The Long Term Care plan, sponsored by CNA, provides eligible faculty and staff with some degree of financial protection from the costs of a variety of services for individuals who are unable to care for themselves.
Summary Plan Description
Types of Long Term Care
- Home Healthcare provides care by a home health agency that sends home healthcare providers to your home to provide nursing care, nutritional services, meal preparation, housekeeping and physical therapy.
- Adult Day Care offers services for up to 12 hours per day for those who cannot stay at home alone.
- Alternative Care Facility provides 24 hour care and supervision for those who need long term care services, but does not provide the same level of care as a skilled nursing home.
- Assisted Living Facility is a residential community that provides a specialized combination of housing, personal support services and care in a home-like environment.
- Nursing Home Care Facility provides services to individuals who are no longer able to live alone.
- Skilled facility offers the highest degree of care with skilled professionals available 24 hours per day.
- Intermediate nursing home facility offers less than skilled care but more than custodial care.
- Custodial nursing home facility offers care for those who do not need the continuous attention of trained medical professionals.
- Other Benefits include caregiver training and a temporary bed holding benefit up to 21 calendar days to hold your bed in a nursing home during your absence.
You may choose a daily maximum benefit amount of $100, $150 or $200. In addition, you may choose one of two inflation protection features, guaranteed or automatic.
- Guarantee Benefit Increase. Every three years you will be able to increase your maximum daily benefit amount. The amount of the daily benefit increase will be not less than a compounded annual 5 percent rate. Premiums for increases are based on the attained age at the time of the offer.
- Automatic benefit increase. This feature will automatically increase the amount of the daily benefits each year by 5 percent of the prior year's amount for life. You may decline any options and will continue to be eligible for automatic approval of the next option.
Your dependents can also be automatically approved for an increase as long as one previous offer is not turned down. If one previous offer is turned down, evidence of good health is required.
If you enroll within 31 days from the date of hire or benefits eligibility you are guaranteed coverage. If you miss this deadline you may apply for coverage subject to evidence of good health during Open Enrollment. Completed enrollment forms should be returned to the Benefits Division.
Find application forms.
- If your enrollment application is denied you may send a letter to CNA requesting reconsideration of their decision.
- Reference the physician you wish to submit further information regarding your medical history and state the reasons you feel should have warranted an approval.
- The letter should be addressed to:
CNA-Group Long Term Care Underwriting
P.O. Box 593925
Maitland, FL 32794-6770
- Your file will be reviewed by a panel of medical professionals. If you wish to have the specific details that contributed to CNA's decision, this information can be sent to you.
- All appeals must be done in writing.
- Premiums are deducted after-tax for active employees.
- Retirees and dependents are billed directly by CNA.
- Premiums are based on a fixed daily benefit and on your age at the time your coverage begins.
- Additional information can be found using the premium calculator located on CNA’s website.
- Premiums are not charged during the period benefits are received.
Lifetime Maximum Benefit
The lifetime maximum benefit equates to 5 years of nursing home benefits based on the maximum daily benefit amount for nursing home care chosen.
- CNA will refund the total amount of premiums paid in the event of the death of a covered individual prior to age 65 less any benefits paid.
- After age 65, the amount of the premium refund will reduce by 10% each year.
- No premiums will be refunded after age 74.
- Death must occur while coverage is in effect for a refund to be paid.
While CNA's standard plan excludes long term care services outside the United States, CNA will make a good faith effort to honor foreign claims provided that CNA can process them properly and that the services received are substantially similar to services covered under the policy.
FULL CLAIMS AND CARE MANAGEMENT SERVICES are provided in
Australia, Canada, England, France, Germany, Greece, Hong Kong, Ireland, Israel, Italy, Lebanon, Malaysia, Netherlands, New Zealand, Scotland, Sweden.
SET BENEFIT PAYMENT AMOUNT are provided in
Argentina, Bahamas, Baltic States, Barbados, Belgium, Brazil, Brunei, Darussalam, Chile, China, Colombia, Commonwealth of Independent States, Czech Republic, Denmark, Finland, Georgia, Guernsey, Hungary, India, Indonesia, Iran, Isle of Man, Kazakhstan, Jamaica, Japan, Jordan, Kenya, Korea, Lesotho, Malta, Mexico, Nigeria, Norway, Pakistan, Papua New Guinea, Peru and Philippines.