Other Benefits

Long-Term Care Insurance - Valassis Communications, Inc. and NCH Associates Paid Through ADP

Someone with a long physical illness, a disability, or a cognitive impairment (such as Alzheimer's disease) often needs long-term care. Many different services help people with chronic conditions overcome limitations that keep them from being independent. Long-term care is different from traditional medical care. Long-term care helps one live as he or she is now; it may not help to improve or correct medical problems.

Long-term care insurance is designed to offer financial support in paying for necessary long-term care services rendered in a variety of settings. Long-term care services may include help with activities of daily living, home health care, respite care, adult day care, care in a nursing home, and care in an assisted living facility. The long-term care policy also includes care management services, which will evaluate your needs and coordinate and monitor the delivery of long-term care services.

It is difficult to predict who will need long-term care. The average cost of nursing home care in the United States is over $50,000 per year. Home health care costs approximately $35,000 per year and a year in an assisted living facility is $26,000 or more. These numbers are expected to increase annually. The chances of needing home health care are substantially greater than needing nursing home care. People are living longer because of advances in medicine and healthier lifestyles, but as people get older, the chance that they may need long-term care increases significantly.

Eligibility
You are eligible for coverage on the first day of the month following your date of hire if you are an active part- or full-time associate scheduled to work at least 20 hours per week.

You are eligible to elect coverage for:

• yourself;
• your spouse or domestic partner;
• parents and parents-in-law;
• step-parents and step-parents-in-law
• grandparents and grandparents-in-law
• children of eligible associates and their spouse/domestic partners; and
• siblings of eligible associates and their spouse/domestic partners.

Enrollment
All new Long-Term Care Insurance requests are subject to approval by John Hancock Life Insurance. All eligible persons must furnish evidence of good health satisfactory to John Hancock Life Insurance Company.

Individuals who are interested in applying for Long-Term Care insurance should contact John Hancock at 1-800-482-0022 to request an enrollment kit. The kit will be sent directly to your home. Once you complete the enrollment kit, you may send it back to John Hancock for processing.

NOTE: John Hancock will notify you upon approval of your application. If your application is not approved, please notify a member of Human Resources.

Cost of LTC Insurance
The annual premium is based on your age, the plan you select and whether you have included the Automatic Benefit Increase (ABI) inflation protection option. With the ABI option, benefits will automatically increase by 5% compounded annually, while premiums remain level. The annual premium is "locked in" at the age the eligible person enrolls. Premiums cannot be increase due to age or health. Premiums may only increase if the premium for all policies in your rating class are increased. The John Hancock Life Insurance Company will mail a rate quote to your home if you are interested in the plan. You can request a quote by calling 1-800-482-0022.

You Have Three Daily Maximum Benefits to Choose From:

Lifetime Maximum Benefit
You have the choice of the three-year option or the five-year option.

Qualification Period
The qualification period for benefits is 90 days from date of benefit eligibility. The qualification period need only be met once per lifetime.

Stay-at-Home Benefit and Hospice Care may be paid during the qualification period.

Inflation Protection Options
Inflation riders add significantly to the cost of long-term care insurance, but will save you from being underinsured later. There are two inflation protection options, the Future Purchase Option and the Automatic Benefit Increase (ABI) rider, which are described below:

Future Purchase Option—Participants will be offered the option to purchase additional amounts of coverage without evidence of insurability, every three years. The increase to the Nursing Home Daily Benefit will not be less than 5% compounded annually over the three year period. The corresponding lifetime maximum benefit will also increase proportionally. These offers are voluntary and insured will receive subsequent offers unless they are over issue age 85, or have been certified for benefits in the six months prior to the increase effective date.

Automatic Benefit Increase (ABI)—The premium adjustment for future inflation increases is built into the plan at the time of initial enrollment. Benefits will automatically increase by 5% compounded annually while premiums remain level. Insureds who purchase this option are not eligible for Future Purchase Option.

Return of Premium at Death Benefit
This benefit provides a refund of a portion of premiums paid, less benefits paid or payable, if the insured dies prior to age 75, according to the following scale:

Qualifying for Benefits
A Licensed Health Care Practitioner (LHCP) must certify that the insured is unable to perform at least two out of six Activities of Daily Living (ADLs) or a separate cognitive impairment trigger is used in determining benefit eligibility for insureds. The loss of functional capacity must be expected to last for at least 90 days.

Activities of Daily Living (ADLs)

• Bathing: the ability to take a full body bath, shower or sponge bath without assistance including transferring to and from the tub or shower.
• Continence: the ability to maintain control of bowel and bladder functions; or, when unable to maintain control of bowel or bladder function, the ability to perform associated personal hygiene, including caring for a catheter or colostomy bag.
• Dressing: the ability to put on and take off all necessary items of clothing and get clothing from drawers, closets, etc.
• Eating: the ability to consume food or other nourishment once it has been prepared and made available to the insured person.
• Toileting: the ability to get to and from the toilet, transfer on and off the toilet, and perform associated personal hygiene.
• Transferring: the ability to move into or out of a bed, chair or wheelchair.

Covered Services Include:

Nursing Home Care—Nursing home care includes skilled, intermediate, or custodial care (performed under the orders of a physician) in a qualified nursing facility. The facility must be either Medicare-certified or licensed by the state to provide skilled or intermediate care or must be a licensed hospice facility. Nursing home care includes physical, respiratory, occupational, or speech therapy by licensed therapists. It also includes hospice care provided by a qualified hospice.

Alternate Care Facility Care—Care received, under the orders of a physician, in assisted living facilities, Alzheimer's facilities, custodial care facilities or other alternatives to a qualified nursing facility, if they meet the qualifications specified in the policy.

Assisted Living Facilities—Are homelike settings that bridge the gap between independent living and skilled nursing care. It is ideal for people who need some daily assistance but not constant nursing care. Often, they provide private suites or small apartments that typically include private baths.

Community-Based Professional Care (CBPC)—CBPC includes home health care, homemaker services, adult day care, and hospice care rendered by a qualified provider in the insured's home or in an adult day care center.

Home Health Care—Includes nursing home care provided by registered nurse, licensed practical nurse, or licensed vocational nurse; physical, respiratory, occupational, or speech therapy provided by licensed therapists; nutritional counseling provided or supervised by a qualified home health agency, custodial care provided by a qualified home health aide, and homemaker services provided by a person who is certified or employed through a qualified home health agency.

Homemaker Services—Non-medical support services that can help an individual remain at home. They include supervision of self-administration of medication, shopping for food, medical supplies, or medication, meal preparation, and light housekeeping. Light housekeeping includes vacuuming, dry mopping, dishwashing, changing bed linens, and cleaning the kitchen and bathroom.

Adult Day Care—Includes a wide range of medical and social support services, provided by a qualified adult day care center. They may also offer transportation, nursing care, counseling and personal care. It must have a planned program of adult day care services at least five days a weeks for at least six hours a day. It must also maintain a written record of medical services for each person and have established procedures for obtaining appropriate aid in a medical emergency.

Informal Care—Informal care includes custodial care and homemaker services provided in the insured's home. Informal care can be provided by a person without professional skills or training (including family members, whether or not that person ordinarily resides in the insured's home). Informal caregivers must be at least 18 years old unless certified or employed by a qualified home health agency.

Informal benefits can be paid in addition to the community-based professional care benefits on any day. The total benefits paid cannot exceed the nursing home daily maximum benefit on any one day.

Stay-at-Home Benefit
The plan includes a stay at home benefit that can be used for a variety of LTC expenses not ordinarily covered. It is available during the qualification period and does not reduce the lifetime maximum benefit. Except for the Care Planning visit, the insured must be living in his/her home. Services include:

• Care Planning Visit;
• Home Modifications;
• Emergency Medical Response System;
• Durable Medical Equipment;
• Caregiver Training;
• Home Safety Check; and
• Provider Care Check.

The total stay at home benefit is equal to 30 times the nursing home daily maximum benefits.

The total benefits payable for caregiver training will not exceed five times the nursing home daily maximum benefit. The insured can receive community-based professional care and/or informal care while receiving stay at home benefits.

Other Benefits
Respite Care—involves having a trained individual take over the caregiver role for short periods, in or out of the home.

Bed Reservation—The plan will continue to pay a benefit to hold a nursing home or alternate care facility bed for up to 60 days per calendar year for an insured whose stay is interrupted for any reason.

Restoration of Benefits—The lifetime maximum benefit can be restored upon request if the insured does not meet the benefit eligibility criteria during the 24 month period immediately preceding the date of the request, and has not exhausted their lifetime maximum benefit. Stay at home benefit cannot be restored.

Waiver of Premium—Premiums will be waived while benefit eligible after completion of the qualification period. No incurred expenses are required for premiums to be waived.

Alternate Plan of Care—An alternate plan of care can be established by mutual agreement between John Hancock and the insured if the care coordinator identifies alternatives to the current plan that are both appropriate to the insured and cost effective. It may provide benefits for services or supplies not otherwise covered under the plan.

International Benefits—While an insured is permanently residing outside the United States, the plan will reimburse up to 75% of the benefit amount available for covered services. No benefits will be payable under the stay at home benefit or for respite care.

Alzheimer's is covered—You can receive benefits for mental and nervous disorders including Alzheimer's and other forms of dementia.

Protection Against Lapse Reinstatement—The policy allows coverage to be reinstated up to five months after the insurance ended, provided John Hancock receives evidence that on the date the insurance ended, the person required substantial assistance by another person in performing at least two ADLs due to loss of functional capacity which is expected to continue for at least 90 days, or required substantial supervision due to a cognitive impairment and pays all past due premiums.

Preexisting Conditions
After the insurance company approves your application and the policy is issued, there will be no exclusions or limitations for preexisting conditions.

Portability
Long-term care coverage is fully portable.

State Benefit Differences
Due to state-specific mandates, the benefits vary slightly in some geographic locations. Only the states where benefits are different from those illustrated in this booklet are listed below. All other policy provisions are described in this document.

Arkansas, Connecticut, Delaware and New Mexico—Residents must be offered the Non-Forfeiture Provision. An insured may elect to stop paying premiums after at least three years of continuous coverage and keep their full daily maximum benefit amount at a lower lifetime maximum benefit. The value of the reduced lifetime maximum benefit will be greater of the sum of the premiums paid into the plan or 30 times the nursing home daily maximum benefit.

Exclusions
The policy does not cover any charges incurred by the insured due to:

• Intentionally self-inflicted injury;
• A result of detoxification of or rehabilitation for alcohol or drug addiction unless drug addiction was a result of the administration of drugs as part of a treatment by a physician;
• Conditions caused by, or contributed to, by committing or attempting to commit a felony, engaging in an illegal occupation, participating in a riot or insurrection;
• A disability caused by war whether declared or not or any act of war, or service in the armed forces or auxiliary units;
• A service or supply for which a charge would not have been made in the absence of insurance;
• Except for the Informal Care Benefit, care provided by a member of your immediate family or by a person who ordinarily resides in your home; or
• A service or supply furnished by or covered as a benefit under a program of any government or its subdivisions or agencies except as otherwise required by law, and except:
  • A program established by the federal government for its civilian employees;
  • Medicare; and
  • Medicaid.

No benefit will be payable for any charge to the extent that a benefit is payable for that charge under Medicare or would be payable under Medicare but for the coinsurance and deductible and copayment provisions of Medicare, except when Medicare is determined to be secondary payor.