Does Geographic Location Make a Difference? A Comparative Analysis of the Socio-Demographic & Attitudinal Characteristics of Active Buyers & Non-Buyers of the Federal Long-Term Care Insurance Program

09/21/2004

U.S. Department of Health and Human Services

Does Geographic Location Make a Difference? A Comparative Analysis of the Socio-Demographic and Attitudinal Characteristics of Active Buyers and Non-Buyers of the Federal Long-Term Care Insurance Program

LifePlans, Inc.

September 21, 2004

PDF Version


This policy brief was prepared under contract between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and Abt Associates. The brief was written by LifePlans, Inc. For additional information about the study, you may visit the DALTCP home page at http://aspe.hhs.gov/_/office_specific/daltcp.cfm or contact the ASPE Project Officer, Hunter McKay, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201. His e-mail address is: Hunter.McKay@hhs.gov.


This data brief is one of eight commissioned by the Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation to analyze survey data collected by Long Term Care Partners from members of the federal family regarding the long-term care insurance offering available to them. This brief analyzes how geography is associated with long-term care insurance. The remaining briefs address: a Profile of Buyers; a Profile of Non-Buyers; a Profile of Non-Responders; a Comparison of Active and Retired Buyers, Non-Buyers and Non-Responders; a Comparison of Engagement and Participation among Buyers, Non-Buyers and Non-Responders; a Multivariate Analysis of Buyers and Non-Buyers; and a Comparison of Active Buyers/Non-Buyers in the Federal, Private and Public Sectors. A Literature Review is also available.

I. BACKGROUND

One of the more ambitious proposals for encouraging growth in the private insurance market was passage of the Long Term Care Security Act (Public Law 106-265). This Act was passed in the summer of 2000 and was signed into law on September 19th of that year. It authorized the U.S. Office of Personnel Management (OPM) to contract for a long-term care (LTC) insurance program for federal employees. Coverage would be available to active federal employees and annuitants (civilian retirees), as well as active and retired members of the uniformed services. "Qualified relatives" of active workers and military personnel including spouses, adult children, parents, and parents-in-law would also be covered by the program. OPM expected that, like the health and life insurance programs it administers, the Federal Long-Term Care Insurance Program (FLTCIP) would become the largest employer-sponsored LTC insurance program in the nation.

The development of the program was in part meant to send a message to other employers around the country that a "progressive" employer is one that offers LTC insurance to its employees. Naturally it was expected that implementation of the program would spur additional interest and growth in the market. The program began in earnest in July 2002, which constituted the beginning of the open enrollment period. The carriers underwriting the program -- John Hancock and MetLife -- formed a joint venture called Long Term Care Partners, LLC, which is devoted exclusively to administering the program.

Long Term Care Partners conducted one of the largest LTC educational campaigns ever. More than one million people requested enrollment kits. As of August 2004, more than 300,000 applications had been received and more than 210,000 policies issued. About 64% of enrollees were active employees and spouses, 31% annuitants and their spouses, and another 5% surviving spouses, parents/in-laws and adult children. Thus, in relatively short order, the FLTCIP became one of the largest group programs in the United States. In part this was due to the significant marketing and enrollment activities including more than 2,100 educational meetings, briefings to human resources staff and outreach programs to affinity groups.

The large number of enrollments affords a unique opportunity to better understand the attitudes and perspectives of both working and retired individuals regarding LTC concerns, the importance of planning, and the role that insurance may (or may not) play in meeting the needs of disabled individuals. An examination of such attitudes can assist policymakers as well as insurers to better understand marketplace opportunities and barriers, and devise strategies to encourage growth in the market.

II. PURPOSE

This is the eighth in a series of data briefs based on the information collected from active buyers and non-buyers of the federal program. The purpose of this data brief is to determine the extent to which the attitudes, opinions and motivations of individuals who purchased and did not purchase the federal LTC insurance policy are in part a function of geographic location. We are also interested in knowing how geography is associated with their experience with LTC and opinions about LTC insurance. Relevant research questions answered in this brief include (but are not limited to) the following:

  • How do the demographic and characteristics of active buyers and non-buyers differ across geographic regions?
  • What are the attitudes and opinions about retirement planning among active buyers and non-buyers across geographic regions?
  • What are the similarities and/or differences in knowledge of LTC and insurance among individuals in each of the geographic regions?
  • Does the extent of exposure to marketing materials and messages vary by geographic region?

III. METHOD AND SAMPLE

Long Term Care Partners used mail surveys to collect information from active buyers and non-buyers. For purposes of this research, the active sample consists of employees who are actively working. A "buyer" is someone who has purchased the insurance plan and paid premiums beyond the free look period. A "non-buyer" is defined as someone who expressed interest in a program but had not purchased the plan at the time that the survey was completed.

Three geographic segments are analyzed: (1) the "DC Area", which comprises the District of Columbia, Maryland, and Virginia; (2) "The East" which comprises all states to the east of Minnesota, Iowa, Missouri, Arkansas and Louisiana; and (3) "The West" which includes all states west of Wisconsin, Illinois, Kentucky, Tennessee and Mississippi. As shown, about 3,300 individuals participated in the various surveys of active and retired buyers and non-buyers. Table 1 below summarizes the sample sizes by market segment and geographic regions.

Table 1: Distribution of Sample by Market Segment and Geographic Region
 Washington, D.C.The EastThe West
Active Buyers196210228
Active Non-Buyers94238223
Retired Buyers226427445
Retired Non-Buyers76257243
Total6321,3481,363

IV. FINDINGS

A. Demographic and Employment Characteristics

Figure 1 summarizes important demographic characteristics of the aggregate active sample of buyers and Figure 2 shows similar characteristics for active non-buyers. Across each of the regions the majority of buyers are married, male, have children living nearby and are highly educated. The average age of buyers across the regions varies between 52 and 54 years. There are statistically significant differences on three variables: income, assets, and education status. Buyers in Washington, D.C. are more likely to be college graduates and to have higher incomes and assets. In fact, the average income of buyers in the D.C. area is $98,261 compared to $81,710 in other regions of the country. Asset differentials are even greater; the average value of liquid assets of active buyers in D.C. is about $226,000 compared to roughly $186,000 in other areas of the country.

Figure 1: Demographic Characteristics of Active Buyers by Geographic Region
Source: Analysis of data from the FLTCIP, 2003.

As shown in Figure 2, the same pattern of results holds true for non-buyers. Again, the only significant demographic differences across regions are education status and income and asset levels. Non-buyers in Washington, D.C. are more likely to be educated and have significantly higher levels of income and assets -- $92,000 compared to $70,000 (income) and $180,000 compared to $158,000 (assets).

While there are no significant age differences between buyers and non-buyers across the regions, buyers tend to be more educated, wealthier and less likely to be married and have children living nearby. This could suggest that buyers may view having the insurance as compensating for their perceived lack of family support, which is still the largest contributor of long term care services.

Figure 2: Demographic Characteristics of Active Non-Buyers by Geographic Region
Source: Analysis of data from the FLTCIP, 2003.

The patterns observed for the active sample of buyers and non-buyers also holds true for the retired sample. In both cases, retiree buyers and non-buyers in Washington, D.C. have higher incomes and are better educated than those in the East and West. There are, however, no significant differences in asset levels. Again, retired buyers tend to be wealthier and more educated than non-buyers across all of the regions. Finally, in contrast to the sample of actives, there were no significant differences in the marital status of buyers and non-buyers by geographic regions. Retired buyers in the west, however, are the least likely to have children living nearby. (See Appendix for more detailed information on retirees.)

B. Attitudes and Experience with Retirement Planning and Long-Term Care

Previous briefs have established that federal employees tend to be active in planning for their retirement and understand the potential LTC risks associated with later life. Their life experiences with relatives or friends may also influence their decisions regarding the purchase of insurance. We asked a series of questions designed to illuminate key differences between buyers and non-buyers across the three geographic regions.

There are few differences across geographic regions among buyers regarding attitudes and opinions about retirement planning. Most (80%) have at least a general sense for how much to save to live comfortably in retirement, have thought about how to pay for LTC (96%) and believe having the insurance is important to retirement planning (97%). Geographic region is also not associated with non-buyers' attitudes about these issues. However, across all regions non-buyers are less likely to have thought about these issues or believe that insurance is an important part of a retirement plan. By and large, these same patterns hold true for the retired sample.

With few exceptions, geographic region is also unrelated to active employees' experience with LTC and attitudes about risk. Active buyers in Washington, D.C. are, however, somewhat less likely to know someone who has experienced financial hardship as a result of caring for an elderly relative. (Note that this population also is has higher levels of income and assets than buyers elsewhere.) Regarding retirees, buyers in the east are the most likely to have had caregiving experience -- 39% compared to 26% -- to have experienced financial hardship as a result of caring for an elderly relative -- 7% compared to 3% -- and know someone who has experienced financial hardship as a result of caring for an elderly relative -- 42% compared to 35%. There were no significant differences in experience across regions among non-buyers.

In past research, one factor that has distinguished buyers from non-buyers is their knowledge of potential payment sources for LTC. The insurance industry has invested heavily in educating consumers about LTC financing and there was an extensive educational campaign for the federal program. In order to gauge the effectiveness of that education, we asked buyers and non-buyers who they believe would pay for LTC if they ever needed it. There were no significant differences in responses among buyers. Among active non-buyers, however, there was an important geographic difference regarding knowledge of payment source for LTC services. Figure 3 summarizes results among active non-buyers and shows that those in the Washington, D.C. area are more likely to understand that they will have to use their own income and assets to pay for care if it is needed.

Figure 3: Active Non-Buyers View of Who Will Pay for Long-Term Care if it is Needed by Geographic Region
Source: Analysis of data from the FLTCIP, 2003.

Non-buyers in Washington, D.C. are also most likely to understand that Medicare or Medicaid will not pay for their LTC expenses. Finally, the further away from Washington, D.C. one gets, the more likely is there to be uncertainty about how LTC costs would be paid if services were needed. This finding may suggest that at least with respect to payment source knowledge, the education campaign in the Washington, D.C. area was more effective than in other parts of the country. Alternatively, it may be that given the higher levels of education, this is knowledge that these individuals had even before the marketing campaign began. These trends were not evident among the retiree sample.

Non-buyers of the federal program were also asked whether or not they currently had LTC insurance and whether they bought the insurance after they heard about the federal program. As shown in Figure 4, non-buyers of the federal program in the Washington, D.C. area are twice as likely to purchase LTC insurance as non-buyers in other geographic regions. Moreover, they are the most likely to have bought the insurance after hearing about the federal program. Somewhat surprisingly, of those non-buyers in the East and West who had insurance, a meaningful proportion of them -- between 17% and 25% -- had not heard about the federal program. This finding again suggests that the education and marketing campaign was either heavily targeted or particularly effective in the Washington, D.C. area. It also suggests that other carriers benefited from the wide net cast by the campaign: between one in five and one in ten non-buyers actually purchased a non-federal policy.

Figure 4: Active Non-Buyers Purchase of Long-Term Care Insurance by Geographic Region
Source: Analysis of data from the FLTCIP, 2003.

C. Experience with the Application Process and Exposure to Promotional Materials

Given some of the major differences in education level and the fact that the program was national in scope, one might have expected differences across geographic region in peoples' experience with the application process. In a prior brief, we demonstrated that non-buyers had a more difficult time understanding the application materials and getting their questions answered than did buyers. This finding holds true across all geographic regions. However, among active buyers, those in the Washington, D.C. area seemed to have an easier time understanding the application and also found it easier to obtain answers to their questions about the program (see Figure 5).

Figure 5: Active Buyers Experience with Application Process by Geographic Region
Source: Analysis of data from the FLTCIP, 2003.

The program sponsors -- Long Term Care Partners -- invested significant resources in the marketing and education campaign. They did so through sponsorship of a variety of promotional activities such as educational meetings, satellite broadcasts, advertisements, articles, brochures, web sites, toll-free numbers, and more. This was done to assure maximum exposure to the program. As outlined in a previous brief, we found that non-buyers were less likely to have actively engaged in activities designed to educate and reinforce the need for insurance protection against the cost of LTC. This is fairly typical across the geographic regions. The extent of non-buyer exposure to educational activities does not vary by geographic region except when it comes to visiting the website and reading articles about the program; non-buyers in Washington, D.C. are far more likely to have visited the website (62%) than are non-buyers elsewhere (34%). They are also more likely to have read newspaper articles about the program than non-buyers elsewhere -- 57% compared to 29%.

The same can be said of buyers: for the most part, exposure does not vary by geographic region. The exception is that compared to buyers in the West and in the D.C. area, those in the East are the least likely to talk to federal colleagues about the program. On the other hand, they are more likely to have read newspaper articles than non-buyers elsewhere. There are few significant variations in exposure by geographic region for the retiree population. Again, retirees living in Washington, D.C. are far more likely to have read newspaper articles about the program than retirees elsewhere.

V. CONCLUSIONS

For the most part, there are few geographic differences in the attitudes and opinions of buyers and non-buyers of the federal program regarding retirement planning and LTC. There are, however, a number of important socio-demographic differences (i.e., those living in the Washington, D.C. area tend to be more highly educated and wealthier), as well as those relating to experience with LTC, especially among retirees. Retirees in the D.C. area have more experience caregiving and are more likely to either know someone who has had, or to have personally experienced, financial hardship as a result of LTC.

Non-buyers in the Washington, D.C. area are also more likely to have purchased a LTC insurance policy not sponsored by the Federal Government than non-buyers in other areas of the country. Moreover, the fact that a meaningful proportion of non-buyers in the East and West who had purchased other policies had not even heard of the federal program, suggests that the marketing campaign may not have been as effective in these areas. This is somewhat supported by the finding that non-buyers outside of Washington, D.C. are also less likely to have been involved in certain promotional activities.

The analysis presented here has focused to a large extent on observed differences between geographic regions on selected variables. It is important to note that on the vast majority of parameters examined, geography is not a particularly important variable.

APPENDIX

Notes for Tables

All significance tests are based on 5% level or better. Notations for significance are as follows: If one category out of three contains the symbol (*), then the category starred is statistically different from each of the other two categories, but the non-starred categories are not different from each other. If two categories out of the three contain the symbol (*), then those two categories are statistically different from each other, but each of those categories is not statistically different from the third one. If all three categories contain the symbol (*), then all three are statistically different from each other.

Unless otherwise specified, only the response category that has a notation of significance was tested against all other categories. In some cases, it was determined that a combination of categories would be tested. These are indicated in the footnotes. It also may be the case that if categories were or were not combined, it could change the results of the test of significance.

Unless otherwise indicated, the first response category (i.e., strongly agree, very important, very likely, etc.) or the yes response was tested. Therefore, if there are no notations for significance, the test was not significant at the 5% level.

TABLE A-1: Socio-Demographic Characteristics of Active Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Socio-Demographic CharacteristicsActive Buyers DCActive Buyers EastActive Buyers WestActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
Average age535254525454
   Less than 50273122403032
   50 to 54262326242623
   55 to 59272625182020
   60 to 641315188913
   65 and over759101512
Gender
   Male465053576058
   Female545047434042
Marital status
   Never Married2217131199
   Married576159706673
   Divorced/separated151524162014
   Widowed453243
   Domestic Partner221111
Presence of children living within 25 miles
   Yes414342536359
   No595758473741
Education level
   Less than high graduate000010
   High school graduate49471712
   Technical/ trade/ business school247574
   Some college152025232837
   College graduate13679*346739642065*29472947
   Graduate degree433325451818
Average income2$98,261*$81,714$81,709$92,386*$70,692$69,603
   Less than $15,000000011
   $15,000 to $24,999011111
   $25,000 to $34,999333347
   $35,000 to $39,999122277
   $40,000 to $49,9992111051516
   $50,000 to $59,9993121181512
   $60,000 to $69,99910101271011
   $70,000 to $74,999788577
   $75,000 to $99,999212324202218
   $100,000 to $124,999171513231014
   $125,000 or more3615162686
Average liquid assets2$184,919$190,856$225,833$180,920$162,053$153,378
   Less than $10,000497131817
   $10,000 to $19,9993345107
   $20,000 to $29,999564388
   $30,000 to $49,9991081291312
   $50,000 to $74,9997121981411
   $75,000 to $99,9998105679
   $100,000 to $124,999899778
   $125,000 to $149,999475846
   $150,000 to $199,9991369354
   $200,000 to $249,99910109236
   $250,000 and above282017361112
Home ownership
   Yes909190878389
   No10910131711
  1. Here, having a college degree or better is tested for significance against not having a college degree.
  2. Averages were calculated by taking the midpoints of the ranges.
TABLE A-2: Socio-Demographic Characteristics of Retired Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Socio-Demographic CharacteristicsRetired Buyers DCRetired Buyers EastRetired Buyers WestRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
Average age65*6666*707172
   Less than 50311322
   50 to 54342532
   55 to 591813121077
   60 to 6423242581410
   65 and over535860747479
Gender
   Male717169687179
   Female292931322921
Marital status
   Never Married998453
   Married716769676973
   Divorced/separated88111097
   Widowed101411191717
   Domestic Partner221000
Presence of children living within 25 miles
   Yes59*5248*605554
   No424852404546
Education level
   Less than high graduate020045
   High school graduate111813121916
   Technical/ trade/ business school465788
   Some college172124312632
   College graduate135*28*31322423
   Graduate degree332527181916
Average income2$79,825*$62,330$59,547$63,918*$49,522$47,304
   Less than $15,000110235
   $15,000 to $24,99913461216
   $25,000 to $34,9992111091510
   $35,000 to $39,9994109121317
   $40,000 to $49,999121517121816
   $50,000 to $59,99913141891113
   $60,000 to $69,999101312779
   $70,000 to $74,9996971252
   $75,000 to $99,99919161519126
   $100,000 to $124,9991764324
   $125,000 or more1544922
Average liquid assets2$126,798$204,151$212,063$181,607$170,558$162,813
   Less than $10,00043431212
   $10,000 to $19,999143757
   $20,000 to $29,999224668
   $30,000 to $49,999697101213
   $50,000 to $74,99999107108
   $75,000 to $99,999796775
   $100,000 to $124,9999781074
   $125,000 to $149,999466455
   $150,000 to $199,9996811978
   $200,000 to $249,999878458
   $250,000 and above443633332422
Home ownership
   Yes949292909091
   No68810109
  1. Here, having a college degree or better is tested for significance against not having a college degree.
  2. Averages were calculated by taking the midpoints of the ranges.
TABLE A-3: Attitudes and Opinions About Retirement Planning and Long-Term Care Among Active Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Attitudes and OpinionsActive Buyers DCActive Buyers EastActive Buyers WestActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
Determined how much to save to live comfortably in retirement
   Yes, a definite sense1252021141715
   Yes, a general sense566262614453
   No181716223631
   Do not plan to retire111331
Thought given to paying for LTC expenses
   A great deal656359252121
   Some323337545049
   Not much thought344212126
   No thought at all000084
How important is LTC insurance to retirement planning
   Very important616160242623
   Somewhat important363638575156
   Not very important322131912
   Not at all important000102
   Have not started planning010547
LTC insurance programs sold today will cover the cost of LTC services needed in the future
   Strongly agree1099125
   Agree747172473438
   Disagree131717425349
   Strongly disagree33210118
How would LTC costs be paid2
   Medicaid142334
   Medicare710851110
   Medigap Supplement Policy121010
   Own health insurance or retiree health care plan242323353035
   Own income39353835*2319*
   Children will help pay111001
   Other323442
   LTC insurance676113
   Don't know3181618172724
  1. Here, having a general or a definite sense of how much needs to be saved were combined and tested as a single yes response. Those who did not plan to retire were removed from the analysis.
  2. Active buyers were asked whether they worried about how to pay for LTC services before they purchased the FLTCIP and how they would pay for LTC in the absence of their LTC policy.
  3. This response category was tested for significance and it was found not to be significant.
TABLE A-4: Attitudes and Opinions About Retirement Planning and Long-Term Care Among Retired Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Attitudes and OpinionsRetired Buyers DCRetired Buyers EastRetired Buyers WestRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
Determined how much to save to live comfortably in retirement
   Yes, a definite sense1322825181519
   Yes, a general sense515961475850
   No171314352731
Thought given to paying for LTC expenses
   A great deal686862272528
   Some303035535952
   Not much thought222181218
   No thought at all001242
How important is LTC insurance to retirement planning
   Very important586255142121
   Somewhat important403741474248
   Not very important214232419
   Not at all important000863
   Have not started planning000879
LTC insurance programs sold today will cover the cost of LTC services needed in the future
   Strongly agree813*8*633
   Agree726770293234
   Disagree191819474747
   Strongly disagree123181816
How would LTC costs be paid2
   Medicaid221231
   Medicare657131416
   Medigap Supplement Policy011222
   Own health insurance or retiree health care plan141617302218
   Own income625754434242
   Children will help pay000010
   Other122422
   LTC insurance899012
   Don't know378961317
  1. Here, having a general or a definite sense of how much needs to be saved were combined and tested as a single yes response. Those who did not plan to retire were removed from the analysis.
  2. Retired buyers were asked whether they worried about how to pay for LTC services before they purchased the FLTCIP and how they would pay for LTC in the absence of their LTC policy.
  3. This response category was tested for significance and it was found not to be significant.
TABLE A-5: Experience with Long-Term Care Among Active Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Experiences with LTCActive Buyers DCActive Buyers EastActive Buyers WestActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
Parent needed LTC
   Yes434143534841
   No575957475259
The repondent has been a caregiver
   Yes243224172428
   No766876837672
The respondent knew someone who used most of his/her assets to pay for LTC
   Yes45*58*55444752
   No554246565348
The respondent has experienced financial hardship as a result of caring for an elderly relative
   Yes41053119
   No969095978991
The respondent knew someone who has experienced financial hardship as a result of caring for an elderly relative
   Yes32*4948344144
   No685152665956
TABLE A-6: Experience with Long-Term Care Among Retired Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Experiences with LTCRetired Buyers DCRetired Buyers EastRetired Buyers WestRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
Parent needed LTC
   Yes343943494952
   No666157515148
The repondent has been a caregiver
   Yes2839*24394332
   No726176615768
The respondent knew someone who used most of his/her assets to pay for LTC
   Yes605951*495251
   No404149514849
The respondent has experienced financial hardship as a result of caring for an elderly relative
   Yes47*3*4127
   No969397968893
The respondent knew someone who has experienced financial hardship as a result of caring for an elderly relative
   Yes3742*33*333738
   No635867676362
TABLE A-7: Self-Assessed Risk of Needing LTC Among Active Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Type of LTCActive Buyers DCActive Buyers EastActive Buyers WestActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
How likely is it that:
a) the respondent thinks he/she will need help with everyday activities such as bathing and dressing
   Very likely10121451210
   Likely19161591514
   Somewhat likely404546363535
   Not very likely252321383028
   Not at all likely64412813
b) the respondent thinks he/she will need home care services for more than three months
   Very likely1215135119
   Likely191621111514
   Somewhat likely454941433738
   Not very likely211622293028
   Not at all likely34312711
c) the respondent thinks he/she will need nursing home care for more than three months
   Very likely1113138119
   Likely17171691316
   Somewhat likely414342403232
   Not very likely252024313429
   Not at all likely675121014
d) the respondent thinks he/she will need care provided in assisted living facility for more than three months
   Very likely16171613129
   Likely212122161617
   Somewhat likely434137423435
   Not very likely171622212928
   Not at all likely3538911
TABLE A-8: Self-Assessed Risk of Needing LTC Among Retired Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Type of LTCRetired Buyers DCRetired Buyers EastRetired Buyers WestRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
How likely is it that:
a) the respondent thinks he/she will need help with everyday activities such as bathing and dressing
   Very likely4*9*761413
   Likely171915141521
   Somewhat likely474743324037
   Not very likely242028332620
   Not at all likely8571459
b) the respondent thinks he/she will need home care services for more than three months
   Very likely57761213
   Likely202015151620
   Somewhat likely494747394038
   Not very likely192124232620
   Not at all likely7571769
c) the respondent thinks he/she will need nursing home care for more than three months
   Very likely47661211
   Likely171814121414
   Somewhat likely434544433537
   Not very likely282527143127
   Not at all likely85925811
d) the respondent thinks he/she will need care provided in assisted living facility for more than three months
   Very likely710841310
   Likely212020161513
   Somewhat likely474644353645
   Not very likely181922272822
   Not at all likely75618810
TABLE A-9: Opinions about Long-Term Care Insurance Among Active Buyers by Geographic Location (D.C. vs. East vs. West)
Opinions about LTC InsuranceActive Buyers DCActive Buyers EastActive Buyers West
What % of your expenses do you expect your LTC insurance to pay
   100%12179
   61%-99%676770
   40%-60%191317
   35%-39%124
   <25%110
TABLE A-10: Opinions about Long-Term Care Insurance Among Retired Buyers by Geographic Location (D.C. vs. East vs. West)
Opinions about LTC InsuranceRetired Buyers DCRetired Buyers EastRetired Buyers West
What % of your expenses do you expect your LTC insurance to pay
   100%8106
   61%-99%656670
   40%-60%242019
   35%-39%334
   <25%011
TABLE A-11: Opinions about Long-Term Care Insurance Among Active Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Opinions about LTC InsuranceActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
Do you currently have LTC insurance
   Yes19*8*10
   No819290
Did you buy your LTC insurance after you heard about the FLTCIP1
   Yes272*4631*
   No283744
   I did not know about the FLTCIP01725
  1. This question was only asked of those people who stated that they currently had LTC insurance; therefore the percentage of people who said they did not know about the FLTCIP are only of those non-buyers and non-responders who have LTC insurance.
  2. The distribution for this question is based on the answers of 18 Active Non-Buyers in the D.C. area, 30 Active Non-Buyers in the East and 32 Active Non-Buyers in the West.
TABLE A-12: Opinions about Long-Term Care Insurance Among Retired Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Opinions about LTC InsuranceRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
Do you currently have LTC insurance
   Yes301819
   No708281
Did you buy your LTC insurance after you heard about the FLTCIP1
   Yes271514
   No795855
   I did not know about the FLTCIP142731
  1. This question was only asked of those people who stated that they currently had LTC insurance; therefore the percentage of people who said they did not know about the FLTCIP are only of those non-buyers and non-responders who have LTC insurance.
  2. The distribution for this question is based on the answers of 29 Retired Non-Buyers in the D.C. area, 90 Retired Non-Buyers in the East and 100 Retired Non-Buyers in the West.
TABLE A-13: Decision Making Process of Active Buyers by Geographic Location (D.C. vs. East vs. West)
Decision Making ProcessActive Buyers DCActive Buyers EastActive Buyers West
I considered buynig LTC insurance prior to the federal offering
   Yes575661
   No434439
I would have bought LTC insurance if the Federal Government had not offered it
   Yes343233
   No151717
   Not sure515150
TABLE A-14: Decision Making Process of Retired Buyers by Geographic Location (D.C. vs. East vs. West)
Decision Making ProcessActive Buyers DCActive Buyers EastActive Buyers West
I considered buynig LTC insurance prior to the federal offering
   Yes677572
   No332528
I would have bought LTC insurance if the Federal Government had not offered it
   Yes404440
   No121314
   Not sure484346
TABLE A-15: Decision Making Process of Active Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Decision Making ProcessActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
How seriously was buying the FLTCIP considered
   Very seriously393333
   Somewhat seriously414240
   Not very seriously131616
   Not seriously at all756
   Did not consider045
How likely did you think it was that you would buy the FLTCIP when you requested the application
   Very likely181817
   Likely575250
   Not very likely252830
   Not at all likely023
TABLE A-16: Decision Making Process of Retired Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Decision Making ProcessRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
How seriously was buying the FLTCIP considered
   Very seriously322524
   Somewhat seriously383936
   Not very seriously152022
   Not seriously at all757
   Did not consider81111
How likely did you think it was that you would buy the FLTCIP when you requested the application
   Very likely13138
   Likely414443
   Not very likely423644
   Not at all likely475
TABLE A-17: Experience with the Application Process Among Active Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Experience with the Application ProcessActive Buyers DCActive Buyers EastActive Buyers WestActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
Was the following easy/difficult for you:
a) getting an application1
   Did not get an application000142125
   Did get an application100100100867975
   Easy to get an application989997999497
   Difficult to get an application213163
b) understanding the application1
   Did not attempt to understand the application000273235
   Did attempt to understand the application100100100736865
   Easy to understand the application97*91*94807076
   Difficult to understand the application396203024
c) answering health questions1
   Did not answer health questions000423844
   Did answer health questions100100100586256
   Easy to answer health questions999798837681
   Difficult to answer health questions132172419
d) reading the application materials1
   Did not read the application materials000303131
   Did read the application materials100100100706969
   Easy to read the application materials888482746770
   Difficult to read the application materials121618263330
Easy/difficult to obtain answers to questions about the federal program
   Very easy40*2928*231722
   Easy566563565248
   Difficult348152824
   Very difficult121636
  1. The responses for "easy" and "difficult" are calculated on the basis of only those respondents who did the specific activity.
TABLE A-18: Experience with the Application Process Among Retired Buyers and Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Experience with the Application ProcessRetired Buyers DCRetired Buyers EastRetired Buyers WestRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
Was the following easy/difficult for you:
a) getting an application1
   Did not get an application000232534
   Did get an application100100100777566
   Easy to get an application1009898969696
   Difficult to get an application022444
b) understanding the application1
   Did not attempt to understand the application000313039
   Did attempt to understand the application100100100697061
   Easy to understand the application939593807578
   Difficult to understand the application757202522
c) answering health questions1
   Did not answer health questions000383948
   Did answer health questions100100100626152
   Easy to answer health questions939290807675
   Difficult to answer health questions7810202425
d) reading the application materials1
   Did not read the application materials000313444
   Did read the application materials100100100696656
   Easy to read the application materials848682737466
   Difficult to read the application materials161418272634
Easy/difficult to obtain answers to questions about the federal program
   Very easy3040*31*221515
   Easy655765565863
   Difficult433162418
   Very difficult101634
  1. The responses for "easy" and "difficult" are calculated on the basis of only those respondents who did the specific activity.
TABLE A-19: Awareness about the Federal Program Among Retired Non-Responders by Geographic Location (D.C. vs. East vs. West)
Awareness about the Federal ProgramRetired Non-Responders DCRetired Non-Responders EastRetired Non-Responders West
Are you aware that the Federal Government is sponsoring a LTC insurance program
   Yes462932
   No547168
TABLE A-20: Exposure to Promotional Activities Among Active Buyers and Non-Buyers by Geographic Location (DC vs. East vs. West)
Promotional ActivitiesActive Buyers DCActive Buyers EastActive Buyers WestActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
Did you do any of the following:
a) talk to colleagues about the federal program1
   Did not talk to colleagues24*36*33405248
   Did talk to colleagues766467604852
   Found it to be helpful78*7365*505957
   Did not find it to be helpful222735505957
b) talk to human resource representative1
   Did not talk to human resource representative808782738381
   Did talk to human resource representative201318271719
   Found it to be helpful2848085648162
   Did not find it to be helpful162015361938
c) attend educational meetings1
   Did not attend educational meetings566558526869
   Did not know about the educational meetings27671015
   Did attend educational meetings422836412216
   Found them to be helpful95919584*8076
   Did not find them to be helpful595162024
d) view satellite broadcasts1
   Did not view satellite broadcasts707172797873
   Did not know about the satellite broadcasts91110111617
   Did view satellite broadcasts21181810610
   Found them to be helpful3938395566762
   Did not find them to be helpful7175443338
e) read "Get Smart About Your Future"1
   Did not read "Get Smart About Your Future"272332273535
   Did not know about "Get Smart About Your Future"49811912
   Did read "Get Smart About Your Future"696860625653
   Found it to be helpful959496818690
   Did not find it to be helpful564191410
f) read advertisements1
   Did not read advertisements464042314137
   Did not know about the advertisements57109814
   Did read advertisements495348605149
   Found them to be helpful868993668075
   Did not find them to be helpful14117342025
g) visit websites describing the federal program1
   Did not visit websites describing the federal program20262934*5851
   Did not know about the websites describing the federal program14441113
   Did visit websites describing the federal program797067623136
   Found them to be helpful979897818386
   Did not find them to be helpful323191714
h) read banner ads1
   Did not read banner ads726878707372
   Did not know about the banner ads10161191617
   Did read banner ads181611211111
   Found them to be helpful4596172426063
   Did not find them to be helpful413928584037
i) read newspaper articles1
   Did not read newspaper articles48*626338*5556
   Did not know about the newspaper articles410951516
   Did read newspaper articles482828573028
   Found them to be helpful928686716868
   Did not find them to be helpful81414293232
j) read general brochures1
   Did not read general brochures121317142019
   Did not know the general brochures121157
   Did read general brochures878582857574
   Found them to be helpful979599828381
   Did not find them to be helpful351181719
k) call toll-free number1
   Did not call a toll-free number595962727676
   Did not know about the toll-free number55361012
   Did call a toll-free number363635221412
   Found it to be helpful5939694757564
   Did not find it to be helpful746252536
  1. The responses for "helpful" and "not helpful" are calculated on the basis of only those respondents who did the specific activity.
  2. The distribution for this question is based on the answers of 37 Active Buyers in the DC area, 25 Active Buyers in the East and 39 Active Buyers in the West. The distribution for this question is based on the answers of 25 Active Non-Buyers in the DC area, 36 Active Non-Buyers in the East and 37 Active Non-Buyers in the West.
  3. The distribution for this question is based on the answers of nine Active Non-Buyers in the DC area, 15 Active Non-Buyers in the East and 21 Active Non-Buyers in the West.
  4. The distribution for this question is based on the answers of 32 Active Buyers in the DC area, 31 Active Buyers in the East and 25 Active Buyers in the West. The distribution for this question is based on the answers of 19 Active Non-Buyers in the DC area, 25 Active Non-Buyers in the East and 24 Active Non-Buyers in the West.
  5. The distribution for this question is based on the answers of 20 Active Non-Buyers in the DC area, 32 Active Non-Buyers in the East and 25 Active Non-Buyers in the West.
TABLE A-21: Exposure to Promotional Activities Among Retired Buyers and Non-Buyers by Geographic Location (DC vs. East vs. West)
Promotional ActivitiesRetired Buyers DCRetired Buyers EastRetired Buyers WestRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
Did you do any of the following:
a) talk to colleagues about the federal program1
   Did not talk to colleagues64*7476758080
   Did talk to colleagues362624252020
   Found it to be helpful2857975676964
   Did not find it to be helpful152125333136
b) talk to human resource representative1
   Did not talk to human resource representative979797949796
   Did talk to human resource representative333634
   Found it to be helpful38310082505750
   Did not find it to be helpful17018504350
c) read "Get Smart About Your Future"1
   Did not read "Get Smart About Your Future"262630374239
   Did not know about "Get Smart About Your Future"866131212
   Did read "Get Smart About Your Future"666864504649
   Found it to be helpful979698868489
   Did not find it to be helpful342141611
d) read advertisements1
   Did not read advertisements373637394447
   Did not know about the advertisements535101210
   Did read advertisements586158514443
   Found them to be helpful929595757782
   Did not find them to be helpful855252318
e) visit websites describing the federal program1
   Did not visit websites describing the federal program545751807676
   Did not know about the websites describing the federal program34471211
   Did visit websites describing the federal program433945131213
   Found them to be helpful49797961009086
   Did not find them to be helpful33401014
f) read banner ads1
   Did not read banner ads868684878281
   Did not know about the banner ads788101316
   Did read banner ads768353
   Found them to be helpful5536882506457
   Did not find them to be helpful473218503643
g) read newspaper articles1
   Did not read newspaper articles39*646442*5261*
   Did not know about the newspaper articles5651109
   Did read newspaper articles563031573830
   Found them to be helpful949390836576
   Did not find them to be helpful6710173524
h) read general brochures1
   Did not read general brochures101313272625
   Did not know the general brochures112076
   Did read general brochures898685736769
   Found them to be helpful1009898818487
   Did not find them to be helpful022191613
i) call toll-free number1
   Did not call a toll-free number615653847780
   Did not know about the toll-free number213397
   Did call a toll-free number374344131413
   Found it to be helpful697100*96*787676
   Did not find it to be helpful304222424
  1. The responses for "helpful" and "not helpful" are calculated on the basis of only those respondents who did the specific activity.
  2. The distribution for this question is based on the answers of 18 Retired Non-Buyers in the DC area, 45 Retired Non-Buyers in the East and 44 Retired Non-Buyers in the West.
  3. The distribution for this question is based on the answers of six Retired Buyers in the DC area, 12 Retired Buyers in the East and 11 Retired Buyers in the West. The distribution for this question is based on the answers of four Retired Non-Buyers in the DC area, seven Retired Non-Buyers in the East and eight Retired Non-Buyers in the West.
  4. The distribution for this question is based on the answers of nine Retired Non-Buyers in the DC area, 29 Retired Non-Buyers in the East and 29 Retired Non-Buyers in the West.
  5. The distribution for this question is based on the answers of 17 Retired Buyers in the DC area, 25 Retired Buyers in the East and 34 Retired Buyers in the West. The distribution for this question is based on the answers of two Retired Non-Buyers in the DC area, 11 Retired Non-Buyers in the East and seven Retired Non-Buyers in the West.
  6. The distribution for this question is based on the answers of nine Retired Non-Buyers in the DC area, 34 Retired Non-Buyers in the East and 29 Retired Non-Buyers in the West.
TABLE A-22: Comparison of FLTCIP to Other Programs Among Active Buyers by Geographic Location (D.C. vs. East vs. West)
Reasons for BuyingActive Buyers DCActive Buyers EastActive Buyers West
Was the FLTCIP compared to other programs
   Yes494546
   No515554
Why was the FLTCIP purchased instead of a different program
a) lower rates
   Yes253335
   No756765
b) better benefits
   Yes232625
   No777475
c) recommended by others
   Yes1268
   No889492
d) easier to qualify
   Yes453839
   No556261
e) easier to get benefits
   Yes111717
   No898383
f) easier to understand coverage
   Yes182125
   No827975
g) Federal Government sponsorship
   Yes736978
   No273122
h) underwritten by Long Term Care Partners
   Yes292827
   No717273
TABLE A-23: Comparison of FLTCIP to Other Programs Among Retired Buyers by Geographic Location (D.C. vs. East vs. West)
Reasons for BuyingRetired Buyers DCRetired Buyers EastRetired Buyers West
Was the FLTCIP compared to other programs
   Yes39*29*33
   No617167
Why was the FLTCIP purchased instead of a different program
a) lower rates
   Yes31*4847
   No695253
b) better benefits
   Yes26*36*33
   No746467
c) recommended by others
   Yes11*66
   No899494
d) easier to qualify
   Yes1922*13*
   No817887
e) easier to get benefits
   Yes796
   No939194
f) easier to understand coverage
   Yes2324*16*
   No777684
g) Federal Government sponsorship
   Yes878681
   No131419
h) underwritten by Long Term Care Partners
   Yes29*39*33
   No716167
TABLE A-24: Reasons for Not Buying the Federal Program: ActiveNon-Buyers by Geographic Location (D.C. vs. East vs. West)
Reasons for Not BuyingActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
Were the following reasons not to buy the FLTCIP:
a) have other insurance like FEHB
   Yes, a reason111117
   No, not a reason898983
b) will buy the FLTCIP later
   Yes, a reason475153
   No, not a reason534947
c) information about the FLTCIP too confusing
   Yes, a reason172323
   No, not a reason837777
d) not happy with the features of the FLTCIP
   Yes221815
   No788285
TABLE A-25: Reasons for Not Buying the Federal Program: Retired Non-Buyers by Geographic Location (D.C. vs. East vs. West)
Reasons for Not BuyingRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
Were the following reasons not to buy the FLTCIP:
a) have other insurance like FEHB
   Yes, a reason241818
   No, not a reason768282
b) will buy the FLTCIP later
   Yes, a reason132423
   No, not a reason877677
c) information about the FLTCIP too confusing
   Yes, a reason132219
   No, not a reason877881
d) not happy with the features of the FLTCIP
   Yes161715
   No848385
TABLE A-26: Factors that Would Make Active Non-Buyers More Interested in Buying the Federal Program by Geographic Location (D.C. vs. East vs. West)
FactorsActive Non-Buyers DCActive Non-Buyers EastActive Non-Buyers West
More interested in buying the FLTCIP if:
a) there were more choices regarding the amount of home care coverage
   Agree506059
   Disagree504041
b) there was a guarantee that premiums will not increase in the future
   Agree768584
   Disagree241516
c) there was a premium discount for couples who purchase the program
   Agree646766
   Disagree363334
d) premiums were tax deductible
   Agree898786
   Disagree111314
Three most important factors that would make a non-buyer more interested in buying
Tax deductible premiums323733
A guarantee that premiums will not increase in the future132123
A premium discount for couples who purchase the program201917
TABLE A-27: Factors that Would Make Retired Non-Buyers More Interested in Buying the Federal Program by Geographic Location (D.C. vs. East vs. West)
FactorsRetired Non-Buyers DCRetired Non-Buyers EastRetired Non-Buyers West
More interested in buying the FLTCIP if:
a) there were more choices regarding the amount of home care coverage
   Agree555960
   Disagree454140
b) there was a guarantee that premiums will not increase in the future
   Agree697778
   Disagree312322
c) there was a premium discount for couples who purchase the program
   Agree656163
   Disagree353937
d) premiums were tax deductible
   Agree777775
   Disagree232325
Three most important factors that would make a non-buyer more interested in buying
Tax deductible premiums252522
A guarantee that premiums will not increase in the future91920
A premium discount for couples who purchase the program251618
This policy brief was prepared under contract between the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy (DALTCP) and Abt Associates. The brief was written by LifePlans, Inc. For additional information on this subject, or to view the other briefs in this series, you can visit the ASPE home page at http://aspe.hhs.gov, the DALTCP home page at http://aspe.hhs.gov/_/office_specific/daltcp.cfm or contact the ASPE Project Officer, Hunter McKay, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201, Hunter.McKay@hhs.gov.
Data Briefs on Federal Long-Term Care Insurance Buyers/Non-Buyers

A total of nine Data Briefs are available from the Office of Disability, Aging and Long-Term Care on this subject:

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