Liability Insurance Rates and Reduced Capacity Add Pressure to the Cost of Long-Term Care Services

The cost of long-term care services continued to rise during the pandemic, and many care providers expect their clients’ costs to increase significantly in 2021.1  A new Willis Towers Watson Insurance Marketplace Realities 2021 Spring Update (“Spring Update”) concludes that 2021 will continue to squeeze long-term and senior care providers from both sides—with general and professional liability insurance rates predicted to increase by 30% or more, and a persistence of 2020’s overall reduced liability capacities in the market for the long-term care provider sector.

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COVID-19 Impact on Long-Term Care Insurance 2020 Survey

What impact did COVID-19 have on the long-term care industry (LTCi) early on? The Society of Actuaries (SOA) recently released a survey trying to answer that question by detailing COVID-19’s impact on LTCi mortality, voluntary lapse and morbidity experience. General findings from the survey were stated as follows:

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Organisation for Economic Cooperation and Development Seeks Information Regarding Long-Term Care Needs and Payment Sources

Over the past few years, insurers, consumers and regulators have asked the question: who, and how, will consumers receive and pay for long-term care? The older, retired population will soon substantially outnumber the working population and the number of private insurers providing long-term care continues to dwindle. A report from the American Council of Life Insurers projects 70% of Americans turning age 65 or older will require long-term care. By 2060, the number of Americans turning age 65 or older will double and those turning age 85 or older will triple. As the population continues to age, the average cost of care continues to rise. Thus, the government faces a looming risk of unbearable expenses as more individuals rely on Medicaid for elder care. In light of this statistical reality, governments, insurers and long-term care (LTC) providers are trying to find cost-efficient ways to offer long-term care to consumers in need and, in turn, increase access to care.

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More Americans Taking on Role as Caregiver

An aging boomer population, limitations or workforce shortages in the health care or long-term services and supports formal care systems, and the ongoing pandemic are some of the reasons why more and more Americans have found themselves serving as unpaid caregivers for family members or friends.

Not only are more Americans taking on the role of unpaid caregiver, but they are doing so for adult recipients who may have increasingly complex medical or support needs. More than 60% of caregivers report in a 2020 AARP survey that their adult care recipient needs additional help due to long-term physical conditions, while about one-third cite memory problems (such as Alzheimer’s or dementia) as the reason. The on-going pandemic also continues to shape aging-in-place (i.e. at home) demand for services, including home health aides.

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Finding the Right LTCi Agent First is Important

Navigating long-term care insurance (LTCi) can be complicated for people planning the type of care they might need, how long they might need it and how they are going to pay for it, according to retirement expert Glenn Ruffenach. In a recent Wall Street Journal Ask Encore column, he examines the importance of finding a knowledgeable, independent agent who “sells policies from multiple carriers and who specializes in long-term-care planning and insurance.”

Mr. Ruffenach recommends several tips to help find the right agent, including using educational and training programs dedicated to LTCi insurance to find agents and other financial professionals nationwide. (For example Certification for Long-Term Care has a locator on its website that identifies its graduates.) He also suggests searching online for local experts or asking others in professional services, such as accounting or tax law, for recommendations. Once you have identified several agents, it is important to talk to all of them to assess who is the best fit for you based on their experience and education as well as your own comfort level with them.

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LTC Providers Significantly Impacted by COVID-19

In a recent article for LTCi Insider, Margie Barrie, an insurance agent with ACSIA Partners, helps contextualize COVID-19’s especially significant impact on long-term care providers, including nursing homes, assisted living facilities and carriers. Based on her own survey as well as data from the American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL), Ms. Barrie explains that nursing homes and assisted living facilities have been hit particularly hard, and she outlines several contributing factors.

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Long-Term Care Insurance Market Updates

We write on a few articles from the past week that we found interesting.

A recent article from Susan K. Neely, President and CEO of the American Council of Life Insurers, “Helping Older Americans Stay in Their Homes,” looks at challenges facing the long-term care insurance market as COVID-19 concerns continue and more and more people consider long-term care their greatest financial concern behind retirement savings. She also discusses how lawmakers are looking for ways to help more people get long-term care insurance.

Read the full ACLI IMPACT article.


In addition, we want to bring your attention to a new Best’s Market Segment Report, “U.S. Long-Term Care Product Performance Pressures Continue.” According to the report, from credit reporting agency AM Best, loss ratios in the LTCi market continue to climb and “poor performance from inadequate pricing is a significant issue for LTC insurers, owing to low interest rates, lapse rates, improving mortality, rising morbidity and policyholder utilization assumptions.”

The Report also looks more closely at certain factors driving rate increases nationwide, the evolution of combo products to meet growing coverage demand and efforts of the National Association of Insurance Commissioners to stabilize the LTCi market. Although, “AM Best views this as a very difficult task given the state-by-state insurance regulatory structures in place, and expects continued use of closed blocks to separate the legacy liabilities from the new ones in order to increase transparency to outside users of financial statements. AM Best also expects LTC insurers to trend toward simplified policy design and fewer assumptions embedded in their policies. Along with carriers slowing down on offering lifetime benefits coverage and inflation-adjusted features, insurers may also soon begin to disregard lapse rates as an underlying assumption for product pricing.”

Read Best’s Market Segment Report. (Subscription Required).


Finally, in “How low interest rates are changing LTC Insurance products,” Tom Rieske, Jr., Managing Director of LTCi Partners, discusses historical trends in LTCi sales (i.e., the trend toward sales of hybrid life and LTC insurance products) and recent reactions to the persisting low-interest rate environment (e.g., development of a hybrid IUL policy with LTC coverage).

Read the full LTCi Partners article.

Considerations When Buying Long-Term Care Insurance

We are linking to another piece highlighting the attractiveness to many consumers of hybrid long-term care products in contrast to stand-alone long-term care insurance. This recent Barron’s article, “Not Everyone Needs to Buy Long-Term Care Insurance. Here Are Some Considerations,” explores some of the considerations when consumers are looking to buy long-term care insurance, including premium costs, benefits payouts and availability of more policy options.

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