As announced in last week's paper, a special open enrollment period for long-term care and life insurance and for a new pet insurance program will be held April 21-May 2.

Benefit Services sent a special mailing to faculty and staff at their home addresses describing these coverages and the options available. If you have not yet received that mailing or have any other questions, contact Benefit Services, 607-255-3936, or e-mail benefits@cornell.edu.

We asked Paul Bursic, director of Benefit Services, about some of the details of Cornell's long-term care plan.

Q: Paul, why should faculty and staff consider enrolling for long-term care insurance?

A: Long-term care insurance covers many of the expenses that people incur when they need home care or nursing home care. Staying in a nursing home in our local area now costs an average of $88,600 a year or $242.75 per day. Long-term care insurance helps pay this cost. It also can be used for home-care expenses, making it possible in some cases for an individual to postpone or avoid going into a nursing home at all.

Q: How does long-term care insurance work?

A: When you sign up for long-term care insurance, you are given a set of choices, in terms of what your daily facility-care benefits could be, the length of time you would be covered, and what the lifetime maximum that you could claim would be. So, you can select from maximum daily benefit amounts of $100, $150, $200 or $250 to cover periods of time from three, five to 10 years. CNA translates this choice into a lifetime maximum lump-sum amount, which you will draw from to pay for your eligible expenses, up to the maximum daily amount, until the total benefit amount has been reached.

Q: I'm still young. Can't I put this off for a few more years?

A: You can, but long-term care insurance works like life insurance in that the older you are when you sign up, the higher your premiums will be.

Relevant statistics also show that many people need extended nursing home care at all ages. Catastrophic injuries or illnesses can cause even young adults to require home-based or nursing home care as they recover. Long-term care insurance is not just a program for the elderly.

Q: What is covered by long-term care insurance?

A: Outside of your home, long-term care insurance covers care received in a nursing home, an assisted living facility and hospice. CNA's long-term care program, Independent Solutions, also covers all or a portion of the costs for custodial care that you might receive in your home. Independent Solutions also offers home hospice, adult day care, caregiver training and respite care.

Q: When would I become eligible for long-term care coverage?

A: Once you are enrolled in long-term care insurance, the benefits start covering your expenses 90 days after your licensed health-care provider certifies that you are unable to perform two out of six activities of daily living (ADLs) without assistance or supervision and will continue to be unable to perform then for the indefinite future.

Q: What are activities of daily living?

A: They are, for example, bathing (washing oneself by sponge bath or in a tub or shower); continence (maintaining control and performing associated hygiene); dressing; eating; using the toilet; and moving into or out of a bed, chair or wheelchair. Alzheimer's and similar severe cognitive impairments are also covered.

Q: How would I plan to cover the first 90 days?

A: The first 90 days of an episode of care are not covered by the insurance plan. This cost-sharing approach keeps premiums affordable, but once you satisfy the 90-day waiting period, you do not have to satisfy it in the future. So, it is like a lifetime deductible in your health plan. The costs of these 90 days must come out of your current income or invested assets or both. If you have established a form of tax-qualified health savings account, those funds can be used as well.

Q: Does the CNA plan of long-term care qualify for coverage under the New York State Partnership program?

A: No, it does not. Individual polices that do qualify for the Partnership Program are available from a few insurance companies. The premium costs for such plans are high by comparison to the CNA plan, and many of the Partnership Program benefit provisions are not all that favorable to our faculty and staff.

Q: What would happen if I signed up for long-term care, but after several years decide to drop it?

A: As long as you had been enrolled for three years or more, your long-term care plan would be "frozen," and should you need long-term care, after the 90-day waiting period you would still receive the daily benefits you had signed up for. However, your lifetime maximum benefit would be reduced, either to the total of the premiums you had paid or to 30 times the Daily Facility Care Benefit, whichever is higher.

Q: What if I retire or take a job elsewhere?

A.: Your long-term care insurance would go with you. CNA would bill you for the coverage.

Q: Will my premiums stay the same over time?

A: The only way your premiums may change is if rates are increased for everyone in your age category with the same plan or if your coverage increases to keep up with the rate of inflation. Every three years, you will have the option to increase your coverage through a special enrollment such as the one at the end of this month. Your original premium will stay the same and only the part of the premium that is based on the additional coverage will be based on your age.

Q: What if I choose not to increase my coverage then? Can I increase it three years later?

A: Yes. You may increase your coverage at any time, but unless you increase it during one of the Special Enrollment periods, you will need to go through the process of medical underwriting to demonstrate to the insurance company that you are healthy when you initially purchase the policy.