 LTC Bullet: ILTCI ’25 Virtual Visit Friday, March 21, 2025 Seattle— LTC Comment: ILTCI ’25 was another successful industry convocation. Your “virtual visit” to the conference follows the ***news.*** *** 3/6/2025, “Milliman’s
annual U.S. industry LTCI claims projection,” by Rachel Marsiglio,
Juliet Spector, and Robert Eaton, Milliman *** TWILIGHT WISH: Every year the ILTCI Conference supports a charity by donating funds and matching attendees’ gifts. Twilight Wish was this year’s recipient. Twilight Wish Foundation is a nonprofit organization dedicated to granting wishes to seniors aged 68 and older who live at or below the poverty level or reside in nursing facilities. Their mission is to honor and enrich the lives of deserving seniors through wish-granting celebrations that connect generations, aiming to make the world a "nicer place to age, one wish at a time." ILTCI reminds attendees: If you forgot to donate, or attempted to donate to Twilight Wish Foundation but experienced some internet issues, please use the link below to donate to this year's charity Twilight Wish so we can support the amazing work they do! Donate here.” I’m sure contributions from non-attendees would be equally welcome. *** *** ILTCI CONTEXT: For the history of
long-term care insurance conferences through 2021, go
here. But that’s 80 pages, so for a quick overview and analysis, check
out this ten-minute “podcast.”
If you’d like to see our most recent virtual visits to ILTCI conferences,
go
here for 2023, and
here for 2024. *** LTC BULLET: ILTCI ’25 VIRTUAL VISIT LTC Comment: The 2025 Intercompany Long-Term Care Insurance Conference convened March 9-12 in Philadelphia at the Marriott Downtown. This year’s theme was “Getting Stronger.” Over 1000 registrants participated representing all aspects of the LTCI business and related fields. This “virtual visit” to the conference is intended to give those who were unable to attend, especially the LTC insurance producers doing the hard sales work out in the commercial trenches, some idea of the content and mood of the meeting. Exhibit Hall Opening Reception The opening reception, Sunday night, March 9, was an excellent kick off. Free drinks and ample food sparked conversation and networking between participants, and with exhibitors and sponsors. Philly cheesesteak sandwiches, mussels in a garlic butter sauce, and a wide selection of Mediterranean food pleased palates. Opening Session The opening general session led by conference chair Jeff Levin of OneAmerica, began at 8am Monday morning, March 10, immediately after an excellent buffet breakfast. Levin recognized former leading lights of the industry by name and talked about how LTCI has grown, shrunk, and expanded again, getting better all the time. This year’s program included 219 speakers, 34 sponsors and 49 exhibitors. Mr. Levin observed that volunteers make the meeting happen and he recognized them. He graciously thanked conference staff Diane Fulton and Christi Trimble for their organizational work. This year ILTCI partnered with Twilight Wish, a charity to make wishes come true for seniors. ILTCI matched contributions to the charity by conference attendees. A drawing for a $1,000 gift card was in play for attendees who filled their “bingo cards” with stamps from each of the exhibit hall booths. After Conference Chari Levin announced that Gina Betz of illumifin will be next year’s conference chair, she invited everyone to ILTCI ’26 that will be held in Orlando, FL at the beautiful Rosen Shingle Creek Resort, about which a marketing video for the property teased audience interest. Next came the announcement of this year’s ILTCI Recognition Award recipients. Carroll Golden, Executive Director of NAIFA Specialty Centers and Denise Liston, Senior VP at illumifin received the honor this year. Both delivered thoughtful remarks in thanks for the recognition, the trophy and the honorarium. They join a proud group of former award recipients including Marc Cohen (2018), Stephen Moses (2019), and Ron Hagelman, Peter Goldstein and the company LTCI Partners (2024, after a five year hiatus without the award being granted). Keynote Speakers This year’s “keynote address” followed. It was unique. Instead of the usual motivational speaker, we were presented a series of video clips from a forthcoming Public Broadcasting System documentary highlighting the challenges of caregiving. The two-hour program, Caregiving, will air on 330 PBS stations across the country in June. Care Scout sponsored the keynote and CEO Samir Shaw introduced a panel of speakers who discussed the origin, planning and challenging creation of the program. This groundbreaking public media documentary delves into the personal stories of caregivers, shedding light on the challenges they face in providing short and long-term care, as well as palliative and end-of-life care for individuals of all ages. The four-person panel representing creators of the documentary and including one caregiver, whose story was especially moving, described how the program was conceived, how caregivers willing to tell their stories were found, and how they completed the project. In the Q&A session that followed, the panel was asked how many of them own LTC insurance. Answer: Not one. That admission revealed the LTCI industry’s fundamental challenge, getting people, even those touched by the challenge of caregiving, to take concrete measures to prepare for the risk and cost of needing care one day themselves. On that issue, I have something to say in the Closing LTC Comment below. Breakout Sessions This year’s breakout sessions were presented in seven substantive tracks: Advisors, Agents, & Agencies; Actuarial & Finance; Claims & Underwriting; Legal, Compliance & Regulatory; Marketing, Engagement, & Research; Management & Operations; and Wellness & Aging in Place Solutions. Following are summaries of each of the breakout sessions I attended. 10:45am, March 10: “How Can
Behavioral Economics Change LTCI (For the Better)?” Moderator: Jodi Anatole, Endeavour
Consulting Session description: Behavioral economics combines elements of economics and psychology to understand how and why people behave a certain way - and can be used to change behavior to create better outcomes. Learn the principles of behavioral science, examples from other industries, and how they can be applied to improve the experience for LTCI - for carriers, producers, and policyholders. Specifically: How do you capture attention and motivate people to make decisions? How do you communicate more effectively? What is the reaction when something doesn’t cost anything? What is a “Nudge”? And ways to adopt this concept into what we do. This will be an interactive session where the audience will have a chance to pose their challenges and experiences where adoption of behavioral economic principles have made an impact. LTC Comment: I found this session fascinating. Richard Mathera explained the many ways people behave irrationally and how to recognize and adapt to those human foibles. Bottom line: Design for clients’ unique needs; reduce uncertainty. That’s how to think about behavioral science. Freedman of Assured Allies explained how his company employs behavioral strategies to help LTCI carriers reduce risk, bring solutions to policyholders, and help people stay at home longer. Behavioral insights helped his company go from “asking people to contact to us to concentrating on specific challenges like how to get dressed.” Monika Shvetz focused on behavioral psychology in advertising. She said “Know your customer is Rule 1. Rule 2 is you can’t be everything for everyone. Develop “mindful marketing strategies.” 2:00pm, March 10: “The Heavyweight
Champions of LTC Planning Strategies” Moderator: Elena Castor, AdvisorEdge
Solutions Session description: Sit ringside for an exciting exhibition of Advanced LTC Planning Strategies. This three round event will spotlight the successful use of IRAs and Qualified assets in LTC Planning, Pension Protection Act (PPA) Qualifying LTC Annuities, and Small Business Owner and Carve-Out Planning. Tax savings and LTC planning are the ultimate ‘one-two’ punch combination; together they’re a knockout. See how these strategies incorporate protection and tax savings to produce 2X the planning value for your LTC prospects while opening an entirely new LTC premium resource. LTC Comment: This session was a revelation to me. I had no idea how vital tax planning is to LTC financing strategy. Mueller from OneAmerica explained how non-qualified annuities and the Pension Protection Act “let us help people with these widely owned annuities.” ACSIA Partners’ Derryberry focused on how IRAs and Qualified Assets magnify the benefits of planning for LTC. He observed that, ironically, the SECURE Act may create greater taxation for an IRA beneficiary than if funds were withdrawn by the original IRA owner. “Using qualified assets and IRAs for premium dollars can be a more efficient IRA distribution strategy compared to ‘defer and die’ where the IRA is transferred at death.” Shawn Britt of Nationwide explained the tax advantages of long-term care insurance for Business owners and employees. She showed charts of allowable tax deductions by decade of age. Use LTCI to “recruit, retain, reward.” 3:45pm, March 10: “Rumble in the
Breakout Jungle! Short-Term Care v. Long-Term Care” Moderator: Stephanie Moench, Oliver
Wyman Session description: If they were boxers, the short-term care insurance industry and the long-term care insurance industry would probably notice each other training in the same gym. While they would likely be in slightly different weight classes, they would share many of the same attributes, have similar goals, and ultimately their personal battles would occur in the same ring. As the extended care market evolves, the relationship between these two competitors may be changing. Are the long-term care insurance and short-term care insurance industries going to become sparring partners who make each other stronger? Will they start to compete head-to-head more often? Like Apollo Creed, will long-term care insurance be forced to reckon with a scrappy, humble, and strong short-term care insurance industry that has the potential for mass appeal? Or, like Rocky and Adrian, will the two industries embrace, express their love for each other, and walk hand in hand into the streets of Philadelphia? During this session, we’ll go to the canvas with an excellent panel of insiders and do a fresh weigh-in on these questions. LTC Comment: As the session description explains, this program compared the roles, strengths and weaknesses of short-term care insurance (STCI) vs. long-term care insurance (LTCI). Moderator Moench of Oliver Wyman clarified key differences between STCI and LTC, such as STCI covers no more than 360 days and is often employed as gap coverage for Medicare. Presenters discussed the question “Can STC and LTC co-exist?” They observed that it is more important to talk about goals and solutions, rather than about types of insurance. STCI can be an alternative for LTCI declines. Most people think of STCI as short term health insurance. It is not short-term major medical. LTCI’s Achilles’ Heel is affordability. The more options producers and prospects have, the better. There is an option for everybody. STCI is not available in every state. Compared to questions that really matter; the choice between STCI or LTCI is not one of them. 9:00am, March 11: “Innovation in
Long Term Care Insurance – A Regulatory Perspective” Moderator: Nolan Tully, Faegre Drinker Session description: This session will be a moderated panel discussion focused on putting forward the regulatory viewpoint on various existing and future innovations in long term care insurance. What do key regulators think about pre-claim wellness programs, new products aimed at continued engagement with policyholders, opportunities that might come from state based public insurance programs and other cutting-edge issues? Come to this session to find out! LTC Comment: Shannon from PA-DOI opened the discussion with a poignant observation: after all these years, we’re still talking about same problems, such as affordability; new products, high care costs, adding LTCI to this, that and the other thing. Tomasz from the Utah ID observed that regulators are not natural innovators so this is not a natural place to look for innovation. That comment encapsulated my impression of this session. The old questions about how to reach the middle market; the regulatory quagmire; the fruitless search for a government program to solve all; and the unsatisfying fall back to identify a public/private combination; all these signal the absence of innovation. Veghte from WA Cares represented the best this kind of thinking can deliver, one more example of a compulsory, payroll-funded, centrally planned, dubiously financed entitlement program. Innovation is needed, but it does not look like we should expect much of it from regulators or government bureaucrats. 10:45am, March 11: “Thinking in the
Middle: How do we serve the Underserved Middle-Income Market?” Moderator: Eileen Tell, ET Consulting,
LLC Session Description: After decades of product innovation and industry effort, LTC insurance still remains a product largely purchased by a small segment of the more affluent Americans. There is large untapped market potential and great need for financial protection among the middle-class. Using data from a recent survey of middle-income consumers, this session will shed insights on the size and nature of demand of LTC coverage within this market segment, discuss some of the barriers to purchase and ways to overcome them. After a brief panel discussion, the audience will get creative and help evaluate, reject, or re-design four new product prototypes intended for appeal to middle-income consumers. LTC Comment: Surveys to understand the LTCI middle market relative to the affluent market show, no surprise, that affordability is key. They indicate better education is needed. Middle income people are less likely to save or insure for LTC than others who are more prosperous. Two reasons: lack of awareness and misunderstanding. They are less likely to believe they will need LTC one day. What might incentivize the middle class to take LTC more seriously? The most important incentive is financial benefits. Middle income people place a high value on advice from personal advisors. So, bring financial advisors more into the mix. After the opening general discussion, this session broke into smaller work groups to consider and evaluate different product models in terms of how they might behave given the challenges and concepts identified in the general session. I missed this portion of the program due to a previously scheduled networking appointment. My impression is that experts have studied LTCI buyers and non-buyers six ways to Sunday for decades. What they rarely explore is the market context in which LTCI sales occur. That market is dominated by the primary LTC payers, Medicaid (44%) and Medicare (16%). Without addressing those elephants in the room, all the detailed research and analysis lead nowhere, beyond being very interesting and stimulating intellectually. 2:00pm, March 11: “Carrier
Perspective: The State of our LTC Industry” Moderator: Ramona Neal, Living Benefit
Review Session description: State of the LTCi industry. Taking a macro view of our industry - where is it today and where is it headed? LTC Comment: The panel included representatives of “pure,” traditional LTCI on the left, mixed LTCI (hybrids) in the middle and mostly life insurance products on the right. Moderator Neal complained “we need one name for the middle category,” which she called “MoneyGuard” to some objection. Larry Nisenson of Assured Allies had several observations about the past, present and future of traditional LTCI. It’s left a “bad taste in the mouth of clients and producers,” “has a history to overcome,” flagging sales say it all. Wellness and annuities offer a path forward. “Innovation is the root of all opportunity.” MacKenzie Madsen of Lincoln Financial Group spoke about the evolution of the hybrid marketplace, starting 35 years ago with Golden Rule, then OneAmerica, looking for younger customers and more affordability. The products need to simplify, offer more value. Joe Laskowski from CareScout opined how career agents dominated early on. Distribution is adapting away from “one size fits all” to “bespoke” products fitting specific clients’ unique needs and preferences. Brian Kendall of OneAmerica Financial observed “we have so many ways now to meet needs. We need to be more open- minded to nontraditional ways of doing things. Hear, hear! 3:45pm, March 11: “The Title Fight:
The Good, the Bad, and the Knockout AI Tactics to Boost Marketing,
Research, & Engagement” Moderator: Winona Berdine, Continental
General Session description: Participate in this this high-energy session where industry experts will coach you on how to transform your business approach using real-world AI tools and techniques. Learn how to work smarter, not harder, by making AI the foundation of your strategies. Discover how to avoid reinventing the wheel, how to ask the right questions (and what NOT to ask), how to tame the skeptics, and tap into AI's potential to simplify marketing, enhance content creation, and drive customer engagement. Whether you're new to AI or looking to expand its use, this session will empower you with actionable insights and takeaways to grow your revenue and audience effectively. LTC Comment: This was a fascinating session unveiling a plethora of ways to put Artificial Intelligence (AI) to work in our professional lives. For example: using AI to answer questions for prospects and clients. Pointing them to specific ways to fill their needs. Ask yourself: “Where am I not using AI?” Then use it in those areas because AI is applicable virtually everywhere. In terms of how to use AI; ask for exactly what you want; provide context; give specific instructions; explain how you’d like the answer printed out. The more guidelines you specify the better results you’ll receive. Here’s my two cents worth. I asked AI to read my 80-page “History of LTC Insurance Conferences,” summarize it, and present the results in the form of an interview. It took Google Illuminate 30 seconds to produce this 10-minute podcast. As Arthur C. Clarke said: "Any sufficiently advanced technology is indistinguishable from magic." Closing LTC Comment: The most telling and unfortunate occurrence of ILTCI ’25 was when the PBS producers of their moving story about caregivers acknowledged that none of them owned LTC insurance. That put the conference’s main shortcoming into stark relief. In none of the general and breakout sessions I attended, and I expect in few if any of the sessions I missed, was attention given to the broader market in which LTC insurance is sold. Medicaid and Medicare dominate that market, but were barely mentioned. I heard nothing about how easy access to Medicaid LTC benefits after care is needed anesthetizes future generations to LTC risk and cost. This reality crowds out demand from the same middle-market prospects LTCI marketers find so elusive. Nor was there any focus on the needs of LTC providers, such as nursing homes, assisted living facilities, and home health providers. They are desperate for private financing sources that pay market rates to relieve their excessive reliance on low Medicaid reimbursements that hamper care quality. Until the LTCI industry wakes up and addresses these public policy issues, no amount of surveys, focus groups, brainstorming, or WISHful Thinking for an easy government solution will succeed. Another reality I found unaddressed at the conference was any recognition of the political and economic turmoil going on in America right now. Whether you like it or hate the current disruption, it is a time—the first time in at least two decades—when substantive change to the policies and rules governing Medicaid LTC eligibility and LTCI marketability is possible. Republicans want to cut $880 billion from Medicaid. Democrats want to protect low-income enrollees. Neither goal is wrong. Both are achievable. But not without more creative thinking and stronger political advocacy. I proposed a way to proceed in a recent column: “Disrupt LTC Now.” I welcome your feedback at smoses@centerltc.com. |