Carroll S. Golden

The US is experiencing “demographic aging.” In less than two decades, the graying of America will be inescapable: Older adults are projected to outnumber children for the first time in U.S. history.¹ What I refer to as the “Shadow Caregiving System” is complex and comprised of multifaceted relationships, including:

• Heterosexual and Same Sex Couples
• Committed but Not Legally Married
• Long-term Marriages
• Short-term or Multiple Marriages
• International Marriages
• Single Income and Dual Income
• Children, No Children, and Step-children
• Solo-agers

In an aging society, the “Shadow Caregiving System” is quickly growing into a “Shadow Caregiving Economy” with long lasting individual and national economic implications.

Who participates in the “Shadow Caregiving System,” or more precisely asked, who doesn’t? A Merrill, Bank of America Company study conducted in partnership with Age Wave, The journey of caregiving: Honor, responsibility and financial complexity, refers to family caregiving as America’s other social security, noting that family members provide more than 95 percent of non-professional care for older adults who do not live in nursing homes.² No matter how you define family, the “Shadow Caregiving System” is rapidly becoming an all-inclusive club.

The life of a caregiver is a juggling act. It is a unique journey with ups and downs that are both unpredictable and personal. There is a steep and destabilizing learning curve. Caregivers act as information coordinators who must devote time and energy in order to understand the confusing maze of medical and financial complications that develop or change. More than 75 percent of caregivers report substantial out-of-pocket costs associated with caregiving. Paying for care recipients’ household expenses (rent/mortgage, food, home modifications) accounts for about half of these costs; providing support for medical costs (such as medications) accounts for an additional one-fifth.³ Caregivers may also be quietly spending their own money in caring or providing care for someone. According to the AgewaveCaregivingWhitepaper,⁴ 52 percent of caregivers have no idea about the total amount that they have spent to date on caregiving related expenses, including home care, transportation, paying bills, everyday household expenses and even costly medical treatments.

More than 16 million Americans provide care to a person with Alzheimer’s disease or other dementias. Caring for a person with Alzheimer’s disease is not only physically taxing but also emotionally draining. These caregivers provide more hours of care per week and, in many cases, support their care recipient for a longer period of time. They are also more likely to perform medical tasks in addition to running errands, managing finances and, most importantly, keeping their loved one safe and secure. Because of the progressive nature of the disease, Alzheimer’s patients are likely to move through many different levels of care over several years. The caregiver is often challenged with many difficult decisions.⁵

There are now four generations at the workplace who participate in the “Shadow Caregiving System.” According to the US Bureau of Labor Statistics,⁶ by 2031 the majority of the workforce will be comprised of the Millennial (1981-1996) and Gen Z (1997-2013) generations. According to a recent Kiplinger article, millennials are just as worried about their parents’ financial security and about 68 percent of them worry that their parents may not have enough money to live comfortably during retirement. On top of that, 61 percent of millennials polled for this study actually went beyond that to worry that their parents would have to become financially dependent on them instead. Along with GenXers, they are increasingly becoming the caregivers of today and tomorrow.

Looking out to the future, the “Shadow Caregiving System” will rely heavily on fewer family caregivers which could also add to caregivers increased emotional and physical strain, competing demands of work and caregiving, as well as financial hardships. There was a decrease in the number of children Boomers had compared to previous generations. Long-distance caregiving and childlessness among the older population puts Boomers at risk of becoming “elder orphans.”7 For those who have the financial means to hire qualified caregivers, there still remains the chore of finding and monitoring qualified caregivers and handling a care recipient’s complex finances. Without a well thought out plan in place, even once the care recipient is deceased, caregiving can morph into settling their affairs which can be stressful, complicated, and time consuming.

The realities associated with the “Shadow Caregiving System” foretells of a burdensome economic crisis, one has to ask why aren’t more individuals and families planning for extended or long term care needs?

While the reasons are complex due to individual experience, circumstances, and generational attitudes, some general explanations seem to surface:

• America’s youth oriented society contributes to the difficulty of discussing aging.
• Industry challenges and bad press has left many with a narrow view of available options resulting in unfamiliarity with the wider array of current planning options.
• The conversation can be a difficult one unless individuals and professionals know how to introduce the topic in a positive, organized way.
• Professionals may not feel comfortable or capable of incorporating extended and long term care planning or referrals to specialists into their practice.
• There is a lack of general public education about the need to plan for extended and long term care.
• The public lacks valuable information about available research, products, and programs to help individuals, families, and professionals who are, or will be themselves, caregivers or care recipients.
• The misconception that Medicare covers long term care or qualifying for Medicaid is the answer to planning for long term care.
• The public is uneducated about the true cost of extended and long term care.

Funding the “Shadow Caregiving Economy”
Significantly states, in the absence of a federal program, are looking at the impact of current and increasing cost-of-care affecting both their residents and state Medicaid budgets. Currently various states, such as Washington, California, New York, Minnesota, etc., by way of legislation, studies, task forces, committees, and programs, are increasingly dealing with burgeoning long term care issues. Washington is the first state to enact a publicly funded long term care program. The Long-Term Services and Supports Trust Act was enacted in 2019 and created the WA Cares Fund, a long term care insurance benefit to help Washington employees cover the cost of long term services and support both during their careers and after they retire. The Trust Act also created the Long-Term Services and Supports Trust Commission, which works on behalf of Washingtonian employees and Long-Term Services & Supports stakeholders to improve, monitor, and implement the program. Workers began contributing to WA Cares Fund on July 1, 2023. All full-time, part-time, and temporary workers in Washington contribute .58 percent of all W-2 income to the WA Cares Fund unless they have an approved exemption or are in a class of employment that requires them to opt-in or excludes them from the program. After meeting both the care need and contribution requirements, residents can access a benefit of up to $36,500 (adjusted for inflation) to pay for care starting July 2026.

Hospital, nursing home, and care facility challenges, as well as staffing shortages, highlighted in news coverages during the COVID-19 pandemic seem to have only temporarily brought some of the realities and demands of providing for long term care to the attention of the public.

In a 2022 survey, Long-Term Care (LTC) Consumer Planning Study,⁷ OneAmerica collaborated with Hanover Research to engage with consumers to better understand consumer behavior and thoughts regarding long term care planning. Respondents were at least 40 years old, currently planning for the “retirement era” of their lives. Neither they nor any immediate family member works in the insurance industry.

According to the survey, consumers place the highest importance on finances when planning for their own and/or their family’s future. More specifically, they rate having enough to retire (86 percent), eliminating debt (74 percent), and creating liquid emergency funds (68 percent) as most important. Long term care planning (48 percent) is considered a relatively lesser priority.

On the other hand, consumers reported viewing long term care planning as serving multiple purposes, led by avoiding heavy burdens on family members. They cite avoiding devastation of one’s own finances (46 percent) and gaining peace of mind (45 percent) to nearly the same degree as avoiding undue burden on one’s family.

Wait, what? There seems to be a disconnect! While consumers place having enough to retire as their highest financial importance on planning for the future (86 percent), they also acknowledge that future long term care planning is important in order not to devastate those very same finances (46 percent).

Sadly, only a very few consumers seem to make the connection. The consumer study indicates that just under a third (29 percent) have researched long term care planning options, and even fewer (16 percent) have implemented a long term care plan. Despite more and more people in more and more generations becoming a caregiver, or having someone close to them become a caregiver, consumers indicate that the lack of certainty around the need for long term care (34 percent) still shows up as the third-most common barrier to planning for long term care.

This lack of planning is costing consumers plenty aside from the physical and psychological stress which impacts relationships and career advancement. According to AARP’s Valuing the Invaluable 2023 Update: Strengthening Supports for Family Caregivers, in 2021, the estimated economic value of family caregivers’ unpaid contributions was approximately $600 billion—up from the $470 billion estimated in 2017. This conservative estimate does not consider the financial cost of care (out-of-pocket and lost wages) or account for the complexity of care provided (i.e., medical/nursing tasks).

It would seem that now is the time to recognize an opportunity for anyone in the financial services industry to reach out to current and potential clients and offer guidance. However, a follow-up study released in June 2023, Long-Term Care (LTC) Financial Professional Planning Study,⁸ by OneAmerica in collaboration with Hanover Research, found that 46 percent of financial professionals don’t recommend or offer long term care to their clients, an additional 25 percent have recommended it in the past but are no longer doing so, and 21 percent said they never offered it.

If the top two reasons financial professionals sell LTCI are the same reasons clients purchase it—to ameliorate the impact of long term care costs of care on client’s finances and family—then why aren’t more LTCI or other funding options being put in place?

For consumers, according to the 2022 consumer study, barriers include the cost of LTCI itself (53 percent), the cost of medical and long term care-associated support (44 percent), and the slightly less-prominent competing financial priorities (25 percent). Not surprisingly, respondents found stable premiums (94 percent), tax-free benefits (92 percent), and unchanging benefits (90 percent) to be highly appealing. The ability to pass unused amounts to heirs (84 percent) also has widespread appeal. These features likely mitigate concerns about the likelihood of never requiring long term care and/or the desire to avoid undue burden on one’s family.

For financial professionals, the 2022 study found that two-thirds would be more likely to recommend LTCI with lower costs. When financial professionals look to insurance provider websites to stay up to date on LTCI products, they most often seek out information on price (75 percent), as well as the level (66 percent) and length (62 percent) of coverage.

According to the OneAmerica 2023 financial professionals study, tax-free benefits and non-increasing premiums are the most appealing features of asset-based long term care protection. In a recent column posted in LIMRA’s Industry Trends, Investors Becoming More Conservative Amid Concerns of Continued Equity Market Volatility, LIMRA’s research shows investors’ interest in annuities, regardless of the type, has increased over the past five years.

“Financial professionals who are familiar with asset-based long term care showed they understand how it can benefit their clients,” said Jeff Levin, vice president of distribution, Care Solutions, OneAmerica. “It’s part of a well-rounded approach to financial planning.”

The OneAmerica study of financial professionals also offers insights into an ideal long term care protection candidate. Experience with long term care remains a top motivator. Clients with incomes between $100K and $500K who are approaching the traditional retirement age between 55 and 64, those who experience a significant life event (silver divorce, self-selected solo agers, child’s college graduation, inheritance, etc.), or those without family who are able or available to provide care are top candidates.

Consumers are searching general web sites (38 percent), health care websites (29 percent), and insurance provider websites (26 percent). These results provide insight into the most ideal places to reach consumers as they attempt to educate themselves and plan for the future. Are you among the 54 percent of financial professionals who recommend/offer LTCI to clients? If not, now is the time to start!

For those who do not qualify/need additional insurance or annuities, or who have budget concerns, there are less rigorous underwriting and non-insurance funding options that may help consumers to plan. The world of options for extended and long term care planning is expanding with product innovation and updated versions of home equity loans, repositioning of life insurances, specialty products, expanding government and local support and services.

Start the conversation, start the planning. Consumers trust family members most when it comes to discussing long term care options. Financial professionals and consumers alike will benefit by approaching long term care planning as a generational issue with appropriate options for different ages, different budgets, and different needs.

Reference:

1. https://www.census.gov/library/stories/2018/03/graying-america.html, The U.S. Joins Other Countries With Large Aging Populations, Jonathan Vespa, March 13, 2018, revised SEPT. 6, 2018 AND OCT. 8, 2019* accessed July21, 2023.
2. https://images.em.bankofamerica.com/HOST-03-19-0704/AgeWaveCaregivingWhitepaper.pdf p.2 accessed July 21, 2023 Italics added.
3. https://business.bofa.com/content/dam/flagship/workplacebenefits/id20_0905/documents/Financial-wellness-of-caregivers.pdf p.12 accessed July 22, 2023.
4. https://images.em.bankofamerica.com/HOST-03-19-0704/AgeWaveCaregivingWhitepaper.pdf p. 22 accessed July 21,2023.
5. https://fa.ml.com/illinois/northbrook/karraspoplin%20schroeder/mediahandler/media/39465 4/caregiving%20article.pdf Caregiving in the age of longevity: A diversity and inclusion perspective, Cynthia L. Hutchins, February 2021, p.7, accessed July 21, 2023.
6. https://www.census.gov/library/stories/2018/03/graying-america.html.
7. https://www.kiplinger.com/retirement/millennials-worry-about-their-parents-finances Brittany Leitner, June 21,2023, p.
8. https://www.oneamerica.com/newsroom/news-releases/oneamerica-long-term-care-survey-shares-consumers-perspectives.
9. https://oasf.my.salesforce.com/sfc/p/#50000000bbUu/a/Ht000001Lv2U/XssVc8tYoKniuDuW7gd5vDx0VnWmZHYmcLHYXjMHluA.

Faegre Drinker held their Fifth Annual Summit, in-person, at their imposing new offices in Chicago, IL. On Tuesday evening, October 18, 2022, the meeting kicked-off with an informal, fun, and engaging get-together at Pinstripes.

The overall format for the interactive meeting was selective, informative, and fast-moving. On Wednesday, after his welcoming remarks, Steve Serfass, partner, Faegre Drinker, introduced Peter Lucas of Davies and John Sieb of Prudential and invited them to share their views about the most significant issues and opportunities facing the LTCI community today.

Lucas urged that while embracing new concepts and insights, the industry should not lose focus on the basics of good policy and claim administration. Additionally, he spoke to the need for administrative flexibility capabilities so firms can quickly pilot new concepts and integrate them into workflows when proven successful. Looking to the future, Lucas addressed the importance of creating attractive career paths and opportunities for young and mid-level professionals while mentoring them to become the next generation of leaders.

Sieb stressed that proactive block management will create shareholder value by leveraging three key strategic pillars: 1) Data and Analytics—data is the new currency with a data lake being a game changer. All business key decisions are now data driven; 2) Digital TPA—positively impact the quality, control environment, customer experience, brand, and cost to serve; and, 3) Claims Management—Prudential Peak trademark…Rock Solid Solutions for Your Total Wellness and Independence focuses on the goal of keeping policyholders happier, healthier, and more independent at home longer, or to be able to remain at home while on claim. Mental, physical and financial wellness, home and on the go-safety and peak planning and on-claim verticals are the cornerstones of the Prudential Peak Total Wellness ecosystem. Expected outcomes are positive impacts on claims, brand, and customer experience. The overall value of proactive block management is to:

• De-risk the block.
• Maximize lifetime value of the customer through cross selling and attracting new customers.
• Enhance customer experience and brand.
• Keep policyholders healthy and at home.
• Optimization/transformation value.
• Prudent capital management.

Serfass also moderated a second engaging panel focused on significant regulatory issues and opportunities in the long term care insurance industry. The panel included Doug Slape, retired deputy commissioner from the Texas department of Insurance; Jan Graeber who previously worked at the Texas Department of Insurance and is now with ACLI; and Shawna Meyer, president and CEO of North American Life and Health. The panel focused on the regulatory community’s take on the current efforts of the LTCI community to improve the wellness of policyholders, as well as regulators’ views on best approaches to ensure compliance with applicable law as wellness initiatives continue to take shape and move forward.

Following these opening sessions, attendees engaged in small group discussions with an opportunity to share their thoughts with the larger group. This interactive format, followed throughout the meeting, led to valuable exchanges.

Wellness has become a buzz word in the long term care industry. After lunch and networking, Fred Garsson of Saul Ewing LLP presented on rebating and its relationship to long term care insurance wellness programs. The session introduced wellness as the main topic for the next couple of sessions.

The next session provided an overview of wellness programs, noting that they are largely focused on pre-insurance-claim intervention but that services can be provided to healthy, at-risk, and on-claim populations alike. Information shared included ground covered by the LTCI community toward amassing data as to the efficacy of various wellness/aging in place approaches as well as where the community is heading. The panel engaged in an interactive discussion on data analytics and the prospects for improved policyholder engagement and outcomes using wellness initiatives. Char Hu, the CEO of The Helper Bees moderated this multifaceted and insightful session on the state of wellness programs in the LTCI market today. John Palmer from GE NALH discussed company considerations for reinsurers, and Rhett Weiland, vice president, Long Term Care Claims Strategy at Prudential Financial described his company’s approach to creating data lakes and data visualization to interpret results.

Robert Eaton from Milliman discussed wellness program study design and various approaches to analyzing program results. The session was followed by small group discussions and a sharing of ideas with the larger group.

The second panel, The Future of Wellness in LTCi; Untapped Potential was moderated by Nolan Tully, Partner, Faegre Drinker. The panelists shared examples of wellness initiatives, including engagement initiatives, support wellness interventions, and care wellness programs. These initiatives and others under development are likely to play a significant part of the long term care insurance conversation for years to come.

Day One closed with an interactive group discussion, led by Matthew Capell, LTCG, followed by an outstanding reception and dinner.

On Thursday, October 20, the day’s meeting began with a two-part session about litigation that the industry can expect as wellness initiatives mature. The panelists explored what carriers and vendors can do to reduce the risk/incidence of such litigation and position their companies to defeat any litigation that arises.

The first session featured panelists Amy Kline of Saul Ewing, and Steve Brogan of Faegre Drinker, who focused on rate increases and claims.

Part Two included panelists Christie Conway of AssuriCare, Jeff Ferrand of LTCG, and Jessica Gallagher, of Faegre Drinker. Numerous examples and supportive information on anti-fraud litigation were shared.

Next up was a newer development in LTC coverage—publicly funded long term care programs. Stephanie Moench of Oliver Wyman and Carroll Golden of NAIFA reviewed the Washington Cares Trust and the feasibility study in progress in California being conducted by the CA Long Term Care Insurance Task Force. The discussion, led by moderator Chris Petillo of Faegre Drinker, also touched on the potential impact of current public option proposals, studies, or programs under consideration by various states and how such options may create opportunities and challenges for insurers.

The theme of newer developments was carried forward in the next panel discussion.

Panelists Loida Abraham of Reframe, Courtney Colby of Thrivent, Maureen Lillis of Independent Living Systems, and Ramona Neal of Living Benefit Review, discussed where the industry may see LTCI products and long term care services head. From new product to new health care initiatives, to improved advisor training, the industry is seeing renewed interest in providing additional options and wider distribution of LTCI choices. The necessity of thorough and in depth advisor/agent education will be essential to the successful distribution of new product.

The conference closed with comments from Nolan Tully of Faegre Drinker, who likened the conference as a precursor to the annual ILTCI conference held in the Spring. Steve Schoonveld, chair of the March 12th-15th conference, provided a quick glimpse of what to expect in Denver. Conference planning is progressing nicely with preparations for record attendance by exhibitors, sponsors, and attendees. The sessions are nearing full development with the general sessions focusing on behavioral finance, asking how consumers choose to purchase long term care insurance and their expectations for care as they age. For more information please email Schoonveld at [email protected] or go to www.iltciconf.org. Registration is open and exhibitor and sponsorship opportunities are still available. Given the brain trust in attendance during the two days, the open debates, the professional diversity of the attendees, the exchanges of ideas and concepts, we rest assured industry professionals are determined to support and engage in a brighter LTCI future.

One of the highlights of the NAIFA IMPACT WEEK: LTC was the session with Hybrid Life + LTCI business leaders. The discussion included which technology apps or programs create an impactful “virtual kitchen table” feel for the client. For the advisor/agent, who places his business through a technology savvy broker or general agency, the surge of forward-moving technology, accelerated by the pandemic, is a “Win Win!” The moderator and speakers all got an early start in building proprietary in-house software as well as deploying off the shelf applications resulting in better client fulfillment processes and better agent support.

They each share insights on how specific technology, apps, and processes can enhance your business model, make it more profitable, expand your client base, render it more client centric, and introduce new efficiencies to both new and seasoned advisor/agent practices.

Moderator: Ryan Pinney, president, Pinney Insurance.

Panelists: Steve Cain, sales and business development leader, LTCI Partners; Marc Glickman, FSA, CLTC, founder and CEO, BuddyIns; and, Max Schmitz, vice president of Marketing and Sales, DI & LTC Insurance Services.

To listen to the full presentation, and find the contact information for the moderator and panelists, free access is available at lecp.naifa.org under the Events tab.

Ryan Pinney opened the session by noting that the future will hold a lot of “unpacking of technology.”

Steve Cain shared that his firm uses the CRM Hubspot on the front-end to capture targeted leads from potential clients who attend the firm’s webinars and presentations. Steve’s advice, “Have a sense of humor when reaching out to new clients; ‘No, we are not stalking you! But we saw that you downloaded this form.’” Steve’s firm also uses SmartOffice on the back-end to ensure efficient processing. LTCI Partners is continually investing in technology. By investing hard and soft dollars in their organization, they assure their firm’s ability to evolve which ultimately benefits the advisors/agents that LTCI Partners supports.

Ryan Pinney agrees. Most advisors/agents do not specialize in back office processes. He admits to having a “scattered mindset.” (Don’t we all wish we could have such a brilliant scattered mind!) The “technology stack” you create, he says, is your “secret sauce.”
Marc Glickman noted that “What’s in your technology stack” should include execution and implementation tools. Marc’s objective is to educate and activate the audience. He employs Active Campaign to nurture, analyze, and attract clients. His firm, BuddyIns, wants the time the client spends to be productive so the client wants to reach out. Marc presents monthly webinars using an open platform model offering education from various specialists on a variety of topics.

Max Schmitz’s home grown technology was born out of frustration. He kept it simple and affordable. Max built an e-app before the carriers were ready to accept them. Why? Because he wanted to address the frustration both advisors/agents and clients felt when facing pages and pages of paperwork. Not only did his e-app create a more efficient process with less errors and missed signatures, but it created a more user friendly feel. Max wanted to take the burden of volume of paperwork off the table, so at Max’s firm, DI & LTC Insurance Services, he created a process that was “less scary.” His aim is to focus on an advisor or agent’s target market and think about how to make buying and selling less complicated and time consuming.

LTCI Partners specializes in supporting the “occasional producer” (financial advisors and benefits brokers). Today, we all have an “Amazon” delivery mentality. Technology is the answer to creating a less painful process aligning with today’s consumer’s comfort level and expectation of the ease of doing business.

Ryan asked the panel to address: “How are you helping advisors/agents benefit from sales tools and fulfillment processes?”

At BuddyIns, Marc suggests using a simple tool that leads to greater productivity and is not expensive. Calendly is today’s virtual scheduling assistant.

The myth, Max added, that only very technology savvy advisors/agents can survive the increasing creation and dependency on technology is “Not true. There is no barrier to entry.” He encourages agents/advisors working with his firm to maintain their style and use technology to build camaraderie. A drop ticket allows his firm to not only screen and scrub the app but to also see if there may be a better fit or carrier for that consumer.

Tom Riekse, who leads LTCI Partners’ marketing and technology efforts, like Max, has led the building of programs and applications in response to evolving support needs. The message is “Let us do the detail work. You do the thing you do best—sales.” They use a HIPAA compliant “Turbo Tax” style underwriting application to screen clients and, depending on the case, a fillable Docusign PDF or carrier’s e-app. It’s whatever works best for the advisor/agent who brings in the case. Another significant ask that Steve feels would benefit all brokers and general agencies would be a consumer friendly illustration that allows agents to compare multiple solutions from multiple carriers. It would be a step in the right direction by educating consumers about various options. Moreover, creating a consistent comparison that aids in selecting the best fit for a client’s individual situation, and which the advisor/agent can retain along with his discussion notes, will help him/her to feel more confident that the “clients best interest” requirement has been met and documented. Price need not be the deciding factor—clearly illustrating and documenting suggested options would help brokers, advisors, and clients.

Given the opportunity for a redo, Ryan asked, “Would each of you pursue integrating technology in your firm given the investment and learning curve?”

“In a heartbeat,” Steve responded. “For example, it has helped with the placement rate by as much as 20 percent.”

For his part, Marc feels employing technology aids has made the industry move toward a more “Amazon” type experience. You can have multiple people on a single call and multiple people paid on a single case. It also allows for mass education as opposed to one-on-one.

Then Ryan asked, “What is the one tool that would benefit someone new to the business?”

Marc called out Zoom webinars to build a new advisor/agent’s client base.

Max spoke about the importance of approaching the topic as a conversation, keeping products and processes in the background. Like NAIFA, where the focus is on helping expand the middle America marketplace, Max suggests that technology, as a tool, helps us to reach that wider audience. Technology can make business more profitable for the agent so he can afford to reach out for lower premium cases. “Do the math!”

Ryan pointed out that using virtual technology, such as Zoom, allows him to drop off of one meeting and seamlessly move onto the next. It returns real, productive time to Ryan that was previously eaten away by driving to and from meetings.

Generally, all the speakers agree that virtual meetings will not disappear as we get a better handle on vaccines to tame the pandemic. Previously, we all experienced “missed” productivity caused by schedules, travel time, clumsy processes and no-shows. Now, by embracing technology tools and services, we can experience the “gains.” Each of these brokers are able to support individual client calls and group advisor/agent calls thus eliminating the expenses attached to covering that same ground before technology became mainstream. Based on who they support, each firm has selected technology driven processes, programs, or created them to increase sales and process business in a less cumbersome manner. All four are moving in the direction of attracting younger advisors/agents by creating an environment attractive to them and their target market.

As Steve reminds us, for the occasional producer, LTCI is a second language. But now technology allows specialists to “join the conversations and do the translating.”

At the end of the day, the extended and long term care industry still needs a mainstream campaign to educate and to re-educate. Some, if not most, carriers have started to speed up the adoption of technology improvements and show interest in becoming more innovative. What else can we do with creative technology developments, time saving applications, and innovations to grow the industry? We will invite this moderator and panel back for NAIFA IMPACT WEEK: LTC next November 2-4, 2021, and see what has changed.

The NAIFA IMPACT WEEK: LTC’s second day opened with a session moderated by a well-known broker/advisor who, along with our panelists, specifically designed the session to engage both long term care specialists and non-specialists in growing their business.

As we can all agree, many consumers are now very aware of quality of care issues. What can you do to increase your sales and customer satisfaction? What information do you need at your finger-tips for your current and future clients? Highlights of this rapid fire session include an overview of long term care planning solutions, resources that top insurers are creating to respond to heightened advisor/agent opportunities, and techniques and tools that respond to increased consumer awareness. The participants took a closer look at technology and how it affects:

• expanded selling/buying opportunities
• the agent/consumer experience
• underwriting requirements and processes

What about the newest public sector initiative? Best interest considerations are also discussed including fiduciary duty and suitability. The session concluded with a focus on best practices for virtual sales and predictions for 2021 and beyond.

Moderator:
Steve Cain, Sales and Business Development Leader at LTCI Partners.

Panelists:
Ryan Bivens, National Sales Manager, Long Term Care, Pacific Life;

Tracy Edgar, Vice President of Sales, Care Solutions, OneAmerica;

Brandon Heskett, National Sales Vice President—SecureCare, Securian Financial;

Tony Massenelli, CLTC, MBA, CBC, Director Long Term Care Sales, Nationwide.

What is out there to help advisors become more educated? During this session, each panelist offers where and how to access suitable advisor/agent resources, including tips and practical advice developed in the field. Significantly, each insurer is creating more and more basic education targeted at today’s consumers…an educated consumer is your best prospect!

Marketplace update. What is changing and what is not? Listen for insights about the growth or lack of growth in various distribution channels. And with an eye to the future, where are the growth opportunities?

What did our panelists reveal about today’s underwriting process? With so much personal information generally searchable and available, which insurers are looking to technology not only to simplify the process but to speed things up—start to finish? Is there only pass or fail underwriting, can clients pivot, has technology and the lack of personal contact led to simplification of the actual process?

Another insightful discussion centered on how to engage younger clients. There are several good suggestions offered during the exchange. How about the “gap” approach? We also heard about how younger clients are approaching extended and long term care by using a “stacking” approach. Or, maybe you are interested in the “life-stage” approach. Another suggestion included using a “conversion” as a potential solution for the right client. One of the panelists suggested looking for opportunities where clients have maxed out their retirement contributions. Yet another panelist spoke about asset repositioning.

In many ways, LTC 1.0 provided a “painful” learning curve. However, we should not forget that the industry is delivering on promises made. Importantly, LTC 2.0 is based on new actuarial assumptions and has the advantage of historic customer data. As for another development in current extended and long term care solutions, there is the recent public Washington State LTC Trust. Basically, employees will have money taken out of their paychecks to fund a state long term care program. It is a complex issue. While the industry has always considered a public/private option for consumers, we will have to see how this state design plays out.

Meanwhile, the question remains as to what insurers are doing to assist advisors in this highly regulated space. As one of the participants remarked, taking money out of a portfolio to protect a portfolio should not engender a suitability challenge. In response to advisor and consumer middle-market demand, some insurers moved from only a single premium pay option to offering multiple premium payment periods.

The question so often heard, “What’s the Best Fit?” is tackled by the moderator and panelists. How will the advisor determine what is most suitable for a client? While all agree that suitability requires a focus on client needs, each participant suggests considerations that may contribute to the overall best fit. Among other suggestions, the participants call out: Age related life-stage issues, death benefit needs, long term care needs, leveraging of resources and/or assets, or legacy planning.

As Steve Cain points out, “We live in this ‘Amazon’ delivery world.” Which insurers were already fast tracking technology solutions pre-COVID and which ones have picked up the pace? The panelists discuss how their company is making the process a better experience for both the advisor and the buyer.

Some 2021 initiatives are revealed. Each insurer is focusing on what they perceive will help customers through the journey. Virtual engagement will continue. Which insurers are expanding education about extended and long term care into retirement planning, family and business protection, and which ones are expanding product innovation to reach more middle-market consumers?

Tony Massenelli points out that “COVID-19 has negatively impacted the occupancy of assisted living facilities, memory care facilities, etc.¹ Meanwhile, demand for home health care has risen sharply.² It’s more important than ever for insurance companies to provide long term care benefits that can be easily accessed for home care or other more secure alternatives including paid care from family members.”

As Steve Cain suggested, “Sometimes less is more.” To one degree or another, we are all experiencing webinar and Zoom fatigue. However, each panelist offered a forward-looking sales strategy that is enhanced by embracing technology. What are these top insurance companies and top producers and advisors doing?

Brandon Heskett from Securian said “Our emphasis is on continuing to evolve our product line to offer consumers more flexible solutions. Right now this means we’re laser-focused on the ability to process business as quickly as possible. Securian Financial developed a toolkit to help guide agents through a remote sales process–starting with a virtual client meeting, then submitting an eApp and finally delivering the policy via e-delivery in states where available. We also launched an online scheduling portal so consumers can proactively schedule their telephone interview instead of waiting to be contacted. And we’re creating more video content to help support and train agents.”

Tony Massenelli from Nationwide said, “We think it is important for advisors to embrace technology. Technology can increase the time advisors have to spend on engaging clients. Everyone is learning virtually—even our children.” Tony also mentioned that any advisor on the session can access Nationwide Retirement Institute where they can find an in-depth program around long term care planning. There is also a downloadable app available.

Tracey Edgar noted, “The need is not going away, it is amplified. At OneAmerica, we will continue to offer social media campaigns. Our initiative going forward is to continue to help advisors connect to consumers in an interactive way.” Tracey suggests, “Having the ‘right, meaningful conversation’ with clients during this especially opportune time. Video conferencing increases the personal touch while we are unable to physically be with clients during the pandemic. We encourage advisors to use ‘pre-underwriting inquiry forms’ and tools that are available. We encourage advisors to look for premium dollars by approaching client needs with a more holistic approach.”

Predictions for 2021 were shared and interestingly they are not all the same!
Steve Cain offered an analogy that many understand. “Whether in a doctor’s office or health care facility, we often see a pain scale or are asked on a scale of one to 10, where is your pain level. Encourage clients not to wait until their pain level is at an eight, nine, or 10!”

Our advice to advisors is much the same. Don’t wait until your pain level is at an eight, nine, or 10. For a more in-depth understanding of where these leading insurers are spending their energy to help you grow your business, go to lecp.naifa.org and click the pop-up ON DEMAND IMPACT WEEK: LONG TERM CARE under the Events tab. Access is free of charge.

References

1. McKnights Senior Living – January 8, 2021, “Pandemic drives senior living occupancy to record lows”. Lois A. Bowers.
2. Jesse Slome, American Association of Long Term Care Insurance Study, AALTCI—November 2020.

The sales and marketing landscape has changed…have you? While many agents and advisors have been “selling remotely” for some years, COVID-19 has driven the importance of being effective up a notch. We will have to learn to create better, more meaningful relationships or turn over a portion of our sales and money under management to transactional apps. COVID-19 has forced both advisors and clients-to participate in, if not to prefer, digital engagement as opposed to face-to-face meetings.

Technology-Driven Client Connections
Personalized, relevant connections will become the differentiator between technology-driven solutions and advisor-driven solutions. Advisors and agents who understand and embrace effective electronic client communication, as well as top-level CRM and marketing automation systems, will lead the way. From the simple to the complex, a modern software-as-a-service (SaaS) Customer Relationship Management tool is your non-verbal personal assistant. This tool speaks directly to you about your most important asset—your client. Choose a system that makes you both responsive and proactive.

Video meetings break down walls between work life and family life. This greater level of transparency and personalization will have long-term implications to client perceptions of needed protections, preferred lifestyles, and the role of the agent/advisor. Some, if not the majority, of your clients may express an interest in continuing to meet “virtually,” so it’s best to perfect your online presence now. Consider if a high-resolution web camera mounted on the top of your computer monitor (as opposed to a built-in laptop webcam) is preferable. We all know a large part of the message communicated and perceived by clients comes from body language and tone. It is for that reason that call center associates are trained to smile—attitude even comes across on the phone. It is difficult to appear professional if you look as if you are sitting in a dark hole due to improper background lighting. Consider using apps that allow you to use one of their backdrops, such as a professional library, or you may want to create your own. The angle of the camera is also very important. You don’t want your audience distracted by an unnatural viewing angle, such as underneath your chin or the top of your head as you read notes. Have you been on a webinar where the screen froze, buffered, or the volume was too low to catch every word? Enough said!

Families Now Keenly Aware of Long Term Care Needs
COVID-19 highlighted that serious illness comes as a part of life—not just as an aging or a longevity issue (although there is that, too!). Historically, it has been challenging for our clients to recognize the extended or long term care “need” and seek a compelling “solution.” Due to the pandemic and ensuing publicity surrounding nursing home, hospital, and facility care issues, all generations have been painfully educated. Now is the time for action!

Grow your business by addressing a top of mind client concern…access and affordability to good extended or long term care insurance and services. Everyone wants to avoid being in a facility when care is needed and instead stay-at-home or age-in-place. Without dedicated funding, remaining at home is often not possible. Moreover, the caregiving chores may fall on family members. This puts your client, as a caregiver, in a role that they may not want to or be able to handle. Being an issue that spans generations may require you to include family members in the planning. Don’t let your client be the one to question why this topic never came up. After all, your client trusts you to be up-to-date on topics of insurance and funding.

Expert Resources for Financial Services Professionals
What if you are not comfortable discussing extended or long term care? Now is an ideal time to get to know a specialist. Kevin Mayeux, CEO of the National Association of Insurance and Financial Advisors (NAIFA), has overseen the development of an extended and long term care Center of Excellence designed to be a go-to resource, available to financial advisors. The NAIFA Limited and Extended Care Planning Center (LECP) was launched in 2019 and includes resources and connections to experts in the field. As the LEPC matures, Mayeux’s vision is for the LECP to grow into a “community” of trusted advisor and agent relationships. Using a variety of communication methods, non-specialists will be able to call upon a knowledgeable extended or long term care specialist. Together, they will better serve the client’s planning needs and better ensure the financial security of the family.

The Center for Medicare and Medicaid Services (CMS) made several one-time allowances to make care more affordable during the COVID-19 pandemic. Rules for Medicare, Medicaid billing, and payments were relaxed. What happens when the immediate crisis passes? Will you have discussed extended or long term care funding needs with your clients? Since many generations have been touched by the issue, will you grow your business while truly offering good generational advice to your client and their family? The word “planning” is in the name LECP for good reason.

What about the right resources? At NAIFA, we have created the right “community” of resources to provide answers and ideas for individual and worksite clients as they tackle the issues they see highlighted in the news! Open to all agents and advisors, the NAIFA Limited and Extended Care Planning Center is ready to help you step up your game. Visit lecp.naifa.org and learn how to become an effective generational advisor/agent by working with specialists who complete—not compete—with your book of business.