Fin 522 final (mod 3, 4, 5,6,7)
cancelable
*disability contracts have less generous provisions and offer questionable protection
Viatical settlement
*involves the sale of a terminally ill insured life insurance policy in exchange for a percentage of the face amount
MODIFIED ENDOWNMENT CONTRACT(MEC)
* a policy is treated as a MEC if it fails the 7-pay test. --7 pay test is meant to discourage a premium schedule that would result in a paid up policy before the end of a 7 yr period * if a policy is a MEC, it is subject to an income first tax treatment w/ respect to loans and most distributions from the policy. a 10% penalty tax also generally applies to the taxable portion of any loan or withdrawal before age 59 1/2
UL insurance: Surrenders, loand, & withdrawals
* similarly to other policies, the policyowner can access his cash value through surrenders and loans -surrenders are subject to surrender charge -a lower rate is credited to amounts borrowed from the policy *by contrast w/ previous policies, it is also possible to withdrawal a portion of the cash value
duration of benefit period
* the policyowner can choose the length of benefit period *policies w/ short benefit periods do not provide comprehensive protection, but offer important premium savings *availability of medicare, social security, pensions, makes its less important to rely on disability income benefits beyond 65
Any occupation
*"any occupation" is substituted to "regular occupation"
Definition of disability
*2 common def of disability: -OWN OCCUPATION -ANY OCCUPATION *most short term policies use an own occupation def *most long term policies use an "own occupation" for the first 2-3 yrs and an "any occupation" def after
deferred annuities vs. other savings
*A fixed deferred annuity is similar to a CD purchased from a bank. *A variable deferred annuity is similar to an investment in mutual funds *Differences w/ other savings include: -tax treatment(deferred annuities are tax deferred) annuities have additional fees -deferred annuities can provide a death benefit during accumulation period
Ordinary Whole life insurance: policy loan
*A portion of the cash value (90%) is available to the policyowner in the form of a loan *The policy owner has to pay interest on this loan: 2 methods to credit interest are: -using a fixed rate specified in the policy -using a variable rate that is tied by formula to some specific index
Mortality charges
*Mortality charge is higher for men than women and generally increase with age *mortality charge is higher for substandard risks(those w/ poor health) *mortality charge is cheaper when proof of insurability was shown more recently *expense charge is higher when extensive underwriting is necessary *expense charge is higher when distribution costs are high
what are some factors that may reduce the need for individual life insurance?
*Beneficiaries may have other sources of income -Death benefit from group life insurance -death benefit from an annuity or pension -deceased personal savings and asset *As individuals grow older, less human capital is lost upon their death *beneficiaries may become less financially reliant or face lower expenses(kids growing up, tuition paid)
Development of Insurance coverage
*Early LTC policies were subject to criticism and prompted government intervention. Policies offered now are much more comprehensive. • LTC policies are typically subject to two sets of requirements: 1. NAIC has a model legislation which is adopted by most states and tends to be amended every year.(All policies must satisfy the NAIC requirements.) 2. HIPAA specifies requirements that a policy must satisfy in order to receive favorable tax treatment.(Only "qualified" policies must meet the HIPAA requirements.
HIPAA Requirements
*HIPAA requirements for favorable tax treatment: - The only insurance protection provided under the contract is for qualified long-term care services. - The contract cannot pay expenses that are reimbursable under Medicare (with exceptions). - The contract must be guaranteed renewable. - The contract does not provide for a cash surrender value or other money that can be borrowed or paid, assigned, or pledged as collateral for a loan.
Ordinary whole life insurance: Premiums
*If premiums are paid for a period shorter than the insureds life, the an ordinary whole life policy is called -a limited payment life if the premiums are paid only during a specified period(10yrs - 65) -a paid up policy if no further premium pmts are due, but the policy remains in effect
Group coverage: LTC
*LTC is increasingly offered as an employee benefit. main differences: - Eligibility requires that an employee be full-time and actively at work. Coverage may be purchased for other dependents than the spouse (e.g. parents). - Cost is slightly lower than in individual market. - Fewer choices with respect to benefit amounts, benefit duration, and the length of the elimination period.
Annuities Death Benefits
*PURE LIFE ANNUITY: has no death benefit and pmts cease when the annuitant dies *JOINT AND SURVIVOR ANNUITY: pmts continue to the annuitant spouse after the annuitant dies. the pmts to the surviving spouse may be reduced by a given fraction(50%) *GUARENTEE PERIOD: a number of monthly(or annual) pmts are made whther the annuitant lives or dies. after the guarantee period, the beneficiary receives nothing upon the annuitants death *INSTALLMENT REFUND ANNUITIES & CASH REFUND ANNUITIES: pay the annuitants beneficiary the difference between the annuitys purchase price and the sum of the monthly pmts
Annuitization: Fixed vs. Variable
*SIMILAR to immediate annuities, deferred annuities can be either fixed or variable -"fixed" "variable" refers to how the money is invested in the accumulation period
Adverse Selection / Underwriting
*SIMILAR to life insurance, there is an adverse selection problem w. annuities markets. Healthy individuals are more likely to purchase annuities becasue they expect to receive more pmts from the annuity *CONTRAST to life insurance, there is little underwriting done for annuities -generally annuity classifications are limited to age and gender
Length of coverage
*Term can provide protection for 1 yr, 10, 20, or to a specified age(65 to 70) *The face amount of a policy is payable only id the insured death occurs during the stipulated term, and nothing is paid in case of survival *Many term life contracts contain a renewability provision that allows the policyowner to renew the policy
NAIC Model Legislation
*The NAIC Model Legislation requirements can be divided into those that apply to "policy provisions" and "marketing." Here are a few examples of these requirements: -Limitations and exclusions are prohibited, except for preexisting conditions, mental or nervous disorders (other than Alzheimer's), alcoholism and drug addiction, result of war, felony, or suicide, treatment in a government facility or services available from Medicare. - Preexisting conditions can only be excluded for 6 months - Applicants must be given the right to purchase inflation protection and nonforfeiture benefits.
UL insurance: Death benefits
*UL offers a choice of death benefits options. 2 options commonly offered are Fixed face amount only face amount + cash value *to compute the insurance charge in a given period, the insurance company multiplies an insurance rate byt the policys "net amount at risk" *The NET AMOUNT AT RISK(NAAR) is the difference between the death benefit paid by the insurance company and the policys cash value
market for deferred annuities
*Unlike the market for indiv. immediate annuities, the market for deferred annuities is quite important *however, w/ deferred annuities converting savings into an annuity is only an option
Variable Universal Life(VUL) Insurance
*VUL incorporates the premium flexibility of teh universal life policy w/ the policyowner directed investment aspect of variable life insurance -permanent protection -same premium flexibility and death benefit options as UL -The cash value can be invested in various funds and as a result, VUL contracts are subject to SEC regulations surrenders, withdrawals and loans are permitted
what is the need for Life Insurance?
*When an individual dies, their dependents may suffer financially from the loss of deceased human capital *some additional expenses are incurred at death, such as funeral expenses *creditors may not want to lend money if they think that their loans may not be fully repaid at the death of the borrower *Key employee life insurance protects a business against the possibility of a loss resulting from a key employees death
1035 EXCHANGES
*a taxable event usually occurs when an existing insurance policy w/ a cash value is surrendered *however, section 1035 of the internal revenue code provides that replacing one life insurance policy w/ another is nontaxable event when certain requirements are met *policyowners replacing existing life insurance policies should be aware of twisting --agents and brokers may suggest the replacement because they receive a high yr commission
Nonforfeiture benefits
*allow the insured to receive some value if the policy lapses bc the required premium is not paid in the future
Longevity risk
*annuities are meant to deal w/ the risk of living too long and outliving ones financial resources
Beneficiary
*are the person(s) who are entitled to receive death benefits
sick leave plans
*are usually uninsured and generally fully replace lost income for a limited period of time, starting on the first day of disability *apply only to full time employees after probationary period of a few months *reduced level of benefits after an initial period *employees are often credited w/ a number of days per yr, which may be accumulated *Benefits may be conditioned on length of service *coordinated w/ social security benefits
Partial disability
*benefits are common under individual contracts *is usually defined as the inability to perform some stated percentage of the duties of the insured occupation or to perform at such a speed that completion of those duties takes a longer than normal amount of time
Term policy features
*convertibility feature: permits the policyowner to convert or exchange the term contract for permanent insurance w/in a specified time frame, without showing evidence of insurability *term policies are easy to compare becasuse they have a simple structure. market is competitive and consumers look for the lowest price *term policies aare easily replaceable and lapse rates are higher than for other life insurance products
Deferred annuities structure
*deferred annuities are similar to universal life policies in the sense that they work like a bank account where -flexible premiums are deposited -expenses are deducted -interest is credited -the balance of the account can be used to purchase an immediate annuity
how does HIPAA define qualifies long term care?
*defines as necessary, diagnostics, preventive, therapeutic, curing, treating, and rehabilitative services, -- are provided by a plan of care prescribed by a licensed health care praticitioner
Noncancelable
*disability contract guarantee that the policyowner can keep the policy in force by paying the premium and the premium will not increase beyond the scheduled amount specified in the policy
Types of disability insurance
*disability income insurance is typically provided through two separate contracts: -short term disability income insurance(STD): --provides benefits for a limited period of time, usually 6 months or less -Long term disability insurance(LTD), --which provides benefits for an extended period of time. LTD benefits usually start after STD benefits(6 moths) *instead of using short term coverage, some employers use sick leave plans
Own occupation
*disability is defines as the "total inability of the employee to perform each and every duty of his or her regular occupation (some long term policies use material duties instead of each and every duty)
UL Insurance: flexible premiums
*during the policy yr, a minimnum premium is required. afterwards, premiums are flexible and can be increased or decreased(even skipped w/ 2 contraints -the cash value must be sufficient to cover the next 60 days of expense and mortality charges -for the contract to qualify as life insurance for tax purposes, a maximum applies to the premiums that can be paid in the contract
Taxation of employer provided benefits
*employer contributions are deductible as a business expense *employee contributions are not tax deductible *employer contributions are not considered taxable income for the employee *with a fully contribution plan benefits are received free of income taxation(also benefits attribute to employee contributions in a partially contributory plan) *with a noncontributory plan, benefits are taxable income for the employee
Deferred annuities : Death benefits
*feature guaranteed minimum death benefit. if owner dies, their beneficiary will receive the greater of the value of the account and the minimum death benefit *minimum death benefit corresponds to the sum of the premiums paid into the contract. some add interestor increase the death benefit periodically
taxation in annuitization phase
*for fed tax purposes, annuities are classified as QUALIFIED or NON QUALIFIED *purchase price of annuities may be subject to a state premium tax ranging from 0% to 3.%
LTC taxation
*for fed taxation, a qualified LTC contract is treated as accident and health insurance - Self-employed persons may deduct the premiums paid, and persons who itemize deductions can include the cost of LTC services - Employer contributions for group contracts are deductible to the employer and do not result in any taxable income to an employee. - Benefits received under a qualified LTC contract are usually received tax-free by an employee.
taxation in accumulation phase
*for qualified annuities, if certain requirements are satisifed contributionsto these annuities may be wholly or partially deductible form the taxable income of the individual *for non qualified annuities, contributions are not deductible form taxable income
partial disabilities
*generally not covered in short term contract - however coverage may be available in long term contracts
Face amount
*generally the amount paid to the beneficiaries upon the insureds death
disability benefits
*giving a disabled employee a level of income that is comparable to his or her regular earnings encourages absenteeism and diminishes the incentive to return to work *disability income plans replace 50-70% of an employees gross income *short term plans, the replacement rate ranges 50-100%. *long term plans, the prevalent percentages are 60-66 2/3% *benefits subject to a maximum dollar amount *short term plans typically have a waiting period, which is the length of time before pmts begin *typically, there is no waiting period for disabilities resulting from accidents, but there is a 1-7 days waiting period for sicknesses *benefits are paid retroactively when the waiting period is satisfied *for short term policies, the waiting (elimination) period often corresponds to the short term benefits period ranging from 2 yrs to lifetime
Annuity Payments: Equity Indexed Annuity
*guarantees a minimum interest rate and offer some exposure to good performance of stock indexes such as the S&P500 -variable annuities are subject to SEC, equity indexed annuities are not
VL insurance: surrender value
*if the policy owner cancels its policy, he can receive a pmt in cash called surrender value *surrender value is equal to the cash value minus a surrender charge *surrender charge is meant to help the insurance company pay for the high first yr selling and underwriting expenses *surrender charge decreases w/ time and eventually disappears
Ordinary whole life insurance: Surrender
*if the policy owner surrenders its policy, he can receive the policys cash value *there is generally a guaranteed schedule of future cash values *usually, there is no cash value in the first two years of the contract *the cash values must be at least equal to those produced by the method prescribed by law
Group Term Insurance
*important part of the life insurance market is group insurance provided by the employer *benefits are a multiple of earnings; this may not be sufficient for those w/ several dependents *group rates may be lower than individual rates bc of lower distribution costs
Estate Taxes
*in addition to fed income tax, life insurance proceeds may be subject to federal estate taxes. *estate taxes will be payable on life insurance proceeds only if the size of the estate is large enough and if 1. the decedent held an incident of ownership in the policy or transferred it by gift w/in 3 yrs of death 2. the proceeds are deemed payable to the estate
VL insurance: investment options
*insurance companies offer several proprietary funds which they manage themselves *may offer the funds of several other recognized investment companies *the investment return on these funds is reflected in the cash value
Variable Life Insurance
*insurance company must pay the cash value according to a guaranteed schedule *similar to ordinary life except that the risk is shifted to the insured *premiums are fixed and level *the insured is given several investment options and he can decide how to invest his cash value
Annuities vs. Bonds
*investing in annuities should be more attractive than investing in bonds -BC those who die early leave their money w/ the pool and make it possible to increase the annuity pmts to those who survive *However, this argument may be weakened when we consider that the return on annuities may be reduced by additional expenses and death benefit provisions
Non qualified annuity
*is not part of an employer provided retirement program and may be purchased by an individual *a portions of each annuity pmt represents a return of nontaxable investment in the contract -after the investment in the contract is recovered, distributions are entirely taxable
Life annuity
*is payable as long as the annuitant is alive. the person on whose life the duration of the pmts is based is called the annuitant
qualified annuity
*is purchased as part of, or in conjuction w. an employer provided retirement(such as an ira) *distributions form a qualified contract are taxable income
Policy owner
*is the party that owns the insurance contract and that generally has the right to change, renew, or cancel a policy.
benefits for older employees
*length of benefit period may be reduced w/ a graded scale *disability income plans typically include provisions to integrate their benefits w/ other sources of disability income (except from individual disability contracts purchased by the employee) *for short term plans, these sources include workers comp, temporary disability laws, and social security -for long term plans, pension benefits and earnings are also considered
Immediate annuity
*makes the first benefit pmt one payment interval after the date of purchase *can be purchased w/ a lump sum or can be financed in advance w/ a single premium or a series of installment---DEFERRED ANNUITY *we call the financing period the accumulation phase and the annuitization period the liquidation phase
Guaranteed renewable
*means that the policyowner has the right to continue the coverage in force has the right to continue the coverage in force by paying the premium due -Premium can be increased but not on an individual basis
Definition of Disability
*most indiv. contracts use def of disability similar to the group contracts ones. *for long term contracts, the dual def of disability is the norm *partial disability benefits are common under indi. contracts.
exclusions
*no benefits will be paid: - For a period during which the employee is not under the care of a physician - For any disability caused by an intentionally self-inflicted injury - Unless the period of disability commenced while the employee was covered under the contract *Additional exclusions in long-term contracts: - War - Participation in assault or felony - Mental illness, alcoholism, or drug addiction - Preexisting conditions (e.g. 12 months)
Ordinary whole life insurance: Premiums / death benefit
*one potential problem w/term insurance is that premium can become very expensive as the individual gets older *An ordinary whole life insurance policy tries to get around this problem by offering level premiums that are payable until the insureds death (fixed and level)
Annuity certain
*payable for a given period of time (10yrs) and is not contingent on the individual being alive
Ordinary whole life insurance: length of coverage
*permanent insurance provides protection for the rest of an insureds life. *most simple form of permanent insurance is ordinary whole life insurance
Contract provisions
*physician report is usually ecessary to fill claim *most policies include a REHABILITAITON PROVISION to encourage disabled employees to return to work --permits the employees to enter a trial work period of 1-2 yrs in rehab employment. benefits are still provided, but at reduced rate *additional benefits include cost-of-living adjustment (COLA) -- continued growth of pension benefits and payment of medical insurance premiums
duration of benefit period. level of benefits payable
*policies w/ long duration periods are rarely available for occupations that involve physical labor or direct involvement in dangerous processes *insurance companies often require repeated verification that the disability still satisfies the qualifications for benefit eligibility
Importance of long term care planning
*population is aging and proportion of over 85 will increase considerably. portion of elderly w/chronic conditions is also increasing families may not be able to provide care *younger persons may also need LTC bc of handicps, mental conditions, illnesses *nursing home care increases faster than inflation
Premiums
*premiums are level during a coverage period, but increase after each coverage period ends *A scale of guaranteed maximum future renewal premium rates is contained in the contract *Term Premiums are normally set to a level that is expected to be sufficient to cover mortality charges,
Tax treatment of Premiums
*premiums are not deductible form taxable income * however, the employer can deduct group life premiums as a business expense. the first $50,000 of coverage is not taxable income to the employee *if a group plan is contributory, an employees taxable income is reduced by any employee contributions for the entire amount of coverage
Annuity Pricing
*prices can be expressed in terms of an annuity factor which measures how much it costs to receive $1 each yr. at retirement annuity factors typically range from 10-20 *expressed in terms of the benefits available per $1,000 purchase price
Annuity contract
*promises to make a series of pmts for a fixed period or over a persons lifetime
Residual disability benefits
*provide for a replacement of lost earnings due to less than total disability -are usually available after a qualification period
Variable deferred annuities: investment options
*separate account: several subaccounts(mutual funds) are available(stocks, bonds) . these funds cannot be accessed by the insurance creditors *Fixed account: gurantees a fixed rate of return for a given term. money is held in insurance companys general account and is subject to creditors claims *option to purchase riders(additional fee) that protect investors against downside risk --these riders referred to as "living guarnatees"
Ordinary whole life insurance: cash value
*since the policy owner "overpays" in the first yrs contract, the insurance company has more than enough money to pay the mortality and expense costs associated with the policy --referred to as the policys cash value *part of the premium paid by the insured is used to pay for an insurance charge and some expenses. the remainder is deposited into a "savings account"
Disability insurance: sources of coverage
*social insurance programs -OASDI(Social security) -temporary disability laws workers compensations *employer-provided plans -sick leave plans(short term uninsured plans) -short and long term disability insurance *Individual disability income insurance policies
Need for individual insurance
*social security benefits are inadequate for all but lower paid workers.(uses restrictive def of disability) *anyone who earns more than about 30,000 per yr from employment and is not already covered by disability income insurance has a significant need for disability income protection *BC moral hazard concerns, insurers limit the occupations eligible for disability insurance and the level of benefits
Complexity of life insurance
*some contracts feature a savings component and they have to address many investment related issues *Since these contracts benefit from a tax favored treatment, the IRS has adopted some complex rules to prevent the exploitations of life insurance for tax sheltering motives *the insurance company must recover from the consumer high first yr commissions and underwriting expenses
Withdrawals, surrenders, and loans
*tax penalties can apply to withdrawals made before age 59 1/2 *most contract impose a surrender charge. (% of assets)
Individual annuity market
*the US market for individual immediate annuities is small *possible reason is "crowding out" effect --the fact that many individuals already receive annuity pmts from their employers pension plan or from social security --individuals are myopic and they do not realize that their savings may be insufficient to provide for lifetime consumption
when benefits start/ recurring disability
*the elimination(waiting) period can be chosen by the policy owner, typically form 30,60,90, and 120 days -when selecting period, must consider ability to pay bills during elimination period *elimination period may be satisfied either w/ consecutive or noncensectuve days depending on the policy wording *most policies have provisions setting forth a specified period of recovery(6 months)
Death Benefit
*the face amount (death benefit ) is generally level during the policy term *increasing the face amount generally requires a proof insurability *some policies have a face amount that increases or decreases during the coverage period (face amount would decrease for a policy purchased to pay off a mortgage)
in order to be considered for life insurance for income taxation purposes....
*traditional whole life policies must meet a CASH VALUE ACCUMULATION test and unversal life polices must meet a GUIDELINE PREMIUM AND CORRIDOR test *these tests are meant to prevent the use of life insurance as tax sheltering investment vehicles and they limit either the premiums or the cash value *if the cash value increases too much versus the death benefit, some universal policies increase automatically the death benefit to ensure that the tax requirement is satisfied
Tax treament of Life insurance
*usually, death proceeds from a life insurance policy are not taxable income for the benficiaries *the inside buildup(investment income on the cash value) is not subject to taxation as long as it is left inside the policy--TAX DEFERRAL *if the policy is surrendered for cash, the taxable amount is the total surrender value(including loans, but net of the surrender charge) less the policyowners current basis in the policy -BASIS = sum of the premiums paid into the policy * income from loans is not taxable *withdrawals are treated frist as a return of the basis(nontaxable portion). the excess is taxable in the yr of withdrawal
VL insurance: SEC requirements
*vl policies must be registered w/the sec and all sales are subject to the requirements imposed on other registered securities -insurance company must be registered as an investment company
Annuitization / Distributions
*w/ a deferred annuity, various options are available if the owner chooses to annuitize *contract typically require that annuitization start before a given age (70). minimum distributions must be made starting at age 72
Annuity Payments
*w/ conventional annuities, annuity pmts may be fixed or increase w/ inflation *w/ a VARIABLE IMMEDIATE ANNUITY--- annuity pmts are tied to the performance of funds selected by the annuitant -if the funds perform well, the annuity pmts increase -if the funds perform poorly, the annuity pmts decrease -annuity pmts are reduced by various charges
UL insurance: Investments
*while standard contracts credit interest based on the insurance companys investment experience, new contracts called INDEXED UNIVERSAL LIFE INSURANCE cedit returns based on an index such as the S&P 500 - the advantage of these policies is that they guarantee a minimum return - the disadvantage is that they et a cap on the return credited
Group disability income insurance Eligibilty
- Be member of a covered class of employees - Be a full-time employee - Be actively at work - Satisfy any probationary period (generally longer for long-term vs. short-term) - Show any required evidence of insurability - Authorize withholding of any required employee contributions
Universal Life Insurance
- cash value is "unbundled" --functions like a bank account where flexible premiums are deposited, charges and expenses are deducted, and interest is credited -different death benefit options are possible -partial withdrawls from the ccash value can be made w/o surrendering or borrowing from the policy -policyowner can be credited a rate greater than the guaranteed rate
How do annuity prices vary?
- higher when interest rates are low(effect is important, prices increase about 7% for a 1% decrease in interest rates) -higher when annuitant is younger or is female -higher when death benefits are more generous(j&s is more expensive than a pure life annuity) -higher when annuity payments are more frequent -higher when adverse selection is an issue -higher when pmts are adjusted for inflation
*if the death benefit chosen is the "face amount + cash value"
- the NAAR is level over time
*if the death benefit chosen is the fixed face amount,
-the NAAR decreases w/time
Sources other than insurance to finance LTC:
1. Personal financial resources • Disadvantage: can drive to poverty 2. Relatives and friends • Disadvantage: may not last forever 3. Welfare (Medicaid) • Disadvantage: must exhaust assets to qualify 4. Continuing-care retirement communities (CCRC) • Disadvantage: expensive 5. Accelerated benefits in life insurance policies • Disadvantage: reduce benefit payable to heirs
Types of Life Insurance
1. Term Life Insurance 2. Permanent Life insurance -Ordinary whole life insurance -variable life insurance -Universal life insurance -variable universal life insurance
chronically ill individual has to meet the following requirements
1. The person is expected to be unable to perform, without substantial assistance from another person, at least two activities of daily living (ADLs) for at least 90 day --(ADLs: eating, bathing, dressing, transferring from bed to chair, using the toilet, and maintaining continence.) 2. Substantial supervision is required to protect the individual from threats to health and safety because of severe cognitive impairment.
how can cash value be accomplished
1. surrender 2. policy loan 3.withdrawal
VL Insurance: death benefit
investment experience can be reflected in the death benefit *performance in excess of a selected target level will fund increases in the death benefit. below the target requires a reduction the death benefit *there is a minimum death benefit equal to the initial face amount of the policy
Characteristics of Individual Policies
• Applicants can choose an elimination period from a set of choices, which may be as low as 0 days or as high as 365 days. • Applicants can also choose the benefit period from several options such as 2, 3, 5 years and lifetime benefits.
