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LTC Calculator

1. Enter your age as of the effective date:

2. Plan Options (Select one)

Optional Feature:(Any Plan)

Your Monthly Premium:
For more detailed plan feature descriptions, see the Outline of Coverage on the Enrollment page.

Calculated premium is for illustration purposes only and is based on the age and plan choices selected. Eligibility for, entitlement to, and amount of actual benefits will be determined according to the terms of the long term care insurance policy.

*Requires the Long Term Care Insurance Application for employee coverage. All spouse/family selections require this form.

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