Under the federal CLASS Act (Community Living Assistance Services and Support Act), benefit triggers
will parallel private sector triggers, although it has yet to be determined whether the law will require meeting two or three activities.
require specific, chronic conditions.
Adult day care is paid for by the policy if one of the benefit triggers
is activated and a dependent adult is taken to a center that typically provides intermediate or custodial type care.
The 1996 Federal Health Insurance Portability and Accountability Act (HIPAA) covers all tax-qualified LTCI policies that have the two standard benefit triggers
for an insured to qualify for benefits.
In addition to an insurer's financial strength, and the benefits, costs and benefit triggers
This perception, however, does not mean that a non-tax-qualified plan will automatically have more liberal benefit triggers
than tax-qualified plans.
Exhibit 2: Eligibility Requirements Tax-Qualified LTC Plans Non-tax-Qualified LTC Plans Common Benefit Triggers
Common Benefit Triggers
* Activities of daily living: * Activities of daily living: HIPAA requires that a policy LTC professionals generally acknowledge only five ADLs.
Nonqualified "Triple- Trigger * Trigger" Contracts Activities Of Daily Inability to perform 2 of Living (ADLs).
The House has passed a broad TPIA bill that would include protection for group life insurers and a variety of other provisions, such as a reduction in benefit triggers
and protection against attacks involving weapons of mass destruction.
If a long-term care insurance policy is a "qualified" policy, the benefit triggers
are dictated in the Internal Revenue Code.
The benefit triggers
are the same as LTCi -- 2 of 6 activities of daily living (ADL's) or severe cognitive impairment.
(such as inability to perform specified activities of daily living) had not been met.