This May, active Harvard faculty and staff and retirees and some members of their families will have the opportunity to apply for long-term care insurance under a new Harvard group plan administered by John Hancock Mutual Life Insurance Company (John Hancock). The decision to offer this new benefit came as the result of requests from the community and after thorough study by the University Benefits Committee (UBC).

"The UBC's Health Care Subcommittee has spent over a year studying long-term care and developing a plan for Harvard that will provide the same benefit amount for costs associated with home care services and nursing home care and allow participants to choose from among several levels of coverage," said Provost Albert Carnesale. "Since long-term care insurance may not be necessary or desirable for everyone, this insurance, like extra life insurance coverage, will be optional."

What is Long Term Care and Who Needs It?

Contrary to popular belief, the need for long-term care services is not limited to the elderly population; it can be required at any age when chronic illness or disability leaves a person unable to independently perform basic daily activities. Under the terms of the Harvard plan, eligibility to receive the long-term care benefit depends on the inability to perform at least two of the following five activities: bathing or dressing; eating; toileting; transferring from bed to chair; or maintaining continence due to a condition that lasts at least 90 days; or those who need substantial supervision due to a cognitive impairment, whether organic (e.g., Alzheimer's disease) or inorganic (mental illness or severe depression).

By some estimates (U.S. Department of Health and Human Services and the Institute for Health Policy Studies at the University of California, San Francisco), as many as 40 percent of working adults between the ages of 18 to 64 can be expected to use long-term care services at some point in their lives. Experts predict that as the population ages (by 2030, the over-65 population is expected to have increased by 150 percent), and as more of the women who once provided care for family members hold jobs outside of the home, the numbers of people who will need outside help for this kind of care will rise.

"Long-term care services are expensive, especially in this part of the country. Right now in Boston, nursing homes cost about $170 per day," says Peter Marsden, professor of sociology in the Faculty of Arts and Sciences and chair of the UBC's health care subcommittee. "Many faculty and staff may feel that their insurance coverage and other financial resources will not be adequate to provide this kind of care. Others may be worried about protecting family assets, such as the home, from the Medicaid requirement that all assets be depleted before nursing home benefits kick in. Still others may have significant responsibility for an elderly parent or in-law and anticipate the need for added services in the future."

"The new long-term care insurance provides some options for those who wish to plan now for these risks, with the advantage of Harvard's group rates," said Marymichele Delaney, associate director of flexible benefits in the Office of Human Resources. "The decision about when and if to purchase insurance for this purpose is one that must be reached by each individual after assessment of many factors, including age, health, and economic resources. Working with John Hancock, the Benefits Office will provide information and discussion between now and the enrollment period in May. I urge those who are interested to attend these sessions or find other means to evaluate their own situations carefully."

What does Harvard's Long-Term Care Insurance Offer?

Among the major features of Harvard's long-term care plan are:

* Guaranteed acceptance into the plan without medical evaluation for all actively-at-work faculty and staff who sign up during the initial enrollment period (May 1997). The guaranteed acceptance for coverage applies to those who are retiring this year as long as they are on the payroll on June 30. After the initial enrollment period, guaranteed acceptance will also be available for any newly hired faculty or staff who enroll within 30 days of becoming eligible and for any faculty or staff who were on a leave of absence or disability during some part of the initial enrollment period and who enroll within 30 days of returning to work on a regular basis.

Retirees, their spouses, and the spouses, domestic partners, parents or parents-in-law, grandparents and grandparents-in-law of active faculty and staff must provide proof of good health, which includes answering some medical questions on the application and may include a personal interview. Current faculty and staff who enroll in the Harvard long-term care insurance plan during future open enrollment periods must provide proof of good health.

Those who leave University employment before July 1 are not eligible for this plan.

* Coverage of various kinds of services, including home care. Harvard's long-term care plan will not be limited to coverage for nursing home care; it will also cover home health care, adult day care, or assisted living facility care at the same daily benefit amount as nursing home care.

* Premiums based on option choices and age at time of enrollment. Participants may choose coverage providing $100, $150, or $200 per day towards the cost of care with a lifetime maximum coverage time period of either three years (1995 days x daily maximum benefit) or five years (1825 days x daily maximum benefit). Because some people may wish to use their own assets for a period of time, the plan also offers a choice of three qualification periods: 90, 180, or 365 days. Once the qualification period has been met, you can be reimbursed for coverage costs as long as you remain certified.

* Participants are responsible for 100 percent of premium. Premiums for active faculty and staff and their spouses or partners may be paid through payroll deduction; retirees and others will be billed directly by John Hancock.

* Complete portability for faculty and staff who leave Harvard.

* No premiums due once eligibility to receive benefits has occurred and the qualification period has been met.

* Premium rates are guaranteed not to change for the first three years.

Where can you learn more?

Special Mailings

* A newsletter describing the new plan will be mailed to all eligible faculty, staff, and retirees in the coming weeks.

* In late April, an enrollment kit will be available by request to faculty, staff, retirees, and other eligible people who are interested in the coverage. Enrollment will take place in May. The plan will become effective July 1.

Open Meetings

A series of informational meetings will be held in late April and May, geared to the special interests of faculty, staff, and retirees. Spouses and partners are invited to attend as are parents and parents-in-law. Dates and locations will be announced soon.

Regular Publications

The April and May issues of The Harvard Community Resource and the April newsletter of the Harvard University Retirees Association will include more information about the plan.

Personal Consultation

Those with questions about the plan options or about financial planning or who wish to meet with a representative of John Hancock Insurance are invited to call the Benefits Office at 496-4001.

There will also be a Web site and toll-free 800 number from John Hancock Insurance beginning in April.