I understand that the Program has a Catastrophic Coverage Limitation, instead of a war/terrorism exclusion. So whats that and how does it affect enrollees?
Only a real catastrophic event that affects such a significant number of enrollees that it threatens to undermine the financial stability of the Program can trigger the Limitation. Both Long Term Care Partners and OPM must agree the event meets this definition. If a catastrophic event triggers the Limitation and the Limitation affects your claim, your Daily Benefit Amount would remain the same, but your Benefit Period would be shortened. Only enrollees who become eligible for benefits as a result of a catastrophic event are affected. Enrollees who file a claim not related to the event are not affected, nor are enrollees who are already on claim at the time. Also, anyone whose claim is denied has the right to an independent third party review of their claim. Long Term Care Partners will restore any benefits reduced under the catastrophic provision if the Program later develops sufficient reserves to cover those reductions. We believe that our Catastrophic Coverage Limitation is much bet
Related Questions
- I understand that the Program has a Catastrophic Coverage Limitation, instead of a war/terrorism exclusion. So whats that and how does it affect enrollees?
- What is the coverage for services incurred in a "disaster" country (e.g., terrorism/war) under the Student Health Insurance Plan?
- What type of catastrophic coverage is available with the REIL Insurance Program?
