Underwriting

Contacts

MassMutual underwriting – 888-505-8952 (agency #064); status@ltcmassmutual.com; 7am-5pm Pacific

Ash Brokerage underwriting (MOO/SL) – Michelle Fairhurst 800-589-3000 (ask for LTC pre-screen); michelle.fairhurst@ashbrokerage.com; 7am-6pm Eastern

Note: 40% of applications submitted to MassMutual are declined because the agent did not do a thorough job pre-screening the client. We feel it is beneficial to you and the client to spend a little extra time up front collecting health information and talking to underwriters, if needed. Completing applications and waiting for them to go through underwriting can take 8-10 weeks. Please review this section for information on the pre-screening process. Due to recent changes in the LTCi industry with carriers restricting applications from clients who have been previously declined, it is even more important to do our underwriting due diligence.

Use the Client Intake Sheet discussed on the Phone Consult page. This form will help you summarize the client's health profile(s). Explain to the client that underwriting for this product has gotten very difficult so we want to make sure we gather the information to match them with the best carrier possible for their situation.

MassMutual has three health ratings – Ultra, Select and Preferred. Ultra is the best rate and comes with a 10% discount. Select is the base rate and what we quote most people, unless we can see they should be quoted at the bottom rate. Preferred is the lowest rating before being declined and comes with a 25% markup from the Select rate. If the client's profile is really clean, let them know their price may come back lower. Mutual of Omaha's ratings are Preferred, Select, and Class 1 (same price variations from Select).

MassMutual (MM) has an online underwriting guide, including height/weight chart on FieldNet (New Sales/Long Term Care Insurance – the Overview section has a link to Field Underwriting Guide). You can save this page to your 'My Links' folder for quick access (click on the icon with the green + to the left of the printer and follow the prompts). For ease of access, we've included the height/weight chart here.

When a client has a combination of issues that is when things get tricky. When in doubt, call or email MM or Ash to pre-screen the applicant. Provide an overview of the client's health profile (no need to give names). They may ask questions that you don't have answers to. Make a note of these to ask the client. If you email MM, use their Pre-Screen Checklist. It may take 24-48 hours to get feedback if you send an email.

If the client's health profile does not look favorable for coverage with MassMutual, check the underwriting guides for Mutual of Omaha (MOO) Secure Solution and State Life (SL) Asset-Care.

Here is an overview of how each carrier looks at a prior decline:

Here is an outline of common conditions we run into:

Negative Decisions

If the client is rated below what you quoted or declined, consider the option of appealing.

Ask MassMutual to send a WHY letter to the client explaining the reason for the lower rating or decline. When the client receives the letter have them call you to discuss. If they feel the reasons are inaccurate or the records were misinterpreted, they can take the WHY letter to their doctor. The doctor would need to write a letter to MassMutual refuting the points listed and fax/email this letter to you. You would forward the appeal letter to the underwriter who handled your client and ask for reconsideration. This process typically takes 3-5 business days. Here are sample emails for communicating with the client.

If not appealable, consult client/Ash for file sharing

If the client feels the reasons in the WHY letter are accurate so there is no reason to appeal, ask the client if they are interested in having you shop other carriers. Ash Brokerage has a file sharing option with MassMutual. The client completes this authorization form, emails it to you and you email it to Ash. Ash can then review the medical records obtained by MassMutual to shop other carriers and give odds on an improved decision. This process usually takes a couple weeks.

If client is uninsurable

If we are not able to get the client approved with any carrier, we recommend they contact an elder law attorney for alternatives to long term care planning. Direct them to www.naela.org. When they click on Find a Lawyer and enter their zip code, they will get a list of attorneys in their area. Many offer free consultations.