| This is step one to obtaining a personalized quote for long term care insurance.The forms are self explanatory. When completed you will have your daily benefit amount & all other information needed to submit your request for a personalized quote. These forms are for your personal & private use. Print them if possible & use as a worksheet. If you are not able to print them...work with a note pad as you scroll the page or if you prefer we will be happy to e-mail the form. All additional information needed will be requested in the quote form after you complete these worksheets. They will include:
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Determining Your Daily Benefit
STEP # 1
Step # 1 is to determine what dollar amount, after all everyday normal expenses, you would have for self insuring ( the more you will be able to afford on a daily basis the lower your needs for insurance coverage will be. This will lower your cost of LTC insurance premiums). Complete tables # 1, 2 and 3 first. Then go to Table A for a step by step guide.
| Your Assets | Total |
|---|---|
| Checking Dollar Amounts | $ |
| Savings, Money Markets, Credit Union Shares | |
| IRAs, 401(k)s, SEP, Keigh, Lump Sum Payments | |
| Real Estate/Property, Other Than Home | |
| Mutual Funds | |
| Annunities (1) | |
| Life Insurance Cash Values (2) | |
| Stocks and Bonds | |
| Nursing Home Trust (Revocable) | |
| Pre-paid Funeral Expenses | |
| Trust, Depending on Condition | |
| Second Car, Recreational Vehicle, Boat, Etc. | |
| Land Contracts | |
| Limited Partnership | |
| Certificates of Deposit | |
| Other | |
| Total Assets |
| Current Income | Monthly | Yearly | Total Yearly |
|---|---|---|---|
| Salary/Wages Dollar Amounts | $ | $ | $ |
| Social Security | |||
| Pension/Qualified Plans | |||
| Net Rental | |||
| Interest & Dividends | |||
| Land Contract/Mortage | |||
| Other | |||
| Total # 2 |
| Expenses/Standard of Living | Monthly | Yearly | Total Yearly |
|---|---|---|---|
| Housing Dollar Amount | $ | $ | $ |
| Insurance (life, medical, home, car) | |||
| Utilities (gas, electric, phone, cable, water) | |||
| Taxes (state, federal) | |||
| Trips, Second Home, Etc. | |||
| Debt | |||
| Support of Parents or Children | |||
| Gifts, Charitable Contributions | |||
| Food/Medicine | |||
| Auto Expense | |||
| Upkeep on Home | |||
| Clothing/Entertainment | |||
| Total # 3 |
| Total Income, all sources (total from table #2) | $ |
| Total Expenses, all sources (total from table #3) | - $ |
| Amount of Self Insurability | = $ |
| LTC Cost (average is curently $46,000 yr. Locations vary) | $ |
| Amount of Self Insurability | - $ |
| Amount of yearly LTC coverage you need. | = $ |
| Daily Benefit Required (divide yearly amount by 365) | = $ |
You now have your daily benefit requirement. There are other choices you will need to make on the quote form. We have listed the recommended choices below, although your desires may be different. We will assist you in determining which would be best for your situation.Recommendations
Policy Lenght of Coverage:Elimination Period:
- Current age 45 to 69 ..........Lifetime Benefits
- Current age 70 to 79 ..........4 years
- Current age 80+ ........... 2 years
Inflation Factor @5% per year:
- Current age 45 to 69 .......... 0 days
- Current age 70 to 79 .......... 30 days
- Current age 80+ ............ 90 days
- Current age 45 to 69 .......... compound interest
- Current age 70 to 75 .......... simple interest
- Current age 75+ ............... none
to complete quote form.
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 Information@ltcfs.com 235 S.W. 33rd St Cape Coral Fl 33914 |  Need a Website? |
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