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| Notice |
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This Web page presents summary information only. Any error or omission here is unintentional and will be resolved in favor of plan documents or applicable federal or state law or rule. See plan documents for details.
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| Eligibility |
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All PEBB-eligible employees who are 18 to 84 years old are eligible to enroll in long-term care insurance. The following individuals in the same age range are also eligible:
- The employee's spouse or domestic partner
- Parents and grandparents of the employee or of the employee’s spouse or domestic partner
- Adult siblings or adult children of the employee or the employee’s spouse or domestic partner
- Non-Medicare eligible retirees and retirees' spouse or domestic partner.
Other family members 18 to 84 years of age who may enroll include the following:
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Your spouse or domestic partner
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Your and your spouse' or domestic partner's parents and grandparents, adult siblings and adult children
Non-Medicare-eligible retirees and the non-Medicare-eligible Spouse or Domestic Partner of the retiree.
Family Members may enroll only with UNUM approval of the Evidence of Insurability Application.
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| Effective Date |
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This insurance goes into effect the first of the month following your enrollment (if it is guarantee issue) or the first of the month following the insurance carriers approval.
Your initial coverage will not begin if you are absent from work because of injury, sickness, temporary lay off or leave of absence on the date that the coverage would normally begin. Coverage begins one minute after midnight on the first day of the month after you return to work.
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| Premium Rates |
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You may choose from $1,000 - $6,000 in Facility monthly Benefit. Your monthly Premium will equal the monthly rate for the plan you choose times the facility monthly benefit amount per thousand.
Rates for $1,000 Monthly Facility Benefit
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Plan 1 Coverage
Long Term Care Facility
Professional Home Care
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Plan 2 Coverage
Long Term Care Facility
Professional Home Care
Total Home Care
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Plan 3 Coverage
Long Term Care Facility
Professional Home Care
Simple Inflation Uncapped
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Plan 4 Coverage
Long Term Care Facility
Professional Home Care
Total Home Care
Simple Inflation Uncapped
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Benefit Duration
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Benefit Duration
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Benefit Duration
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Benefit Duration
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AGE
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3 YR
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6 YR
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Unlimited
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3 YR
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6 YR
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Unlimited
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3 YR
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6 YR
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Unlimited
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3 YR
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6 YR
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Unlimited
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18-30
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2.20
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2.90
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4.00
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3.40
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4.50
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6.40
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3.70
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4.90
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6.80
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5.50
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7.40
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10.50
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31
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2.20
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3.00
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4.00
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3.40
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4.60
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6.50
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3.80
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5.00
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6.90
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5.60
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7.60
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10.70
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32
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2.20
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3.00
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4.20
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3.40
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4.70
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6.60
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3.80
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5.20
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7.20
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5.70
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7.80
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11.10
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33
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2.30
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3.10
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4.20
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3.50
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4.80
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6.70
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4.00
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5.50
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7.30
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6.00
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8.10
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11.40
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34
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2.40
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3.20
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4.30
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3.60
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4.90
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6.90
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4.20
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5.60
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7.60
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6.20
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8.40
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11.70
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35
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2.50
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3.30
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4.50
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3.70
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5.10
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7.10
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4.30
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5.90
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7.90
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6.40
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8.70
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12.20
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36
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2.50
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3.40
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4.60
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3.80
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5.20
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7.30
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4.50
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6.10
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8.10
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6.60
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9.00
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12.50
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37
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2.60
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3.60
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4.80
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3.90
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5.40
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7.60
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4.70
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6.40
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8.60
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6.90
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9.40
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13.10
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38
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2.80
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3.70
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4.90
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4.10
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5.60
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7.80
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5.00
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6.70
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8.80
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7.20
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9.80
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13.60
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39
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2.90
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3.80
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5.20
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4.30
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5.80
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8.20
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5.20
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6.90
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9.20
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7.50
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10.10
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14.10
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40
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3.00
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4.00
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5.40
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4.50
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6.10
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8.50
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5.40
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7.20
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9.60
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7.80
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10.50
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14.70
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41
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3.10
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4.10
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5.60
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4.70
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6.30
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8.90
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5.70
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7.50
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10.10
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8.20
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11.00
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15.30
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42
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3.30
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4.40
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5.80
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4.90
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6.60
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9.20
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5.90
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7.90
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10.50
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8.50
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11.60
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16.00
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43
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3.40
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4.60
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6.10
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5.10
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6.90
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9.60
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6.20
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8.20
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11.00
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8.90
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12.00
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16.60
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44
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3.60
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4.80
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6.40
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5.30
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7.20
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10.10
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6.50
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8.70
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11.50
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9.30
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12.70
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17.40
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45
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3.80
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5.10
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6.70
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5.60
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7.60
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10.60
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6.90
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9.10
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12.10
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9.80
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13.20
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18.30
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46
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3.90
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5.30
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7.10
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5.90
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8.00
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11.20
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7.10
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9.50
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12.50
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10.20
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13.80
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19.00
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47
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4.10
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5.60
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7.40
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6.20
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8.50
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11.80
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7.40
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9.90
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13.00
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10.60
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14.50
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20.00
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48
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4.40
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5.90
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7.80
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6.60
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9.00
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12.50
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7.80
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10.40
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13.70
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11.30
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15.30
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21.10
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49
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4.60
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6.10
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8.10
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6.90
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9.40
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13.10
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8.10
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10.80
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14.30
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11.80
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16.00
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22.10
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50
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4.80
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6.40
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8.60
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7.30
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10.00
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14.00
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8.50
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11.30
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14.90
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12.40
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16.90
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23.30
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51
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5.10
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6.80
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9.00
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7.80
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10.50
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14.80
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9.00
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11.90
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15.70
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13.10
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17.70
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24.60
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52
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5.40
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7.20
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9.50
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8.30
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11.20
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15.70
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9.50
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12.50
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16.40
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13.80
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18.70
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25.80
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53
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5.80
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7.60
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10.10
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8.80
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11.90
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16.70
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10.00
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13.10
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17.20
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14.60
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19.70
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27.40
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54
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6.10
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8.10
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10.60
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9.30
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12.70
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17.70
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10.40
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13.70
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18.00
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15.20
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20.70
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28.70
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55
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6.50
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8.60
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11.10
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9.90
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13.50
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18.70
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11.00
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14.50
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18.70
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16.10
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21.70
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29.80
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56
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6.90
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9.10
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11.90
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10.50
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14.40
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20.00
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11.60
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15.30
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19.90
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16.90
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23.00
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31.80
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57
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7.40
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9.80
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12.70
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11.30
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15.40
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21.40
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12.40
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16.30
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21.00
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18.00
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24.40
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33.70
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58
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7.90
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10.50
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13.60
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12.10
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16.50
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23.00
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13.10
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17.20
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22.20
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18.90
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25.80
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35.60
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59
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8.60
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11.20
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14.60
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13.00
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17.70
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24.60
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14.00
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18.40
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23.50
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20.30
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27.50
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37.90
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60
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9.30
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12.10
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15.60
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13.90
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18.90
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26.40
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15.00
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19.40
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25.00
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21.60
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29.10
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40.20
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61
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10.10
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13.20
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17.00
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15.00
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20.70
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28.80
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16.20
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21.10
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27.10
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23.10
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31.60
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43.50
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62
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11.10
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14.50
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18.60
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16.40
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22.50
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31.30
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17.70
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22.90
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29.20
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25.00
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34.10
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46.90
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63
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12.20
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15.90
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20.30
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17.80
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24.50
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34.10
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19.10
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24.90
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31.60
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26.90
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36.80
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50.70
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64
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13.40
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17.40
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22.10
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19.40
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26.70
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37.10
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20.80
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27.00
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34.10
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29.00
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39.60
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54.40
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65
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15.30
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19.80
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25.00
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21.70
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29.80
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41.50
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23.50
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30.30
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38.20
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32.20
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43.90
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60.40
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66
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16.90
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21.90
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27.80
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23.60
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32.60
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45.40
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25.80
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33.30
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41.90
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34.80
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47.70
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65.70
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67
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18.90
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24.30
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30.70
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25.90
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35.70
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49.50
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28.30
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36.40
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45.70
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37.60
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51.50
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70.80
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68
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20.90
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26.90
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34.00
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28.20
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38.90
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54.10
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30.80
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39.60
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49.80
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40.60
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55.70
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76.60
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69
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23.20
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29.70
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37.50
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30.90
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42.50
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59.00
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33.70
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43.10
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54.30
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43.80
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59.90
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82.40
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70
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25.70
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32.90
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41.40
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33.70
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46.50
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64.50
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36.80
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47.20
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59.20
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47.30
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64.80
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89.10
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71
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28.50
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36.50
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46.00
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37.00
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51.00
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70.70
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40.50
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51.80
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64.90
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51.50
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70.60
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97.10
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72
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31.60
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40.50
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50.80
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40.50
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55.90
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77.20
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44.60
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57.00
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71.20
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56.00
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76.80
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105.00
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73
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35.10
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44.70
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55.90
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44.50
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61.30
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84.30
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48.80
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62.10
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77.50
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60.80
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83.30
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113.80
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74
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38.80
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49.50
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61.60
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48.70
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67.10
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91.90
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53.60
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68.20
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84.60
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66.00
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90.40
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122.80
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75
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46.80
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59.50
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74.00
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58.10
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80.10
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109.40
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63.80
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80.80
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100.20
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77.90
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106.60
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144.50
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76
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51.40
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65.30
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81.20
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63.20
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87.20
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119.10
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69.10
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87.60
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108.70
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83.80
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114.70
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155.60
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77
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56.40
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71.70
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89.10
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68.70
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94.90
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129.50
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75.30
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95.40
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118.20
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90.50
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123.90
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168.00
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78
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61.90
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78.60
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97.40
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74.80
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103.30
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140.70
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81.50
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103.10
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127.50
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97.20
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133.30
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180.30
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79
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68.00
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86.10
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106.60
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81.40
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112.40
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152.80
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88.70
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112.20
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138.60
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104.90
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144.00
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194.50
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80
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74.70
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94.50
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116.70
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88.60
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122.30
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165.90
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96.00
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121.20
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149.40
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112.80
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154.60
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208.50
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81
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82.30
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103.80
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128.00
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96.80
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133.50
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180.50
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105.10
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132.20
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162.70
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122.30
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167.50
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225.20
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82
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91.30
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115.00
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141.40
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106.60
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146.90
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198.00
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114.70
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144.20
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177.00
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132.70
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181.90
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243.80
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83
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100.90
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126.80
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155.50
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117.20
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161.30
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216.70
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125.80
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157.80
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193.10
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144.90
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198.20
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264.70
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84
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111.20
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139.40
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170.30
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128.40
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176.70
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236.10
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136.40
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170.90
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208.40
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156.50
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214.10
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284.70
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| Tax Treatment |
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Payroll deducts premiums for this insurance post tax. You may be able to deduct the cost of your premium payments from your income tax. Please see your tax advisor for information.
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| Premium Rate Increases |
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Premium rates for your initial coverage will not increase as long as you continue to pay the premium.
If you increase your coverage, the premium for initial coverage will not increase. However, the premium to pay for the coverage increase will go up as it will tie to your age when the increase goes into effect.
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| Premium Payment of Dual Covered Employees |
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If you and your spouse or partner are both state employees and both enroll in long term care insurance, you may choose to have the premium paid from your individual pay or from on of the individual's pay. You can make this selection on the enrollment form.
If one of you leaves state service (through retirement, for example), payroll can roll over the premium deduction for this coverage from the pay of the employee who is leaving to the pay of the employee who is remaining. Complete and submit the form to request this.
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| Description of Benefit |
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You are eligible for a monthly benefit after:
- You become disabled
- You are receiving services in a long term care facility or assisted living facility or adult foster home; or professional home care services if your plan includes a professional home care services benefit; or total home care if your plan includes a total home care benefit;
- You have satisfied your elimination period; and
- A physician has certified that you are unable to perform, without substantial assistance from another individual, two or more activities of daily living (ADLs) for a period of at least 90 days, or that you require substantial supervision by another individual to protect you and others from threats to health or safety due to severe cognitive impairment. You will be required to submit a physician certification every 12 months.
A monthly benefit will become payable once all of these requirements are met. The treatment and services you receive for your disability must be provided pursuant to a written plan of care developed by a licensed health care practitioner.
If you have an existing loss of ADLs or severe cognitive impairment on your effective date of coverage, that loss or impairment will only be eligible for coverage if you recover from that loss or impairment. The insurance carrier must receive acceptable proof of your ADL or cognitive recovery, such as a physician’s statement or an assessment.
The amount of your monthly benefit will be based on the coverage options you chose and the place of residence used for long term care. If your coverage includes professional home care services, the benefit payment will be based on the number of days you receive these services.
Total Home Care Benefit
You will receive the monthly total home care benefit amount if you are disabled and you choose to receive care anywhere other than in a long term care facility or assisted living facility.
This care can be provided at any type of facility, such as an adult day care facility or your home. Care can be provided to you by:
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A formal caregiver, such as a licensed home health care provider, a registered nurse, a licensed practical nurse
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An informal caregiver, such as a friend or relative
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| Contact the plan |
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Contact Unum at: (800) 227-4165, or visit their web site.
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