University Times

It's official: Pitt will begin providing its employees optional, long-term care insurance at group rates beginning July 1, now that the required 5 percent of eligible staff and faculty have signed up for the plan.

Some 9,600 employees (including full-time and tenured part-time faculty, and regular full-time staff working at least 18.75 hours per week) had been classified as "guarantee issue" employees, meaning they would automatically be accepted for group long-term care insurance — without having to fill out a medical questionnaire — if they enrolled by April 30.

As of Monday morning, about 480 "guarantee issue" employees had enrolled, exceeding the 5 percent minimum required for the plan to be offered here, said James W. Edgerton, assistant vice chancellor for Human Resources.

"I'm guessing that with the activity we've had in the last couple of days, that number is probably going to go up by another 40 or 50 people," he said yesterday.

Just because employees missed the April 30 deadline doesn't mean they can't enroll in the future, even after July 1, the date the plan goes into effect here. But they will have to complete medical questionnaires and could be rejected by Pitt's long-term care insurer, Unum Life Insurance Co. of America.

In the future, new staff and faculty who meet "guarantee issue" standards would be automatically accepted into the plan if they enrolled within 60 days of their hiring dates.

However, current staff and faculty who do not now qualify as "guarantee issue" employees (such as part-time, untenured faculty and staff working less than 18.75 hours per week) but who later meet those standards — say, through promotions to full-time status — would not gain "guarantee issue" status and would be required to fill out medical questionnaires, said Edgerton.

Also eligible for group rates through the University's long-term care plan (although they must complete questionnaires and could be rejected for coverage) are: Pitt retirees, and staff/faculty members' spouses, adult children, siblings, parents (including in-laws) and grandparents (including a spouse's grandparents) ages 18 to 80.

Unum's questionnaire includes, among other things, several "knockout" questions, as Edgerton called them — meaning that applicants are ineligible for coverage if they answer "yes" to any of them. Questions include:

* "Do you use mechanical devices such as a wheelchair, a walker, quad-cane, crutches, hospital bed, dialysis machine, oxygen or stairlift?"

* "Within the last five years, have you received medical advice, been diagnosed or treated by a member of the medical profession or other health care professionals for Alzheimer's, dementia or organic brain syndrome?"

* "Within the last five years, have you received medical advice, been diagnosed or treated by a member of the medical profession or other health care professionals for the disease AIDS?"

Unum also will reject HIV-infected applicants and people with Lou Gehrig's disease, multiple sclerosis and Parkinson's disease. But Unum will not automatically exclude applicants with histories of cancer and heart disease. The full questionnaire can be downloaded from: www.unumprovident.com/enroll/upitt.

Like Pitt's dental and vision plans, the long-term care plan will be employee-paid. It will cost the University nothing except for administrative expenses.

An individual's monthly cost would depend on the person's age and coverage choice. The younger a person is when the insurance is purchased, the lower the cost. Once an employee or family member buys into the plan, his or her rate is locked in as long as payments continue to be made. Rates will not go up as participants age.

Minimum coverage will be for $1,000 per month for one year in a nursing home. Maximum coverage will be for $6,000 per month (with periodic inflation adjustments) for nursing home care as well as total home care, for an unlimited period.

— Bruce Steele