CLASS Act - New Federal Long-Term Care Insurance Plan

President Obama signed into law comprehensiveCongress made CLASS an "opt out" plan. This is an
healthcare reform legislation that contains a programimportant point that people need to be aware of. Unlike
known as the Community Living Assistance ServicesSocial Security or Medicare that are mandatory,
and Supporters Act (CLASS Act).CLASS is a "voluntary, opt-out" plan. If that sounds
The passage of CLASS does not negate the needconfusing, it is. Read the question below regarding "opt
for private long-term care coverage in any way. Manyout".
of the details regarding the CLASS program are notWhat will the insurance coverage cost?
yet defined and will be developed through GovernmentThe monthly premium that will be charged by the
regulation. The following is designed to address what isgovernment and deducted from paychecks has yet to
known currently and to answer the most commonbe determined. There have been a wide range of
questions being asked.estimates - and we will not speculate on the final cost.
What are the general provisions of the CLASS Act?Congress required that the CLASS plan should be
The most of the important details for the CLASSfiscally sound for a 75-year period. Simply stated, the
program have not (yet) been defined. They will begoal was to have the amounts paid by participants
developed by the Department of Health and Humanultimately be sufficient to pay future benefits without
Services over the next few years.the need for taxpayer support.
But, simply stated, CLASS creates a new voluntaryBecause of the "guaranteed (health) issue" nature of
government program under which participants will paythe CLASS plan, many experts explain that those
a monthly premium and will be eligible for modestmost likely to apply for CLASS policies will be those in
benefits for their long-term care needs after five yearspoorer health. This will likely create more people
of paying premiums.requiring benefits in future years. A fiscally sound plan
While CLASS is often characterized as a long-termwill mean initial premiums could be high (as much as
care program, it is primarily designed as a program to$1,500 to $2,500 a year per-person. Some say they
provide future assistance to the working disabled.could be higher. But we'll have to wait for the
Traditional long-term care insurance requires thatDepartment of Health and Human Services (HHS) to
applicants meet certain good-health requirements.set the rates people will pay.
CLASS will not have such health qualificationPremiums can be increased yearly to ensure that the
requirements. The plan will be available on aCLASS fund is actuarially sound.
guaranteed-issue basis.Remember that CLASS is not a contractual obligation.
When will the CLASS Act begin?Future provisions (from costs to benefit eligibility) can
While provisions of the CLASS Act become effectivebe changed. And, of course, while the intent of the law
in 2011, there are so many details to be worked outis to avoid taxpayer funds, CLASS could inevitably find
that most experts don't expect the plan will becomeitself underfunded the way Social Security and
available until 2013.Medicare currently find themselves.
For example, not only do costs have to be determinedExplain the five-year waiting period before benefits
but employers must be given sufficient time tobegin.
educate employees and prepare to start withholdingOnce enrolled, participants must pay premiums for five
premiums from employee paychecks.years, after which they will be eligible to receive certain
Following implementation and withholding of the firstbenefits for their long-term support and service needs.
payments from employees' paychecks, there is aThey must also have worked for at least three of
five-year waiting period during which premiums mustthose five years.
be paid before the participant becomes eligible toWhat coverage or benefits will be provided?
receive benefits. As a result, the earliest anyone couldWhile the exact benefits to be provided under the
be receiving CLASS benefits may be as late as 2018.CLASS program are yet to be determined, here is
Who will pay?some general information.
CLASS is intended to be a voluntary plan primarilyRemember that to be eligible for benefits, you must
offered by employers and paid for by employees. Orpay premiums for five years to be eligible to receive
simply stated, money will be withheld from paycheckscertain benefits for long-term support and service
-- similar to the way Social Security (FICA) paymentsneeds. The participant must have a functional
are withheld from paychecks.impairment expected to last more than 90 days and
There are provisions to make the offering available towhich requires substantial assistance with two or three
others who may be self-employed or who may notActivities of Daily Living, or has substantial cognitive
have access to the plan through an employer.impairment.