Expert's View

Anyone who is now enrolled in the federal Long-term Care Insurance program – or has thought of doing so – will be well aware of the dismay that swept through the ranks when significant premium increases were announced by OPM. Many thought that OPM had failed in its duty to keep premiums and benefits as they were, especially for those who were already enrolled. However, as is so often the case, the problem lay with assumptions about costs and benefits that turned out to be too rosy. Because the organizations that offered this coverage have to break even at a minimum, either premiums had to go up or benefits go down, or both.



OPM has now issued guidance to agencies. Among the most significant points raised are these; and I quote:


"Current enrollees will receive personalized letters providing information about changes to their premiums, if any, and opportunities to change their benefits.





"All enrollees will receive at least two personalized choices:



(1) Keep their current benefit levels and accept any applicable premium increase. If the enrollee decides to accept this option, no action is required on their part. This is the default option — enrollees who do not take action to request a different choice will receive this choice.



(2) Change their current benefit levels to a specified level of benefits in the FLTCIP 2.0 plan design with updated premiums.


Enrollees facing a premium increase will also receive a third option:


(3) Downgrade their coverage in FLTCIP 1.0 to a specified level of benefits in FLTCIP 1.0 in order to keep their premiums approximately the same as they are currently paying. Please see the FAQs at for more information.


"No enrollee’s coverage will change unless he/she voluntarily chooses to change it.


"Enrollees may request other changes to their coverage not specified in their Special Decision Period letter. They will be able to model some changes on the web at They may need to call Long Term Care Partners at 1-800-582-3337 (TTY 1-800-843-3357) to discuss these changes, including the premiums for coverage and underwriting requirements.


"The Special Decision Period ends Monday, December 14, 2009. Elections must be submitted by that date."


Watch your mail box and check with you personnel office if you have any questions.