Long-Term Care Form (UNUM)
Customer Service: 1-800-227-4165
Group Number: 0100057-0004
Long-Term Care (LTC) insurance is important for people of all ages if they want to preserve financial security and independence in the event of an extended disability. And despite popular misconceptions, the need for long-term care insurance isn't just for the elderly as many working age adults have disabling illnesses and injuries as well. This benefit is designed to help you pay for care services, such as in home care or nursing home care. These expenses are typically not covered by health insurance, Medicare or Medicaid. Eligible employees can elect a monthly benefit $1,000 to $4,000 per month on a 3 year or 6 year plan. Employees can apply for a benefit once they are unable to perform the designated number of assisted daily living activies and the elimination period has passed. Employees should review the plan carefully.
- Click here to view the Group Booklet on LTC Insurancex
- Click here to view the Summary of Benefits
- Click here to view LTC FAQ's
- Please visit the LTC website for additional forms, rates, information, certificates, Long-Term care calculator and more.
Any active LSUS employee is eligible for Long-Term Care coverage provided the following:
- Employed at 75% of full-time effort or greater (at least 30 hours per week)
- Appointed for a duration of at least one semester or greater (121 days or greater)
Employees, spouses, parents and grandparents may enroll in this plan. Employees and spouses are guaranteed issue within the first 30 days of hire. Coverage for parents and grandparents is contingent upon completion of an evidence of insurability form and being approved by underwriting. Coverage for employees and spouses after the first 30 days of employment is contingent upon completion of an evidence of insurability form and being approved by underwriting.
Enrollment Forms (paper forms are required):
- Click here for the enrollment form (new hires turn into HR no later than the first 30 days of hire).
- Click here for evidence of insurability forms. (only required on late applicants / annual enrollment).
Insurance is portable upon separation of employment or retirement. Employees must complete a portability form with payment and send directly to UNUM within 30 days of coverage termination. Click here to view the portability form.