each year $ $ • Policy 1 Policy 2 What other benefits does the policy cover? 23. Is there a waiver of premium benefit? (Refer to yes/no yes/no page 23) If yes, How long do you have to be in a nursing home • before it begins? Does the waiver when you receive home care? yes/no yes/no • 24. Does the policy have a If nonforfeiture benefit? yes, what kind? (Refer to page 23) yes/no yes/no 25. Does the policy have a return of premium benefit? yes/no yes/no to page 24) 26. Does the policy have a death benefit? If yes, are yes/no yes/no there any restrictions before the benefit is paid? (Refer to page 23) 27. Will the policy cover one person or two? one/two one/two Tax-qualified status yes/no yes/no 28. Is the policy tax-qualified? (Refer to page 13) Partnership Policy yes/no yes/no 29. Is the policy tax-qualified? (Refer to page 11 ) What does the policy cost? (Refer to page 11) 30. What is the premium for the basic coverage? $ $ each • $ $ each year • 31. What is the premium if the policy covers home health care? $ $ each month • $ $ each year • 32. What is the premium if the policy covers an assisted living facility? $ $ each month • each year $ $ • 33. What is the premium if the policy has inflation coverage? each $ $ • each year $ $ • 34. What is the premium if the policy has a nonforfeiture benefit? each month • $ $
$ $ What other benefits does the policy cover? 23. Is there a waiver of premium benefit? (Refer to page 23) If yes, • How long do you have to be in a nursing home before it begins? • Does the waiver when you receive home care? 24. Does the policy have a nonforfeiture benefit? If yes, what kind? (Refer to page 23) 25. Does the policy have a return of premium benefit? to page 24) 26. Does the policy have a death benefit? If yes, are there any restrictions before the benefit is paid? (Refer to page 23) 27. Will the policy cover one person or two? Tax-qualified status 28. Is the policy tax-qualified? (Refer to page 13) Partnership Policy 29. Is the policy tax-qualified? (Refer to page 11 ) What does the policy cost? (Refer to page 11) 30. What is the premium for the basic coverage? • each • each year 31. What is the premium if the policy covers home health care? • each month • each year 32. What is the premium if the policy covers an assisted living facility? • each month • each year 33. What is the premium if the policy has inflation coverage? • each • each year 34. What is the premium if the policy has a nonforfeiture benefit? • each month • each year Policy 1 Policy 2 yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no one/two one/two yes/no yes/no yes/no yes/no $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
cmte_b_ltc_shop_wg_180416_guide_redline_180416.docx