4 Reasons CLASS Act Will Be More Expensive than Private Coverage

Posted on May 21st, 2010 by Em-Power Services

Most of the press on CLASS Act hails the program for solving a problem that has devastated millions of American families. And there are some important benefits, but you almost forget that people will need to actually pay premiums themselves that are projected to be $180-$240 per month. By statute, CLASS Act will be funded exclusively by participant premiums. And those premiums must be set to ensure the program is actuarially sound for 75 years.

  1. Adverse selection
    I discussed adverse selection on my previous post as causing more unhealthy people to participate in greater numbers than those of healthy people. I think it’s pretty clear why that would cause premiums to be higher than private insurance carriers who require medical underwriting to control cost. With no underwriting, CLASS is a good thing for the sick people who cannot get less expensive private coverage making CLASS a high risk pool for people uninsurable in the private market.
  2. Subsidized premiums
    Under CLASS premiums are only $5 per month for students and poor Americans. Noble intention, but subsidizing premiums for a segment of society creates an entitlement for a segment that is paid for by everyone else. The amount of the subsidy is the difference between $5 and aged based premiums projected to be $180-$240 per month. Do you think this could make premiums higher?
  3. Limits on premium increases
    CLASS Act boxes the government in a corner with regard to complying with its own regulations and it will require premiums to be higher. Any person who attains age 65, or who has paid in for 20 years and is not working, cannot have their premiums increased. This is good if your premium can’t be increased and not so good if an increase is needed and it must be spread over a smaller number of participants.
  4. Limitation of money that can be spent on marketing and administration
    CLASS specifies that 97% of all premium collected must be used to pay benefits. On the surface this sounds like a good thing. Let’s eliminate corporate excess and let the government deliver more bang for the buck. Hmmm. How has the government done with its Social Security and its own budget?

According to the American Society of Actuaries, reviewing claims alone often costs private insurers more than this – and administrative cost of enrollment, premium collection, marketing and education, the last of which is very important if CLASS is to gain widespread participation to avoid adverse selection. Even with extensive educational efforts, private long-term care insurance companies have sold only about 8% of the market to date.

If you are an employer wanting to learn more about how Long Term Care differentiates your benefits or a broker looking to help your clients with Long Term Care, reach out and contact Doug Ross at 800-483-1115 or visit EMpowerLTCI.com.

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