| Non-Tax Qualified | Tax Qualified |
|---|---|
| 1. Medical necessity CAN be a benefit trigger | 1. Medical necessity CANNOT be a benefit trigger |
2. Activities of daily living. Two of five ADLs trigger benefits No "90 day" requirement Defined as needing "regular human assistance or supervision" | 2. Activities of daily living Two of six ADLs trigger benefits (continence added) Must certify inability to perform ADLs for at least 90 days Defines as "unable to perform (without substantial assistance from another individual)" |
| 3. Cognitive Impairment Not described as "severe" cognitive impairment Definition does not apply "substantial supervision" test | 3. Cognitive Impairment Described as "severe" cognative impairment Definition applies "substantial supervision" test |
| Non-Tax Qualified | Tax Qualified |
|---|---|
| 1. Nonforfeiture, not required, not offered in most states | 1.Must OFFER a Nonforfeiture option |
| 2. Coordinates with Medicare but pay deductable for days 21-100 | 2. Medicare exclusion Coordination with Medicare is mandatory for reimbursement plans Definition includes: "reimbursable under(Medicare) or would be so reimbursable but for the application of a deductable or co insurance amount", i.e., we cannot pay Medicare deductibles and co insurance. |
| 3. Current ancillary benefits package | 3. Enhanced ancillary benefits package |
| 4. Underwriting and rates Preferred Advantage Preferred and Standard rate classes ClassicPreferred, Standard, Rate classes 2 & 3 | 4. Underwriting and rates Preferred Advantage Preferred and Standard rate classes ClassicUnderwriting same as Preferred Advantage, i.e., Preferred and Standard rate classes |
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