A Report on the Actuarial, Marketing, and Legal Analyses of the CLASS Program. E. Profile of Declines by Employment Status

10/14/2011

While the CLASS Program is structured in a manner that maximizes participation -- even among those who already may have functional dependencies -- the one requirement that does afford some level of control regarding enrollment is the work requirement. To enroll in the program, an individual must be employed. Therefore, if one wants to obtain a profile of likely early enrollees to the program, a focus on the sub-set of employed individuals declined for private LTC insurance is clearly warranted. This group is already educated about the risk and need for coverage, has expressed its preferences through a willingness to pay for private insurance, and is likely to be highly motivated to participate in a public program, even if benefits levels are less than what they might have desired in the private market. In the analyses that follow, we segment data in terms of employment status. We have definitive employment status on roughly 18,500 declines.

As mentioned, many companies do not track in their system whether or not an applicant is employed. We do know from previous studies of buyers and non-buyers of LTC insurance that roughly 70% of all applicants for LTC insurance are employed. Tables 2 and 4 highlighted the fact that the rate of employment among individuals declined for insurance is much lower than for the population of applicants as a whole, at least with respect to those ages 60 and over.

Table 5 shows the relationship between key demographic characteristics of the sample by employment status. As shown, employed declines are more likely to be younger, male, and married, but less likely to have functional or cognitive issues than their non-employed counterparts.

  TABLE 5: Relationship between Socio-Demographic Characteristics and Employment Status  
    Employed     Not Employed  
Age
   Age 60 48%** 18%
   Age 60-69 43% 57%**
   Age 70 or above   9% 25%**
   Average age 60 65**
Gender
   Male 54%** 45%
   Female 46% 55%**
Marital Status
   Married 72%** 67%
   Single 27% 33%**
   Widow 1% 0%
ADL Loss 0.1% .2%**
IADL Loss 0.4% 1.2%**
Cognitively Impaired   3% 6%**

Not shown in the table is the fact that employed applicants who were declined due to health status are slightly older (age 60) than are all employed applicants (age 58). Moreover, they tend to be somewhat more male (54%) than the total pool of all employed applicants (45%).

Table 6 summarizes the relationship between employment status and primary diagnosis among declines. The only statistically significant differences in the medical diagnosis profile between the two groups are that mental health issues and stroke/CVA/Circulatory problems are more prevalent among those not working. Among those employed, there is a somewhat higher proportion of individuals with a myriad of other diagnoses which are reflected in the “Other” category.

TABLE 6: Declines by Medical Diagnosis by Employment Status
    Employed     Not Employed  
Primary   Diabetes/ Endocrine 12.3% 11.4
Cancer 8.3% 8.5
Stroke/CVA/Circulatory 7.7% 9.1***
Fractures/Bone Problems/ Musculoskeletal 13.4% 13.2
Neurological Issues (excluding Parkinson’s)   9.2% 9.5
Cardiac Problems 13.2% 12.9
Respiratory 3.3% 3.2
Mental Health 7.1% 8.5***
Abnormal Labs/Unstable Condition 2.2% 2.0
Other 15.5%*** 14.1
Auto-Immune 3.2% 3.1
Liver/Kidney 3.9% 3.8
Multiple Conditions .6% .6

Clearly, one’s medical status is closely related to age. To gain a better understanding of the relationship between primary diagnoses and age, Table 7 arrays the data by age, employment status and diagnosis.

TABLE 7: Declines by Medical Diagnosis and Employment Status by Age
  Employed Not Employed
  < Age 60  
(A)
  Age 60-69B  
(B)
  Age 70+  
(C)
  < Age 60  
(D)
  Age 60-69  
(E)
  Age 70+  
(F)
Primary   Diabetes/ Endocrine 11.5% 13.6%AC 10.3% 7.8% 12.1%D 12.6%D
Cancer 7.6% 9.0% 8.6% 6.1% 9.1%D 8.8%D
Stroke/ CVA/ Circulatory 5.5% 9.4%A 11.0%A 5.7% 9.0%D 11.8%DE
Fractures/ Bone Problems/ Musculoskeletal 15.3%BC 11.8% 10.8% 14.7% 13.1% 12.5%
Neurological Issues (excluding Parkinson’s)   8.1% 8.9% 17.0%AB 10.0% 8.5% 11.4%E
Cardiac Problems 10.0% 15.8%A 18.4%A 7.1% 12.1%D 18.8%DE
Respiratory 2.9% 3.6% 4.4% 2.0% 3.5%D 3.5%D
Mental Health 9.4%BC 5.6%C 2.0% 15.7%EF 8.1%F 4.3%
Abnormal Labs/ Unstable Condition 2.4%C 2.3%C .9% 2.2% 2.1% 1.8%
Other 18.6%BC 13.1% 10.5% 18.8%EF 15.0%F 8.6%
Auto-Immune 3.9%BC 2.6% 1.6% 5.1%EF 3.1%F 1.8%
Liver/Kidney 4.1% 3.8% 3.8% 4.0% 3.7% 3.8%
Multiple Conditions .7% .3% .7% .9% .5% .5%

The key observations from this table are that:

  • Among declines under age 60, mental health is more prevalent than for other age groups and it is also highly correlated with employment status: those who are not-working are roughly twice as likely to have mental health issues cited as a primary reason for a decline and this is true across all age segments.

  • Fractures/Bone Problems/Musculoskeletal issues as well as Auto-immune issues are more prevalent among the under age 60 employed declines than among other age groups.

  • Diabetes and Endocrine problems are most prevalent among employed individuals age 60-69. Also, individuals age 60-69 who are employed are more likely to have cardiac issues than are those who are not-employed.

  • Among individuals age 70 and over, Stroke, CVA/ Circulatory issues, along with Neurological and Cardiac problems comprise the major reasons for decline. Neurological problems are more prevalent among the employed.

Table 8 below further segments the data by focusing on age and gender differences in the profile of medical diagnoses for individuals who are employed and were declined coverage.

TABLE 8: Employed Declines by Medical Diagnosis by Age and Gender
  EMPLOYED Individuals by AGE Group
Less Than Age 60 Age 60-69 Age 70 or Above
  Male (%)  
(A)
  Female (%)  
(B)
  Male (%)  
(A)
  Female (%)  
(B)
  Male (%)  
(A)
  Female (%)  
(B)
Primary   Diabetes/ Endocrine 15.6%B 7.9% 16.1%B 9.6% 11.5% 7.8%
Cancer 7.8% 7.5% 9.7%B 7.8% 11.0%B 4.1%
Stroke/ CVA/ Circulatory 6.6%B 4.5% 10.6%B 7.7% 11.9% 9.3%
Fractures/ Bone Problems/ Musculoskeletal 14.3% 16.2% 9.1% 16.0%A 7.4% 17.5%A
Neurological Issues (excluding Parkinson’s)   7.4% 8.6% 8.7% 9.4% 16.8% 17.5%
Cardiac Problems 14.6%B 6.0% 19.2%B 10.6% 21.9%B 11.5%
Respiratory 2.9% 2.8% 3.2% 4.4%A 3.8% 5.6%
Mental Health 6.7% 11.8%A 4.6% 7.2%A .9% 4.1%A
Abnormal Labs/ Unstable Condition 2.7% 2.2% 2.9%B 1.4% 1.3% 0.0%
Other 14.4% 22.3%A 10.0% 17.8%A 7.6% 16.4%A
Auto-Immune 1.8% 5.8%A 1.4% 4.6%A .2% 4.5%A
Liver/ Kidney 4.6% 3.7% 4.1% 3.3% 4.7%B 1.9%
Multiple Conditions .6% .8% .5% .4% .9% 0.0%

Key observations from Table 8 include:

Under age 70, among employed applicants, males tend to have higher rates of Diabetes/Endocrine, Stroke/CVA/Circulatory, and Cardiac problems than do females.

Across all ages, mental health and auto-immune issues as primary decline reasons among employed individuals are higher for females than for males.

View full report

Preview
Download

"index.pdf" (pdf, 350.5Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appA.pdf" (pdf, 150.08Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appB.pdf" (pdf, 548.14Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appC.pdf" (pdf, 150.56Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appD.pdf" (pdf, 318.45Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appE.pdf" (pdf, 319.19Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appF.pdf" (pdf, 155.03Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appG.pdf" (pdf, 181.05Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appGa.pdf" (pdf, 151.02Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appGb.pdf" (pdf, 123.12Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appH.pdf" (pdf, 256.35Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appI.pdf" (pdf, 358.34Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appJ.pdf" (pdf, 1.21Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appJa.pdf" (pdf, 396.06Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appJb.pdf" (pdf, 313.17Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appJc.pdf" (pdf, 252.71Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appJd.pdf" (pdf, 261.97Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appK.pdf" (pdf, 186.22Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appL.pdf" (pdf, 788.88Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appM.pdf" (pdf, 249.45Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appN.pdf" (pdf, 7.72Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appNa.pdf" (pdf, 208.04Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appNb.pdf" (pdf, 6.96Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appNc.pdf" (pdf, 622.02Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appNd.pdf" (pdf, 211.36Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appO.pdf" (pdf, 2.01Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appP.pdf" (pdf, 9.15Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appPa.pdf" (pdf, 233.71Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appPb.pdf" (pdf, 253Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appPc.pdf" (pdf, 546.97Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appPd.pdf" (pdf, 505.4Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appPe.pdf" (pdf, 462.21Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appQ.pdf" (pdf, 285.57Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"appR.pdf" (pdf, 797.76Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®