Angie Hughes, LTCP

Tech And The Health Space

Angie Hughes, LTCP

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November 1, 2022

I’m guessing most of you reading this publication might be expecting something life insurance facing. Well, that simply isn’t the space I cut my teeth in, so I’ll speak to tech and the health space.

It does amaze me how some industries can be very tech-forward and others not so much. I’ve seen quite a bit of advancements in the life insurance arena with some BGAs bringing out their own tech platforms for quoting and enrolling term life insurance and this is great news for that transactional business. For the more complicated sales, paper may still be the way to go; file building, talking to underwriters, setting up the purpose of the coverage is very important.

When it comes to health lines…well it leaves a bit to be desired. Necessity brings innovation and that is exactly what has happened in the Medicare world.

When CMS (Centers for Medicare and Medicaid) decided that agents could no longer access the Medicare website to run prescription drug plans and Medicare Advantage plans, the tech world got busy. It started getting very crowded, noisy, disruptive and competitive for all alike. Fast forward three quick years and you are seeing all kinds of quote/enroll platforms for MA/PD and PDP plans.

For those of you not in this industry, you might be the lone ranger. Everyone quickly realized the potential for renewable, compounding commissions and decided to take a look. That’s when we really started to see the innovations. Some platforms are proprietary meaning you must have carrier contracts with a BGA to have access, some you can buy, and even some you can white label.

What this means to the agents is efficiency for comparing plans that change every year—saved time so you can spend less time with chit chat and more time getting to plans and pricing—and easier access to see and save your clients’ data year after year. This is critical as you could easily have a client base of 100+ and getting to each of them in a short 54-day window can become challenging, especially when keeping up with new mandates facing them this year. Call recording and maintaining that call record for 10 years is required for this selling season so that’s forced more innovation in being able to make this as easy as possible for the agents. And if you don’t understand the importance of this, how about one-third to one-half of your annual production in the Medicare space will be done in a quick 54 days! Efficiency is the name of the game!

In the Medicare industry challenges must be seen as opportunities because there are some, if not a lot, of agents that will give this up due to mandates, so this creates an opportunity to grow your book of business not to mention those retiring agents that need a trusted agent to come in and help serve and take over for the clients.

With the release of this publication we will be almost halfway through AEP (annual election period) so to those of you navigating the sea of Medicare beneficiaries, I applaud you and wish you the best of luck and finish strong!

Happy selling!

Image by Joshua Woroniecki from Pixabay

Welcome To A World Of Disruption

Angie Hughes, LTCP

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May 1, 2021

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The markets, the politics, the insurance industry—everything is disrupted. I choose to see noise and disruption as opportunities. If you don’t, it will eat you alive. You’ve got to find some sort of silver lining and move with it. If you are feeling it, so are your clients. Of course, you know by now that my passion lies with extended care planning, Medicare and disability planning. I personally feel that these three topics, if not handled properly, will cause irreversible damage to your clients financial future. And yet so many agents and advisors shy away from these topics and I do understand why. They are all health related planning strategies and that can be quite daunting for those that are not immersed in that space. Well then, go find someone you trust and work with them. This is important to you and to your clients. If you don’t believe me, go scan your social media feeds and tell me how many Go Fund Me or charities that you see where families are asking for help due to lack of income resources to pay for care due to illness or accidents. It’s just a conversation to strike up and then see where it leads.

Let’s talk about these three critical topics that need to be discussed as your client ages and what that means to you as their agent/advisor.

Disability Income Insurance
This type of protection is paycheck protection. Forgo the pandemic, how many American’s have enough money set aside should something happen and they can no longer bring home the bacon? Not many, that’s how many. Do consumers want to talk about the likelihood that they could some day, during their working years, the accumulation phase of the grind, not be able to provide for their family? Of course not, but why is it important to you? If you don’t bring up this piece of protection while they are young and working to accumulate wealth, and their health crumbles or they are in a life changing accident, how can you help them plan for the future when all they can think about is what bill, insurance, or investment am I going to cancel to still be able to feed my children?

Long Term Care Insurance
This type of protection is also a form of disability protection. It’s not protecting a paycheck per se, but it is protecting from unexpected expenses. At some point the paycheck is going to end, or at least isn’t that the American dream? Work hard then play hard. The goal is to accumulate enough that you can rest and enjoy a time frame in your life when your health is still intact and you can travel, spend time with grandkids, granddogs, try new things and just have more time to enjoy life and stop the grind. That’s when you need to have a plan for extended care. No one builds into their income planning strategies the idea that “What if I need extended care…how will I pay for that?” I don’t believe consumers need to have huge policies but they need to have something. If it is reasonable that you are going to live a long life, because that’s how you are planning for your retirement income to play out, then isn’t it reasonable to think you could need care at some point in your life? Well sure it is. Then help your clients make a plan. Extended care planning is nothing more than providing an income stream to pay for care in the event of a disability post accumulation.

Medicare
And now it is time to think about your health care coverage once you’ve quit working and no longer carry group or individual health insurance. This is a big decision. Don’t meddle in Medicare. If you thought long term care insurance was tough, don’t haphazardly offer advice on Medicare. There are so many parts, and enrollment windows are very specific. Don’t be confused by the TV commercials and ads which over simplify the process. Consumers have no idea what to do here and they need a professional to sort it out for them. If their health is compromised at the time of enrollment into Medicare, this will be the last health insurance decision they will make for the rest of their lives. And let’s not forget that Medicare does not cover custodial care for extended care needs nor does it provide an income for care not covered by Medicare.

I am hoping that with this article you can at least acknowledge that the disservice we do for our clients by not helping them prepare and plan for unexpected expenses could be quite devastating to them financially—which in turn impacts you financially. It is just a conversation. Just ask your clients if they have a plan. They will tell you. Remember this: They see you for your advice. If we aren’t opening the door for them to make an educated decision then we didn’t open the door at all.

Happy Selling!

LTCI Panel

Jim Glickman, Angie Hughes, LTCP, Don Levin, JD, MPA, CLF, CSA, LTCP, CLTC and Claude Thau

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March 1, 2019

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Q What is your outlook for the stand-alone LTCI market? In what market segments are you seeing sales activity and/or optimism?

Glickman
The stand-alone LTCI market will continue to be a major part of the LTCI solution, with over 50 percent of the present value of the long term care premiums on new policies being generated by stand-alone policies, and almost all of the rest being generated by the hybrids where most of the premium is actually life insurance premium. With the stand-alone LTCI new business premiums now quite stable and the future rate increase risk on those new policies minimal, I expect the new business volume for stand-alone LTCI to start increasing, especially among those carriers involved in offering tax advantaged, benefit advantaged, or worksite solutions.

In addition, everyone at the state and federal regulatory level realizes that a vibrant stand-alone market is necessary to help deal with the long term care crisis that will be created by the baby boomers if better penetration of LTCI does not occur. Both the National Association of Insurance Commissioners and the Federal Insurance Office are working with the industry, the ACLI, and non-profit think tanks to develop potential changes (including possible tax incentives) to spur the market.

All of this bodes well for not only the stand-alone market, but for the hybrid market as well, and most important for society at large.

Hughes
My personal outlook on the stand-alone LTCI market is hopeful. Hopeful that the advisors will continue or start the long term care conversation. You can’t have a fire unless you create a spark! I’m finding that if my agents/advisors make the initial contact with their clients, instead of waiting to be asked about it, there are more chances for success. Now with that being said, I never miss an opportunity to turn every phone call into something related to long term care and always ask about any business opportunities due to the tax deductibility of some or all of the premiums.

Levin
We are on the verge of a tsunami that will quickly overtake the United States in terms of caring for the elderly. China faces an even more dire set of circumstanced due to the failed policies associated with one child per family and the wanton killing of female babies.

Even with the need for long term care increasing annually, market penetration has never exceeded 10 percent of the market over the last twenty years. That means that there are still over 72 million baby boomers and 84 million Gen X-er’s who need to talk to us!

Sales continue in the Baby Boomer market, but have definitely reached down to the GenX-ers and the following generations. The younger generations are clearly looking at the lessons learned by their parents in terms of being caregivers and are making long term care planning part of their long term financial plans and portfolios.

Financial advisors, estate planning attorneys, and other insurance producers are grasping the significance of not addressing long term care with their clients and, as a result, are embracing the products as well as working with experts like us for this one specific aspect of their clients long term plans.

For all of these reasons, I remain optimistic that the industry overall (to include hybrids, combo products, and life insurance with long term care riders) will continue to rise to meet the ever growing needs of our country as it ages in place.

Thau
a) It will probably rebound somewhat.

b) We can improve our consumer messaging significantly, both in the individual market and the work-site market (messaging to employers, as well as employees).

c) To help the middle market, we can sell more smaller policies, leveraging the State Partnerships.

d) People will arrange a variety of financial resources to address their potential long term care needs; stand-alone policies will be only one piece.

e) The industry raised prices, limiting the market to the affluent (especially with the benefit designs we were selling), yet took away the endless benefit period which is what affluent people want. We now have an endless benefit period available again. It leads to more sales, even of shorter benefit periods. Yes, I do mean to say that the availability of an endless benefit period increases the sales of shorter BPs as well as generating endless BP sales.

Q In your view what can the industry, and perhaps legislators, do to make stand-alone LTCI affordable for a larger percentage of the population?

Glickman
As I mentioned in the prior question, the industry, the trade organizations, the state regulators, and the federal regulators are all focused on potential legislative solutions that will spur more LTCI adoption across a cross section of potential insureds.

Chief among these potential solutions are:

Tax advantaged solutions to pay premiums, including penalty free/tax free withdrawals from retirement accounts (401Ks, 403Bs, IRAs), allowing FSAs to elect, and above the line deductions. While this option seems remote, it can be actuarially demonstrated that the savings available from privately financed LTCI on a broad scale will more than offset the cost of the foregone taxes initially.
Employer based solutions such as an LTCI savings plan for paying LTCI premiums or direct LTCI expenses on an opt out basis (where the employee is automatically enrolled and must choose to opt out) similar to how 401Ks are handled. A Department of Labor determination in December, 2018, allows employers to payroll deduct disability insurance for all employees automatically. Employees then need to opt out to avoid paying for the disability coverage. A similar provision for LTCI would vastly expand the LTCI market. A smaller and easier change in the ERISA law, specifically exempting LTCI, would expand the offerings of voluntary purchase LTCI in the workplace.
Changes in the IRS code such as allowing cash values to spur new and consumer exciting products such as Universal LTCI policies. Eliminating the minimum two ADL requirement from the TQ policy definition would allow for deferred annuities to be included as a basic LTCI benefit, creating a product that would start paying monthly benefits once a person became old and frail, even if they were not yet ADL dependent. Expanding the current 1035 exchange rules to allow NTQ annuities to fund LTCI premiums for one or both insureds who are married and filing taxes jointly. This modest enhancement would vastly expand LTCI coverage to trillions of dollars in NTQ annuities which cannot be utilized for long term care expenses (or premiums) without severe tax consequences.
Changes in state regulation that are widely and uniformly adopted, such as partnership plans allowing, without additional rules, the non-partnership policies approved in their state. In particular, this would allow insureds to avoid unaffordable compound inflation and minimum benefit amount requirements. Another easy change would be to eliminate the risk based capital penalty that currently prevents insurers from seriously considering noncancelable LTCI policy designs.

Some companies are already starting to expand their product within current laws through offerings that appeal to a broader base of consumers by offering a unisex product through employers, creating single and ten pay alternatives, offering lifetime benefit periods, and offering return of premium death benefits that are payable in addition to LTCI benefits.

Hughes
In my opinion we missed the mark on the LTC Partnership Program. It appears the hybrids have found their home with those that can afford single premium transfers or higher than traditional LTCI premiums and traditional LTCI has found its home on a budget. I don’t mind that view, however where we missed the mark is by requiring inflation on the traditional plans. If the biggest swath of buyers that could really benefit from LTCI plans is middle America, then don’t force them to add the most expensive rider to their contract. Don’t get me wrong, I believe inflation is important and, quite frankly, that’s what sets LTCI apart from hybrids—the ability to grow the benefits—but if we have something to lose, but not millions to lose, let us build the proper policy without having to slap inflation protection on there. Maybe just a higher daily/monthly benefit for a shorter duration is the answer.

Levin
Tax qualification of the Section 7702(b) stand-alone long term care insurance plans was a huge step. The availability of State Partnership to all fifty states an even larger one. Now we need to be able to offer clients the ability to pay for these plans with qualified funds, especially if it is a hybrid or combo plan falling under Section 101(g). They may be running their cash reserves down by paying for their parents’ care and childrens’ college educations, leaving them non-qualified cash poor. Being able to use qualified funds would require additional federal legislation. While this has been bantered about for many years, I firmly believe that the time for action is now. I hope that organizations like NAIFA, NLTCN, the Society of Financial Service Professionals, et al, as well as insurance carriers currently in the marketplace offering these products, will expend appropriate levels of lobbying to bring forth this necessary legislation—providing relief to consumers and promoting even greater sales.

Thau
I suggest expanding the question to include regulators as well as legislators and to include media. As noted in my first response, there is a lot the industry can do to provide improved messaging.

Government and media could provide better messaging as well. Things we/they could do:
a) Explain that past price increases on existing business have led to today’s prices being more stable. (Government and media reports on rate increases lead financial advisors and consumers to fear rate increases on policies being issued today. This is a “look through the rear window” approach, as I can explain.)

b) Government and media have publicized and questioned claim denials, sometimes being right but sometimes falsely accusing carriers. Why not publicize evidence that the industry is doing a good job?

The Federal government engaged LifePlans to do a study regarding claim payment. The study concluded that the industry was doing very well.
California published a study that was hugely biased against the industry. For example, if a client contacted an insurer during the elimination period and the insurer provided the desired information, CA counted that as a denied claim because no claim payments were due. Furthermore, their methodology ignored that claim later when it was paid! I successfully got CA to agree that their method was flawed, but they refused to issue a correction.
The Independent Review (IR) process helps protect consumers. Each year, our Broker World survey publishes some data relative to IR. That data has been impressive for the industry, but we are limited in what we can obtain. I’ve asked regulators to get data themselves, or to ask me to act on their behalf, so that we can get better data.

c) Of course, the government and politicians continually give mixed signals, making it easy for people to conclude that the government will pay for care “by the time I need it.” Many years ago, some states did “Own Your Future” mailings in which they informed consumers that the consumer is primarily responsible for long term care expenses. We reported on results in the Broker World survey. It would be timely to send more such mailings now.

d) More states could adopt State Partnerships and the original four states could shift to the Deficit Reduction Act Partnership to provide more consistency.

e) The LTCI certification process could be improved in a variety of ways, leading to better education of advisors.

f) Slowing the fiduciary bandwagon might help. Emphasis on fiduciary responsibility discourages financial advisors from discussing long term care issues because:

With increased documentation, they have less time to discuss ancillary issues, particularly as those issues then generate more need to document.
The threat of fiduciary charges causes them to focus on the areas of their expertise. Discussing areas in which they are less familiar (long term care) exposes them to what they perceive to be disproportionate fiduciary risk.
You might think FAs would then outsource long term care discussion to LTCI specialists. It does not always work that way because:
- Advisors are fearful of referring people to third-party experts because, if the third party screws up, they could lose their client.
- They also fear that if the third party screws up, they could be blamed (fiduciary).
- They also fear that the third party might poach their client or inadvertently introduce the client to a competitor.

g) The industry, media and others often suggest that LTCI should not be bought before age 60 (or so). That advice is incorrect, as we can demonstrate.

h) Protect the industry from people doing genetic testing, then buying LTCI if they have the APOE gene. We may need an assigned risk pool for people who fall into that category.

i) Tax breaks would help, but we should be able to sell without tax breaks.

j) One percent CBIO qualifying for Partnership can be important for core/buy-up programs.

k) By the way, the new NAIC Shopper’s Guide is significantly better than its predecessors. It will be interesting to see its impact. I’m not expecting much impact, because I think it is treated as a compliance document and is very long.

l) This strays to the combo side, but §101g features can be excellent contributions to long term care planning. Yet the regulators forbid the use of “long term care” relative to such features. I think that is a very counterproductive position.

The industry needs to improve significantly the quality of pre-qualification of health conditions. Doing so would lower the decline rate and also get more people insured. It would result in noticeably more interest in LTCI among financial advisors. How might we do so?

a) General agents could perhaps do analysis demonstrating the improved results for cases which were pre-qualified.

b) The message should be trumpeted repeatedly.

Q Much of the current long term care risk abatement activity seems focused on asset-based long term care solutions. What are your thoughts and/or experience with these products?

Glickman
Asset-based LTCI is quite attractive to many insurance companies due to its minimal LTCI cost structure and its maximal appeal to consumers. It makes a lot of sense for anyone purchasing a life insurance policy to have this additional flexibility to use the life insurance proceeds to pay for their LTCI expenses, as long as they realize that if they need to do so, they will no longer have the life insurance benefits that instigated the original purchase. Likewise, if someone determines they need LTCI, and doesn’t need the life insurance coverage, this is a very expensive way to purchase LTCI. I would be hard pressed to advise anyone to buy one of these types of hybrids that only pay LTCI benefits up to the death benefit, if it is being bought for its LTCI coverage, while I would equally oppose not including it, at a minimal additional charge to a life insurance policy being bought for the client’s need for life insurance, just in case.

However, one of the hybrid designs, only offered by a handful of companies, is one that provides life insurance with LTCI and an extension of benefits rider that continues the LTCI coverage after the life insurance benefits are essentially exhausted, providing much more significant LTCI coverage especially if the compound inflation option is elected. With the liberalization of underwriting rules that are generally available on the life hybrids when compared to the stand-alone policies, it is a good fall back plan for even stand-alone LTCI specialists to have access to sell.

Hughes
I have lots of experience with asset-based long term care planning solutions. They work where they work but they are not the be all, end all, for long term care planning. I still say you will never get more out of a life/long term care contract then you will out of a traditional LTCI policy. Now I have found that I have younger agents, who don’t have a history of explaining rate increases on older traditional blocks, and they are ok selling traditional LTCI—as they should be. You must understand the pricing of today’s policies and the rate increase regulations. On the flip side I have those that don’t ever want to have a conversation with a client about why their policy took a rate increase, so they gravitate to the life-based solutions. As an advisor to the advisors I have to keep my eyes and ears open to the industry and listen to what agents’ clients want their long term care solutions to do for them and pick the best one. Nothing is one size fits all.

Levin
There is no doubt that a great deal of the demise of the traditional long term care insurance market (declining from $1.024 billion of sales in 2002 to 2017’s $176 million—LIMRA statistics) can be attributed to fewer carriers in the marketplace and a decline in interest rates, as well as the attrition of the career agent forces with several of the major players. Factor in the advent of a wide range of asset-based products giving producers the ability to better tailor solutions to the desires of their clients—this has led to unprecedented growth in this market to the point that it is now surpassing the traditional market.

All of that notwithstanding, we are discovering that many financial advisors are not thrilled about losing the assets under management required to purchase these asset-based products because such purchases serve to deprive them of an ongoing stream of income. For this reason alone the pendulum is swinging back towards stand-alone LTCI.

In the same vein, all professionals (advisors, attorneys, other insurance producers) in positions that can be construed as possessing a fiduciary responsibility to their clients who do not broach the subject of LTCI in the course of regular reviews run the risk of being held personally liable under the Doctrine of Reliance. Courts are becoming increasingly sympathetic to the plaintiff bar bringing these claims.

I also believe that there is still no better way to leverage a client’s money than with a stand-alone LTCI insurance product. Factoring in the ability for the monthly maximum and pool of benefits to grow by virtue of inflation protection riders, as well as the tax qualification and partnership considerations of these plans, I suspect that the pendulum will continue to swing back in the direction of traditional stand-alone coverage.

Thau
a) Linked products could appropriately be called “asset-based” in the past because they were usually sold as single premium policies which involved moving an asset into the combo policy. Today, most of these policies are not sold as a single premium. Therefore the “Combo,” “Linked” and “Hybrid” terms fit, but “asset-based” no longer fits well.

b) These are excellent alternatives to stand-alone LTCI. For many clients, linked benefit should be the default solution.

c) However, often they are sold illogically. For example, as indicated above, stand-alone LTCI policies issued today do not have the premium instability of the older LTCI policies. However, regardless of whether the client favors linked policies for a sound reason or not, it often makes sense to provide what they are requesting. We don’t do people a favor if our educational efforts result in them doing nothing, especially if they otherwise would have secured valuable protection.

d) The industry and regulators could make it easier to compare linked benefit products to each other.

e) Comparing linked to stand-alone also is difficult. Insurers could position linked products more effectively in their portfolio, etc.

f) The shift toward linked benefit policies is not as momentous as people think. The statistics are distorted because:

They are based on premium rather than eventual coverage.
- Single premium linked benefit policies and 10-pay linked benefit policies distort the results.
- A higher percentage of stand-alone policies may have benefit increase features, which is significant to future coverage.
- However, the average benefit period of linked policies with extensions of benefits might be longer than for stand-alone (although shared care should be factored in).
Lots of statistics include, in the linked benefit totals, policies with no extension of benefits. Depending on the purpose of the analysis, including such policies can be misleading.

Q In your opinion, should LTCI professionals be shifting a significant amount of their effort to point-of-care planning?

Glickman
Although I would not encourage agents to emphasize selling to those already needing care, and with a very limited life expectancy, I would always encourage LTCI professionals to be knowledgeable and have access to all possible LTCI solutions for their clients. However, I believe that point-of-care solutions (essentially substandard annuities packaged inside an LTCI policy form) are a very limited market opportunity for anyone involved in any other form of LTCI planning.

Hughes
If by that you mean maximizing their assets, using all avenues to maintain choice, then I would say that we’ve forgotten the definition of insurance. Why would one use every penny from every dollar of their own money when they could pay a premium and transfer the larger risk to the insurance company. If choice or control is the concern, there are options still available that allow for that flexibility. It’s called a cash benefit or an indemnity contract. That’s your maximum flexibility. Therefore, working with someone that maintains knowledge of the long term care industry is critical. If this isn’t your focus, let someone else do the hard work and you just keep options open for your clients. I have found that I would rather have a plan in place before, rather than having to plan at point of crisis. Planning is the key to anyone’s financial future and, of course, all well laid plans can change, but you must have a road map to know where you are going.

Levin
This business remains all about it being client-centric.

The wide array of products (despite the shrinking number of carriers in the marketplace) both allows and requires us to genuinely listen to the client, perform serious fact-finding, and then serve as their advocate by providing them with both suitable and appropriate coverage—whether it is stand-alone, hybrid, combo, short term, or critical care coverage.

Remaining client-centric, demonstrating the utmost of professionalism, and constantly growing in product and industry knowledge, will allow LTCI professionals—Planning Advocates—to better serve their clients.

Thau
a) I think we can and should be doing a lot more to help people who currently need care and/or are caregivers.

b) I think we should be doing more to help people who are uninsurable.

c) I think we should do more to help even insurable people reduce their exposure to long term care and reduce the likely cost and caregiver burdens.

d) However, I’m not comfortable with the word “shifting.” I think doing a) through c) will give us an opportunity to do more effective family long term care planning which might result in more LTCI policies being sold.

LTCI Panel

Angie Hughes, LTCP, Mike Smith and Ryan K. Hogan

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March 1, 2017

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Q: Anxiety about large rate increases and “use it or lose it” are two of the biggest obstacles in making the stand-alone LTCI sale. How can agents address these objections?

Hughes
I am wondering if that is the biggest obstacle for consumers or advisors? As advisors, we definitely have to be comfortable with talking about rate increases. Whether it is legacy blocks of business or new carrier entrance into the long term care space, we need to understand why this happens. As for consumer, they need to understand that LTCI is a health insurance product—and just like all other health lines, these can take increases. The great thing is that LTCI policies don’t take rate increases every year, but when they do it is all at one time or maybe spread out over three years as we are seeing today. Now I will admit, a policy sold in 2007 that takes a 90 percent rate increase is effectively about a 13 percent increase each year, and that’s hard to stomach, but a policy sold in 2000 that takes a 15 percent increase over three years (45 percent total increase) is effectively a 2.6% increase annually. What we should be telling our consumers is that if we had to mentally factor in a two to three percent increase every year, would that still be “doable”? Most of the time you should get a yes. If not, then maybe we should question the suitability. We’ve seen carriers come out with step-rated inflation and why that hasn’t taken off is interesting to me. Wouldn’t this be a win-win to the carrier and client, where they can control the stopping point if they wanted to freeze the growth and freeze the premium? I find reassurance in a Society of Actuaries pricing study that shows policies sold in 2000 had a 40 percent likelihood of a future rate increase compared to policies sold in 2007 with a 30 percent likelihood and in 2014 with a 10 percent likelihood. And here we are in 2017.

As for the “use it or lose it,” that objection is easily overcome today since we have some wonderful solutions based around life insurance that offer a death benefit if you never need long term care—because we all know with 100 percent certainty that life is fatal.

Smith
Use it or lose it is not really lose it anymore, it is more like you get what you paid back in the form of benefits. This may ease some of the regret, knowing you have paid LTCI premiums for years, only to discover you may no longer be able to afford the policy. So, you either drop the coverage or reduce the benefits to fit your budget. Keeping the plan in force, even at a reduced rate, is a smart thing to consider. Something is always better than nothing when it comes to LTCI.

Hogan
Large Rate Increases—We point to the latest study from the Society of Actuaries, Long-Term Care Insurance: The SOA Pricing Project, showing agents that the potential rate increases on products sold today is very slim as well as discuss the past and why we have large rate increases on the older products. The conclusion “New Policy Pricing: Today’s Environment” (on pg. 8) states that:

“Carriers that are considering entering the LTC market or have discontinued selling LTC products should welcome the current pricing environment. To be clear, this paper does not claim that today’s LTC products will not need future rate increases. Rather, based on an analysis of pricing assumptions and historical experience, we conclude that LTC policies priced today are significantly less likely to need future premium rate increases than any earlier product generation.”

You can find the full study at https://www.soa.org/Files/Sections/ltc-pricing-project.pdf.

Use it or Lose it—We address this primarily with the use of the Shared Care Rider or showing, side-by-side, a comparison of traditional LTCI with a GUL compared to a hybrid. The traditional with a GUL is likely to be similar cost, yet if the insured goes on claim he will not cannibalize the death benefit.

Q: The need for LTCI certification training dissuades many agents from pursuing LTCI sales. What suggestions do you have for them regarding their clients’ potential long term care exposure?

Hughes

I will admit, the LTCI certification did deter some agents from selling LTCI, but they were either in the downsizing phase of their business or didn’t really prospect for LTCI. Fast forward to today and it is just something we must do—just like AML, annuity certification, CE credits and on and on. I have been conducting classes since 2008, and I’m amazed at how many advisors get something new out of each class. And believe you me, nothing has changed in the message besides the current statistics.

I could tell you that most of the consumers that purchase LTCI won’t fall into the Medicaid system but you just never know, so if it fits for the client then explain to them how this can protect something of value to them with the dollar for dollar protection of assets against Medicaid spend down (DRA states). Most advisors sell an inflation option, by default putting clients into a Partnership qualified plan, so those advisors might as well embrace the training and stay current with the concept of Medicaid.

I am more concerned with advisors just bringing up the topic of long term care planning with all the solutions we have today versus them knowing the ins and outs of Medicaid. I’ve seen firsthand how some LTCI is better than no LTCI when a family gets into that crisis moment and they need help and breathing room.

Smith

If an agent is not willing to invest in themselves and learn the skills required to create an affordable, effective long term health care plan, they should partner with another agent that is certified. The client’s risk is still there; the advisor still needs to provide an answer to handling the long term health care expenses.

Partnering up with another agent is a prudent business decision. All advisors have a responsibility to make their client base aware of the costs involved with a long term health care episode. Not having a discussion and ignoring the risk shouldn’t be an option. An advisor leaves himself in a vulnerable position if this risk is not addressed.

Hogan

The need for LTC is not going away and it should be addressed with their clients as part of a financial planning process. If they are dissuaded by the certification training, then they need to pair up with an LTCI advisor that can assist their clients. We also like to promote the training, stating how it’s good information, it’s not difficult, and from time to time we have incentivized them with a $100 CE bonus after they write their first case.

Q; What drawbacks are there to using life and annuity riders to mitigate the long term care risk in the place of stand-alone LTCI?

Hughes

The resounding theme that you will hear from LTCI “purists” is that the inflation component doesn’t work well. Now with that being said, there are some life/LTC combos that do ok, and others that don’t do so well with it.

So, assuming the inflation piece is left off the life/annuity policy, the biggest drawback is that when the client needs to use the policy for long term care the policy benefits have remained stagnate for 15-25 years while cost of care is trending to be significantly higher than the benefits purchased.

I often remind clients and advisors that a stand-alone LTCI policy will bring bigger benefits than a life/LTC or annuity/LTC policy just due to inflation. Now if the client has enough funds to hedge against inflation then there could be a comparison made but that’s not your typical sale.

I have also found that annuity/LTC solutions only fit well when it comes to a funding mechanism. It’s an easy conversation when someone has an annuity out of the surrender period and we can just 1035 the funds over and whatever it gets them is what they get in benefits.

Smith

The only drawback is if there is either not enough current cash flow to afford a new policy or something in savings to fund the life or annuity product. Underwriting was a drawback, but in today’s market there are both simplified issue life and guarantee issue annuity products that may accelerate benefits to pay for long term care, chronic care and terminal illnesses.

Hogan

The biggest risk is that the goal of the insurance is not being truly addressed. Many agents will sell a life policy with a long term care rider thinking that this covers things. However, if the client wants/requires $500,000 in life insurance and subsequently liquefies this due to a long term care claim then the client’s needs may not be truly met. This and the fact that not all long term care riders or chronic illness riders are equal. The devil is in the details and must be looked at. Hybrid solutions can be perfect for a client, however it’s best to focus on insuring the client for what the goal is. And hybrid solutions do not leverage as well as a traditional plan.

Q: Are you seeing more producers combining hybrid products with traditional LTCI to provide a more comprehensive planning solution?

Hughes

I wish I could say I was, but I’m not. I think of this approach as if I were talking to a younger person about life insurance. Yes I could sell them term life, but I should really broach the conversation about permanent life insurance and perhaps suggest a combination of both. Life is like a teeter-totter—as we age our needs and goals change and that causes the teeter-totter to tip. We do “outgrow” term insurance and need more permanent insurance as we age.

The same goes for long term care planning. Why not start off with a traditional policy—with or without inflation—that you can buy on a budget, and then as life goes on look to add a hybrid to fill the gap and pay back the premiums upon death for what the cost was to own the LTCI policy? It makes sense to me, but I fear that LTCI is still considered a complex sale. We feel we need to explain everything and dazzle them with our knowledge, or get in and get out, because if someone asks for a quote then we need to take the app and hope it gets through underwriting.

If you think about it, our issue age for LTCI has dropped nearly 20 years in age (70 down to 50), so why not put something in place while clients are still young and healthy and coverage is affordable? If a serious health concern develops at a young age you’ve just afforded that family some breathing room, and if not then you can build the comprehensive plan when the mortgage is paid off, the kids are off payroll, and life is in a different stage.

Smith

Yes, we are seeing producers migrate to a portfolio of options, including life insurance, annuities and traditional long term care insurance to address the high probability and cost of a long term health care expense. We recommend advisors have all of the tools available to help clients find a suitable, affordable option to handle the long term care expenses.

Hogan

We are, yes. Part of our charm is that we look at all angles and present multiple solutions depending upon the case. Our brokers like this and look to us to provide both traditional and hybrid solutions if they make sense for the client.

Q: Do you think “financial advisors” and “estate planners” could reasonably face litigation in the future for failing to address the long term care risk? If so, what steps would you recommend to minimize this exposure?

Hughes

In my mind this is the fear tactic used to try and get action from the advisors that have clients with the funds to buy a long term care policy. Do I think they could face litigation? Sure. But who can’t these days? The real question is “What is the real reason you don’t consider LTCI for your clients?” As of today I believe I’m seeing that President Trump is going to act on the fiduciary rule, but does that mean that we are any less responsible for what’s right for the client? Of course not, and I believe most will always act in the best interest of their clients.

I have found that for anyone that has had a personal experience with a care situation, no matter how long or short, it was impactful. We worry about the long term effects to one’s portfolio if they were to need care for an extended period of time. Maybe they could weather a short term care need. But wouldn’t it be helpful to the spouse and/or the kids to know that they have an advocate to assist them in time of need with finding caregivers and helping them decipher information?

The only way to minimize exposure is to start the conversation, plant the seed, and document, document, document everything.

I use this analogy: If I never sent my daughter to school to learn how to read and write, how can I expect her to do these things? Same with long term care—how can your clients say “no” if you don’t give them a chance?

Smith

Absolutely, and especially those advisors that bill themselves as a “financial advisor” or an “estate planner”. In today’s litigious society, suing someone or being sued is pretty easy. When “Ma and Pa” have passed away, and passed along their lifetime savings to home health care associates, assisted living facilities and funeral homes, the heirs may not appreciate an empty bank account.

We recommend that an advisor either get educated, certified and appointed to handle the long term care risk or that he partner with another agent that has prepared to discuss the problem and expense involved with a long term care claim and present a viable solution.

Hogan

Either get certified to write LTCI yourself or pair yourself up with an LTCI partner that will respect your goals as a financial advisor as well as not compete for your clients. I also think FAs should understand LTCI better and how it works with financial planning. Too many are quick to jump to an asset/hybrid solution when that primarily pulls funds away from their AUM. A better solution could be to set up a $50-100k trust for LTCI where the interest on that goes to fund an LTCI policy as well as pay for any overages. Again this addresses the “use it or lose it” fear.

How Can The Industry Engage More Agents And Their Clients In The Long Term Care Risk Discussion?

Tiffany Albert, Barry J. Fisher, Marc Glickman, Angie Hughes, LTCP and Alex Ritter, FLMI, LTCP

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February 1, 2015

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Tiffany Albert, LifeSecure Insurance Company

Barry J. Fisher, LTCP, Broadtower Insurance Solutions, Inc.

Marc Glickman, FSA, MAAA, LTCP, LifeCare Assurance Company

Angie Hughes, LTCP, CSA, Producer’s XL

Alex Ritter, FLMI, LTCP, Art Jetter & Company

Q: What specific challenges do you see to influencing brokers successful with other product lines to commit to having the LTCI discussion with their clients, and how can the industry address them?

Tiffany Albert: Historically, long term care insurance (LTCI) has had a reputation for being a complex and complicated product. As such, brokers who have truly embraced LTCI have established a unique expertise and often choose to sell it exclusively. Similarly, brokers with other lines of business tend to shy away from selling LTCI. More recently, brokers have developed a renewed interest in strengthening their voluntary offerings as a result of the Affordable Care Act (ACA) and are looking to boost their earnings by offering other products. This presents a great opportunity to learn more about LTCI and its benefits.

In selling LTCI, as with any insurance product sales, it is important that brokers invest time in understanding their clients’ needs. LTCI is not a one-size-fits-all type of product. Each plan is custom designed for the client, so having a good line of sight into his financial goals and how much coverage he is seeking is imperative.

LifeSecure remains focused on creating competitively-priced, straightforward product designs. This helps the client to make a buying decision more efficiently and enables the agent to close the sale more quickly. LifeSecure also simplifies the selling process by maintaining the fastest underwriting turnaround time in the industry and by offering an electronic application process.

As carriers, we must continue to offer unique and innovative solutions that help more agents do business in LTCI. We must also ensure we’re providing agents with a strong educational background on LTCI to make it easier for them to sell the product and protect their clients. Our industry as a whole will benefit from having more LTCI experts.

Barry Fisher: Day-to-day compliance burdens, along with the Affordable Care Act (ACA), have, in my opinion, reduced much of the agents’ excess bandwidth to take on new products of any kind. So unless their clients ask for LTCI, it is overlooked. A broker needs to make a commitment of time and effort to successfully take on a new product line such as long term care insurance. It requires new knowledge, CE, and now they also need to understand life insurance and annuities. Brokerage general agents (BGAs) can help agents bridge this gap, but the challenge is there. I also believe that the ACA has sucked discretionary premiums out of everyone’s pocketbook, making it harder to find the money to pay for new insurance. The combination of these factors creates a tough environment for long term care sales.

Marc Glickman: Addressing the following two challenges will allow brokers to more easily commit to the LTCI market:

The first challenge is to simplify the LTCI discussion. By focusing at a high level on the benefits of the coverage, brokers unfamiliar with the LTCI space can more easily educate their clients. Based on each client’s profile, brokers can be prepared to determine which clients are the best leads for different LTCI coverages. For example, although the hybrid life/LTCI market is often suggested as a substitute for standalone LTCI, the two products are clearly geared toward different clientele. Greatly simplified, hybrid products fit those who are already in need of life insurance or annuities but are willing to substitute those benefits for an LTCI benefit should the need arise. On the other hand, stand-alone LTCI is geared toward healthy individuals with assets to protect against a catastrophic event should they outlive their life expectancies. With this mindset, stand-alone coverage that offers comprehensive benefits such as lifetime benefits, 10-pay and single pay are designed to meet the need.

The second challenge is new business price stability. LTCI new business pricing has increased to a point where it is extremely unlikely that future increases will be necessary. In addition, with virtually every major carrier having needed to perform substantial rate increases due to the under-pricing of legacy business, it is important to recognize that even with those increases, premiums for the legacy business are still lower than the current new business premiums.

The legacy business under-pricing was primarily caused by lower lapse and interest rates than originally anticipated. Conversely, current products use lapse and interest rates that are so low it is difficult to develop scenarios in which they will be insufficient on a forward-going basis.

Angie Hughes: What I find in my distribution to be the biggest challenge facing most brokers today in having discussions around LTCI is just that they are successful in other product lines, but with LTCI being a resistant topic for both broker and consumer, why bother. It is, by far, easier to wait for the consumer to ask about LTCI and then give them some quotes than it is to really work up the conversation and present the need for LTCI and what it does for the family once they are in a crisis. With LTCI, you have to be very patient and comfortable with the word “no.” You will be told no far more often than yes, but if we don’t at least give consumers a chance to say no, are we really doing our job? How the industry can help is a double-edged sword. We ask for easier products, fewer moving parts, and then we don’t really like them. We also want rate stability, but what is that anymore? We are living in a challenging time with LTCI sales, and if our hearts believe that this type of insurance can really help families, then we must continue to bring up the topic, have the tough conversations, and just educate families on what really happens when they need help and who actually pays for the care.

Alex Ritter: Consumers have grown increasingly aware of the need for long term care planning. Clients want to have the long term care planning discussion. They will have it with someone. If their broker isn’t talking about it, someone else will.

We need to understand that new business pricing problems are behind us. Older generation policies were subjected to rate increases, and some carriers left the market. However, the carriers selling LTCI today found accurate pricing, solid underwriting and policy design solutions.

Q: What factors should agents consider regarding a decision to address the long term care risk in planning discussions with clients?

Fisher: New product choices mean that consumers have the opportunity to do a lifetime of long term care planning. Agents need to be fluent in general long term care matters, but I don’t think they need to be experts. They should be able to rely on their BGA for detailed support. Sometimes the discussion with the prospect will be about life insurance with coverage for chronic illness as a “bonus” benefit. Other times traditional long term care insurance or linked products where the life insurance is actually the incidental benefit will take center stage. Therefore the broker will need to hone his fact-finding skills so he knows what his client’s needs and focus of attention are.

Glickman: The planning discussion should be designed to understand whether the projected retirement income can support the catastrophic costs associated with long term care, together with the ongoing retirement needs of the healthy spouse. While the answer could be care provided by the spouse or the children, the emotional and physical impact on healthy family members providing that informal long term care needs to be properly understood by the client. If the answer is to use retirement income funding, it needs to be understood how much of those funds can pay for care, what types of services can be afforded, and whether adequate funds will remain for the primary retirement needs. Generally, the availability of LTCI provides significant quality of care improvements with funding for better services/facilities and the ability to remain at home longer.

Hughes: I believe that everyone should hear about LTCI, but not everyone needs to buy it. Probably the first question in deciding on whether or not to continue the discussion is, “Are you healthy enough?” Why go down the painful task of taking an application just to have your client declined due to health reasons? This is where your field marketing office can assist greatly. All carriers have knock-out questions and medications. I would say the next factor would be finances: “Can you afford it?” Now that is the million-dollar question, and you will see great debate around this. At what point should someone rely on aid or self-insure? Again, this goes back to my adage, everyone should hear about it but not everyone will buy. Is something better than nothing? My opinion is yes!

Ritter: With the increased emphasis placed on underwriting, prequalifying a client’s health is crucial. To help brokers maximize placement, we have a brilliant chief underwriter on staff who can help select the right carrier and help place cases. Good field underwriting ensures that the broker’s time is well spent and prevents unwanted surprises for both broker and client.

Understanding client finances, including the ability to pay ongoing premiums, the ability or desire to self-insure, and the amount of assets the client wishes to protect is essential. Understanding the client’s employment and income tax situation can help the advisor direct the most tax-savvy payment method.

Every client has a unique set of circumstances, wants and needs. When brokers have done proper fact finding, we can help them find these value propositions, which close sales.

Albert: As with any product, it starts with knowing your client—not only understanding his financial goals, but also considering things such as age, health and family history. LTCI means different things to different people. Understanding a client’s perspective can help agents present LTCI as a meaningful, easy-to-understand product that is a critical piece of the financial planning puzzle. An agent can also help create a benefit plan that matches a client’s personal needs and budget. Even younger clients are showing a greater level of interest in LTCI as they consider different ways to protect their health and financial futures. LTCI doesn’t have to be an “all or nothing” decision. Remember, when a life-changing event happens, having some coverage is better than having none at all.

Q: What product solutions are helping or could help reduce consumer reluctance to use insurance to address the long term care risk?

Glickman: Life or annuity products with LTCI riders may be helpful in providing a vehicle for self-funding lower cost but higher frequency long term care events. Stand-alone LTCI provides catastrophic coverage, or lower cost solutions for only the long term care expenses.

There are several tax-advantaged ways that stand-alone LTCI can be leveraged:

1) 1035 Exchanges to Stand-alone LTCI: The IRS allows clients to convert deferred tax gains from an existing life or annuity contract into an LTCI plan on a tax-free basis. Despite pre-tax dollars being used for this purpose, LTCI benefits are received tax free and the client may never have to pay taxes on those capital gains. This tax advantage has been available since 2010, yet has not been utilized much since then.

2) Reverse Combo: Stand-alone products have often offered return of premium nonforfeiture options. When term life insurance is added to this product as an additional rider, the cash flows are similar to the life hybrid products, but with more LTCI coverage and, often, higher death benefits for similar or lower premiums. This is due to the inherent inefficiencies caused by the MEC contract rules and tax corridors rules, which are not applicable to the reverse combo.

3) Step-rated COLA: There are standalone LTCI product designs emerging in which premiums can be made much more affordable in early years, only increasing in future years at a slow but affordable level, while the inflation protection continues to increase at a compounded rate.

Hughes: Hybrids and linked benefits seem to lessen the tension when it comes to addressing long term care. I still believe that if you want to solve the long term care risk, then LTCI is the right solution. However, consumers like the “But what if I never wake up and don’t need long term care?” This answers that problem, but rarely have I found that a life without a long term care rider product is less expensive than a comprehensive LTCI solution. I still like to bring up hybrid and linked solutions, as the consumer is more relaxed about talking about death than he is about what happens before we die. We might get sick and need some help—then what?

Ritter: Enabled by state long term care partnerships, matching benefit periods to assets brings about affordable premiums. Short term care plans can get the ball rolling with lower cost and simpler underwriting. Hybrid LTCI linked with life or annuities offers liquidity in return for the consumer self-insuring a portion of the risk. Buying LTCI at work offers convenience and potential tax advantages.

Albert: When LifeSecure entered the market, our goal was to create innovative product solutions that were easy to sell and easy to understand. Having just a few decision points for consumers, competitive pricing and simple features, such as our Benefit Bank and simplified issue multi-life product, have made it easier to introduce the idea of LTCI. Again, carriers must continue to look at forward-thinking, modern approaches to long term care solutions to better meet our customers’ needs.

Aside from products, cultivating a better understanding of LTCI is vital. Groups such as Life Happens are doing a great job at helping consumers understand what’s at stake in long term care situations and how LTCI can help. Carriers and brokers must continue to be advocates for our industry and accelerate efforts year-round to help raise awareness of the risks associated with long term care and the importance of this necessary protection.

Fisher: With the addition of more hybrid and linked planning solutions to traditional choices, suitability becomes a key element in deciding which program is best for the client. “Cost-effectiveness” between various products can be opaque, so clarity for agents and consumers hasn’t necessarily gotten any easier. Ultimately, having more choices is better. Agents should avoid the “panacea trap,” where they believe one solution fits all. Differentiating clients by their life stage is a good general rule of thumb, and listening to what they’re interested in will be the key to success.

Q: Partnering with an LTCI specialist is often proposed as a solution for advisors successful with other lines. What suggestions and/or experience can you share about finding and forming a productive relationship with an LTCI specialist?

Hughes: If I could figure this out, life would be grand! This is easier said than done. The advisors who are successful in other lines really don’t want to bother with a product that they perceive as complicated, expensive and often possibly a point of contention when it comes to the relationship they have with their clients. I can’t say as I blame them, but I do think this is something that can prove to be quite successful if the pairing of professionals works out. I do believe the key to success here is expectations. You have to set the right expectations between both advisors. The expectation that not every case is going to be smooth and the expectation that I’m not going to give you my “A” list of clients right off the bat.

Ritter: A large number of brokers with whom we work sell LTCI. However, some brokers tell us they are so heavily focused on their own specialty that they would rather partner with an LTCI specialist. We have been successful in matching up brokers and LTCI specialists. We find that when a broker refers a client to the specialist, the closing rate is very high.

It is essential that the specialist confirm through word and deed that the client belongs to the broker.

It is not uncommon for a broker to write a substantial life or annuity case based on needs uncovered by an LTCI specialist.

Albert: It is important to work with a licensed and LTCI-certified specialist who understands the industry and the comprehensive array of products currently offered. The specialist should also have relationships with at least a few different carriers so the client has options when it comes to underwriting guidelines and product choice.

In short, anyone exploring a partnership should do his due diligence. If you’re looking for a subject matter expert (SME), make sure that he really is a LTCI SME. It’s also important to research the carriers you’re writing with, the type of policies they sell, and to ensure that they work with similar integrity and principles that you bring to your clients.

Fisher: While I’ve always thought that this sort of relationship is a good thing, most brokers I know don’t want any agent to “get their nose under the client’s tent,” so to speak. Also, at this point, I think the day of the LTCI specialist is coming to an end and I’m not sure how many of those who continue in this area are up to speed on the hybrid and linked choices that are out there today. If agents and advisors really want to do the right thing, I believe they should do it themselves or have someone in their office who specializes in long term care planning.

Glickman: The most successful specialists are expert in understanding needs and solutions, and describing them in a simplified and intuitive way to advisors. LinkedIn discussion groups have become a good resource for finding these specialists and vetting them based on their responses. The remaining challenge is splitting commissions in an equitable way, commensurate with the value that the specialists are providing.

Q: What can LTCI specialists do to influence their peers in other lines to address and provide solutions for the long term care risks their clients face?

Ritter: The LTCI specialist must impress upon his peers the importance of incorporating long term care planning into their practices. The problem of long term care funding in America is not going away.

LTCI offers excellent compensation. Since lapse rates are extremely low, renewals can provide consistent revenue for years to come.

Selling LTCI is the right thing to do. A long care event can have a profoundly negative effect on family finances, quality of life and the disposition of wealth. Financial professionals have a duty to discuss long term care planning with their clients, and they must do their best to ensure that the risk is transferred. [AR]

Albert: It’s as easy as opening the lines of communication, whether the goal is forming a partnership or simply promoting LTCI. In order to bring the best solutions forward, brokers need to commit to being collaborative and reaching across the lines of business. Speaking as someone who has held leadership positions in agent trade associations, I know they can also help by raising the profile of LTCI in our trade groups. Considering the growing need for LTCI, which is not going away, we all need to be industry advocates. Starting the conversation and putting the demand for care, caregiver shortages, long term care risks and statistics in relatable terms will make it more tangible for others and raise awareness of the important solutions carriers and agents are offering.

LTCI is a much needed product for many Americans, as we are now living longer than any other generation. If you are not offering this to your clients, then someone else may be. [TA]

Fisher: If a long term care insurance specialist really wants to work with other agents, I think they need to prove that they understand all long term care planning options: traditional, hybrid, linked and annuities. They also need to be very careful not to go beyond the “mandate” that’s been given to them by the referring broker. [BJF]

Glickman: Specialists need to make more of an effort to market their services through speaking and networking opportunities with non-LTCI agents. Education about topics that overlap, such as the benefits and limitations of living benefits, is in great demand and will immediately add value for non-LTCI agents. Also, identifying other sales opportunities such as penetration of the executive carve-out benefit market will help expand the need for specialists’ services. [MG]

Hughes: You really do have to set yourself up as “the resource” when it comes to your peers. They need to see that you eat, sleep and breathe LTCI and keep your finger on the pulse of the industry. LTCI is ever-changing these days, so it is important as an LTCI specialist to be just that—a specialist. Some call it a niche market, but I see it as a specialized field that requires time and energy to stay attuned to what’s happening and how the solutions to the long term care risk can be solved in many different ways. I have found that speaking at local organization meetings with absolutely no intent to sell is a great way to set yourself apart. Be active in your town’s local insurance chapters. Get yourself speaking gigs. Everyone wants to hear about LTCI without being sold. [AH]

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How Can The Industry Engage More Agents And Their Clients In The Long Term Care Risk Discussion?