Green Oak works with many retirement organizations in planned giving outreach and operations. Based upon its long history of services to older persons, Green Oak Consulting Group provides additional support services to retirement organizations. Two programs, the Health Advisory Service and LTC Policy Valuation Service are described below.
Health Advisory Screening Program
1. What is the Health Advisory Screening Program?
The Health Advisory Screening Program (HAS) provides two critical services. First, it audits a participating community’s application package to make sure that all the allowable information is being collected while eliminating any inappropriate or potentially illegal questions.
On a continuing basis, HAS conducts an independent, third party evaluation of each applicant’s potential risk for using long-term care services. It does this using a national database of retirement community residents developed over many years. The participating Community receives an individual report about each applicant’s insurability that can be integrated into its own, broader admission criteria.
2. Why is this important?
Through the initial audit, the Community will be assured that its application package is in compliance with federal disclosure standards.
On an individual evaluation basis, liability under ADA and Fair Housing may be reduced due to the use of national norms that establish a realistic actuarial evaluation. Further, the evaluation structure is targeted to indicate potential dementia issues that might not otherwise be identified.
3. How does it work?
In coordination with Green Oak Consulting Group (Green Oak) and Avon Long Term Care, (Avon), an intake form is incorporated into the Community’s application package. This form, along with the applicant’s physician report, is submitted to Avon. In some cases, a telephone interview may be conducted with the applicant to verify certain information. The Community generally receives a report within 5-7 working days.
4. What does the information tell the Community?
The basis for the risk assessment is whether or not the applicant would be approved for coverage under an individual LTC insurance policy. In most cases, there will be a clear “Yes” or “No” response. In borderline situations, there will be additional back-up information for the Community to investigate further. The Community is not bound by this information. The process is simply an independent evaluation of an applicant’s risk for using LTC services. The Community can incorporate the results as it chooses.
Green Oak staff work in coordination with the Community to evaluate outcomes and identify general trends that may be significant indicators of marketing and operational issues.
5. Why was this service created?
Green Oak was asked by retirement community leaders to develop this third-part review process because they were concerned about both their compliance and liability in accepting applicants. Unknowingly accepting a poor risk applicant has significant long-term financial ramifications. However, declining an applicant without clearly stated criteria and a defined evaluation process, could lead to more immediate problems.
6. Has the service been tested?
Yes, since 1998, two multi-site systems and several stand-alone communities have implemented and utilized the program. Results have been effective for evaluating individual applicants. Equally important, as the individual results are compiled, participating communities are getting a broader perspective about the type of applicants that are attracted to them, the impact of their marketing program and the effectiveness of their internal review process.
7. Will the HAS Program facilitate the CARF-CCAC review process?
HAS incorporates many of the elements that a third-party accreditation system might address. It might be one way for a community to demonstrate conformance to review standards. However, HAS is not affiliated with CARF-CCAC. The application and interpretation of CARF-CCAC standards, policies and procedures, as well as all decisions concerning conformance to standards and qualification for application and accreditation, shall be determined solely by CARF-CCAC. HAS has no power or influence to affect the CARF-CCAC administration or decision-making process.
8. Where do we go for more information?
Please contact Bill McMorran of Green Oak toll-free at 866/221-7643. He can also be reached at wmcmorran@greenoakconsulting.com
Valuing Long-Term Care Insurance Policies
A Unique Service for Innovative CCRC Marketing
1. What is the Green Oak LTCi Valuation Service?
Increasingly, CCRC applicants often have their own long-term care insurance (LTCi) policies already in place. It discourages them from moving into a full service, entry fee CCRC.
The Green Oak LTCi Valuation Service can determine a realistic, actuarial value of the applicant’s individual policy coverage and report this to the CCRC marketing staff. Using this data, staff can, if it so chooses, offer some form of discounted entry fee based upon the applicant’s existing LTCi policy. This boosts sales.
2. Why is this important?
It is estimated that 1 of 6 older Americans now have some form of individual LTCi coverage. LTCi sales are growing exponentially, putting entry fee CCRCs at an emerging disadvantage. Applicants do not want to pay entry fees for what they see as duplicative benefits.
Compounding this problem is that no two LTCi policies are the same. Over the past thirty years, there has been an array of different products and benefits offered by competing insurers. Further, there are a range of benefits that buyers can choose from in each of these diverse policies. No common value can be determined.
3. How does the LTCi Valuation Service work?
Applicants who have an LTCi policy will be asked to submit a copy of the policy, the “Explanation of Benefits” and any separate riders. Green Oak Consulting Group (Green Oak) and Avon Long Term Care Consultants, (Avon) has an experienced team of actuaries and analysts who will review the policy on its own merits.
This review includes individual waiting periods, the benefit duration, benefit eligibility criteria, inflation protection, levels of coverage, the applicant’s current age and finally, the insurer’s financial strength ratings.
From this review, an individual net present value (NPV) will be calculated and reported to the CCRC marketing staff. From this consistent valuation process, CCRC staff can determine if it wants to extend a discount to the applicant, and if so, what the appropriate amount should be.
Selecting the appropriate amount is ultimately a decision by the CCRC. The Green Oak Valuation Service provides a consistent calculation model.
Documents can be faxed directly to the Valuation team. CCRC’s can expect a response within 3-5 working days. Team members will also be available to answer any questions that might arise in the process.
4. How Does the CCRC Protect Itself in Offering Discounts?
The CCRC will need to define a legal amendment to its contract for those who accept a discount. The requirements would be that in exchange for the discount, the applicant agrees to:
1. Add the CCRC to the list of entities to be notified by the insurer if the applicant stops paying premium. As an alternative, the donor could pay the premium as part of his/her CCRC billing, so long as it is a specific line item. The CCRC would then make payment.
2. Make an assignment of benefits to CCRC if the applicant requires insured benefits. Failing to maintain the policy or not assigning of benefits would allow CCRC to seek repayment of the original discounted fee, plus interest. This may or not be exercised but the CCRC should retain the right to do so.
5. What Are the LTCi Valuation Service Benefits to the CCRC?
There are several short-term benefits to the CCRC in using the Green Oak Valuation Service.
• The valuation service provides a new boost to advertising and access to an untapped market
• The valuation service allows market staff to re-contact their prospects to ask about LTCi coverage
• It removes applicant roadblocks, making new sales easier
• It sets the participating CCRC apart from the competition that does not offer these discounts
There are also significant long-term benefits for providing entry fee discounts to applicants.
• The CCRC has a new, locked-in revenue source if the applicant requires LTC care
• Improved occupancy rates create a more stable bottom line
• Cash flow can be significantly improved.
6. Does the LTCi Valuation Service Ensure that the Applicant is Insurable?
No, the LTCi Valuation Service does not evaluate an applicant’s current health status and the risk of accepting that applicant into the Community. The LTCi Valuation Service essentially determines the current value of the applicant’s existing long-term care insurance coverage. To determine an applicant’s current health insurability, as well as protect the Community from liability under ADA and FHA, Green Oak also provides a separate Health Applicant Screening Program. The Health Applicant Screening Program is based on an underwriting evaluation, rather than an actuarial review. It can work in coordination with the LTCi Valuation Service.
7. For more information about the LTCi Valuation Service and Applicant Screening…
Please contact Bill McMorran of Green Oak toll-free at 866/221-7643. He can also be reached at wmcmorran@greenoakconsulting.com.
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