The Independent In-Person Assessment Process
This policy brief provides information on the benefit eligibility assessment process in the private long-term care insurance industry. It focuses on how long-term care insurers use the information in the adjudication process, who is involved in the process, and how activities of daily living and cognition are assessed.Date Updated: 04/06/2011
LifePlans interviewed and surveyed managers involved in the claims adjudication process from the majority of long-term care (LTC) insurance carriers selling policies in the market. We asked a series of questions related to the role of the in-person benefit assessment within the claim adjudication process and how individual activities of daily living (ADLs) and cognitive status are measured. We did this by examining a sample of commonly used benefit determination assessment instruments used by carriers…
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This policy brief provides background on the historical development of benefit eligibility triggers in the private long-term care insurance market. Understanding how these triggers came into being can provide important information to those charged with implementing the CLASS Plan.
This policy brief provides information about how long-term care insurers implement benefit eligibility triggers in the private insurance market. The way in which companies have operationalized benefit eligibility triggers can inform the development of regulations for the CLASS Plan.
This policy brief identifies the elements states use for an assessment of a person’s physical and cognitive limitations and need, and compares these elements to the requirements of the CLASS Plan.