Long-Term Care Policy Holders Drew Record Benefits This Year

The more than $12 billion paid represents an increase of $2 billion over the total claim benefits drawn in 2018.

The nation’s long-term care insurers paid out $12.3 billion in claims during 2021, representing a significant increase over prior years, according to the American Association for Long-Term Care Insurance (AALTCI).

As pointed out by Jesse Slome, AALTCI director, the amount of claimed benefits paid to policyholders grew by approximately $700 million compared to the 2020 payout. According to the association’s annual report of claims paid, the $12.3 billion paid represents an increase of $2 billion over the total claim benefits paid by the industry in 2018.

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“Claim benefits were paid to some 336,000 policyholders,” Slome says. “Some claims amount to small amounts and some can be significant, totaling over $1 million.”

Partly explaining the growth in payments is the fact that the number of individuals paid during 2021 grew by roughly 11,000 compared to the prior year.

“Even if you do a simple calculation, the average claim amount paid out for the year would equal $36,600. And claims can last for several years,” Slome adds. 

The amount reported represents claims for those owning traditional or health-based long-term care insurance. The association report does not include data for those who have purchased a linked-benefit policy. These include life insurance or annuity policies that can also provide payouts for qualifying long-term care needs.

According to data provided by Genworth’s U.S. life insurance division, fewer than 10% of those who will likely need long-term care insurance own a policy. Related data from Northwestern Mutual suggests seven out of 10 people over the age of 60 will face a long-term care event.

What typically prompts a person to decide to inquire about or purchase long-term care insurance is having experienced the need for such care in their own family, according to Northwestern Mutual. Or, perhaps, they are facing a medical issue of their own.

A HealthView Services analysis reveals that an average, healthy 65-year-old male/female couple has a 75% chance of at least one spouse requiring some form of long-term care if each live to their actuarial life expectancies. “Regardless of the type of care required, those who fail to plan for long-term care may face substantial medical bills with few means to pay other than by liquidating assets,” it says.

Plaintiffs Allege ERISA Breach Against Chicago Consultant

A new complaint claims that West Monroe ESOP participants who sold stock in the company did not receive fair market value from company distributions.

Retirement plan participants invested in the West Monroe defined contribution (DC) employee stock ownership plan (ESOP) allege that plan fiduciaries improperly appraised the company at a deflated valuation that undervalued employees’ shares.

According to a complaint filed in the U.S. District Court for the District of Illinois, the plaintiffs claim that Chicago-based digital consulting firm West Monroe violated provisions of the Employee Retirement Income Security Act (ERISA) by failing to act in the interests of participants invested in the company ESOP.

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The plan invested primarily in the stock of West Monroe Partners, according to court documents. The plaintiffs allege that plan participants who cashed out company stock holdings were shortchanged by distributions from plan fiduciaries managing the plan.

As alleged in the complaint, the company was appraised by defendants in April and the value was pegged at $515.18 million as of year-end 2020, or $515.18 per share. The defendants used the April valuation to repurchase almost 28,000 shares of company stock from the plan at the alleged discounted price, according to the complaint, from the accounts of the plaintiff and class members.

“As a result, the defendants cashed the plaintiff and class members out of the plan for well below the fair value of their shares,” the complaint states. “Within weeks, the company would reveal that its stock’s true fair value was almost five times higher than the price the class receive.”

According to the suit, this led to employees who cashed out of the plan to receive well below the fair market value for their shares.  

“The defendants’ April 2021 valuation was neither careful, skillful, prudent, nor diligent, and it grossly undervalued the company stock held in the plan,” the complaint states.

After West Monroe completed the distributions and stock buybacks, the company revealed in October that it had sold 50% of the total shares to a third-party investor, MSD Partners, for a price nearly five times higher than was paid out to retirement plan participants, according to court documents. The suit says the deal valued West Monroe at approximately $2.5 billion, or $2,500 per share.  

“This new valuation did not come out of thin air,” the complaint states. “Long before the deal closed, the defendants’ preparations to sell half of the company would have alerted them that company stock was worth much more than $515.18 per share.”

Additionally, while West Monroe allegedly deflated the value of the ESOP participants’ stock, it enabled the company’s leaders to take advantage of the discount, the complaint alleges. Months before making distributions to employees, the company created an additional avenue for senior leaders to benefit by allowing them to buy additional shares of company stock at the lower valuation.

“The defendants thus allowed the company and its senior leaders to buy more stock at the same deflated price used to cash out [plan participants], just before the company announced the leap in valuation,” the complaint states. “As a result, West Monroe and its senior leaders captured exorbitant profits.”

West Monroe declined comment for this article.

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