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Long-Term Care rider
Understanding the
Requirements and Premiums
for the Great American Life®
Long-Term Care Annuity
B1050506NW
A Long-Term Care Rider is designed for healthy individuals who are planning for their future care. As a producer, it’s important to make reasonable efforts to submit qualified applicants. There are some central questions to ask your client that will help determine if this Long-Term Care Rider might be right for him or her. By taking the time to assess a client’s eligibility with this guide and the worksheets noted below, you can speed up application processing time and help your qualified client receive his or her policy in a timely manner.
Discuss the following suitability details with your client to make sure he or she understands this product and what it can and cannot offer: • With your client, review the Long-Term Care Insurance Eligibility Worksheet to complete the questions about medical eligibility.
• Complete the Long-Term Care Insurance Personal Worksheet with your client to help determine if his or her available assets are appropriate for this product. • Talk with your client about their financial plans or needs for long-term care.
If a client does not fit the medical or financial standards set by our company, the application will not be accepted. This brochure should assist you in understanding the process of determining medical eligibility for this rider. For additional details on this product, review the Great American Life® Long-Term Care Annuity product brochure and Product Guide.
Getting Started
Talk with your client about his or her medical history and current medical situation. Keep in mind that clients who have a high risk for long-term care will not be selected. By understanding these high-risk conditions and your client’s history, you can make the application process efficient and prompt. Furthermore, awareness of these requirements will allow you to concentrate your sales efforts on clients who have a good likelihood of being approved for this rider. Please note that medical eligibility, premiums and long-term care benefits are based only on the primary owner designated at the point-of-sale. Medical Eligibility
Applicants will be declined if they require assistance or supervision to perform two of the following Activities of Daily Living: Applicants will be declined if they require assistance or supervision to perform two of the following Instrumental Activities of Daily Living: Applicants will be declined if they use any of the following medical appliances or equipment: Applicants will be declined if they currently use care services such as home health, nursing home or adult day care.
Medications
Any medication (prescription or over-the-counter) taken by your client is significant and must be reported during the medical eligibility telephone call. This guide provides you with the names of some of the medications that most often result in a declined application. This list is not all-inclusive. It’s important to talk with your client about all medications he or she is taking. Review this list carefully, as many medications are sold under various and similar-sounding names.
Medical Conditions, (A–Ch)
While this list of medical conditions is extensive, please take the time to thoroughly discuss medical conditions with your client. Applicants will be declined if they have any of the following conditions: Acquired Immune Deficiency Syndrome (AIDS) • Steroid use at or greater than 10 mg per day Alcohol Abuse/Alcoholism (See Drug/Chemical • Co-morbid condition of diabetes requiring • Co-morbid condition of cardiomyopathy, carotid artery disease, heart valve disease or Amputation that meets any of the following: • Two or more limbs amputated due to trauma • Co-morbid condition of peripheral vascular • One or more limbs amputated due to disease • Symptoms that limit activity or daily activities • Symptoms requiring hospitalization within Autonomic Insufficiency (Shy-Drager Syndrome) • Treated with three or more medications • Treated with one or more antipsychotic Arteritis, (Temporal Arteritis or Giant Cell Arteritis) • Tobacco use within the past 24 months • Co-morbid condition of circulatory problems Cancer that has recurred in the same organ or that • Requires therapeutic medical equipment Cardiomyopathy with any of the following: • Symptoms that limit activity or daily activities • Symptoms that limit activity or daily activities • Treated with four or more medications • Co-morbid condition of Congestive Heart • Steroid use at or greater than 10 mg/day • Co-morbid condition of atrial fibrillation, • Methotrexate use greater than 15 mg/week heart valve disease or replacement, peripheral • Three or more intra-capsular injections in past • Co-morbid condition of coronary artery • More than two replacements/revisions of the Carotid Artery Disease, unoperated in combination • Tobacco use within the past 24 months • Co-morbid condition of stroke, TIA or • Tobacco use within the past 24 months • Treated with four or more medications • Symptoms that limit activity or daily activities Medical Conditions, (Ch–E)
Chronic Fatigue Syndrome with any of the • Co-morbid condition of osteoporosis, scoliosis • Treated with three or more medications • Symptoms that limit activity or daily activities Degenerative Joint Disease (See Arthritis) • Co-morbid condition of depression or • Treated with one or more narcotic medication Depression/Nervous Disorders with any of the • Symptoms that limit activity or daily activities Chronic Obstructive Pulmonary Disease (COPD) • Symptoms requiring hospitalization within the • Treated with three or more medications • Treated with one or more antipsychotic Claudication (See Peripheral Vascular Disease) • Co-morbid condition of chronic fatigue • Treated with three or more medications Diabetes Mellitus with any of the following • Steroid use at or greater than 10 mg/day • Tobacco use within the past 24 months Congestive Heart Failure (CHF) with any of the • Treatment with steroids (excludes inhalers) • Treated with four or more medications • Co-morbid history of circulatory disease, • Symptoms that limit activity or daily activities • Co-morbid condition of emphysema, chronic • Co-morbid condition of cardiomyopathy or • Co-morbid condition of atrial fibrillation, Coronary Artery Disease/Arteriosclerotic Heart Disease (CAD, ASHD) with any of the following: • Treated with four or more medications • Symptoms that limit activity or daily activities • Ongoing symptoms that limit activity or daily Drug/Chemical Dependency (including drugs, alcohol and other chemical dependency) with Degenerative Disc Disease with any of the following: • Requires therapeutic medical equipment • Symptoms that limit activity or daily activities • Treated with four or more medications • Tobacco use within the past 24 months • Symptoms that limit activity or daily activities • Co-morbid condition of Congestive Heart • 3 or more intra-vertebral injections in past • Steroid use at or greater than 10 mg per day • Steroid use at or greater than 10 mg/day Epilepsy/Seizure Disorder with any of the following: • Vertebroplasty within the past 12 months • Treated with three or more medications • Most recent seizure within the past 12 months • Co-morbid condition of osteoporosis, scoliosis Medical Conditions, (F–Pe)
• Treated with three or more medications • Symptoms that limit activity or daily activities • Co-morbid condition of depression or • Treated with one or more narcotic medication Myocardial Infarction (See Coronary Artery DiseaseJ Nephrectomy, Unilateral (Loss of one Kidney) Herniated Intervertebral Disc with any of the Obsessive Compulsive Disorder (See Depression) • Symptoms that limit activity or daily activities • Treated with three or more medications Osler-Weber-Rendu Disease (Telangiectasis) • Treated with one or more narcotic medication High Blood Pressure/Hypertension with any of the • Tobacco use within the past 24 months • Treated with four or more medications • Symptoms that limit activity or daily activities • Symptoms that limit activity or daily activities • Co-morbid condition of degenerative disc • Co-morbid condition of scoliosis or kyphosis Ileitis, Regional, end stage (See Colitis) • Bone Mineral Density T-score of -3.0 or • Vertebroplasty within the past 12 months Pancreatic Insufficiency, chronic or multiple episodes Pancreatitis, chronic or multiple episodes Lymphoma, Non-Hodgkin’s and Hodgkin’s Disease Macular Degeneration with any of the following: • Symptoms that limit activity or daily activities Peripheral Vascular Disease with any of the • Progressive or increasing visual loss • Tobacco use within the past 24 months • Symptoms that limit activity or daily activities Melanoma that has recurred or has spread from the • Co-morbid condition of stroke, TIA or Medical Conditions, (Ph–Z)
• Co-morbid condition of leg ulcers or • Treated with four or more medications • Co-morbid condition of atrial fibrillation, • Steroid use at or greater than 10 mg/day • Co-morbid condition of degenerative disc Polycystic Kidney Disease with any of the following: • Co-morbid condition of osteoporosis, scoliosis • Co-morbid condition of renal failure or renal Stroke (single stroke/TIA) – within the past Polymyalgia Rheumatica with any of the following: Stroke (single stroke/TIA) –with any of the • Requires therapeutic medical equiment • Symptoms that limit activity or daily activities • Tobacco use within the past 24 months • Treated with steroids greater than 10 mg • Co-morbid condition of diabetes or glucose • Co-morbid condition of Congestive Heart • Symptoms that limit activity or daily activities • Treated with four or more medications • Co-morbid condition of TIA or ministroke Stroke (more than one stroke/TIA) or one of each • Co-morbid condition of osteoporosis, scoliosis Thromboangitis Obliterans (See Arteritis) Transient Ischemic Attack (TIA) (single TIA) Post Paralytic Syndrome with any of the following: • Requires therapeutic medical equipment • Symptoms that limit activity or daily activities • Treated with anti-Parkinson’s medication Urinary Incontinence with any of the following: • Continual dribbling or complete incontinence • Use of catheter, intermittent or indwelling • Treated anti-Parkinson’s medication • Tobacco use within the past 24 months • Circulatory problems including claudication Vertebral or Spinal Disorder (See Spinal Stenosis) Shy-Drager Syndrome (Autonomic Insufficiency) • Requires therapeutic medical equipment • Symptoms that limit activity or daily activities Weight and Height
Weight issues can introduce problems when treating other conditions such as functional or mobility deficiencies, diabetes, cardiac insufficiencies, etc. Applicants possessing a functional or physical impairment complicated with a height and weight combination outside the minimum and maximum boundaries listed below will be declined. These boundaries apply to both male and female applicants.
Weight Minimum
Weight Maximum
Premiums
Monthly premiums are based on the client’s age, sex, and choice of Daily Benefit Factor and Aggregate Benefit Limit. If your client receives the Account Value over two years (a Daily Benefit Factor of two years), the maximum daily benefits will be greater. If your client receives the Account Value over three years (a Daily Benefit Factor of three years), the benefits last longer, but the maximum daily benefits will be less. Once the Account Value is depleted, Great American Life® will continue to pay a maximum daily benefit, up to an Aggregate Benefit Limit. This means that benefits provided by Great American Life can match (a 200% Aggregate Benefit Limit) or double (a 300% Aggregate Benefit Limit) the Account Value as of the first day long-term care benefits begin.
Premiums are expressed as a percentage of the contract’s Account Value.
Aggregate Benefit Limit: 200%
Aggregate Benefit Limit: 300%
Issue Age
Daily Benefit Factor:
Daily Benefit Factor:
Daily Benefit Factor:
Daily Benefit Factor:
Monthly Annual Monthly Annual Monthly Annual Monthly Annual Monthly Annual Monthly Annual Monthly Annual Monthly Annual
0.024% 0.290% 0.025% 0.300% 0.015% 0.180% 0.016% 0.190% 0.036% 0.431% 0.037% 0.441% 0.018% 0.210% 0.019% 0.230% 0.025% 0.304% 0.026% 0.316% 0.015% 0.184% 0.016% 0.196% 0.037% 0.443% 0.038% 0.455% 0.018% 0.214% 0.020% 0.234% 0.027% 0.318% 0.028% 0.333% 0.016% 0.188% 0.017% 0.202% 0.038% 0.455% 0.039% 0.469% 0.018% 0.218% 0.020% 0.238% 0.028% 0.333% 0.029% 0.349% 0.016% 0.192% 0.017% 0.208% 0.039% 0.467% 0.040% 0.483% 0.019% 0.222% 0.020% 0.242% 0.029% 0.347% 0.030% 0.365% 0.016% 0.196% 0.018% 0.214% 0.040% 0.479% 0.041% 0.497% 0.019% 0.226% 0.021% 0.246% 0.030% 0.361% 0.032% 0.381% 0.017% 0.200% 0.018% 0.220% 0.041% 0.491% 0.043% 0.511% 0.019% 0.230% 0.021% 0.250% 0.031% 0.371% 0.034% 0.403% 0.017% 0.204% 0.019% 0.232% 0.042% 0.499% 0.045% 0.539% 0.019% 0.232% 0.022% 0.262% 0.032% 0.381% 0.035% 0.425% 0.017% 0.208% 0.020% 0.244% 0.042% 0.507% 0.047% 0.567% 0.020% 0.234% 0.023% 0.274% 0.033% 0.391% 0.037% 0.447% 0.018% 0.212% 0.021% 0.256% 0.043% 0.515% 0.050% 0.596% 0.020% 0.236% 0.024% 0.286% 0.033% 0.401% 0.039% 0.469% 0.018% 0.216% 0.022% 0.268% 0.044% 0.523% 0.052% 0.624% 0.020% 0.238% 0.025% 0.298% 0.034% 0.411% 0.041% 0.491% 0.018% 0.220% 0.023% 0.280% 0.044% 0.531% 0.054% 0.652% 0.020% 0.240% 0.026% 0.310% 0.036% 0.431% 0.043% 0.513% 0.019% 0.226% 0.024% 0.290% 0.046% 0.555% 0.056% 0.678% 0.021% 0.248% 0.027% 0.320% 0.038% 0.451% 0.045% 0.535% 0.019% 0.232% 0.025% 0.300% 0.048% 0.580% 0.059% 0.704% 0.021% 0.256% 0.028% 0.330% 0.039% 0.471% 0.046% 0.557% 0.020% 0.238% 0.026% 0.310% 0.050% 0.604% 0.061% 0.730% 0.022% 0.264% 0.028% 0.341% 0.041% 0.491% 0.048% 0.580% 0.020% 0.244% 0.027% 0.320% 0.052% 0.628% 0.063% 0.757% 0.023% 0.272% 0.029% 0.351% 0.043% 0.511% 0.050% 0.602% 0.021% 0.250% 0.028% 0.330% 0.054% 0.652% 0.065% 0.783% 0.023% 0.280% 0.030% 0.361% 0.044% 0.529% 0.052% 0.630% 0.022% 0.260% 0.028% 0.341% 0.056% 0.674% 0.067% 0.811% 0.024% 0.288% 0.031% 0.367% 0.046% 0.547% 0.055% 0.658% 0.023% 0.270% 0.029% 0.351% 0.058% 0.696% 0.070% 0.839% 0.025% 0.296% 0.031% 0.373% 0.047% 0.565% 0.057% 0.686% 0.023% 0.280% 0.030% 0.361% 0.060% 0.718% 0.072% 0.867% 0.025% 0.304% 0.032% 0.379% 0.049% 0.584% 0.059% 0.714% 0.024% 0.290% 0.031% 0.371% 0.062% 0.741% 0.074% 0.896% 0.026% 0.312% 0.032% 0.385% 0.050% 0.602% 0.062% 0.743% 0.025% 0.300% 0.032% 0.381% 0.063% 0.763% 0.077% 0.924% 0.027% 0.320% 0.033% 0.391% 0.054% 0.646% 0.066% 0.793% 0.027% 0.320% 0.034% 0.405% 0.067% 0.809% 0.082% 0.982% 0.028% 0.341% 0.035% 0.417% 0.057% 0.690% 0.070% 0.843% 0.028% 0.341% 0.036% 0.429% 0.071% 0.855% 0.086% 1.041% 0.030% 0.361% 0.037% 0.443% 0.061% 0.734% 0.074% 0.894% 0.030% 0.361% 0.038% 0.453% 0.075% 0.902% 0.091% 1.100% 0.032% 0.381% 0.039% 0.469% 0.065% 0.779% 0.078% 0.944% 0.032% 0.381% 0.040% 0.477% 0.079% 0.948% 0.096% 1.158% 0.033% 0.401% 0.041% 0.495% 0.068% 0.823% 0.083% 0.995% 0.033% 0.401% 0.042% 0.501% 0.083% 0.995% 0.101% 1.217% 0.035% 0.421% 0.043% 0.521% 0.074% 0.894% 0.089% 1.069% 0.036% 0.427% 0.044% 0.533% 0.088% 1.055% 0.107% 1.290% 0.037% 0.449% 0.046% 0.553% 0.080% 0.964% 0.095% 1.144% 0.038% 0.453% 0.047% 0.565% 0.093% 1.116% 0.113% 1.362% 0.040% 0.477% 0.049% 0.586% 0.086% 1.035% 0.101% 1.219% 0.040% 0.479% 0.050% 0.598% 0.098% 1.176% 0.119% 1.435% 0.042% 0.505% 0.051% 0.618% 0.092% 1.106% 0.107% 1.294% 0.042% 0.505% 0.052% 0.630% 0.103% 1.237% 0.125% 1.508% 0.044% 0.533% 0.054% 0.650% 0.098% 1.176% 0.113% 1.369% 0.044% 0.531% 0.055% 0.662% 0.108% 1.298% 0.131% 1.581% 0.047% 0.561% 0.057% 0.682% 0.104% 1.253% 0.123% 1.484% 0.047% 0.563% 0.059% 0.706% 0.113% 1.366% 0.138% 1.667% 0.049% 0.594% 0.061% 0.728% 0.110% 1.330% 0.132% 1.600% 0.050% 0.596% 0.062% 0.751% 0.119% 1.435% 0.145% 1.752% 0.052% 0.626% 0.064% 0.775% 0.117% 1.407% 0.142% 1.715% 0.052% 0.628% 0.066% 0.795% 0.125% 1.504% 0.152% 1.837% 0.055% 0.658% 0.068% 0.821% 0.123% 1.484% 0.151% 1.831% 0.055% 0.660% 0.070% 0.839% 0.130% 1.573% 0.159% 1.923% 0.057% 0.690% 0.072% 0.867% 0.129% 1.561% 0.161% 1.947% 0.058% 0.692% 0.073% 0.884% 0.136% 1.642% 0.166% 2.008% 0.060% 0.722% 0.076% 0.914% Daily Benefit: 2 years
Daily Benefit: 3 years
Daily Benefit: 2 years
Daily Benefit: 3 years
Application,
Aggregate Benefit: 200%
Aggregate Benefit: 200%
Aggregate Benefit: 300%
Aggregate Benefit: 300%
Application Process
You can help your client understand what to expect during the application process. Review the application process shown below for the annuity and rider, and discuss these expectations and processes with your client. Note: States may require that your client receive or sign additional items. Here’s what your client can expect: Review the following items with your client:
r Great American Life® Long-Term Care Annuity Brochure r Things You Should Know Before You Buy Long-Term Care r Long-Term Care Insurance Potential Rate Increase Disclosure Form Have your client complete and sign the following items:
r Long-Term Care Insurance Personal Worksheet r Long-Term Care Insurance Eligibility Worksheet Please note: If your client answers “yes” to any questions on the Eligibility Worksheet, the application will not be approved for the rider. What happens next:
• After the completed application is received by the Great American Life Home Office, your client will be contacted via telephone within 36 hours at the time requested on the application. Your client will be asked questions about his or her medical history • After completing the telephone medical eligibility interview, the application will be reviewed • Within two weeks of submitting the application to Great American Life, we will let you and your client know if the application for the Long-Term Care Rider has been approved.
If your client is denied for this Long-Term Care Rider, we can still issue the annuity contract.
If you have questions about this annuity, rider or medical eligibility, please contact a Sales Advisor
at (800) 438-3398, ext. 17197.
For use with contract forms P1030705NW and P1030805NW and rider form number R1030905NW. Contract form numbers may vary according to the state in which a contract is sold. Products not available in all states. A subsidiary of Great American Financial Resources®, Inc. www.galic.com
Copyright 2006 by Great American Life Insurance Company®. B1050506NW
For Producer Use Only • Not for Consumer Distribution

Source: http://www.annuity1.com/as_palette/docs/galic/galic_ltc_producerguide.pdf