FLTCIP Oversight
The FLTCIP is sponsored and regulated by the U.S. Office of Personnel Management (OPM) and supported by the strength and stability of John Hancock Life & Health Insurance (John Hancock).
The FLTCIP was created by an act of Congress, the Long-Term Care Security Act of 2000 (Public Law 106-265), to serve an unmet health care need for federal civilians, uniformed service members, and certain qualified family members. It is the only employer-sponsored group long term care insurance (LTCI) program that is overseen at the federal level.
| Federal Law | Long Term Care Security Act of 2000 |
|---|---|
| Regulator | Regulated by OPM |
| Contract period | Seven-year contract with the insurance carrier that includes annual performance metrics |
| Premiums | Premiums paid 100% by enrollees |
Continuation of coverage
As part of OPM's oversight, it states in the FLTCIP Benefit Booklet that if the group policy ends, OPM intends to continue FLTCIP insurance coverage by replacing the group policy with another one that will:
- be effective on the day after the group policy ends
- provide coverage that is substantially the same as that provided by the group policy
- calculate premiums based on the same issue ages as under the group policy
In the unlikely event that the group policy ends and there is no replacement policy as described above, the current insurer of the FLTCIP will continue FLTCIP coverage for all existing enrollees.
Financial Strength and Stability
Under the Long Term Care Security Act, each contract with the insurance carrier is for a term of seven years. In May 2023, OPM extended the FLTCIP contract with John Hancock for another seven-year term. Previously, John Hancock was awarded the FLTCIP contract in 2016 and 2009, and co-insured the first FLTCIP contract, bringing significant experience in the LTCI marketplace and some of the strongest financial and claims payment ratings.
Risk fees that are contractually payable to John Hancock to manage investments are set by OPM in the FLTCIP contract, capped and subject to performance metrics. These metrics include requirements for providing outstanding customer service with dedicated representatives, quickly processing approved claims payments, and timely review of applications for coverage.
John Hancock Life & Health Insurance Company financial strength ratings1:
A+
- A.M. Best -
AA-
- Fitch -
A1
- Moody's -
AA-
- S&P -
Claims
FLTCIP enrollees' satisfaction with the claims process is very high, averaging 96%.
There is also added consumer protection built in to the FLTCIP claims process. If your benefit eligibility or claim for benefits is denied by the FLTCIP, you have the right to appeal the decision by first requesting a review by an appeals committee. If the denial is upheld, you may then request a review by an independent third-party. If the reviewer finds that the claim was improperly denied, the decision is reversed and the FLTCIP must pay the claim accordingly.
FLTCIP claims highlights:
Note: Enrollees must first be approved for benefit eligibility before they can receive claims payments from the FLTCIP.
Claims payments
(since the program began)
$2.81
Billion
total claims paid
1.45
Million
total invoices paid
30
Thousand
total claimants
$94
Thousand
average paid per claimant
97%
Approval
for benefit eligibility
These figures are as of December 31, 2023.
Claimant details
(since the program began)
79
average age
57%
female
43%
male
32MO
average time benefits are received
These figures are as of December 31, 2023.
Innovation
John Hancock is committed to developing long term care insurance solutions to meet the changing needs of the federal family. In 2019, the FLTCIP 3.0 plan was introduced, and it includes a first-of-its-kind feature, the Premium Stabilization Feature, designed to help reduce the need for premium increases.