Virginia 8 Hour Initial LTC Continuing Education Course

This eight-hour course applies to producers who need to earn their initial certification in order to transact long-term care (LTC) insurance in Virginia. This course will cover key principles and concepts related to long-term care insurance coverage and will discuss a number of important issues surrounding long-term care, including an introduction to the history and concepts related to LTC, what long-term care insurance is and its associated uses, levels of care, eligibility for coverage, settings for care, the Activities of Daily Living, alternatives such as Medicare, Medigap and Medicare Advantage plans, and Medicaid.  

The course continues with a deep look at long-term care policies, including the basics and in-depth material. Elimination periods, general underwriting, benefit periods, tax issues and tax-qualified contracts, agent and insurer responsibilities, replacement concerns, optional benefits and riders are thoroughly explored. Specific sections of the course detail the National Association of Insurance Commissioners Long-Term Care Model Act and its requirements.  

The course thoroughly details Virginia’s Medicaid Medical Assistance program. The course includes all pertinent statutes, rules and regulations encompassing the state’s Medicaid and Long-Term Care Partnership program. In Virginia, the state's Medicaid program is called Virginia Medicaid. It operates under the umbrella of the Virginia Department of Medical Assistance Services (DMAS) and uses the brand name Cardinal Care for its managed care plans.  

The course contains numerous illustrations and graphics to assist comprehension, as well as simplifications of difficult laws and rules. 

The course concludes with a final exam that must be successfully passed in order to receive certification for the course. 

Specifically, the course explores: 

• The history of long-term care coverage, the current state of affairs and statistics related to purchasers and coverage, and the premium costs; 
• What long-term care insurance really is, levels of care such as skilled care and unskilled care, home health and community care, and alternative care methods, like assisted living facilities, retirement complexes, adult daycare, group homes, respite care, the PACE program, and more; 
• The Activities of Daily Living (ADLs), cognitive impairment issues, settings for care including potential costs, corresponding facilities including private versus semi-private care, dementia facilities, adult family homes, nursing homes, and regional differences in the mix of care; 
• Who pays for long-term care, Medicare and Medigaps are explored as well as Medicare Part C Advantage plans and how these plans may be related to long-term care coverage, how Medicare Part D, the Prescription Drug plan, may fit into long-term care; 
• The long-term care policy: the basics of the contract, important terms and definitions associated with coverage, an in-depth dive into the ADLs and Instrumental Activities of Daily Living (the IADLs) and how they may trigger benefits; 
• Underwriting the policy, including personal and family health history, gender, age and current health status, who should and who should not buy long-term care insurance, the extension of benefits provision is detailed, as well as benefit periods and amounts of coverage; 
• Tax concerns associated with tax-qualified long-term care (TQLTC) and non-qualified policies, general provisions, nonforfeiture concerns, long-term care partnership programs and their associated requirements, private long-term care, and inflation protection options and issues; 
• The agent’s responsibilities in transacting LTC, suitability concerns and mandates, protections against unintentional lapse of the policy, exclusions found in LTC policies, a deep discussion on replacement concerns, and marketing and advertising information; 
• Specific and related sections of the NAICs Model Act MDL-641 and how they are related to Virginia’s LTC requirements.This in-depth part of the course details the fine points of the act, and addresses numerous topics and how they are integrated into the state’s laws and rules. 
• Virginia state-specific laws and rules surrounding long-term care, including: 
  • The current state of affairs related to LTC, costs for LTC in Virginia, LTC and Medicaid reform in the state, adoption of NAIC regulations; 
  • Minimum standards for individual policies, licensee training requirements, rate stabilization; 
  • Virginia LTC insurance Partnership Program, its history, why choose a partnership plan and how they work, asset protection, qualifications for partnership plans, reciprocity, waivers, inflation protection mandates; 
  • Medicaid in Virginia and its transformation over time, cost containment, dual-eligible patients, Medicaid criteria, Medicaid payor of last resort, Medicaid eligibility for LTC in the state, programs for those under 65 or disabled, programs for those age 65 and older and for persons of any age needing LTC, and much more; 
  • Asset limits and exemptions/exceptions, home and community-based waivers and eligibility criteria, income and asset eligibility criteria for Medicaid payment of LTC services, countable and uncounted assets, assets of married couples, look-back periods; 
  • The Virginia estate recovery program and examples, estate recovery on partnership plans; 
  • Home and community-based services in Medicaid, Medicare and home healthcare, the Program of All-inclusive Care for the Elderly (PACE),  
  • The interaction between private LTC and Medicaid, LTC partnership plans in Virginia, consumer protections in the state, required disclosures, a deep look at suitability, protection against unintentional lapse, the right to reduce or increase coverage and restrictions on premium increases. 

VA Bureau of Insurance Course ID: 229541