they're comfortable with that. So I don't think that's limiting. I think it's just important to embrace that it's health insurance, not like-based long-term care, and therefore you're gonna have the risk of rate increases.

SPEAKER_03 6:36

Yeah, and I think there's tried and true knowledge that we try to impart wherever we can on these study groups, and it's always going to come down to reading the contract, right? At the end of the day, it's something we hate to do. It's easier to do than ever nowadays with your favorite AI tool and um, you know, summarizing and having it pick out passages uh in the contract that speak to your general inquiry, right? We don't just go into a contract and expect to read every word necessarily. We generally will open up a contract because we have a specific objective, right? How do we file a claim? Like you said, uh non-cancelable guarantee renewable language. Do we have any of that present? Do we not, right? Um, you know, how do we certify claims, right? How do we get uh to a claim eligible status with this policy? So I think that's always going to depend, carrier to carrier. It can't just be taken as a given, right? So um doing that homework is definitely a big deal to understand what you're selling and to be able to set expectations right with the client, right? No back-end bad surprises. And yeah, just like you're doing with traditional long-term care, you can't sit across the table from somebody and guarantee there will never be a rate increase. And I think I'm of the same mind as Mark in thinking that short-term care is probably the ripest product to start having stripes of rate increases over the next five, ten, fifteen plus years. I think. Um do I call it by design? Uh debatable, but I I think when I talk about product design, I talk about levers, right? There are certain levers that a carrier can pull to limit their exposure, whatever they need to do to become comfortable offering the product and to price it responsibly, right? You can uh have a product that's lenient on underwriting, but it may, you know, come at the lever of being more expensive or having a limited sort of plan design. I think uh I see short-term care right now, especially with a lot of the changes going on in the market and the enhancements to the products. I'm seeing a lack of um sort of safety levers being pulled uh in a way. Um, you know, the true limiting factor of the exposure has always been we're dealing with a one-year benefit period at max. I know I'm going to pay out one year's worth of benefit at a relatively modest benefit, but we are starting to see in the marketplace um incredibly high daily benefits being offered on some plans. We're seeing um restoration of benefits on some plans with less lenient language that are starting to cross us over that barrier from we're looking mostly at a one year to maybe we're looking at a two-year plan, right? We're starting to see inflation protection options coming out with short-term care. And all of a sudden, the uh the exposure to the carrier becomes a lot less predictable and transparent, right? So uh in knowing that you kind of tie that to um you know propensity for rate increases. Jason, would you like me to show the table comparison of Manhattan life versus traditional policy pricing? I would love that. I think that

Carrier Comparison: Premium-to-Benefit Analysis

SPEAKER_03 10:25

would be super helpful.

SPEAKER_00 10:26

Uh let me just can I share my screen?

SPEAKER_03 10:29

Of course you can.

SPEAKER_00 10:30

Okay, where is it? I gotta find my share screen. This um share.

SPEAKER_03 10:35

Yeah, zoom controls are all new lately.

SPEAKER_00 10:37

Okay, there we go. All right. So what I did, um, and what I do with most products when they come out is I do uh an analysis to just really see how they play in the in in the marketplace, right? So based on age and gender and partner status and different ways of paying so that so that you can sort of put this new policy in your brain and where it would best fit, right? So um when I first looked at Manhattan Life, for example, I was concerned when you see prices that look too good to be true. So um I did a comparison and and I looked at Thrivant, um, a two-year policy, both without inflation and with inflation, Aetna, uh Manhattan Life and Bankers Life one year with a 5% compound, which is their most cost-effective way of purchasing their product. And um, and I use the same monthly premium. So we're talking basically $100 a month, and what can you buy for it and what do you get for it? And if we look at the total value, so um, so I used a 60-year-old woman um going into claim at 85, holding it for uh 25 years, so either going in at age 80 or 85. And with Thrivant, um, the person would have $3,300 a month with no inflation, $3,000 with inflation. It's a little better with the inflation at age 85, but you know, maximum they're getting $86,700 as a total benefit. Um home care plus Aetna, you know, $1,500 a week, 52 weeks, cash, zero-day elimination period. Um, you're still talking $7,800, um, $78,000. So very in comparison, some, you know, within some leveraging with Thrivant, but remember, this is all up front, which is what makes you nervous about some of these, these um home care, I mean these uh short-term care products, is they're giving all of their money up front. And and we do know that there's about a 33% chance of using more um risk associated with those first 90 days of care, right? I mean, when we look at insurers, what do they do? They usually charge anywhere from 7% on the low end to 25% of the high end for those for that home care period. So um, and many insurers won't even decrease the elimination period for that first 90 days, right? So, um, and here we're getting twice as much value in a short-term care product in cash with zero day. Um, and then I will go to the end just to really compare. And and here you have the same with uh, you know, similar with bankers. Bankers is a 15-day again reimbursement, and and you're still at 73,000. Um, and the uh the cash Aetna product is still significantly better, right? Because it's cash, they don't have to pay the uh and um 78,000 and you have cash and you get zero day instead of 15 service days. And then we get to Manhattan life, right? And and we have both a facility care and a home care benefit, and we're looking at 72,000 um in the and so we're going up uh we can yeah, so this doubles, right? So you can go up to a maximum uh doubling of the policy, and so we're looking at $18,000 a month or $6,000 a month in facility care, $18,000 in home care, upfront in cash day zero. I mean, it it doesn't even compare. And between the the home care alone is $216,000, and you still get the $72,000, which is comparative to the other short-term care products. So, how can a company you know give that much more benefit and and and not have a problem is the question.

SPEAKER_03 14:44

Um so uh I think it's a fair question to ask, and and Jackie also makes a good point. What about the underwriting differences, if any, because you know, you think about uh Thrivant in this comparison, they have far more protections in the way of upfront underwriting than some of these other carriers as well. So that has to also

Underwriting Differences Across Carriers

SPEAKER_03 15:06

be a factor when you think about security of offering the benefit from the carrier perspective and absolutely, absolutely.

SPEAKER_00 15:13

So you've got you know, four times, five times the benefit of of these other policies with less underwriting and all of it front loaded. It's it's um, you know, it's concerning. So when would I use this product? When somebody um doesn't qualify for some other products and they understand the risk that that you tell them up front, there could be a hundred percent rate increase in this. And I wouldn't be surprised if there were, right? And if they don't flinch, you know, then then you know, if there's a 200% rate increase, then you know they're they'll probably be ready as well. But um I I it does, it does, it does worry me.

SPEAKER_02 15:55

And Linda, I do think also when you say 100% rate increase, we're talking about $106 a month going to $212 a month. Maybe that's not as severe because it is a more affordable price point to start off with.

SPEAKER_00 16:09

Right. So here's the key. A lot of people sell this policy as an inexpensive policy, and it can't be sold as an inexpensive policy for people who are struggling because when they get their rate increases, they're going to be crushed. And that's the last thing we want to do to people. This is this as a real option for people who want real benefits but can't get it because of medical issues. Then they don't mind if you say, you know what, this could have a 100% rate increase. Well, the cost benefit is still there with 100% rate increase. And for people who don't qualify for something else, you know, it's still a value at $212 a month. So as long as you're selling it to the right people, it makes sense. But you can't say to someone, oh, gee, look at all how much you get more for $106. It's such a bargain. You know, you can't afford much. Let's get you a really good policy. Um, because uh the potential for rate increase in my mind is is pretty high. And then those people can be uh devastated, maybe having to drop um, you know, they may instead of being going up to 212, they'll have to go down uh and drop half the value of their policy. Um, and maybe they should have started at half the benefit, right? So that they didn't waste that money all those years because every single dollar to some of these people is so significant. So we don't want them spending money that's not going to have future value to them.

SPEAKER_02 17:32

You know, kind of our message, you know, is always been buy what you can afford to keep. Exactly. Regardless of what the situation is. I think as long as they commit to that budget and commit to that process, I think then you run, you don't run into that as much.

SPEAKER_00 17:47

Exactly. Exactly. Right. Yep. Yeah. So I just want to show everyone. Yeah.

SPEAKER_03 17:52

This is super helpful, especially putting it in a what kind of benefit am I looking at for the same amount of premium? And you definitely do a good job of bringing to light the fact that

Selling Responsibly: Buy What You Can Afford to Keep

SPEAKER_03 18:04

that's a lot of money to be giving out in benefit, especially in that first 90 days. That's uh that's a huge protection for most carriers offering that 90-day elimination period. You see bankers even with a little bit of hedge on a 15 service day elimination period gives them some time, you know. See if you get through the first two weeks um receiving professional care and pay benefits uh after that point. So this is a really nice comparison. Definitely super helpful. And I agree there's still going to be good fits for, you know, the Manhattan life of the world, uh, but you just kind of need to flip the conversation. It's not about designed to remain level if you, knowing everything you know, can see the potential for rate increases right in front of you with a comparison like this, right? But it's okay to sort of lean into that conversation. I would expect rates to increase. I would expect them to increase X percent if I had to guess. You know, people do buy insurance products that are on an increasing premium schedule that's to be understood. Um, you know, you just have to be up front with your belief in the likelihood, right? And and the amount and price and and purchase responsibly.

unknown 19:28

Yeah.

SPEAKER_00 19:28

And Manhattan Life has tremendous value in the sense that um, you know, it's a cash benefit, it's a zero day, you can get a lot of money up front and it's growing, where most of the short-term products don't, um, or they are reimbursement like bankers and thriving. So there is value to this for people who don't qualify for other products or qualify for a bankers, and you say, you know what, you want the cash, right? There's very few products um that have cash that can grow like this. So if they it may not, you don't have to worry so much about the 106, you know, 212 would still be a huge value. So that's it's as long as you sell it uh with them understanding the value, then it can help.

unknown 20:14

Yeah.

SPEAKER_03 20:14

Yeah, and it's

Manhattan Life Age Range and Process Advantages

SPEAKER_03 20:15

interesting. Manhattan Life also does um offer to a lower age range than other short-term care products. Am I correct in saying that? I believe they go down to 45, but they also go all the way up to 89 that I've seen. Right.

SPEAKER_02 20:29

So yeah, they're pretty broadly. I think the other thing is it's not just about health, it's about process. Some people don't want to go through the process of filling out the long application and going through underwriting. And even though we do it day in and day out, right? So we've kind of become a part of our norm. Um, for clients, they're not moving forward with long-term care because there's just too much going on in their life and they just don't want to spend all that time on this one problem they're trying to solve. So I think the ease of being able to get the policy in place is really important. We're seeing this really popular in the Medicare market. Agents that are selling Medicare are running into clients where they're like, hey, if I could add this really easily, no one's ever offered this to me. I'm happy to add my long-term care. I'm not gonna like excruciate as much over the cost-benefit analysis, right, that Linda's showing. I just want something that's gonna be there when I need it, gets the job done, low cost, and I can check the box and move on with my life, or get my spouse off my back, or whatever it is, right? They're trying to solve for. So I think that process can't be understated. Why people are not purchasing insurance has to do with the process of getting it. So this is a much better process. Linda, can you speak to kind of what the application approval process is?

SPEAKER_00 21:41

You know, it's a it's very easy, um, a very easy process. Communication isn't always perfect, but I think they're they're working on that. Um, I think they've been inundated. So that that was part of the problem. And and and it is, it's one of those products that Medicare people are doing uh as as you know, they're doing the Medicare and they're coming right. Back with Manhattan Life because it is so easy to get people through the underwriting process and issued very quickly. And the price point looks great. And that's the only part I just want Medicare people to be very careful of. That you know, they often, you know, it's one thing if you sell it on the ease of the product, the simplicity of the underwriting, the speed of which you go through underwriting. But when you're talking about how how great the cost is, you have to include uh things that are too good to be true, usually are. And this, and there's a, you know, we have to be realistic that there could be a rate increase on this and in some at some point.

SPEAKER_03 22:40

Thankfully, folks that are dealing with Medicare supplements and the like, uh, you know, are already dealing with a health product that is going to have generally year-over-year rate increases. So that is kind of what gives it sort of uh synergy with uh Medicare folks. And I think another thing that gives it synergy that we'll continue to see is maybe their favorite Medicare supplement carriers offering this short-term care plan and sort of marketing them, not necessarily side by side, but as complimentary, you know, sister products for the senior market, right? Uh I think we'll continue to see more carriers that are extremely active in the Medicare supplement, Medicare Advantage space continue to offer short-term care products. I mean, obviously Aetna's been a leader for a while, but we even see um Welleby is a relatively newer entrant. I think they have some tweaks to make to their product before it's going to spreadsheet out in a competitive way. Um, you know, their tiered underwriting can be a little bit not only difficult to understand from a process perspective, but um can really hurt the value compared to what other carriers can offer the same applicant. But you see well be well-be Medicare supplement owners get pretty significant discounts on their short-term care plan. Uh, and we're starting to see a whole lot of add-ins on short-term care products, which um, you know, definitely make them feel a bit more appealing, right? Uh value-added benefits, right? Yeah, yeah, value-added services, prescription discounts. I mean, uh, we can take a look at some of the new uh value-add services on Aetna's refresh plan, but there's I I don't think two hands is enough to count the amount of them. Um, so you're starting to see them play really well with just senior market um, you know, insurance products in general. So I think it'll kind of continue in that way. But I definitely think uh some folks are kind of sitting back a little bit and saying, well, let's see what plays out with uh these couple carriers duking it out right now before we actually throw our hat in the ring.

SPEAKER_02 25:01

Yeah, I do think broadly the short-term care market has kind of evolved into the Aetna Manhattan Life Bankers model, which is more like, like you pointed out, a long-term care alternative product. And then the ones that have limited exposure, but are more about the value-added services. GTL is a good example of that. Yes. Um, it's really not about the total benefit or the leverage as much as what can I get, you know, as a cash benefit for a need that I'm more likely to have. You know, they'll give you, you know, a certain amount per prescription with GTL. So you know that by buying the policy, you're at least getting your money's worth that way. And then anything extra you get from the long-term care or the short-term care side, I should say, the 90-day benefit it has, you know, is just cherry at the top. But it's not like designed to solve the exact same issue. It's more to check a box. I think there's probably like six to 10 short-term care carriers in the market out there. But we we tend to focus on the ones that have the richer benefits as the long-term care alternative. So that's what you're gonna see in the buddy system and and all of our materials.

Aetna Recovery Care Choice Product Updates

SPEAKER_03 26:06

100%. Yeah, Romeo. Um, this is interesting. I I didn't realize this, but Romeo said I've just learned that the prescription reimbursement on Aetna short-term care is only one on claim, not obvious in their printed info. So that's that's good to know. Uh, I'll have to take a deeper look at that myself. Um, but yeah, when we look at underwriting, I would say Aetna tends to be the carrier with the more underwriting sweet spots, I guess I would say, um, as opposed to say a Manhattan life. Um, the reason I say that is because I just know of two kind of heavy hitter um underwriting sweet spots.

SPEAKER_02 26:47

Number one, on intended.

SPEAKER_03 26:49

Yeah. Yeah, exactly. Uh so Aetna, no build chart. So you're not gonna have to worry about being disqualified for height weight. Number two, they take insulin-dependent diabetics, which uh, if you do enough business across a number of carriers with enough clients, you will know that that tends to be a really hard one to place. There's only a couple of carriers that are really going to take insulin-dependent diabetics. Believe it is under 50 units of insulin a day, uh, is what they will consider. So um certainly an avenue to look for there. Um, even if you also kind of know in the back of your mind, well, Meat Full of Omaha will take insulin-dependent diabetics. You may have a larger uphill getting approved because that case starts rated with moo. Anything else added to that, you're gonna be on really, really thin ice, um, basically already in rated individual consideration territory just with the insulin-dependent diabetes alone. So Aetna might be your um, you know, your next go-to there. Um Manhattan Life, just because I have their underwriting questions um pulled up, they are going to ask about your prescriptions. Um, their knockout questions are relatively simple, um, you know, simple for for many to get through. They're gonna ask about HIV rates, they're gonna ask about Medicaid or early Medicare due to disability. They're gonna ask about your ADL uh assistance needs currently. They're gonna ask about Alzheimer's, Parkinson's, Huntington's, um, and they're gonna ask about diabetic complications, which um, you know, would include neuropathy, kidney disease, um, any sort of dialysis, things of that nature. Uh, and they ask right up front on the knockout questions, which is why I shout out Aetna on the underwriting side. They're gonna ask about insulin-dependent diabetes right on the knockouts, um, treatments in the last 12 months, surgeries that haven't been performed, um, or just have pending test results. Uh, they are also going to ask about uh a few uh if you're taking medications for a few problem conditions, they're part twos where they really start to ask about stroke, TIA, uh, diabetes again, and and just a handful of other medical conditions, and they'll ask about your prescription drugs. So um it's not exactly come on in the water's fine, um, but it's definitely a bit more limited compared to say your normal traditional long-term care uh health question experience. Uh let's see here. Let's talk a little bit about some of the changes with Aetna's short-term care product because these uh these really surprise me. Number one, recovery care choice is the name of the new product. I think the biggest thing that you could just slap on a billboard is max benefits up to $700 per day, which is why I'm saying we're getting we're losing our levers a little bit with some of these products. $700 per day is unbelievable. Um, and even a deal for existing clients to uh add to their plan up to the $700 max daily benefit with a 15% discount. I thought that was interesting as well. Uh only in a handful of states right now. Yep. Go ahead.

SPEAKER_02 30:23

Yeah, I want to mention something too. Some people, you know, will have objections about the duration of coverage with plans that are a one-year plan. But when you're getting a very high daily benefit on a cash, you know, or indemnity style, you can always put the extra money in the bank and have it fund a longer duration yourself. You know, so I think it's also a mindset, right? For me, it's more of the value you're getting for that, for that level of benefit. And if you're getting good value, I don't think you should shy away from it. Um, there may be certain limits, like you know, the IRS per diem limit when it comes to long-term care. I'm not exactly sure if that applies or how it would work related to short-term care payments, you know, cash payments. Um, because generally the the the you know, those types of benefits can be tax free. But again, be careful, you know, if you are, I'll say overinsuring, if you will, the first year from that perspective. But, you know, if it's coming out of your insurance dollars, even what you're paying in taxes, that has much less of a sting. I'm getting $21,000 a month, right? $700 a day is $21,000 a month, and my tax bill is $5,000. Out of that, you know, it's coming out of what you're getting paid. Um, so it's not as severe of a concern.

SPEAKER_03 31:34

Yeah. And, you know, in general, um, again, we're starting to see lots of riders, lots of add-ins that you can choose from. So I saw the daily hospital confinement indemnity benefit rider. That's a mouthful. Try saying that five times fast. Uh, if you're confined to a hospital, which includes hospital or which includes observation stays, um, again, maximum benefit of up to $700 daily. Um, sample policy benefit amount as $10 per day. Uh, let's see. Um, maximum number of days per period of care is a choice of three to 10 or 20 days with a lifetime maximum of 365 days. So this applies when you're on claim and you are confined to a hospital. Um, we talked a little bit about the prescription drug indemnity benefit. They have bed reservation benefit, Medicare Part B excess charge rider, I believe this is a rider, pays the difference between the Medicare allowed amount and the actual amount charged by your provider for Medicare Part B claims. So that that tends to be a big one. If your um services that you're receiving do not accept Medicare assigned rates, Medicare assignment, um, you know, helping to pay that gap is a really interesting benefit to be able to add. Um, the recovery care choice does come with inflation protection, but as uh Romeo mentioned, only on facility care, not on home care. Thank you for that. Um, Romeo, have you done much work with the new uh recovery care choice yet? And if you have, what are your thoughts?

Overcoming the "It's Only One Year" Objection

SPEAKER_01 33:15

I have, and I've gotten consistent objections to, but it's only one year. It's only one year. And so by going to a traditional long-term care insurance first, three, four, five years, whatever you're selling, and then ask them, what if you get all the money in the first year? Now they finally get it. If you don't do that first, they really don't get it, and it's a problem.

SPEAKER_03 33:36

Yeah, people think about the probabilities of needing care, but uh, what about the probabilities of only needing one year of care or having a use one?

SPEAKER_01 33:45

What if you used one year of care and left a hundred thousand left for your heirs? How would you like that?

SPEAKER_03 33:50

Right. Um, so any other um thoughts in how you're designing the plan, Romeo, or how you're using it with clients?

SPEAKER_01 34:01

No, basically, um, I I just you I feel more comfortable selling without inflation because getting at 40 years old, ending up with a two and a half million dollar benefit, they can't do it for that price. There's no way that's possible. And I just like saying, look, if you can get $252,000 in one year or $21,000 a month, that's enough for three years in and elf. And uh what do you think? And people are like, Yeah, that's cheap. I can afford that. Yeah, my market though is Joe Lunchbucket, who's not gonna buy an eight, nine, ten thousand dollar year long-term care policy. My market is the poor people who don't have money and uh they love me. Right.

SPEAKER_03 34:43

Awesome. Uh let me see, what else do we have here? So I did see that there is a pre-existing condition exclusion limitation on the plan, um, not covered by the policy, or any attached riders for the first six months beginning on the date you become insured. Um, so it looks like a six-month look back and can't claim within the first six months. We see that on some plans in the work site market as well. Um kind of all of your in industry standard exclusions. Uh benefit rider for mental health visit indemnity. Um up to 20 visits per policy year. So just a lot of like picky choosy things that you can add to the plan as well. I think that's pretty common in the senior market with Medicare supplements and and Medicare Advantage, you're starting to see those value-added services everywhere. So, again, the synergy um is pretty clear there. Uh anything else? Anyone have any other things they want to share about um maybe experiences with the new Aetna plan, any short-term care case studies, their thoughts on what they're seeing in the market? Anyone have anything else they want to share here?

Short-Term Care as an Elimination Period Gap Fill

SPEAKER_03 36:04

Anyone position this as something to cover the elimination period and then go with a much longer elimination period on a traditional or hybrid as a catastrophic design? Yes, that it using short-term care as a gap fill is a very widely accepted practice, but I would say it's probably an underused practice. You know, it does require uh a little bit of a surgeon's diligence to go in there and and make the calculations, but that's what creating a holistic plan, uh a really customized plan is all about. So I say definitely explore that. Um, go for it where you think it fits because short-term care is a very highly accepted gap filler with the zero-day elimination period. Many folks worry about that 90 days, especially when you get to the long-term care insurance personal worksheet on your favorite application, right? When you have to write out that number of how much their care might cost them during that elimination period, that's what gets them thinking, and that's something that could certainly help.

SPEAKER_02 37:06

Yeah, let me also add, uh, Matt, I think that's a great idea. I would pair that with Amada senior care because now you have to file a claim with two companies. Even more important to have like a claims concierge that can help the client file the claim. So they're able to do it on the short-term care side, and then you have the same kind of person to help you file the claim on the long-term care side. So that's the challenge I see with multiple policies, is just the administration, right, and tracking of what's going on. But I like that and the diversification of it, you know, in case something happens to one of the carers or the other, rate increase, it just hedges a little bit, right? That you're not having that disruption. But uh incorporate that in your process of having somebody they can go to to help. Um, so they're not frustrated, you know, with the experience at point of claim.

SPEAKER_00 37:50

Yeah, I was gonna say I was gonna say at some point that it made, you know, before it's some of the policies, so like uh ThriveInt is a 7% utilization to get a zero-day elimination period. Um, uh National Guardian Life just now, you know, where their new product is at 10%, um, used to be 25%. When it was 25%, it made a lot of sense to use a a short-term product to fill that space. Um, when you're 10% or less, you you you tend to do better with, you know, just go with the product because it's just easier. As you say, it's just one administration and the premiums are pretty close. Um, but when if you're doing um a mutual Omaha, which is 15%, now you start getting into the range that you might do better with um uh using an an adjunct product or with products that that don't have um an elimination period. So for people who are um say using like a New York life, which has a 20-day, but they still have the 70 day for facility care, they might might just assume have a 20 day, you know, fulfilled so they can use, you know, not use their policy for the first 90 day, right? And so they can go right into facilities. So they're all those like little things that um that can um that that I think makes that that 90 day valuable. But to Mark's credit, absolutely, you want to partner with a home care agency that does the claims because claims does take time and effort, and you as the agent, um, they're gonna be coming to you if if if it's a real hassle factor. So you want to make sure and and and isn't um, and if you go to a uh somebody who's like myself who does claims, you know, it doesn't matter if it's a short-term claim or a long-term claim, the process is the same. And it and so um it's it's a lot of work for a very short payout. So um uh something so definitely if you're planning on that, you got to guide them to an agency that can help them to the claims throughout the whole process.

SPEAKER_02 39:46

Actually, that's oh sorry, Jason.

SPEAKER_03 39:49

Well, what we hear from John and the folks at Amada uh a good amount is that if people don't go directly to their agent or don't go to somebody like Amada, they may feel that they are in an eligible claim scenario. They go to the carrier, their claim has been denied before anybody has kind of told them, hey, we're pre-claim, but we're not at uh a true eligible claim yet. All they hear is their claim was denied from the carrier. Oh, I knew it. They never wanted to pay me my benefits anyway. They just wanted to take my premium dollars, right? So I think that's where a lot of the benefit comes in, is that if you build that bridge and they have the conversation with Amada first and say, you know, we're almost there, but we're not there yet to the point where the carrier would approve our claim and start paying benefits, right? That that helps the emotional side, um, you know, the the bad case scenario.

SPEAKER_02 40:45

Yeah, Linda, given that you do like that claims concierge service, I know you have like a fee for service for your higher-end clients. Have you run into a lot of short-term care claims and what's been I've had no short-term care claims.

SPEAKER_00 40:57

But what I do, so for but for long-term care, so like I have a a cost for you know clients to come in to do the full conscience service, um, but I won't charge them more than a monthly benefit. So, you know, somebody only has you know $3,000 in a monthly benefit. I'm not gonna charge them more than one month. I'm not gonna, you know, so uh and then in it, so if I think about these short-term claims that are worth like, you know, that that their whole thing is worth $30,000, it's it's really hard to charge them. I mean, how can you take money from these people and you end up, and I feel like I would almost have to do it, you know, pro bono, which I probably would, but I really would prefer not to. So um, you know, it's it's one of those things that I think using the um home care agencies is the answer.

SPEAKER_02 41:44

Yeah, the MATA is a good example of that, where even though it's a smaller policy, because the client might otherwise self-fund their services out of pocket for the difference, or you know, when they run out of benefits, that's still a great client to have built a relationship with for them. So it makes a good business case too, right?

SPEAKER_00 42:01

For them to be Oh, absolutely. For them, it's a great thing because they're gonna get that they've got all this money. A lot of times people will minimize their care for the first 90 days trying to get through an elimination period, which makes it hard on the home care agency as well as the clients, because the home care agency is trying to minimize the person coming into their age, you know, out to support them to get through the 90 days, when it would have been so much easier just to get their their one comprehensive aid that's going to be in there six to eight hours every day to support that person in home care. So, you know, you know, if if you know, it and if they're only using like, you know, two or three hours trying to get through that that elimination period, even though there's a four-hour minimum, sometimes home care agencies will work with them. It it's a different caregiver who works for two to four hours than the caregivers who typically work, you know, six to eight. So they really um, you know, they'd like to get that continuity from day one if they can. So it makes it worth it for the home care providers to have that benefit. Absolutely.

SPEAKER_02 43:06

Jason,

Group and Retiree Market Opportunities

SPEAKER_02 43:07

real quick before we uh just get off of short-term care. Um, one of the exciting opportunities I think with the market is that, you know, as you know, we're doing a lot with the group market, which is usually work-site people actively at work, but there's this large market where we're seeing, you know, censuses and groups that are retirees. Or there are groups where we have an actively at work population and we have a retiree population and we can only serve the working population with the um the group products. I am seeing a lot of interest from the carriers in starting a group short term care program that would be more designed for retirees. Kind of like what we have with True Freedom. So if you guys are familiar with that home care subscription service, True Freedom, we have a affinity group type of program for them. And that's really, I think, the best target market is that retiree population. So to me, I'm paying attention to that short term care market. Also, because I see the volume of opportunity to offer it to Medicare, you know, agencies, right? That have groups, and we might be able to tie them even to an affinity type of opportunity there, not just an employer. So that's why I would say also pay attention to this is is the market's growing, the carers are interested, right? Which is a key factor, is supply of product. We see that that's continuing to increase. I think you're going to see opportunities for volume types of approaches to this market. And you could picture it being something with its self-enrollment process for a group, right? Where people are signing themselves up and you're able to set up a website where people go to a landing page that you educate them and they end up buying the product um themselves that way. I think that is where we'll get much more access to the mass market, you know, 65 plus market.

SPEAKER_03 44:51

100%. And um before I wrap it, I just want to shout out this one page. I shared the uh Aetna brochure in the chat, the um New Recovery Care brochure. And I want to give a shout out to this page. I just really like it. I think one of the benefits of you know having a health insurance, a Medicare provider in this space is pieces like this, right? That talk about where do you plan to or where are you thinking about receiving your care or where are you planning on recovering? What is Medicare actually going to provide for you? And turns out, finds out that it's to find out it's very limited, right? Medicare's coverage for long or short-term care uh has always historically been limited or had certain conditions or hoops to jump through in order to have Medicare be a payer on it in any way, right? Even for uh skilled nursing care in that first 20 days, you got to be admitted as an inpatient for at least three days, right? And talking about where recovery care choice will come in and actually help you where Medicare may not or may not help you enough. So I thought this was a really interesting piece. I think um many of the people in this market that you will be talking to are of the age where they're thinking about Medicare. And, you know, they may think that absolutely all of their bases are covered. Turns out that they are not all covered, and this is a very important one to cover. So uh yeah, I just really like that synergy there. I like uh, you know, a lot of the incumbent long-term care carriers just kind of think of it from a policy benefits perspective, from an emotional long-term care perspective. And I like that Edna kind of puts the spin on the Medicare perspective for the senior market. And I think if I were to wrap it up, you know, obviously there are, you know, things to watch about short-term care, uh, you know, positive and negative slash unknown, right? Um, but I think one of the things that it is absolutely doing that's a great thing to always take away, is that it's giving

Medicare Gaps and Final Advisor Takeaways

SPEAKER_03 47:17

us um access to coverage for a lot more people uh than ever. And at the end of the day, this industry has done so well in having solutions pop up that serve uh uh a portion of the market that previously couldn't be served for underwriting reasons, for age-related reasons, for financial reasons, right? And short-term care um meets a lot of those previously blocked markets, you know, affordable pay as you go premiums. Uh, in the case of Etnes Plan offering down to age 40, uh, short-term care plans, many offering to people uh as old as 89, right? And um some interesting underwriting niches, and at the very least, a simplified underwriting process. So it brings a lot of good to this market. But as always, our due diligence is going to um establish our barometer, our appetite for who we offer this to. Uh, is it very limited situations or very broad stroke situations? But it fits a lot of interesting gaps. It's an interesting arrow to have in your quiver always. And I guarantee you at some point down the road, it could help a client who you previously couldn't help before. So I would definitely keep it on your radar, whether you're in an approved state or not, um, for clients out of state. Just always good to know this stuff. And I appreciate everybody's contribution to the conversation, whether it be speaking up on product, Linda, the comparison was wonderful. Or uh if you just ask questions to help everybody learn, I really appreciate it. And I think that'll do it for today. Uh, if you are interested in the worksite side and maybe are even interested in products outside of long-term care, we're gonna have the standard as a guest on our Thursday worksite study group. We're gonna have Tyler from the Standard on that study group call. And he's gonna talk us through uh the standards, very reputable disability offerings, so long-term and short term disability for employer groups. So if you're interested in that, that's what will be going on on Thursday. Uh otherwise, I will see you this time next week. I appreciate y'all. Be well. We'll talk to you soon.