DC Disability and Long-Term Care Insurance Flashcards

A DC LTC insurance policy's 'benefit trigger' most commonly requires the insured to be unable to perform a certain number of activities of daily living (ADLs). The standard number is:

Answer: 2 of 6

Most LTC policies trigger benefits when the insured is unable to perform at least 2 of 6 standard ADLs: bathing, continence, dressing, eating, toileting, and transferring.

Which DC disability income policy provision ensures the insurer cannot cancel the policy or raise premiums as long as the insured pays premiums on time?

Answer: Guaranteed renewable

A guaranteed renewable policy cannot be canceled by the insurer as long as premiums are paid, though the insurer may increase premiums for an entire class of policyholders.

In a DC disability income policy, a 'residual disability' benefit is designed to pay benefits when:

Answer: The insured returns to work but suffers a proportionate loss of income due to their disability

Residual (partial) disability benefits compensate the insured for proportional income loss when they return to work on a limited basis due to their disabling condition.

A DC LTC insurer must offer a 'free-look' period of at least how many days for a newly issued LTC policy?

Answer: 30 days

DC LTC insurance regulations require a 30-day free-look period, giving consumers more time than the standard 10-day period for other life/health products to review and return the policy.

Under DC law, a group disability income policy provided by an employer is typically subject to:

Answer: ERISA (federal law) in addition to DC insurance regulations

Employer-sponsored group disability plans are governed by ERISA at the federal level as well as applicable DC insurance regulations for the insurance component.

A DC disability income policy that includes a 'social insurance substitute' benefit will reduce its benefit payment when the insured:

Answer: Receives Social Security disability benefits

A social insurance substitute (SIS) provision reduces the private disability benefit by the amount the insured receives from Social Security disability (SSDI) or similar government programs.