Frequently Asked Questions: Long Term Care

We have collected a series of commonly asked questions and corresponding answers for the Long Term Care plan. In addition there are those questions prepared by the sponsoring insurance company, CNA. Such information may assist you in understanding enrollment and benefit provisions of this new benefit plan.

For CNA FAQs

1. Go to http://www.ltcbenefits.com
2. Click on "Enroll Now"
3. Enter NWUN as identification number or password
4. Frequently Asked Questions may be found under "Plan Information"

Eligibility

• Who is eligible for the CNA plan?

• How do I appeal CNA's decision not to approve my application for long term care insurance?

Leave of Absence

• What if I'm not actively at work (leave of absence) on the date my coverage would normally begin?
• What If I Leave Northwestern University, can I continue the Long Term Care Insurance Plan?

Contributions

• Are premiums deducted from my paycheck on a pre-tax or after-tax basis?
• Are Long Term Care insurance Contributions reimbursable from my FSA Health Care Account?

Claims

• Will CNA pay claims overseas?

Eligibility

Who is eligible for the CNA plan?

1. Faculty and exempt staff appointed on at least a half-time basis and non-exempt staff scheduled to work at least 17.5 hours per week.
2. U.S. Citizens living abroad (i.e., expatriates). A spouse, parent, grandparent, etc who is a U.S. citizen and lives abroad is eligible if he or she is associated with a benefits eligible Northwestern University employee.
3. Foreign citizens living in the U.S. A spouse, parent, grandparent, etc who is a foreign citizen living in the U.S. is eligible if he or she ia a permanent resident of the U.S. and he or she is associated with a benefits eligible Northwestern University employee. Foreign citizens on rotational assignments or temporary visits are not eligible.
4. Foreign citizens living in foreign countries. A spouse, parent, grandparent, etc who is a foreign citizen is eligible if he or she is associated with a benefits eligible Northwestern University employee. Spouses, parents, grandparents, etc. are not eligible if they are foreign citizens living in a foreign country.
    
   

How do I appeal CNA's decision not to approve my application for long term care insurance?

You should sent a letter to CNA requesting reconsideration of their decision. In this letter you should reference the physician you wish to submit further information regarding your medical history. You can also state the reasons you feel should have warranted an approval. CNA has a full appeals procedure in place and the file will be reviewed by a panel of medical professionals during this process. If you wish to have the specifics details that contributed to CNA's decision, this information would be sent to your physician due to the confidentiality of medical records between a physician and CNA. All appeals correspondence is done in writing. The letter should be addressed to:

CNA-Group Long Term Care Underwriting
P.O. Box 593925
Maitland, FL 32794-6770

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Leave Of Absence

What if I'm on a leave of absence on the date my coverage would normally begin?

You may submit a completed long term care enrollment form for the CNA sponsored Long Term Care insurance plan within 31 days of returning to work. Coverage will commence the first of month following your return to work.

An application submitted after 31 days from your return to work will not guarantee LTC coverage. You will have to submit a completed application and demonstrate evidence of good health satisfactory to CNA.

Long Term Care Applications

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Can I continue the Long Term Care Insurance Plan if I Leave Northwestern University?

Yes, at separation of University employment, you may continue your Long Term Care insurance. The sponsoring insurance company, CNA, will bill you directly on a quarterly basis. Contributions will remain the same as you were paying while actively employed.

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Contributions

Are premiums deducted from my paycheck on a pre-tax or after-tax basis?

Deductions for Long Term Care coverage are after-tax. Deductions pay for the employee's coverage. Coverage for a spouse, parent, etc are paid directly to CNA.

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Are Long Term Care insurance contributions reimbursable from my FSA Health Care Account?

No. Insurance Contributions including health, dental, long term care and other contributions are not reimbursable from an FSA account. You may contact a tax accountant or tax adviser to seek information if long term care Contributions are includable as a deductible expense on your Federal tax return.

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Claims

Will CNA pay claims overseas?

Yes, 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.

CNA will pay claims in any country where they can process claims based on their presence or that of one of their vendors in that country. In countries where CNA does not have a presence, CNA will make a good faith effort to process claims, if possible. Claim payment in foreign countries may involve negotiating a per diem amount if Long Term Care services comparable to covered services are not available, which CNA will provide to the Insured regardless of the actual Expense Incurred.

Paying Claims Overseas
To facilitate overseas claim management, CNA relies on an agreement with Crawford-THG. Crawford-THG provides a complete range of services in the fields of loss adjusting, claims management, healthcare management, risk survey and evaluations. With a network of offices in all major countries, the CNA/Crawford-THG partnership allows CNA to offer full claims and care management services in the following countries:
Canada, England, Scotland, Ireland, Germany, Netherlands, France, Sweden, Israel Greece, Italy, Lebanon, Hong Kong, Malaysia, Australia, New Zealand.

In other countries where CNA cannot provide local care management services, CNA utilizes Crawford-THG's local presence to process claims and administer benefit payments. CNA then negotiate a set benefit payment amount, which they provide to the insured regardless of actual expenses incurred. CNA offers this level of claim service in the following countries:
Argentina, Australia, Bahamas, Baltic States, Barbados, Belgium, Brazil, Brunei, Darussalam, Canada, Chile, China (Peoples' Republic of China), Colombia, Commonwealth of Independent States, Czech Republic, Denmark, Finland, France, Georgia, Germany, Greece, Guernsey (Channel Isles, Hungary, India, Indonesia, Iran, Ireland (Republic of), Isle of Man, Italy, Kazakhstan, Jamaica, Japan, Jersey (Channel Isles), Jordan, Kenya, Korea (Republic of), Lebanon, Lesotho, Malaysia, Malta, Mexico, Netherlands, New Zealand, Nigeria, Norway, Pakistan, Papua New Guinea, Peru and Philippines

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