Forum Session

Private Long-Term Care Insurance: Where Is the Market Heading?
April 15, 2011


Sally Coberly, PhD


With the leading edge of the baby boomers reaching age 65 this year, states facing challenges in financing their Medicaid programs, and federal budget deficits ballooning, concern is growing about how long-term services and supports (LTSS) for the elderly and people with disabilities will be provided and financed in the future. Private long-term care insurance (LTCI) has been postulated as a way to protect individuals from catastrophic expenses, provide flexibility in where and how services are delivered, and reduce reliance on Medicaid as the primary payer for LTSS. Yet the promise of LTCI has not been fulfilled. The number of individuals who purchase LTCI remains quite small despite various federal and state efforts to promote the market. Lagging sales have been attributed to a number of factors including consumers’ lack of understanding about their risks for needing LTSS and the extent to which current private insurance policies and public programs pay for these services. Moreover, some insurers have found LTCI a difficult product to price and market. Interest continues, however, in the potential of LTCI to relieve pressure on Medicaid and in how the LTCI market might be affected by the Community Living Assistance Services and Support (CLASS) Act, a voluntary LTSS insurance program enacted by the Patient Protection and Affordable Care Act of 2010. This Forum session provided an update on both the individual and group LTCI markets, explored the industry's challenges and successes, and discussed the role private insurance might play in meeting individuals' LTSS expenses in the future.


A Discussion Featuring:
Marc A. Cohen, PhD, President, LifePlans, Inc.; Steve Sperka, MBA, Vice President, Long-Term Care, Northwestern Mutual Life; Paul E. Forte, PhD, Chief Executive Officer, Long Term Care Partners, LLC

With Comments From:
Mary Beth Senkewicz, JD, Deputy Commissioner, Office of Insurance Regulation, State of Florida, Chair
Senior Issues Task Force, National Association of Insurance Commissioners

Slides from the presentations by Dr. Cohen, Mr. Sperka (see notes in comments section of PDF), and Dr. Forte are available for download.

Related Materials

For more information on long-term services and supports (LTSS), see "National Spending for Long-Term Services and Supports (LTSS), 2012," (The Basics, March 27, 2014). And for more on the CLASS Act, see "The Community Living Assistance Services and Supports (CLASS) Act: Major Legislative Provisions" (The Basics, updated January 3, 2013)

See also the SCAN Foundation's "Understanding How Long-Term Care Benefit Triggers Are Implemented in the Private Insurance Setting" by Marc A. Cohen, Jocelyn Gordon, and Jessica Miller (CLASS Technical Assistance Brief Series, no. 3, Spring 2011).

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