How will you pay each year’s premium? From my income From my savings/investments My family will pay ⁭ ⁭ ⁭ [Have you considered whether you could afford to keep this policy if the premiums went up, for example, by 20%?] Drafting Note: The issuer is not required to use the bracketed sentence if the policy is fully paid up or is a noncancelable policy. What is your annual income? (circle one) $[30,000] $[30-50,000] Over $[50,000] ⁭Under ⁭ Drafting Note: The issuer may choose the numbers to put in the brackets to fit its suitability standards. How do you expect your income to change over the next 10 (check one) change Increase ⁭No ⁭ ⁭Decrease If you’ll pay premiums with money only from your own income, a rule of thumb is that you may not be able to afford this policy if the premiums will be more than 7% of your income. Will you buy inflation protection? (circle one) ⁭Yes ⁭No If not, how do you plan to pay for the difference between future costs and your daily benefit amount? my income my savings/investments family will pay ⁭From ⁭From ⁭My The national average annual cost of care in [insert year] was [insert $ amount], but this figure varies across the country. In 10 years the national average annual cost would be about [insert $ amount] if costs increase 5% annually. Drafting Note: The projected cost can be on federal estimates in a current year. What elimination period are you considering? Number of days _______Approximate cost $__________ for that period of care. How do you plan to pay for your care during the elimination period? (circle one) my income my savings/investments family will pay ⁭From ⁭From ⁭My Questions Related to Your Savings and Investments Not counting your home, about how much are all of your assets (your savings and investments) (circle one) $70,000 Over $250,000 ⁭Under ⁭$70,000-$100,000 ⁭⁭$100,000-$250,000 How do you expect your assets to change over the next 10 years? (circle one) about the same ⁭Stay ⁭Increase ⁭Decrease
How will you pay each year’s premium? ⁭ From my income ⁭ From my savings/investments ⁭ My family will pay [Have you considered whether you could afford to keep this policy if the premiums went up, for example, by 20%?] Drafting Note: The issuer is not required to use the bracketed sentence if the policy is fully paid up or is a noncancelable policy. What is your annual income? (circle one) ⁭Under $[30,000] ⁭ $[30-50,000] Over $[50,000] Drafting Note: The issuer may choose the numbers to put in the brackets to fit its suitability standards. How do you expect your income to change over the next 10 (check one) ⁭No change ⁭ Increase ⁭Decrease If you’ll pay premiums with money only from your own income, a rule of thumb is that you may not be able to afford this policy if the premiums will be more than 7% of your income. Will you buy inflation protection? (circle one) ⁭Yes ⁭No If not, how do you plan to pay for the difference between future costs and your daily benefit amount? ⁭From my income ⁭From my savings/investments ⁭My family will pay The national average annual cost of care in [insert year] was [insert $ amount], but this figure varies across the country. In 10 years the national average annual cost would be about [insert $ amount] if costs increase 5% annually. Drafting Note: The projected cost can be on federal estimates in a current year. What elimination period are you considering? Number of days _______Approximate cost $__________ for that period of care. How do you plan to pay for your care during the elimination period? (circle one) ⁭From my income ⁭From my savings/investments ⁭My family will pay Questions Related to Your Savings and Investments Not counting your home, about how much are all of your assets (your savings and investments) (circle one) ⁭Under $70,000 ⁭$70,000-$100,000 ⁭⁭$100,000-$250,000 Over $250,000 How do you expect your assets to change over the next 10 years? (circle one) ⁭Stay about the same ⁭Increase ⁭Decrease
cmte_b_senior_issues_exposure_ltc_redline_guide_adopted.docx