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IMPORTANT - Please read!
Effective -, the cost for coverage under your employer's group long term care plan will increase.
The calculator below provides an illustration of your cost both before and after this change in pricing.
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Select your state of residency at time of your initial purchase.
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Enter your ageage as of the effective date.
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If your funded coverage uses a different age, enter it here.
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How long would you like to receive monthly benefit payments?
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How much will each monthly benefit payment be?
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 | Long Term Care Facility |
| 75% Professional Home Care |
 | Compound Inflation |
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| $0.00 |
$0.00 |
× |
$0.00 |
÷ |
$1,000 |
= |
$0.00 |
$0.00 |
(A) |
| rate for plan chosen |
rate for plan chosen
beginning - |
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monthly benefit
amount |
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your lump sum premium |
your premium
beginning - |
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| $0.00 |
$0.00 |
× |
$0.00 |
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= |
$0.00 |
$0.00 |
(B) |
| rate for funded plan |
rate for funded plan
beginning - |
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based on
funded amount |
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funded premium |
funded premium
beginning - |
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(A) MINUS (B) |
= |
$0.00 |
$0.00 |
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EMPLOYEE/REHIRED RETIREE COST |
EMPLOYEE/REHIRED RETIREE COST
beginning - |
Rounding for display purposes applied.
For more detailed plan feature descriptions, see the Outline of Coverage on the Enrollment page.
To calculate the cost for a decrease in your current coverage under this plan, enter your insurance age into the calculator. Your insurance age is the age when you were issued your current coverage.
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/retiree selections require this form.
If you are an employee/rehired retiree electing coverage after your guarantee issue enrollment period, Evidence of Insurability is required for any level of coverage.
** Your state of residency, at the time you initially purchase coverage, is used to determine your rates. If you are purchasing additional coverage and didn’t live in this state at that time, select “Other”.
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