Employee Benefits More Complicated – Start Planning Now

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Employee Benefits More Complicated – Start Planning Now

By Chris Noffke, REBC, CSFS, GBDS, Vice President of Employee Benefits

When I look at the coming year, 2026 feels like it’s shaping up to be a rollercoaster ride for health insurance and other benefits. Rising medical costs, specialty drugs, and policy changes are making benefits strategies more complex and personalized than ever. The One Big Beautiful Bill Act locked in permanent pre-deductible telehealth coverage for high-deductible health plans, a big win for employers and employees who value easier, more flexible access to care. That’s one of the smooth parts of the ride, but some of the looming changes will cause nearly 76,000 Wisconsin residents to lose affordable health care. The bill adds new cost-sharing rules and, in the future, will adjust eligibility windows that could change how individuals access coverage. 

Careful attention and proactive planning will be essential for group health, dental, and vision plans. What may appear to be a simple renewal in 2025 could feel very different in 2026 once these changes take effect. That’s why building a strategy now is so incredibly important. A thoughtful benefits strategy isn’t just about checking the compliance box; it’s about staying ahead of renewal cost pressures, protecting your employees’ access to choice in care, and keeping your organization competitive in a tightening labor market.

If you wait until renewal season to react, options will be available, but it could be too late to make thoughtful decisions. With a proactive plan in place, you’ll be ready to navigate changes with confidence and some control. Employers need to clearly communicate, use cost management strategies, and technology to help employees make informed choices.

If your group provides employee benefits and insurances, let’s start the conversation now. I can help you evaluate your current benefits as our team supports more than a hundred independent physician companies with these decisions. I will help identify potential impacts from the 2026 changes and develop a strategy that keeps your plan strong and sustainable. Contact me at chris.noffke@wismedassure.org or 608.442.3734.

Picture of Chris Noffke, CSFS, GBDS

Chris Noffke, CSFS, GBDS

Vice President, Employee Benefits

Reach out to me to learn more. You can contact me at chris.noffke@wismedassure.org or 608.442.3734.

Send me an email!
Picture of Chris Noffke, CSFS, GBDS

Chris Noffke, CSFS, GBDS

Vice President, Employee Benefits

Reach out to me to learn more. You can contact me at chris.noffke@wismedassure.org or 608.442.3734.

Send me an email!

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisions. Full disclaimer and contact information.

Ready to Retire? Your Financial Rx for a Smooth Transition – Free Webinar

After a long and dedicated career, the thought of retirement is both exciting and a little overwhelming. You’ve spent your life providing the best care for your patients, but who is providing the best care for your financial future? Join us for a complimentary, one-hour webinar designed specifically for physicians like you who are either considering retirement or have recently made the transition.

The Doctor’s Guide to a Financially Healthy Retirement
Date: Tuesday, October 14, 2025
Time: 6:00 p.m. – 7:00 p.m.
Location: Online (Link to be provided upon registration)

We’ll cover the critical topics that can make or break your retirement plan, giving you the knowledge and confidence to move forward. Join us to learn actionable advice on:

  • Navigating Medicare and Health Care Costs: Understanding your options and ensuring you have the right coverage in place.
  • Maximizing Social Security Benefits: Strategies to optimize your benefits and when to start drawing them.
  • Generating Sustainable Income from Investments: How to transition from accumulating wealth to generating a reliable income stream.
  • The Power of Roth Conversions: Is converting your traditional IRA to a Roth IRA the right move for you? We’ll discuss the pros and cons.
  • Tax-Efficient Withdrawal Strategies: Don’t let taxes erode your hard-earned savings. Learn how to withdraw from your accounts in the most tax-advantageous way.
  • Long-Term Care Planning: Plan for your potentially largest expense in retirement.

This is an educational session designed to empower you to make informed decisions about the next chapter of your life.

Your retirement deserves the same level of attention to detail you’ve given your patients.

Click here to register now.

Please feel free to forward this invitation to any physician colleagues who might also find this information beneficial. The financial health of our medical community is a shared priority. This complimentary education session is provided by WisMed Assure & WisMed Financial.

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisionsFull disclaimer and contact information.

Wisconsin Physician License Renewal Now Open

By The Wisconsin Medical Society, reposted with permission

The Wisconsin Department of Safety and Professional Services (DSPS) will open physician license renewal on Friday, September 12, 2025. To keep your license active, you must submit a completed renewal application with payment by 11:59 p.m. on October 31, 2025. Once submitted, your license will remain active while your application is under review.

How to Renew

  • Visit license.wi.gov and log in through the “Welcome Back” section.
  • If you’ve forgotten your login credentials, check your renewal notice, which usually includes your username (but not your password).
  • If your username isn’t available, select “request support” on the site and submit a help ticket for login assistance. Click here for step-by-step instructions.
  • The renewal fee is $120.

Continuing Education Requirements

Physicians must attest to the completion of continuing medical education (CME) as part of the renewal process. Proof of CME completion is not required at the time of renewal but may be requested later if you are randomly selected for audit. Additional instructions for fulfilling audit requirements will be provided in early 2026 before the audit begins.

Updates to Renewal Questions

Physicians may notice that some renewal questions look slightly different this year. DSPS is working with the Lorna Breen Heroes Foundation to remove stigmatizing language from applications and renewals. This is an ongoing effort, and more information will be shared as the work continues.

The Wisconsin Medical Society (WisMed) fully supports the efforts and changes made by DSPS in partnership with the Lorna Breen Foundation. WisMed is honored to serve on the steering committee for a grant from Advancing a Healthier Wisconsin (AHW) on the effort to improve state license and hospital privileges questions for physicians. That grant is headed by the Wisconsin Hospital Association (WHA), and is separate from the grant WisMed is leading to establish a Health Professional Assistance Program for physicians and other health care professionals. 

Renewal Holds

Some physicians may see their renewal listed as “on hold.” This occurs when there are outstanding obligations to:

  • The Department of Revenue (unpaid taxes), or
  • The Office of the Commissioner of Insurance (Injured Patients and Families Compensation Fund, IPFCF).

Your renewal notice will include instructions for resolving these obligations. Currently, OCI reports that approximately 10% of physicians have outstanding IPFCF obligations. Physicians are strongly encouraged to address these matters promptly to avoid renewal delays.

Workforce Survey

A workforce survey is included with license renewal; physicians are strongly encouraged to complete it. The Department of Health Services (DHS) uses this data to secure Health Professional Shortage Area (HPSA) designations, which bring federal funding to Wisconsin to help increase access to care.

These funds support:

  • Loan repayment programs for health care professionals
  • Federally Qualified Health Centers (FQHCs)
  • Other resources that expand care in underserved communities

Survey data is also shared with researchers and institutions for workforce analysis. For example, DSPS partnered with Marquette University on a report analyzing dental workforce trends using similar survey data.

More Information

Additional information is available at DSPS LicensE. The Physician Continuing Education Requirement is available at DSPS.wi.gov.

For assistance, see LicensE Customer Information or contact renewal staff at DSPSRenewal@wisconsin.gov or 608.266.2112.

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisionsFull disclaimer and contact information.

Add This New Invaluable Rider to Your Term Life Coverage

By Tom Strangstalien, Executive Director Individual Insurance Planning

We often view term life insurance coverage as a commodity – the more coverage we can secure at the lowest cost the better. This is a flawed premise. There are numerous options and riders to at least consider when purchasing term life protection. An innovative new rider shatters this basic premise to pieces!

The last thing on your mind when securing term life insurance is probably your future long-term care needs. This life insurance is usually purchased when we’re younger, our income is lower, and we have debts and loved ones to protect. However, long-term care needs are real. The costs are exorbitantly high and the odds of needing some form of care in our life are statistically shocking. Consequently, the cost of long-term care protection is not inexpensive, and when you’re younger, it might not fit into your overall budget. An innovative new optional rider addresses this dilemma.

The monumental rider I’m referencing allows for the “conversion” of term life insurance to a whole life policy that not only provides life insurance protection but also benefits for long-term care, including home health care, assisted living, adult day care, respite care, and nursing home care. Basically, the benefits will be used for long-term care, or the life insurance amount will be paid to the beneficiaries of the contract. It’s a win-win.

The conversion of the policy can be done within ten years of the policy issue date with no medical underwriting! In essence, you’re getting “guarantee issue” future long-term care protection. And of course you don’t know what your future health will look like. This rider can be purchased between the ages of 18 and 60, in amounts between $100,000 and $2,000,000 in protection. The really great part is that it’s extremely affordable.

Likely your financial plan includes some form of life insurance protection. Throughout your life your needs and overall financial plan evolves and changes, and long-term care planning will become a bigger priority the older you get. Why not “lock in” the ability to secure some future long-term care protection now at a very affordable price?

If you’re interested in exploring this dynamic coverage, my team can easily provide a quote. Contact me at tom.strangstalien@wismedassure.org or 608.442.3730.

Picture of Tom Strangstalien

Tom Strangstalien

Executive Director Individual Insurance Planning

Reach out to me to learn more. You can contact me at tom.strangstalien@wismedassure.org or 608.442.3730.

Send me an email!
Picture of Tom Strangstalien

Tom Strangstalien

Executive Director Individual Insurance Planning

Reach out to me to learn more. You can contact me at tom.strangstalien@wismedassure.org or 608.442.3730.

Send me an email!

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisionsFull disclaimer and contact information.

Cyber Liability Insurance – An Often Overlooked Essential

By Jensen Peck, Business and Professional Insurance Executive

Cyber liability insurance is often overlooked but is essential for physician groups of all sizes. Ten years ago, cyber liability insurance wasn’t really discussed as a necessary option. Unfortunately, in 2024 there were 14 data breaches involving more than one million health care records affecting 237,986,282 U.S. residents. That’s approximately 69.97% of the nation’s population. A lot of cyber events were able get through by simply using malicious or phishing emails to staff – taking advantage of human error.

You probably know that strong cyber security and good policies and procedures are key to protecting your data, but are you aware of the importance of proper cyber liability coverage and the role it can play in protecting your business and your income? Let’s briefly review some common misconceptions, questions, and basic coverages we often see with cyber liability.

But what if I already have cyber built into my malpractice policy?

Yes, some malpractice insurance policies do have basic cyber coverage endorsements on the policy, but it’s very limited coverage, often excludes crucial coverage, and has very low limits. Two coverages that are often excluded by the cyber endorsement that many groups need are contingent/dependent business interruption and contingent/dependent system failure. Those coverages protect you from financial loss if you rely on third party systems (like EMR) and they are compromised.

How do I know if I have the right limits?

Cyber insurance is usually offered in limit increments of $1M ($1M, $2M, $3M, etc.). Choosing your cyber limits can be difficult since there isn’t always a right answer. Something to consider when setting limits are the types of data you store. Do you store PHI, financial records, Social Security numbers, or just email addresses? The more sensitive the data, the higher the potential liability. If your systems (EHR, billing, scheduling, etc.) go down, how long could you operate without them? Estimate daily revenue loss versus downtime days. Add overtime/temporary staffing costs to catch up. It’s also important to benchmark yourself with industry standards. Luckily for our clients, we can benchmark you against other health care clinics around the country as well as other industries – giving a good picture of where you stand with others with similar revenues.

Much like your employee benefits and malpractice insurance, it’s important to explore your options every few years to ensure that you have appropriate limits and coverages as well as a reasonable premium. Reach out to us if you want to explore any of these options!

Picture of Jensen Peck

Jensen Peck

Business and Professional Insurance Executive

Reach out to me to learn more. You can contact me at jensen.peck@wismedassure.org or 608.442.3731.

Send me an email!
Picture of Jensen Peck

Jensen Peck

Business and Professional Insurance Executive

Reach out to me to learn more. You can contact me at jensen.peck@wismedassure.org or 608.442.3731.

Send me an email!

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisions. Full disclaimer and contact information.

Understanding the Annual Medicare Open Enrollment

By Alisa Allen, RHU, REBC, Medicare Benefits Insurance Advisor

Each year Medicare allows beneficiaries to make changes to how they receive Medicare coverage during the annual open enrollment period. Let’s review a few of the basics and your options during this annual event.

Medicare at a Glance

Medicare is the federal health insurance program for people 65 and older and younger adults with long-term disabilities. People with Medicare may choose to receive Medicare benefits through original Medicare (Parts A and B) or through a Medicare Advantage plan administered by a private health insurer.

With original Medicare, you can also sign up for a separate Medicare Part D prescription drug plan to cover outpatient drugs. Individuals usually purchase a Supplemental insurance policy to help with deductibles, coinsurance, and other out of pocket costs after Medicare.

Medicare Advantage plans, which include services covered under Medicare Parts A and B, typically include Part D prescription drug coverage as part of the plan. Medicare Advantage is an alternative to Original Medicare. You still need to sign up for Part A and B before you choose a Medicare Advantage program and you will continue to pay Part B premiums.

What is the Medicare Open Enrollment Period?

The annual Medicare open enrollment period runs from October 15 to December 7 each year. During this time, people with Medicare can review Medicare plans offered in their area and make changes to their Medicare coverage – this goes into effect on January 1 of the following year. This includes:

  • Switching from Original Medicare to a Medicare Advantage – or vice versa
  • Switching between Medicare Advantage plans
  • Electing or switching between Medicare Part D prescription drug plans

NOTE: This does NOT include making changes or enrolling in a Medicare Supplement with no medical underwriting approval. Special circumstances can come into play, but “no questions asked” changes to supplements are typically not included in the Open Enrollment period.

Medicare Advantage and Medicare Part D prescription drug plans change from year to year, so it’s always a good idea to compare your options annually. Marketing for 2026 plans begins on October 1 – you’ll see more advertising for these programs during this time.

WisMed Assure is here to help you navigate every step of this journey. Alisa Allen, our Medicare Insurance Specialist, has extensive experience with educating and assisting individuals on Medicare basics and insurance options that coordinate with Medicare.

Alisa is happy to help make this an easier process for you and your family. Reach out to Alisa at alisa.allen@wismedassure.org or call her direct at 608.665.9443 for assistance. 

Picture of Alisa K. Allen, RHU, REBC

Alisa K. Allen, RHU, REBC

Medicare Benefits Insurance Advisor

Reach out to me to learn more. You can contact me at alisa.allen@wismedassure.org or 608.665.9443.

Send me an email!
Picture of Alisa K. Allen, RHU, REBC

Alisa K. Allen, RHU, REBC

Medicare Benefits Insurance Advisor

Reach out to me to learn more. You can contact me at alisa.allen@wismedassure.org or 608.665.9443.

Send me an email!

Note: WisMed Assure and its agents are not affiliated with any Medicare program.

We do not offer every plan available in your area. Currently we represent 9 organizations which offer 53 products in our service area. Please contact Medicare.gov, 1.800.MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options.

This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisionsFull disclaimer and contact information.

Federal Student Loans: Consider a New Payment Plan

By Mark Ziety, CFP®, AIF®, Financial Advisor, WisMed Financial

Navigating the world of federal student loans can be complex, especially with constant changes to repayment plans and forgiveness programs. Here is a breakdown of the latest updates and options to help borrowers make informed decisions.

A Look at Income-Driven Repayment Plans

The landscape of income-driven repayment (IDR) plans is evolving, with some plans being phased out and a new one on the horizon. Here’s a quick guide to who should consider each plan:

  • Income Contingent Repayment (ICR): This plan is generally not recommended unless it is the only option available to you. Typically, parents with Parent Plus loans will select this option as it is their only choice unless they can consolidate loans to access other payment plans.
  • Saving on a Valuable Education (SAVE): Those enrolled in SAVE can stay on this plan and there is still no payment required for those who need more time to adjust their budget. Be aware that this plan will be eliminated July 1, 2028, interest started to accrue as of August 1, 2025, and payments do not count toward loan forgiveness.
  • Income-Based Repayment (IBR): There are two versions of this plan, one for borrowers with loans before July 1, 2014, and one for borrowers with loans after that date. The IBR 2014 plan (loans after July 1, 2014) typically has the next lowest monthly payment after SAVE making it the plan to highly consider when switching from SAVE.
  • Pay as You Earn (PAYE): This plan is very similar to the IBR 2014 plan but is also being phased out after July 1, 2028. Importantly, it has the same payment as the IBR 2014 plan. Those who don’t qualify for the 2014 version of IBR usually consider PAYE as the next best plan after SAVE.
  • Repayment Assistance Plan (RAP): A new plan is expected to be available by July 1, 2026. This could be the preferred plan for those with low to moderate income. The plan is notable because unpaid interest will not accrue, the monthly payment could be lower than other plans, and each month’s payment reduces principal even if the payment is less than that month’s interest charge.

Important Dates and Program Changes

Keep these key dates and rule changes in mind:

  • Partial Financial Hardship: The requirement for a “partial financial hardship” to qualify for IBR plans has been removed, making it easier to switch to this plan.
  • Grandfathered Rules: If you want to stay on an older plan like PAYE or IBR after July 1, 2026, you must not take out any new loans or a new consolidation loan after that date.
  • Parent PLUS Loans: If you have Parent PLUS loans and want to make them eligible for certain IDR plans, you must consolidate them before July 1, 2026.

Updates to the PSLF Buyback Program

The Public Service Loan Forgiveness (PSLF) Buyback program is a significant development for those pursuing PSLF. This program allows borrowers to “buy back” months of forbearance or deferment to gain credit toward the 120 qualifying payments needed for PSLF. This may be a great way to recoup forgiveness credit for those who have been in the SAVE forbearance. While currently limited to those who have already completed their 120 qualifying months, the program is expected to eventually open to all borrowers.

For more details on the current state of student loans, watch the full videos by WisMed Financial, Inc. here and here.

For personalized help with your financial plan, please contact Mark Ziety, CFP®, AIF®.

Picture of Mark Ziety, CFP®, AIF®

Mark Ziety, CFP®, AIF®

Executive Director of WisMed Financial
Certified Financial Planner™ Professional

Reach out to me to learn more. You can contact me at mark.ziety@wismedfinancial.org or 608.442.3750.

Book an appointment with me!
Picture of Mark Ziety, CFP®, AIF®

Mark Ziety, CFP®, AIF®

Executive Director of WisMed Financial
Certified Financial Planner™ Professional

Reach out to me to learn more. You can contact me at mark.ziety@wismedfinancial.org or 608.442.3750.

Book an appointment with me!

Note: This article is for informational purposes only and should not be considered as financial or tax advice. Please consult with a qualified financial advisor or tax professional before making any financial decisions. Full disclosures.

2025 Volume 3

Federal Student Loans: Consider a New Payment Plan

By Mark Ziety, CFP®, AIF®, Senior Advisor, WisMed Financial

Closeup image of graduation cap and money on table.

Navigating the world of federal student loans can be complex, especially with constant changes to repayment plans and forgiveness programs. Here is a breakdown of the latest updates and options to help borrowers make informed decisions.

Read more…


Cyber Liability Insurance – An Often Overlooked Essential

By Jensen Peck, Business and Professional Insurance Executive

System hacked. Internet security

Cyber liability insurance is often overlooked but is essential for physician groups of all sizes. Ten years ago, cyber liability insurance wasn’t really discussed as a necessary option. Unfortunately, in 2024 there were 14 data breaches involving more than one million health care records affecting 237,986,282 U.S. residents. That’s approximately 69.97% of the nation’s population. A lot of cyber events were able get through by simply using malicious or phishing emails to staff – taking advantage of human error.

Read more…


Ready to Retire? Your Financial Rx for a Smooth Transition – Free Webinar

mature caucasian woman use laptop computer at home

Presented by Mark Ziety, CFP®, AIF®, Senior Advisor, WisMed Financial and Alisa Allen, RHU, REBC, Medicare Benefits Insurance Advisor

After a long and dedicated career, the thought of retirement is both exciting and a little overwhelming. You’ve spent your life providing the best care for your patients, but who is providing the best care for your financial future? Join us for a complimentary, one-hour webinar designed specifically for physicians like you who are either considering retirement or have recently made the transition.

Read more…


Employee Benefits More Complicated – Start Planning Now

Roller coaster

By Chris Noffke, REBC, CSFS, GBDS, Vice President of Employee Benefits

When I look at the coming year, 2026 feels like it’s shaping up to be a rollercoaster ride for health insurance and other benefits. Rising medical costs, specialty drugs, and policy changes are making benefits strategies more complex and personalized than ever.

Read more…


Add This New Invaluable Rider to Your Term Life Coverage

An elderly man sits on a couch, leaning on a cane and looking lost in thought.

By Tom Strangstalien, Executive Director Individual Insurance Planning

We often view term life insurance coverage as a commodity – the more coverage we can secure at the lowest cost the better. This is a flawed premise. There are numerous options and riders to at least consider when purchasing term life protection. An innovative new rider shatters this basic premise to pieces!

Read more…


Understanding the Annual Medicare Open Enrollment

Company employee benefits manual, with cover opening to reveal tabbed contents.

By Alisa Allen, RHU, REBC, Medicare Benefits Insurance Advisor

Each year Medicare allows beneficiaries to make changes to how they receive Medicare coverage during the annual open enrollment period. Let’s review a few of the basics and your options during this annual event.

Read more…


Wisconsin Physician License Renewal Now Open

By The Wisconsin Medical Society

Time to renew.

The Wisconsin Department of Safety and Professional Services (DSPS) will open physician license renewal on Friday, September 12, 2025. To keep your license active, you must submit a completed renewal application with payment by 11:59 p.m. on October 31, 2025.

Read more…


Adapting Employee Benefits to Support Your Staff

By Chris Noffke, REBC, CSFS, GBDS, Vice President of Employee Benefits

When I first entered the world of insurance nearly 20 years ago, the employee benefits landscape in Wisconsin was very different from what it is today. Back then, employee benefits centered almost exclusively around traditional health plan’s networks. Employers were primarily concerned with keeping costs manageable, while providing a basic level of coverage that checked the necessary boxes. Choices were not as limited, and customization was common.

Fast forward to today, and the shift is nothing short of pre-built benefits at a high cost. The employee benefits market has evolved dramatically, driven by changes in health care regulations, market competition, and the increasing expectations of both employers and their teams. Employees now expect a more robust and customizable benefits packages that go beyond just health insurance. We’re seeing a demand for Short-Term Disability (STD), Long-Term Disability (LTD), Life Insurance, Health Savings Accounts (HSA), Health Reimbursement Arrangements (HRA), and more – all becoming integral parts of employee benefits packages. Moreover, with a diverse and changing workforce, plus competition from large health care systems, adaptability has become key in managing group benefits effectively.

Reflecting on the journey, I’m reminded of the countless conversations and problem-solving moments that have defined my career. The relationships I’ve built and the trust I’ve earned are a testament to the commitment we’ve all shared in pushing the envelope and making sure employee benefits in Wisconsin are among the best.

If your group is feeling the strain of rising health care costs, or if you’re simply looking for a way to better manage your benefits strategy, let’s have a conversation. Contact me at chris.noffke@wismedassure.org or 608.442.3734.

Together, we can navigate the complexities of today’s market and find solutions that work not just for today, but for the future. After all, the only thing constant in this industry is change, and the best way to face it is side by side.

Picture of Chris Noffke, CSFS, GBDS

Chris Noffke, CSFS, GBDS

Vice President, Employee Benefits

Reach out to me to learn more. You can contact me at chris.noffke@wismedassure.org or 608.442.3734.

Send me an email!
Picture of Chris Noffke, CSFS, GBDS

Chris Noffke, CSFS, GBDS

Vice President, Employee Benefits

Reach out to me to learn more. You can contact me at chris.noffke@wismedassure.org or 608.442.3734.

Send me an email!

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisions. Full disclaimer and contact information.

Hybrid Policies Shine in Addressing Long-term Care Concerns

By Tom Strangstalien, Executive Director Individual Insurance Planning

It’s not a secret that the rapidly increasing cost of long-term care is driving dramatic increases in long-term care (LTC) insurance premiums. You may also have been victim or witness to a dramatic increase in long-term care insurance premiums on a policy purchased years ago.

In the 1990s and early 2000s, people realized the potentially huge benefit of buying long-term care insurance. Along with advances in medicine and the benefits of nutrition and exercise, life expectancy increased. Coming with that was the demand for long-term care services, assisted living facilities and home health care. Popularity in long-term care insurance grew exponentially and consumers bought policies with lifetime premiums, ten pay premiums or even single premiums at an affordable price.

Actuaries calculate statistics with acute precision to guide insurance companies to make their profits. However, this is one of very few instances where they missed the mark. Typically, with life and health insurance, a significant number of people will not hold the policy for their lifetime, and the policy will lapse. This lapse rate was miscalculated, as people who purchased these policies held on to them. Furthermore, inflation for this sector of health care was severely under calculated. Simple supply and demand economics manifested cost increases well beyond the costs of other consumer goods and services. Exacerbating the situation was the decrease in interest rates, as long-term bonds are purchased to provide the future benefits.

Now, consumers are experiencing the results of this perfect storm. We are seeing shockingly increased premiums, lowered benefits or even offers by insurance companies to buy-out or provide a dramatically lower paid-up benefit. Thankfully, actuaries have learned the impact of past transgressions and traditional long-term care policies are now priced properly. But what does this mean to you? A very expensive insurance protection, along with the risk that it may never be used, so what should you do?

What happens if you pay for LTC insurance but never actually need it?

Despite long-term care insurance being so costly, I remain steadfast that long-term care protection is paramount to your financial plan! The facts speak for themselves; longtermcare.gov and the AARP agree, 70 percent of people 65 and older will require long-term care and meeting that need will continue to become more expensive.

Genworth’s Cost of Care Survey shows national annual median costs increased across the board for assisted living facilities (6.1%), home care (4.3-4.4%) and skilled nursing facilities (3.2-3.5%). The median monthly cost of an assisted living facility is $4,051, a home health aide costs $4,385 and a private room in a skilled nursing facility $8,517 a month. Genworth estimates these costs will almost double over the next 20 years.

There’s a new option for long-term care planning: hybrid life insurance long-term care policies. Actuaries have been properly pricing life insurance policies for decades. They now know the amount that will be paid out in benefits and when that benefit will be paid. In these hybrid policies, the life insurance benefit can be paid out early if needed for long-term care. If benefits are not used for long-term care, the life insurance amount is paid upon death to the policyholder’s beneficiaries. This addresses the concern of never using the policy. Benefits will not be taxable if paid out for long-term care and the life insurance benefit is paid out income tax free. In the majority of cases, this type of plan outperforms self-funding.

Hybrid policies have a lot going for them:

  • They offer flexible premium payment options. You can make one lump-sum payment, pay over ten or twenty years, or pay premiums over time.
  • It is often easier to qualify for coverage as the insurer knows what will be paid out in benefits.
  • A hybrid policy can also pay for home health care, assisted living, adult day care and even respite care for a loved one.
  • Permanent life insurance policies build cash value that can be cashed out in the future if you feel there’s no longer a need for long-term care protection or independent wealth negates the benefit.

You have options…lots of options to choose from

Hybrid life and long-term care policies come in several shapes and sizes.

  • Linked benefit policies are true hybrids that link a life insurance policy to a long-term care policy. With these, the typical long-term care benefit amount is close to or equals the life insurance amount. The greater the life insurance amount, the greater the LTC benefits.
  • You can also get a long-term care rider on a life insurance policy which only allows you to add LTC coverage at the time you buy the life insurance policy – you can’t add it later.
  • There are chronic illness or critical illness riders that let you accelerate the death benefit to pay for care if you have a qualifying chronic lifetime illness.

If you currently own some form of LTC insurance and want to compare which coverage may fit best into your current financial plan, we are here to comprehensively explore all the options and make sure your plan is suitable and won’t blow up at a time when you may need it most.

If you do not yet have any form of LTC insurance, the longer you wait, the more expensive it will become. I highly recommend exploring a hybrid life insurance / long-term care policy and getting it early. The younger and healthier the better! Avoid crisis mode or future exorbitant premiums.

As your financial partner, your WisMed Assure team is here to take care of your personal financial security so that you can take the best possible care of yourself, your family and your patients.

Contact me today to protect your tomorrow at tom.strangstalien@wismedassure.org or 608.442.3730.

Picture of Tom Strangstalien

Tom Strangstalien

Executive Director Individual Insurance Planning

Reach out to me to learn more. You can contact me at tom.strangstalien@wismedassure.org or 608.442.3730.

Send me an email!
Picture of Tom Strangstalien

Tom Strangstalien

Executive Director Individual Insurance Planning

Reach out to me to learn more. You can contact me at tom.strangstalien@wismedassure.org or 608.442.3730.

Send me an email!

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisionsFull disclaimer and contact information.