SignatureCare

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SignatureCare
LONG TERM CARE INSURANCE
SignatureCare®
Designed to Fit You and Your Lifestyle.
INVEST
INSURE
RETIRE
LTC4500
Coverage provided by Policy Series MM-400-P et al. (In ID, MM-400-P-ID, in PA, MM-400-P-PA through MM-405-P-PA, and in NC, MM-400-P-NC). Underwritten by Massachusetts Mutual
Life Insurance Company of Springfield, MA. Policy provisions and benefits may vary from state to state and some of the benefits illustrated here may not be available in your state. Please
refer to the special supplement (if applicable) enclosed with this brochure to describe any variations for your state. Your Outline of Coverage will provide you with a brief summary of
coverage, but only the actual insurance policy contains the governing contractual provisions, exclusions and limitations.
The information contained here is being provided with the understanding that it is not intended to be interpreted as specific legal or tax advice. Neither Massachusetts Mutual Life
Insurance Company nor any of its employees or representatives are authorized to give legal or tax advice. Individuals are encouraged to seek the guidance of their own personal legal or
tax counsel.
Picture the Possibilities
You’ve worked hard over the years.
Now is the time we can answer the ‘What-Ifs’ –
And you’ve probably set aside quite a bit of money for
What if I wrote that novel I always dreamed of writing?
retirement, perhaps even considerable wealth.
You’ve done so because you know that in order to fund your
active lifestyle, you are going to need every penny of it.
As many of us know, we are only now just peaking. Sure, our
knees may not be what they used to, but all in all, we are ready
for, and looking forward to, all that awaits us.
What if I took on that volunteer work I’ve always felt was
somehow my duty – and give back to the community?
And what if I finally shot the rapids, or ran that marathon, or
hiked the Rockies?
What if….?
This point in our lives gives us a wonderful opportunity to go
back over our past and, with 20/20 vision, look at the choices
we’ve made. What would we do over? What would we do
different? We have the chance to live a little differently, to live
a little better, and to live a lot for ourselves. The choices we
make today, finally, are choices we make just for ourselves.
Picture Independence and Self-Determination
While we can’t predict that the choices we are going to
Simply put, long term care is a combination of services –
make will all go as well as planned, we can prepare for the
personal care, health, social, and supportive. The goal is to
uncertainties that are sure to be a continued part of our lives.
provide assistance and improve the quality of life of those with
For example, when you reach age 65, you have a 40% chance
of needing some form of long term care.1 Most long term care
needs arise when a person is unable to perform a few simple
Activities of Daily Living (ADLs) without assistance, such as
chronic, long term conditions. Long term care does not seek to
cure a medical condition. And because the risk of needing long
term care increases with age, it is important to plan for your
long term care needs now, while you are healthy and insurable.
eating, bathing, maintaining continence, or getting in and out of
SignatureCare® Long Term Care Insurance is intended to be a
bed. Some, unfortunately, may suffer from other chronic long
tax-qualified insurance product that can help us prepare for
term care needs such as a Alzheimer’s disease or similar
some of these uncertainties – as well as the substantial costs2
cognitive impairment that may require around-the-clock care.
associated with a long term care need.
While considerable support can be provided by family and
When you choose to purchase a SignatureCare long term care
loved ones, the best way to ensure that you receive the type of
insurance policy, you are making the choice to help protect
care you want – in the setting you choose – is an individual
yourself, your assets, your family and loved ones against the
long term care insurance policy from Massachusetts Mutual
major burdens – both financial and emotional – associated with
Life Insurance Company (“MassMutual”) that can help to:
long term care. The following pages describe for you
• Protect your assets and your estate – including your home
our SignatureCare product and the many optional benefits
• Protect your spouse’s standard of living, financial security and
peace of mind
available – choice of care, choice of settings, choice of
premium options – allowing you to choose a policy design
• Support your desire not to become a burden on family and
friends
that fits your lifestyle and your needs.
• Preserve your independence and self-determination, by
allowing you to live out your life as you wish, where you
wish.
1. Health Insurance Association of America: Guide to Long Term Care Insurance, 2002
2. Average annual cost for nursing home care (semi-private) is $57,764.90. Average daily cost for
eight hours of home care is $144.96. Source: MetLife Mature Market Institute, August 2003
SignatureCare® Base Policy
MassMutual’s SignatureCare® Long Term Care Insurance
provides you the freedom to design a plan that works for you
and your lifestyle, while helping you protect your assets, your
family and your future. Policy provisions and benefits may vary
from state to state and some of the benefits illustrated here may
not be available in your state.
BASIC PLAN DESIGN 3
SignatureCare offers two basic plan designs to meet your
personal needs.
Facility Services Only plan4
This cost-effective plan provides benefits for care provided
in Nursing and Assisted Living Facilities. Once you have
satisfied the elimination period and are eligible for benefits,
SignatureCare covers you for skilled, intermediate and
custodial levels of qualified long term care. This policy pays
100% of actual charges incurred, up to the Daily Benefit
Amount you select, for a stay in a Nursing or Assisted Living
Facility. In addition to the Daily Benefit Amount selected, a
Prescription Drug Benefit of up to $100 per month is payable
while you are confined to a Nursing or Assisted Living Facility
and receiving benefits under the policy.
Facility Services and Home and Community Based
Services plan
This comprehensive plan pays 100% of the actual expenses you
incur for both Facility Services and Home and Community
Based Services, up to the Daily Benefit Amount you select.
For additional premium, this benefit provides you with the
independence to receive care in a familiar home or community
setting. SignatureCare reimburses 100% of your actual
expenses up to the Daily Benefit Amount you select, for care
provided by a licensed or certified (where required) home
health care agency, independent home health care provider, or
for care provided through adult day care programs and hospice
care facilities. This benefit also reimburses you for services
provided by licensed or certified (where required) home care
providers including:
➣ Professional Nurse (RN, LPN, LVN)
➣ Physical Therapist
➣ Speech Therapist
➣ Respiratory Therapist
➣ Occupational Therapist
Additionally, we will reimburse you for training provided to
your informal caregiver, up to a lifetime maximum of five times
your Daily Benefit Amount. Should a health emergency arise
while receiving home health care, this plan will also provide up
to $100 per trip for ambulance transportation costs (up to 4
times per calendar year) to or from a Nursing or Assisted living
facility for Facility Services provided under the policy. An
Emergency Response System Benefit is also available to cover
the actual charges you incur for such a system, up to $50 per
month. Both the Emergency Response System Benefit and the
Ambulance Benefit reimbursements are payable while you are
receiving Home and Community Based Services and are in
addition to your selected Daily Benefit Amount.
Regardless of the plan you choose, you have the added security
of knowing as long as you continue to pay your required
SignatureCare® Special Built-in Benefits
UP TO 70% JOINT DISCOUNT
OPTIONAL PERSONAL CARE ADVISOR
If you share a household with someone, SignatureCare offers
a joint coverage policy. If you are both approved, you may
receive up to a 70% discount on the second individual,
depending on your age and the age of the joint applicant. This
joint policy provides identical coverage for each of you. All
provisions of the policy apply to each insured individually
and separately. Joint coverage is limited to spouses in Maryland.
SignatureCare provides you with an optional Personal Care
Advisor at no additional cost to you. This personal service
will provide you with one-on-one consultation regarding your
benefits – whether you have a question regarding your benefits
or you require assistance locating services in your area. Your
Personal Care Advisor will work with you and your family to
make this as smooth a process as possible.
BED RESERVATION
OPTIONAL CARE COORDINATION
This benefit reserves your bed in a Nursing or Assisted Living
Facility should a temporary hospitalization or other absence be
required. We will reimburse you the actual daily charges you
incur up to your Daily Benefit Amount for a maximum of 60
days per calendar year.
After speaking with the optional Personal Care Advisor, and in
the event the insured requests additional care coordination, we
will arrange, at no cost, for a Care Coordinator to contact the
insured to assess and coordinate appropriate care and services;
provide assistance in developing a Plan of Care and assist
with necessary claims documentation. The optional Care
Coordinator will be a registered nurse.
3. State or other restrictions may apply. Premiums may be subject to increase and will vary according to your State and coverage selected.
4. Not available in OR, RI, or VT
premiums, your policy cannot be cancelled. Additionally, there
are no limitations on pre-existing conditions.
BENEFIT ELIGIBILITY
You will be eligible for SignatureCare benefits if, within the
previous 12 months, a Licensed Health Care Practitioner
certifies that:
• You are unable to perform at least 2 of 6 Activities of Daily
Living for an expected period of 90 days due to loss of
functional capacity. This means you require substantial
assistance in at least 2 of the following activities: bathing,
eating, dressing, moving in or out of bed, a chair or
wheelchair, using the toilet or maintaining continence for a
period expected to last at least 90 days; or
• You have a severe Cognitive Impairment. This means you
require continual supervision due to a deterioration or loss of
intellectual capacity. This includes Alzheimer’s disease or
similar forms of irreversible dementia.
The ninety (90) day requirement does not establish a waiting
period before which benefits may be paid or before which
services may constitute Qualified Long Term Care Services.
A Licensed Health Care Practitioner is defined as a physician,
registered nurse, or a licensed social worker.
DAILY BENEFIT AMOUNT
This is the maximum amount your policy will pay on any one
day for Facility Services or Home and Community Based
Services (if elected). Benefit amounts are available in $10
increments to a maximum of $300 per day. Policy minimums
vary by state.
ELIMINATION PERIOD
This is the amount of time you must pay for your care prior
to receiving long term care benefits. You can think of it as
a deductible period, counted as calendar days5 from date of
incurral. SignatureCare offers a choice of 0, 30, 90 or 180 day
elimination periods,6 and once you have satisfied your selected
elimination period, no further elimination period is required for
future benefits.
BENEFIT PERIOD
The benefit period and Daily Benefit Amount determine the
total value of your policy and indicate the period for which
benefits are payable once you qualify. The benefit amount is
determined by multiplying the daily benefit by 365 (the
number of days in a year), then multiply that figure by the
benefit period you elect. Choose the length of benefit period,
including Lifetime, that you think works best for you.
POOL OF BENEFITS APPROACH
SignatureCare provides a pool of benefits approach. This
approach gives you maximum flexibility and customization.
For example, if you use only a portion of your Daily Benefit
Amount, the balance remains available for future services, and
may extend your benefits beyond the benefit period elected. If
you choose a lifetime benefit period then an unlimited pool of
benefits is available to you.
LIMITATIONS AND EXCLUSIONS
Please refer to page 11 of this brochure for Limitations and
Exclusions.
PREMIUM WAIVER
ALTERNATIVE PLAN OF CARE
If you are eligible for benefits, after 90 calendar days5 of
confinement in a Nursing or Assisted Living Facility, we will
waive your premium for as long as you are confined. On a joint
policy, we will waive premiums for both individuals when only
one of the individuals is confined for more than 90 calendar
days.
Under the Alternative Plan of Care, once you are eligible for
benefits, we will work with you and your licensed health care
practitioner to determine if an Alternative Plan of Care is best
for you. The Alternative Plan of Care benefit includes medical
and non-medical services such as environmental alterations for
handicap access or special lifts or ramps. Not available for
providing Home and Community Based Services if your policy
provides Facility Services Only.
RESPITE CARE
Respite Care provides temporary relief to a spouse, friend or
family member who is providing your care. The reimbursement
may be for care provided in your home, a Nursing Facility, an
Assisted Living Facility or through a community-based
program. No elimination period is required. Payment will be
the actual daily charges you incur for services covered under
your policy, up to the Daily Benefit Amount of your policy.
The maximum benefit payable is 30 days per calendar year.
30-DAY FREE LOOK
After you receive your policy, you will have 30 days to review
your SignatureCare long term care insurance policy and all the
provisions you elected. Within this free look period, you may
return the policy to your MassMutual representative or the
company and your entire premium will gladly be refunded.
5. If you receive services at least once during any 7 day period (Sunday through Saturday), 7 calendar days will be counted toward satisfaction of the Elimination Period or the
Waiver of Premium waiting period.
6. 180 day elimination period not available in CT, GA, SD and VT.
SignatureCare® Optional Benefits
At MassMutual, our commitment is to you. Therefore, for
additional premium, we offer a variety of optional benefits to
address such concerns as inflation protection, indemnity
benefits, nonforfeiture and informal caregiver benefits. These
benefits are available depending on the basic plan selected.
State or other restrictions may apply. Please refer to the Outline
of Coverage and any supplement to the brochure in your
application packet for state specific variations.
INFLATION PROTECTION
It may be years before you use your long term care insurance
policy, so you can help to protect yourself against inflation with
one of two inflation protections options:
• Compound Inflation Option – which increases your Daily
Benefit by 5% per year on a compound basis for the life
of the policy, even while you are receiving benefits. Your
premiums will remain the same as your Daily Benefit
Amount increases.
• Simple Inflation Option7 – which increases your Daily
Benefit by 5% of the original daily benefit for the life of the
policy, even while you are receiving benefits. Your premiums
will remain the same as your Daily Benefit Amount increases.
PAYMENT OPTIONS
In addition to a Lifetime Premium payment option, you can
obtain paid-up coverage after either 10 or 20 years. You may
pay the same premiums for either 10 or 20 years, at which
point coverage is contractually paid up and no more premiums
will ever be due.
7. Not available in DE and WI. Referred to as “Simple Benefit Increase Option” in OH.
NONFORFEITURE BENEFITS
MassMutual’s SignatureCare offers two nonforfeiture options
that help provide you with peace of mind if you lapse your
policy or die without exhausting, or perhaps even using, any of
your benefits. You can choose from the following Nonforfeiture
options:
• Full Nonforfeiture Benefit Rider
With the Full Nonforfeiture Benefit, if you die while your
policy is in force, we will pay your beneficiary the total
premiums you have paid regardless of the amount of benefits
you may have received. If you lapse your policy at any time,
your coverage continues in full. However, the new benefit
amount payable is limited to the total of all premiums paid.
Any benefits paid to you after your policy lapses will be
subtracted from the benefit amount. Upon your death, we
will pay your beneficiary an amount equal to any remaining
benefits not paid.
• Shortened Benefit Period Nonforfeiture Rider
If you lapse your policy after it has been in force for at least
three years, your coverage continues in full. However, the new
benefit amount payable is limited to the total of all of the
premiums paid, but never less than 30 times the daily benefit
amount at the time of lapse. Any benefits paid to you after your
policy lapses will be subtracted from the benefit amount.
Benefits will be paid normally until the new benefit amount
described above is exhausted or you die. Upon your death,
there is no return of any unpaid benefit amount.
INDEMNITY BENEFIT RIDER
HCBS FIRST DAY COVERAGE RIDER
With this option, if you qualify for benefits, we’ll simply pay
you your Daily Benefit Amount, regardless of the actual
expenses incurred. This option is not available with the Home
and Community Based Services Monthly Benefit Rider.
This optional benefit allows you to begin receiving benefits
payable on the first day of claim for HCBS regardless of your
policy’s Elimination Period. Not available with Facility
Services Only base plan.
HOME AND COMMUNITY BASED SERVICES
(HCBS) WAIVER OF PREMIUM BENEFIT RIDER 8
LIMITED FAMILY CAREGIVER BENEFIT RIDER
With this option, if you are eligible for benefits and have
received HCBS services for 90 calendar days,9 no premium will
be due following the 90th day. The 90 days do not have to be
consecutive, but must be satisfied during a single claim period.
On a joint policy, we will waive premiums (for both individuals)
when only one of the individuals is eligible for benefits. This
option is not available with Facilities Services Only coverage.
HOME AND COMMUNITY BASED SERVICES
(HCBS) MONTHLY BENEFIT RIDER
This option changes the benefits payable under HCBS coverage
from a Daily Benefit Amount to a Monthly Benefit Amount, up
to thirty one (31) times Daily Benefit. For example, if your
Daily Benefit Amount is $100, this benefit will allow you to be
reimbursed for up to $3,100 per month, rather than $100 per
day. You have more versatility with the timing of your services.
This option is not available with the Facilities Services Only
coverage, or the Indemnity Benefit Rider. Additionally, one of
the Inflation Protection Riders must also be purchased.
This benefit allows a family member to care for you. If you
qualify for benefits, we will pay a benefit equal to 75% of the
Daily Benefit for informal care provided by a family member
not living with you for up to 365 days over the life of your
policy. Once the benefit is exhausted it cannot be restored and
the premium for the rider will no longer be charged. This option
is not available with the Facilities Services Only coverage.
RESTORATION OF BENEFITS RIDER
This option is available if you select a benefit period other than
lifetime. Your benefit period will be totally restored if you
recover and are not eligible for benefits for at least 180
consecutive days. You may restore benefits up to a lifetime
maximum of twice the original pool amount.
PAID-UP SURVIVOR BENEFIT RIDER 10
If you purchase a joint policy and both of the following occur:
1) the end of the 10th policy year; and 2) the death of either
insured; the policy and any attached riders will be paid-up and
no further premiums will be due for the surviving insured. Not
available with limited pay options (10-pay or 20-pay).
8. Not available in CT.
9. If you receive Home and Community Based Services at least once during any 7 day period (Sunday through Saturday),
7 calendar days will be counted toward satisfaction of your 90 day waiting period.
10. Not available in NY.
Picture Your Peace of Mind
You are unique. Your circumstances, responsibilities and goals
receiving high marks from independent rating services for our
for tomorrow dictate your financial strategies today. And today,
financial strength.11 For many years, the analyses and ratings
security should be a major consideration in every financial
from these independent firms have helped consumers make
decision you make.
informed decisions. We invite you to review the ratings assigned
When choosing a SignatureCare long term care insurance
policy for yourself or a loved one, you are also choosing one of
the nation’s premier financial companies – Massachusetts
Mutual Life Insurance Company. MassMutual serves more than
ten million policyholders and participants, and we operate the
to Massachusetts Mutual Life Insurance Company and compare
them to any other issuer of long term care insurance. These
ratings refer only to the overall financial status of the company
and are not recommendations of the specific policy provisions,
rates or practices of the insurance company.
Company for their benefit. As a policyholder, you’ll find that
We are confident that our excellent investment performance,
MassMutual has the financial strength and commitment to
continued operational efficiencies, favorable underwriting
provide the protection and service you deserve.
experience and customer satisfaction pursuits will make your
Founded in 1851, MassMutual is one of the most highly
respected insurance companies in the nation, consistently
choice of MassMutual as your long term care insurance
provider a choice that will help provide you with the security
and peace of mind you want.
11. As of 11/2004
Standard & Poor’s (Rating AAA – Extremely Strong),
Moody’s Investors Service (Rating Aa1 – Excellent),
A.M. Best Company (Rating A++ – Superior) and
Fitch (Rating AAA – Exceptionally Strong)
Massachusetts Mutual Life Insurance Company and its subsidiaries,
C.M. Life Insurance Company and MML Bay State Life Insurance
Company. Ratings are subject to change.
LIMITATIONS AND EXCLUSIONS
No benefits will be paid, and the Elimination Period will not be satisfied for any confinement, care,
treatment, or service(s):
• provided to you by a person in your Family;
• provided outside the United States or its territories, or Canada, except as described under Coverage
Outside the United States in the Benefit Provisions section of the Policy;
• for which you have no financial liability or that is provided at no charge in the absence of insurance;
• provided in facilities operated primarily for the treatment of alcoholism or drug addiction;
• provided in facilities operated primarily for the treatment of Mental or Nervous Disorders. However, this
shall not operate to exclude coverage for loss which results from Alzheimer’s or any other demonstrable
organic disease such as senile dementia;
• For any claim, bill or other demand or request for payment for health care services provided and
determined to be furnished as a result of a referral prohibited by §1-302 of the Health Occupations
Article. (in MD only)
• Providing duplication of benefits provided under any Motor Vehicle Responsibility Law (in PA only)
These may vary by State.
NON-DUPLICATION OF BENEFITS
Benefits are not payable under the policy for expenses incurred to the extent that such expenses are
reimbursable under Medicare or would be so reimbursable but for the application of a deductible or
coinsurance amount; or for any other state or federal worker’s compensation plan, or other governmental
program (except Medicaid).
For purposes of satisfying the Elimination Period, days on which you are eligible for benefits, but
coverage is excluded due to the Non-Duplication of Benefits provision, will count toward satisfaction of
the Elimination Period.
State Specific Supplements
Several states require the publication of additional information regarding this brochure. Click on your
state below, if applicable, to review the additional information required by your state.
•
Alaska
• Massachusetts
• Pennsylvania
•
Colorado
• Minnesota
• South Carolina
• Connecticut
• Missouri
• South Dakota
• Florida
• Montana
• Tennessee
• Georgia
• New Jersey
• Vermont
• Hawaii
• New York
• Virginia
• Illinois
• North Carolina
• Washington
• Indiana
• Oklahoma
• Wisconsin
• Maryland
• Oregon
LONG TERM CARE INSURANCE
ALASKA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Alaska (Policy Forms MM-400-P-AK and Optional Riders):
In the Daily Benefit Amount described on page 7, the maximum daily benefit will be $350.
INVEST
INSURE
RETIRE
LTC4500aAK
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
COLORADO
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Colorado (Policy Forms MM-400-P and Optional Riders):
Colorado Basic and Standard Long Term Care Plans are offered as policy numbers MM-201-P1-CO (Basic) and MM-202-P-1-CO (Standard).
In Colorado, both a Basic Long Term Care Plan and a Standard Long Term Care Plan are
required to be presented to you along with our SignatureCareSM Series.
The State of Colorado has defined the Basic Long Term Care Plan as being suitable for sale to
persons with moderate incomes and the Standard Long Term Care Plan as suitable for sale to
persons with middle or high incomes. Both are intended as QUALIFIED plans. The following
lists the benefits available under each of these plans. No other benefits, features, premium
discounts or options are available under these plans other than those specifically listed:
BASIC
STANDARD
Facility Care or
Home Care Daily Benefit:
Actual expenses incurred up to
$110.00 per day
Actual expenses incurred
up to $110.00 per day
Elimination Period:
60 days
60 days
Maximum Benefit
$115,000
$192,000
Additional Benefits Included in BOTH plans: Waiver of Premium
Bed Reservation
Case Management Services
Home Modification and Supportive Equipment
Caregiver Training
Optional Benefits Available
under BOTH plans:
Compound Inflation Protection
Shortened Benefit Period Nonforfeiture
INVEST
INSURE
RETIRE
LTC4500aCO
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
CONNECTICUT
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Connecticut (Policy Forms MM-400-P-CT and Optional Riders):
Respite Care is included in those services listed under Home and Community Care on page 6.
In the Daily Benefit Amount described on page 7, the maximum daily benefit for Fairfield
County will be $350.
In addition to The Premium Waiver described on page 7, if the optional Home and
Community Based Services benefit is selected, we will also waive your premiums after you
have received 90 Home and Community Based Services visits.
The Home and Community Based Services (HCBS) Waiver of Premium Benefit Rider,
asdescribed on page 9, is not available.
INVEST
INSURE
RETIRE
LTC4500aCT
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
505
LONG TERM CARE INSURANCE
FLORIDA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Florida (Policy Forms MM-400-P-FL and Optional Riders):
Benefits and Premium amounts will vary according to the coverage selected.
All references to Nursing Facility are replaced by the term Nursing Home.
The long term care insurance policy described in the Brochure is guaranteed renewable. This
means you have the right, subject to the terms of the policy, to continue the policy as long as
you pay your premiums on time. Massachusetts Mutual Life Insurance Company cannot
change any of the terms of the policy on its own, except that, in the future, it may increase the
premium you pay.
_____________________________________
FLORIDA LICENSED AGENT (Please Print)
INVEST
INSURE
RETIRE
LTC4500aFL
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
GEORGIA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are that are unique to Georgia (Policy Forms MM-400-P-GA and Optional Riders):
For the Elimination Period, referenced on page 7, if Home and Community Care Services is
selected, the maximum elimination period is reduced to from 90 days to 60 days.
Nonforfeiture Benefits and Nonforfeiture options (referenced on page 8) are called
Continuation of Coverage Benefits and Continuation of Coverage options.
The Full Nonforfeiture Rider referenced on page 8 is called the Full Continuation of Coverage
Benefit Rider.
The Shortened Benefit Period Nonforfeiture Rider referenced on page 8 is called the Shortened
Benefit Rider.
The Limitations and Exclusions referenced on page 11, is deleted and replaced with the
following:
No benefits will be paid and the Elimination Period will not be satisfied for any
confinement, care, treatment or service(s):
• provided to you by a person in your Family;
• provided outside the United States or its territories, or Canada, except as described
under Coverage Outside the United States in the Policy Benefits section of the Policy;
• for which you have no financial liability or that is provided at no charge in the
absence of insurance;
• provided in facilities operated primarily for the treatment of alcoholism or drug
addiction;
• provided in facilities operated primarily for the treatment of Mental or Nervous
Disorders. However, this shall not operate to exclude coverage for loss which results
from Alzheimer’s or any other demonstrable organic disease or other organic brain
disorders such as senile dementia, which are covered.
For the Non-Duplication of Benefits referenced on page 11, the following statement is added:
“The Policy will provide for covered expenses that exceed the amount paid or payable
under Medicare.”
INVEST
INSURE
RETIRE
LTC4500aGA
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
HAWAII
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Hawaii (Policy Forms MM-400-P-HI and Optional Riders):
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page
8 of the brochure, a contingent benefit upon lapse will be available if: (a) the policy
lapses as described under the Grace Period and Unintentional Lapse provisions of the
policy; and (b) the premium rates for the policy are substantially increased. The benefit
provided will be in the form of a Shortened Benefit Period as described on page 8 of the
Brochure in the Shortened Benefit Period Nonforfeiture rider provision.
In the Limitations and Exclusions provision referenced on page 11, the first bullet point is
revised as follows:
• provided to you by a person in your immediate Family.
INVEST
INSURE
RETIRE
LTC4500aHI
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
ILLINOIS
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Illinois (Policy Forms MM-400-P-IL and Optional Riders):
All references to Long Term Care Insurance Policy are replaced by the term, Traditional Long
Term Care Insurance Policy.
All references to “MassMutual representative” are replaced by the term, “MassMutual
producer”.
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page
8 of the brochure, a contingent benefit upon lapse will be available if: (a) the policy
lapses as described under the Grace Period and Unintentional Lapse provisions of the
policy; and (b) the premium rates for the policy are substantially increased. The benefit
provided will be in the form of a Shortened Benefit Period as described on page 8 of the
Brochure in the Shortened Benefit Period Nonforfeiture rider provision.
The section, entitled Non-Duplication of Benefits, also on page 11 of the Brochure, is deleted
and replaced with the following:
Effect on Benefits Due to Medicare or Other Governmental Programs
Benefits are not payable under this Policy for (a) expenses incurred to the extent that
such expenses are reimbursable under Medicare or would so be reimbursable but for the
application of a deductible or coinsurance amount; or (b) for any other state of federal
worker’s compensation plan, or other governmental program (except Medicaid).
For the purposes of satisfying the Elimination Period, days on which you are eligible for
benefits, but coverage is excluded due to the Effect on Benefits Due to Medicare or
Other Governmental Programs provision, will count toward satisfaction of the
Elimination Period
INVEST
INSURE
RETIRE
LTC4500aIL
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
INDIANA
This supplement to your brochure will describe the benefits and features of SignatureCare®
that are unique to Indiana (Policy Forms MM-400-P-IN and Optional Riders):
The Limited Family Caregiver Benefit Rider referenced on page 9 is not available.
INVEST
INSURE
RETIRE
LTC4500aIN
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
305
LONG TERM CARE INSURANCE
MASSACHUSETTS
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Massachusetts (Policy Forms MM-400-P-MA and Optional Riders):
The references in the brochure to “Nursing Facility” are replaced by “Nursing Home.”
Adult Day Care, referenced on page 6, also includes Dementia Day Care and Social Day Care.
Home and Community Based Services, described on page 6, also includes benefits for home care, personal
care services, and adult day health program.
Policies with a daily benefit amount of $130 or greater qualify for MassHealth (Medicaid) Exemptions, and
a 10 or 20 Year payment selection, referenced on page 8, will include the purchase of the Compound Inflation
Protection benefit.
The references in the brochure to “Alternative Plan of Care” are replaced by “Alternate Plan of Care.”
The Full Nonforfeiture Rider is called Full Shortened Benefit Period Nonforfeiture Rider.
Limitations and Exclusions (referenced on page 11 of the brochure) are deleted in their entirety and
are replaced as follows:
LIMITATIONS AND EXCLUSIONS
No benefits will be paid and the elimination period will not be satisfied for any confinement, care,
treatment, or service(s):
• provided to you by a person in your Family;
• provided outside the United States or its territories, or Canada, except as described under the
Coverage Outside the United States in the Benefits Provision section of the Policy;
• for which you have no financial liability or that is provided at no charge in the absence of
insurance;
• provided in facilities operated primarily for the treatment of alcohol or drug detoxification or
rehabilitation; or
• provided in facilities operated primarily for the treatment of mental or nervous disorders, unless
Facility Services provided for under the policy are performed in a specific wing or unit of such
facility.
The first paragraph of the Non-Duplication of Benefits provision, referenced on page 11, is deleted in its
entirety and replaced with the following:
Benefits are not payable under the policy for: (a) expenses incurred to the extent that such expenses
are reimbursable under Medicare or would be so reimbursable but for the application of a deductible
or coinsurance amount; or(b) for any other state or federal worker’s compensation plan.
INVEST
INSURE
RETIRE
LTC4500aMA
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
MARYLAND
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Maryland (Policy Forms MM-400-P-MD and Optional Riders):
Under the Facility Services Only plan, referenced on page 6, an optional Hospice Care
Program Benefit Rider is also available. If you become terminally ill, this option pays your
actual expenses incurred under this Program, up to the Daily Benefit selected.
In the Benefit Eligibility Provision on page 7, the definition of Licensed Health Care
Practitioner is deleted and replaced with the following:
• A physician;
• a registered professional nurse;
• a licensed social worker; or
• other individual who meets such requirements as may be prescribed by the Secretary
of the Treasury.
The Full Nonforfeiture Rider, referenced on page 8 of the brochure, is not available.
The Shortened Benefit Period Nonforfeiture Rider, referenced on page 8 of the brochure, is
deleted in its entirety and is replaced by the following:
• SHORTENED BENEFIT PERIOD NONFORFEITURE RIDER
If you lapse your policy after it has been in force for at least five years from the policy
date and coverage is not reinstated, coverage will continue and the Daily Benefit
payable will be equal to the Daily Benefit amount in effect on the Nonforfeiture Date,
for the applicable Benefit Period shown in the Benefit Schedule of your policy.
The Paid Up Survivor Benefit Rider referenced on page 9 is available.
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page 8 of the
brochure, a contingent benefit upon lapse will be available if: (a) the policy lapses as described
under the Grace Period and Unintentional Lapse provisions of the policy; and (b) the premium
rates for the policy are substantially increased. The benefit provided will be in the form of a
Shortened Benefit Period as described on page 8 of the Brochure in the Shortened Benefit
Period Nonforfeiture rider provision.
INVEST
INSURE
RETIRE
LTC4500aMD
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
MINNESOTA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Minnesota (Policy Forms MM-400-P-MN and Optional Riders):
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page
8 of the brochure, a contingent benefit upon lapse will be available if: (a) the policy
lapses as described under the Grace Period and Unintentional Lapse provisions of the
policy; and (b) the premium rates for the policy are substantially increased. The benefit
provided will be in the form of a Shortened Benefit Period as described on page 8 of the
Brochure in the Shortened Benefit Period Nonforfeiture rider provision.
In the Limitations and Exclusions provision referenced on page 11, the first bullet point is
revised as follows:
• provided to you by a person in your immediate Family.
INVEST
INSURE
RETIRE
LTC4500aMN
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
MISSOURI
This supplement to your brochure will describe the benefits and features of SignatureCare®
that are unique to Missouri (Policy Forms MM-400-P-MO and Optional Riders):
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page 8
of the brochure, a contingent benefit upon lapse will be available if: (a) the policy lapses as
described under the Grace Period and Unintentional Lapse provisions of the policy; and (b)
the premium rates for the policy are substantially increased. The benefit provided will be
in the form of a Shortened Benefit Period as described on page 8 of the Brochure in the
Shortened Benefit Period Nonforfeiture rider provision.
Limitations and Exclusions (“referenced on page 11of the brochure”) are deleted in their entirety and are replaced as follows:
LIMITATIONS AND EXCLUSIONS
No benefits will be paid and the Elimination Period will not be satisfied for any
confinement, care, treatment, or service(s):
• provided to you by a person in your Family;
• received outside the United States or its territories, or Canada, except as described
under Coverage Outside the United States in the Benefit Provisions section of the Policy;
• for which you have no financial liability or that is provided at no charge in the
absence of insurance;
• provided in facilities operated primarily for the treatment of alcoholism or drug
addiction; or
• provided in facilities operated primarily for the treatment of mental or nervous disorders. However, this shall not operate to exclude coverage for loss which results from
Alzheimer’s or any other demonstrable organic disease such as senile dementia or
mental or nervous disorders resulting from physical injury.
INVEST
INSURE
RETIRE
LTC4500aMO
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
305
LONG TERM CARE INSURANCE
MONTANA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Montana (Policy Forms MM-400-P-MT and Optional Riders):
References to “spouses” in the brochure are revised to read “spouse/domestic” partner.
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page
8 of the brochure, a contingent benefit upon lapse will be available if: (a) the policy
lapses as described under the Grace Period and Unintentional Lapse provisions of the
policy; and (b) the premium rates for the policy are substantially increased. The benefit
provided will be in the form of a Shortened Benefit Period as described on page 8 of the
Brochure in the Shortened Benefit Period Nonforfeiture rider provision.
INVEST
INSURE
RETIRE
LTC4500aMT
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
NEW JERSEY
This supplement to your brochure will describe the benefits and features of SignatureCare® that are unique to
New Jersey (Policy Forms MM-400-P-NJ through MM-405-P-NJ and Optional Riders):
The reference to Joint Discount on page 6 is deleted and replaced with the following:
SignatureCare® offers coverage to an insured and an additional insured under a policy with special
rates. This policy provides identical coverage for each of you. All provisions of the policy apply to
each insured individually and separately.
All references to term “joint coverage or joint policy” shall be replaced with the term “Additional Insured
coverage or Additional Insured Policy”.
Under Premium Waiver referenced on page 7, premiums are waived for both the insured and an additional insured.
Under the HCBS Waiver of Premium Benefit Rider referenced on page 9, premiums are waived for both
the insured and an additional insured.
The Paid-Up Survivor Benefit Rider referenced on page 9 is available.
The Limitations and Exclusions on page 11 are deleted and are replaced as follows:
LIMITATION AND EXCLUSIONS
No benefits will be paid and the Elimination Period will not be satisfied for any confinement, care,
treatment, or service(s):
• provided to you by a person in your Family;
• provided outside the United States or its territories, or Canada, except as described under the
Coverage Outside the United States in the Benefits Provisions sections of the Policy;
• for which you have no financial liability or that is provided at no charge in the absence
of insurance;
• provided in facilities operated primarily for the treatment of the disease of alcoholism or drug
addiction; or
• provided in facilities operated primarily for the treatment of Mental or Nervous Disorders; or
• that results from sickness or injury for which benefits are provided under any state or federal
workers’ compensation plan, or governmental program (except Medicaid).
The Non Duplication of Benefits on page 11 is deleted and is replaced with the following:
Benefits are not payable under this Policy for expenses incurred to the extent that such expenses are
reimbursable under Medicare or would be so reimbursable but for the application of a deductible or
coinsurance amount.
For purposes of satisfying the Elimination Period, days on which you are Eligible for Benefits, but
coverage is excluded due to the Non-Duplication of Benefits provision, will count toward satisfaction
of the Elimination Period.
INVEST
INSURE
RETIRE
LTC4500aNJ
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
305
LONG TERM CARE INSURANCE
NEW YORK
This supplement to your brochure will describe the benefits and features of SignatureCare®
that are unique to New York (Policy Forms MM-400-P-NY et al., and Optional Riders):
All references in the brochure to “Nursing Facility” are replaced by “Nursing Home.”
All references to “Home and Community Based Services” are replaced by “Home Care Services.”
The Daily Benefit Amounts, referenced on page 6, are available in increments of $10 from $100-$350 within
the New York Metropolitan Area (the counties of Bronx, Kings, Nassau, New York, Queens, Richmond,
Suffolk, Rockland and Westchester) and $70-$300 outside of the New York Metropolitan Area.
Joint coverage, referenced on page 6, is available for Spouses and Domestic Partners only.
The Full Nonforfeiture Benefit, referenced on page 8, is available through the combination of the Full
Shortened Benefit Period Rider with the Full Return of Premium Benefit Rider.
Full Shortened Benefit Period Nonforfeiture Rider: This rider provides a nonforfeiture benefit in
the event of policy lapse due to nonpayment of premium. If the policy lapses due to nonpayment of
premium, coverage will continue and benefits will be payable based on the daily benefit in effect on
the date of lapse. The benefit amount payable becomes equal to the total of premiums paid for the
policy and all riders
The Full Return of Premium Benefit Rider provides benefits in the form of a Return of Premium
upon death of the insured (last to die under joint coverage).
The Limitations and exclusions, referenced on page 11, are deleted and replaced by the following:
No benefits will be paid for any confinement, care, treatment, or service(s):
• provided to you by a person in your immediate Family or any Secondary Insured named on
the Benefit Schedule;
• provided while the insured is outside the United States and its possessions;
• for which you have no financial liability or that is provided at no charge in the absence of
insurance;
• provided in facilities operated primarily for the treatment of alcoholism or drug addiction; or
• provided in facilities operated primarily for the treatment of Mental or Nervous Disorders.
The Non-Duplication of Benefits provision, referenced on page 11, is deleted and replaced by the following:
Benefits are not payable under the policy for expense incurred to the extent that such expenses are
reimbursed under Medicare or would be so reimbursed but for the application of a deductible or
coinsurance amount; or for services for which benefits are provided by any other state or federal
worker’s compensation plan, or other governmental program (except Medicaid).
For purposes of satisfying the Elimination Period, days on which you satisfy the conditions on
Eligibility for Payment of Benefits, but coverage is excluded due to Non-Duplication of Benefits,
will count toward satisfaction of the Elimination Period.
INVEST
INSURE
RETIRE
LTC4500aNY
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
505
LONG TERM CARE INSURANCE
NORTH CAROLINA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to North Carolina (Policy Forms MM-400-P-NC and Optional Riders):
On page 7 of the Brochure, under Benefit Eligibility, the term “continence” is defined as the
ability to maintain control of bowel and bladder function; or, when unable to maintain control of
bowel or bladder function, the ability to perform associated personal hygiene (including caring
for catheter or colostomy bag).
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page
8 of the brochure, a contingent benefit upon lapse will be available if: (a) the policy
lapses as described under the Grace Period and Unintentional Lapse provisions of the
policy; and (b) the premium rates for the policy are substantially increased. The benefit
provided will be in the form of a Shortened Benefit Period as described on page 8 of the
Brochure in the Shortened Benefit Period Nonforfeiture rider provision.
The first paragraph under the heading of Non-Duplication of Benefits (referenced on page 11)
is deleted in its entirety and replaced by the following:
Benefits are not payable under the Policy for:
• expenses incurred to the extent that such expenses are reimbursable under Medicare or
would be so reimbursable but for the application of a deductible or coinsurance
amount; or;
• any benefits paid or payable under any federal workers’ compensation plan, or other
governmental program (except Medicaid); or
• occupational injury or sickness which are paid under the North Carolina Workers’
Compensation Act but only to the extent such services or supplies are the liability of
the employee, employer or workers’ compensation insurance carrier according to a
final adjudication under the North Carolina Workers’ Compensation Act or an order
of the North Carolina Industrial Commission approving a settlement agreement under
the North Carolina Workers’ Compensation Act.
INVEST
INSURE
RETIRE
LTC4500aNC
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
OKLAHOMA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Oklahoma (Policy Forms MM-400-P-OK and Optional Riders):
On page 7 of the brochure the term “pre-existing condition” is defined as a condition for which
medical advice or treatment was recommended by, or received from a provider of health care
services, within six (6) months preceding the effective date of coverage of an insured person.
Massachusetts Mutual Life Insurance Company’s SignatureCare long term care
insurance covers pre-existing conditions.
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page
8 of the brochure, a contingent benefit upon lapse will be available if: (a) the policy
lapses as described under the Grace Period and Unintentional Lapse provisions of the
policy; and (b) the premium rates for the policy are substantially increased. The benefit
provided will be in the form of a Shortened Benefit Period as described on page 8 of the
Brochure in the Shortened Benefit Period Nonforfeiture rider provision.
INVEST
INSURE
RETIRE
LTC4500aOK
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
OREGON
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Oregon (Policy Forms MM-400-P-OR and Optional Riders):
The references in the brochure to “Nursing Facility” are replaced by “Nursing Home.”
Facility Services, referenced on page 6 of the Brochure, include care provided in a secure
Alzheimer’s unit of a Residential Care Facility.
Home and Community Based Services, referenced on page 6, includes care provided in
Adult Foster Care.
INVEST
INSURE
RETIRE
LTC4500aOR
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
PENNSYLVANIA
This supplement to your brochure will describe the benefits and features of SignatureCareSM that are
unique to Pennsylvania (Policy Forms MM-400-P-PA through MM-405-P-PA and Optional Riders):
The Full Nonforfeiture Benefit Rider on page 8 of the brochure is deleted in its entirety and replaced
with the following:
Full Shortened Benefit Period Nonforfeiture
If your policy lapses due to nonpayment of premium, coverage will continue in full and the new
benefit amount will be equal to the greater of the total of premiums paid for the policy and all
riders, or 30 times the Daily Benefit in effect at the time of lapse. Any benefits paid to you after
the policy lapses will be subtracted from this new benefit amount. Upon your death, we will pay
your beneficiary an amount equal to any remaining benefits not paid as continued coverage.
A Full Return of Premium Benefit Rider is also available for additional cost. Under this rider, if your
policy lapses due to your death and has not previously lapsed due to nonpayment of premium, the total
or premiums paid, with no deduction for benefits already paid to you, will be paid to your beneficiary.
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page 8 of the
brochure, a contingent benefit upon lapse will be available if: (a) the policy lapses as described
under the Grace Period and Unintentional Lapse provisions of the policy; and (b) the premium
rates for the policy are substantially increased. The benefit provided will be in the form of a
Shortened Benefit Period as described on page 8 of the Brochure in the Shortened Benefit
Period Nonforfeiture rider provision.
In the Limitations and Exclusions provision referenced on page 11 is deleted in its entirety and
replaced with the following:
• provided to you by a person in your family (except if the optional Limited Family Caregiver
Benefit is purchased);
• provided outside the United States or its territories, or Canada, except as described under the
Coverage Outside the United States in the Benefit Provisions section of this Policy;
• for which you have no financial liability or that is provided at no charge in the absence of
insurance;
• provided in facilities operated primarily for the treatment of alcoholism or drug addition;
• providing duplication of benefits provided under any Motor Vehicle Responsibility Law; or
• provided in facilities operated primarily for the treatment of Mental or Nervous Disorders.
However, this shall not operate to exclude coverage for loss which result’s from Alzheimer’s
or any demonstrable organic disease such as senile dementia.
INVEST
INSURE
RETIRE
LTC4500aPA
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
SOUTH CAROLINA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to South Carolina (Policy Forms MM-400-P-SC and Optional Riders):
All references in the Brochure to a nursing facility or an assisted living facility also include
care in a custodial care facility.
INVEST
INSURE
RETIRE
LTC4500aSC
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
SOUTH DAKOTA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to South Dakota (Policy Forms MM-400-P-SD, MM-401-P-SD and Optional
Riders):
All references to the term “representative” are replaced with the word “agent”.
All references to the term “actual” when used in relationship with the word “expenses” or
“charges” are deleted.
All references to a joint policy or joint coverage apply to Policy form MM-401-P-SD.
The Paid-Up Survivor Benefit Rider, referenced on page 9, is only available with Policy form
MM-401-P-SD.
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page
8 of the brochure, a contingent benefit upon lapse will be available if: (a) the policy
lapses as described under the Grace Period and Unintentional Lapse provisions of the
policy; and (b) the premium rates for the policy are substantially increased. The benefit
provided will be in the form of a Shortened Benefit Period as described on page 8 of the
Brochure in the Shortened Benefit Period Nonforfeiture rider provision.
In the Limitations and Exclusions provision referenced on page 11, the first bullet point is
revised as follows:
• provided to you by a person in your family unless: the family member is a regular
employee of the service or care provider furnishing the service or care; the service or
care provider receives the payment for the service or care; and the family member
receives no compensation other than the normal compensation for an employee in his
or her job category
INVEST
INSURE
RETIRE
LTC4500aSD
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
TENNESSEE
This supplement to your brochure will describe the benefits and features of SignatureCare®
that are unique to Tennessee (Policy Forms MM-400-P-TN and Optional Riders):
The 10-year and 20-year Payment Options, referenced on page 8, are only available if either the
Full Nonforfeiture Rider or the Shortened Benefit Period Nonforfeiture Rider (also referenced
on page 8) is also purchased.
INVEST
INSURE
RETIRE
LTC4500aTN
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
505
LONG TERM CARE INSURANCE
VERMONT
On pages 4 and 5 of the Brochure, in the section titled “Picture Independence and Self
Determination”, the statistical information found in the second paragraph of the section, and
referenced by footnote #1, includes services that may not qualify for coverage or could be
covered by other insurance.
In the Limitations and Exclusions provision referenced on inside of the back cover, the first
bullet point is deleted and replaced with the following:
• provided to you by a person in your Family, unless the Family member is a paid
employee of the institution in which you are receiving care.
INVEST
INSURE
RETIRE
LTC4500aVT
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
VIRGINIA
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are that are unique to Virginia (Policy Forms MM-400-P-VA and Optional Riders):
The Benefit Eligibility Section referenced on page 7 is called Conditions On Eligibility for
Payment of Benefits.
The Full Nonforfeiture Benefit Rider referenced on page 8 is called the Full Shortened
Benefit Period Rider.
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page
8 of the brochure, a contingent benefit upon lapse will be available if: (a) the policy
lapses as described under the Grace Period and Unintentional Lapse provisions of the
policy; and (b) the premium rates for the policy are substantially increased. The benefit
provided will be in the form of a Shortened Benefit Period as described on page 8 of the
Brochure in the Shortened Benefit Period Nonforfeiture rider provision.
The second paragraph of the Non-Duplication of Benefits provision on page 11 is deleted and
replaced with the following:
For purposes of satisfying the Elimination Period, days on which you meet the
Conditions On Eligibility for Payment of Benefits, but coverage is excluded due
to the Non-Duplication of Benefits provision, will count toward satisfaction of the
Elimination Period.
INVEST
INSURE
RETIRE
LTC4500aVA
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
WASHINGTON
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Washington (Policy Forms MM-400-P-WA and Optional Riders):
BENEFIT ELIGIBILITY
The following bullet is added to Benefit Eligibility on page 7:
• having a level of disability similar (as determined under regulations prescribed by the
Secretary in consultation with the Secretary of Health and Human Services) to the level of
disability described in the first bullet point.
LIMITATIONS AND EXCLUSIONS
The Limitations and Exclusions on page 11 are deleted in their entirety and replaced with
the following:
No benefits will be paid and the Elimination Period will not be satisfied for any confinement,
care, treatment or service(s):
• provided to you by your family;
• provided outside the United States or its territories, or Canada, except as described under
the Coverage Outside the United States in the Benefits Provisions section of the policy;
• for which you have no financial liability or that is provided at no charge in the absence
of insurance;
• provided in facilities operated primarily for the treatment of chemical dependency;
• provided in facilities operated primarily for the treatment of mental or nervous disorders;
• for care provided by rest cures and routine physical examinations; or
• that results from sickness or injury for which benefits are provided under any state or
federal worker’s compensation plan or other governmental program (except Medicaid).
The Non-Duplication provision on page 11 will be referred to as the Coordination of Benefits with
Medicare provision.
INVEST
INSURE
RETIRE
LTC4500aWA
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
LONG TERM CARE INSURANCE
WISCONSIN
This supplement to your brochure will describe the benefits and features of SignatureCareSM
that are unique to Wisconsin (Policy Forms MM-400-P-WI and Optional Riders):
The references in the brochure to “Nursing Facility” are replaced by “Nursing Home.” Also,
the Facility Services Only Policy, described on page 6 of the brochure is referred to as a
Nursing Home Insurance Policy.”
The Alternative Plan of Care referenced on page 7 is not available with the Nursing Home
Insurance Policy.
Nonforfeiture Benefits:
If you choose not to select either of the optional Nonforfeiture riders described on page
8 of the brochure, a contingent benefit upon lapse will be available if: (a) the policy
lapses as described under the Grace Period and Unintentional Lapse provisions of the
policy; and (b) the premium rates for the policy are substantially increased. The benefit
provided will be in the form of a Shortened Benefit Period as described on page 8 of the
Brochure in the Shortened Benefit Period Nonforfeiture rider provision.
INVEST
INSURE
RETIRE
LTC4500aWI
© 2005 Massachusetts Mutual Life Insurance Company, Springfield, MA. All rights reserved. www.massmutual.com
MassMutual Financial Group is a marketing designation (or fleet name) for Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
105
Massachusetts Mutual Life Insurance Company
and af.liates, Spring.eld, MA 01111-0001
www.massmutual.com
© 2005 Massachusetts Mutual Life Insurance Company. All rights reserved.
MassMutual Financial Group is a marketing designation (or fleet name) for
Massachusetts Mutual Life Insurance Company (MassMutual) and its affiliates.
405
C:057062-000

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