Long Term Care Hypothetical -Client | Family | Web Based Self Assessment

Long Term Care Asset Utilization Modeling

How quickly could long-term care consume the assets you’ve accumulated, and how could insurance change that?

NAIC Long-Term Care Insurance Personal Worksheet

Fillable educational form for discussion and submission. Back to the calculator.

Educational copy of the Long-Term Care Insurance Personal Worksheet (NAIC Model Regulation #641, Appendix B / IIPRC LTC application-form standards). Not a carrier application, not a quote, and not a determination of suitability. Official PDF · NAIC Shopper’s Guide pages 48–51 (PDF). Type is 12-point equivalent. A rule of thumb: if premiums come only from your own income, more than 7% of income may be hard to sustain.

Applicant
Premium information

The premium quoted in this worksheet isn’t guaranteed and may change during underwriting and while the coverage is in force.

Questions about your income

What resources will you use to pay your premium?

Inflation may increase the cost of long-term care in the future.

How do you plan to pay for your care during the elimination / waiting / deductible period?

Questions about your savings and investments

If you’re buying this coverage to protect your assets and your assets are less than $50,000, experts suggest you think about other ways to pay for your long-term care.

Certification

Submission emails the address you entered. This is not an insurance application. A licensed producer and the issuing company apply their own filed suitability standards.