Long Term Care
CalPERS has currently suspended open enrollment in their Long-Term Care program due to the uncertainty in the long-care term market and is no longer accepting applications. CalPERS has released information on how current Long-Term Care Policyholders will be impacted by a 52% rate increase, along with details of members eligible for an award settlement in their current Class Action Lawsuit. Additional information can be found on the website links provided below.
Long-Term Care Policyholders:
- A rate increase of 52% will take into effect no earlier than November 2021 and will be phased in over two years. There may be a possible increase of 25%, if necessary that will occur no earlier than Fall of 2022.
- The cause of an increase in rates is due to the Long-Term Care Fund taking a shortfall of $2.1 billion and only being 69% funded.
- Long-Term Care Policyholders who cannot afford the rate increase are being offered benefit packages that may allow them to avoid the increase. The benefit packages will be offered 60 days before the rate increase goes into effect. For those who do not accept, a rate increase will take into effect on their November 2021 billing due date.
The benefit packages include: reducing duration of benefits, reducing daily benefit amount and reducing inflation protection.
- Individuals currently receiving long-term care will not be affected by the rate increase, should those individuals no longer need their long-term care services they will be subject to the rate increase.
- Individuals may cancel at any time, however, no refunds on premiums will be provided.
- Individuals who convert their policy in 2021 may still be subject to the 25% increase in 2022.
Class Action Lawsuit: Holly Wedding, et al. v. California Public Employees’ Retirement System, et al
- Members included in the Settlement Class Action Lawsuit are: citizens of CA in February 2013, purchased an LTC Policy from CalPERS during period of 1994-2004 that included automatic inflation protection benefits and were affected by the 85% premium increase by CalPERS in 2013.
- There are nine settlement benefits categories, the categories are based on member factors such as; current policy holders or those who have let policy lapse, member on claim or not on claim, paid premiums after a certain increase, or is living or deceased. Additional details on the nine settlement benefit categories can be found on the CALPERS Long-Term Care Class Action Settlement link below.
- If approved by the court, the class members who opted into the settlement award are entitled to receive a refund of all paid premiums paid to CalPERS LTC Policy and must give up their policy OR have the option to have their premium refund issued to an insurance carrier and obtain a replacement in insurance policy.
- Members who opt in the settlement benefit must complete an Award Acknowledgement Form by September 22,2021. The Award Acknowledgment Form can be found here
- Members who wish to exclude or “opt out” of the settlement must complete and send a timely request for an Exclusion Form or a writing containing all required information no later than December 13,2021. The Exclusion Form can be found here.
You can find additional information here:
CalPERS Long-Term Care Policyholder Rate Increase FAQ
CalPERS Long-Term Care Class Action Settlement
Benefit Overview
Long-term care refers to the services provided to people who have difficulty managing the activities of daily living due to illness, injury, disability, cognitive disorder or aging. People of all ages require long-term care for a variety of reasons. From accidents to strokes, health-related impairments can change everything.
CalPERS Long-Term Care Coverage Offers Flexibility and Control
CalPERS comprehensive plans allow you to design coverage that best meets your personal needs:
- Plans tailored to different needs and budgets
- Affordable options to keep up with the rising costs of receiving long-term care
- Benefits designed to help cover the cost of receiving long-term care at home
- Limited benefits that are available if you need care outside the United States
- A marital discount that is available when both spouses or eligible domestic partners apply and at least one is approved
Eligibilty
CalPERS Long-Term Care coverage is designed for current California public employees, retirees, their spouses, parents, parent-in-law, adult children and adult siblings, between the ages of 18 -79.
California public employees include, but are not limited to, those employed by the state departments, state Assembly and Senate, judicial systems, school districts, cities, counties, special districts, public universities and community colleges. To maintain the tax-qualified status of the program, eligibility has not yet been extended to domestic partners. This relationship is pending change to IRC Title 26, section 7702B Z(f)(2).
You do not need to participate in CalPERS retirement or health benefit programs to be eligible. Eligible family members may apply to the CalPERS Long-Term Care Program even if the public employee or retiree that makes them eligible does not apply for coverage or is not approved for coverage.
Applicants must pass underwriting in order to be approved for coverage. If you have questions about eligibility, please call our long-term specialists at (800) 908-9119.
How Do I Apply?
Obtain a CalPERS Long-Term Care application kit by:
- Visiting the CalPERS Long Term Care Program
- Calling a long term care specialist at (800) 908-9119
- They will also be able to answer any questions about eligibility.
Long Term Care Open Application Video
Please watch the Long Term Care Open Application video as the CalPERS Deputy Executive Officer for Benefit Programs Policy and Planning, discusses the open application process for the revitalized CalPERS Long-Term Care program. Testimonials are included from members who have experience with Long-Term Care insurance.