Frequently Asked Questions
Why is training mandatory for LTCI producers?
In an attempt to help states burdened with burgeoning Medicaid expenses related to long-term care, Congress passed the Deficit Reduction Act (DRA) of 2006 to restore incentives for states to implement long-term care partnership programs while making it much more difficult to shield assets when applying for Medicaid eligibility.
This action was necessary because long-term care expenses have been increasing dramatically as a component of state Medicaid budgets. According to the Centers for Medicaid and Medicare Services (CMS), the percentage of public costs for nursing home expenses grew from 26.8% in 1970 to 59.4% in 2007, an astonishing 122% increase! Long-term care partnership is designed to encourage more Americans to address their future risk of long-term care expenses through private insurance instead of public assistance.
Congress recognized that the complex long-term care partnership between private long-term care insurance, public health care assistance and consumers would require some careful explanation by producers. In an attempt to address this need for consumer education Congress inserted a mandatory producer training requirement into the act, with the specifics to be filled in by each state applying for a State Plan Amendment (SPA) to implement partnership programs.
Meanwhile, the National Association of Commissioners (NAIC) was updating the Long-Term Care Model Act of 2000, which included a draft of mandatory requirements for initial and follow-up training for long-term care producers. After updating the recommended content outline with a few references to long-term care partnership, the NAIC released the 2006 Long-Term Care Model Act, which included a requirement for eight-hour initial and four-hour follow-up LTC training for LTCi producers.
How many states have enacted mandatory training for long-term care producers?
The majority of states have mandatory training requirements in place for long-term care producers. As of July 1, 2014, 42 states have implemented training requirements based on the 2006 Act. These are the states that ClearCert administers on behalf of participating carriers, because the carrier in each state must verify producer compliance.
Four states - California, New York, Indiana and Connecticut - implemented partnership programs in the 1980's, which have remained in place. These states have specific training requirements for long-term care producers and separate requirements for producers that represent partnership policies. The partnership programs in place in these states differ in many respects from partnership under the 2006 Act. Not surprising, required training is also markedly different from the standard of the 2006 Model Act. Courses completed in each state are not reciprocal (able to used for credit) in other states with long-term care training requirements, and courses completed in any other state are not reciprocal for credit any original partnership states.
Two other states have long-term care training requirements that have been in place for some time and are also distinct from the Act's standards: Delaware and Michigan. In addition to carrier-specific options that may be available, ClearCert's carriers will accept either the completion of a ClearCert Certified Michigan course of at least four hours in length or the completion of a ClearCert Certified course of at least four hours in length in any state that has implemented the 2006 Act plus a 1-hour ClearCert Certified Michigan course. Note that as with other states that haven't implemented a training requriement based on the Model Act, completions in Michigan are not reciprocal to Model states.
How is this training different from other required training, specifically Continuing Education?
All states that have implemented a version of the 2006 Act's training requirement have specified that insurance carriers, not state insurance departments, are accountable for validating producer compliance. This placed long-term care insurance carriers into an unfamiliar role and introduced a new training paradigm.
Another important difference has to do with reciprocity, or the credit that one state offers to a producer who completes required training in another state. In the past, producers who met their resident's states continuing education requirement received reciprocal credit for meeting the continuing education requirement of non-resident licensed states. Because producers resident in states that do not have the Act's training requirement in place may have non-resident licenses in states that do have the requirement, resident producers may need reciprocal credit in their resident state for courses completed in a non-resident state. This is also true for the completion of state-specific short courses in the seven states (GA, MA, MN, SD, VA, VT and WI) that require them when initial training is completed in a different Model state and in the three states (MA, SD and WI) that require such a course when refresher training is taken in another state.
Why are there such significant differences between state training requirements, since they are based on the 2006 Model Act?
Although the 2006 NAIC Long Term Care Insurance Model Act provided a template for mandatory training, many states modified the requirements in important ways. The most important differences involve:
- - whether additional state-specific content must be included in courses
- - whether state approval of courses is required
- - whether producers must take a course in their resident state
- - how reciprocity works (receiving credit in one state for taking a course in another state)
How have states communicated their training requirements to the industry?
Most states that have implemented mandatory training requirements have done so through the action of the state's legislature. The resulting legislation usually includes details related to the training requirement.
Some states' insurance departments have communicated the training requirements directly to the industry through insurance bulletins or websites. In some cases certain elements - such as course content requirements - are communicated only to course providers or insurance carriers.
Of course, training firms are also a source of information about mandatory training, as are insurance carriers. Since the insurance carriers are ultimately responsible for mandatory LTCi training, their communications regarding training requirements should be considered the "gold standard."
I am licensed in a number of different states. Do I need to take a course in each of these states? How does reciprocity work between states?
For the most part the completion of an initial training course in one licensed state is reciprocal to other licensed states, so in most cases you only need credit in one state for the completion of initial training. Unlike reciprocity for continuing education, you receive reciprocal credit for the course you complete, not the satisfaction of the requirement. Therefore other elements of the state's regulations - such as the date by which a refresher course must be completed - still apply. For examplek if you are an Iowa resident with a non-resident license in Minnesota, you must complete a refresher course within 24 months of the last 8 or 4 hour course you took to remain qualified to represent long-term care insurance in Minnesota - even though your status in Iowa is valid until the end of the CE tri-ennium that begins after the date of that course.
Here are some additional considerations to keep in mind in determining in which state to earn credit.
The course must be completed in a state that has implemented a training requirement based on the Model Act (all states except CA, CT, DC, DE, IN, HI, MS, NM and NY).
If you are non-resident in Texas, you should complete initial and refresher training courses in either your resident state or Texas. If your resident state has not adopted a training requriement based on the Model Act you must take courses in Texas.
If your resident state allows reciprocity for residents, and you are licensed in a state that requires the completion of an additional course on the state's Medicaid or Partnership rules if initial training (GA, MA, MN, SD, VA, VT and WI) or refresher training (MA, SD and WI) is completed in another state, you may want to take the course in that state so you don't have to take two courses - as long as your resident state allows you to complete training in another state (all states except AZ, CO, IA, MN, OH, TN, TX and WV). Of course, you would not receive continuing education credits in your resident state.
Bottom line, be sure to carefully review the initial training requirements for each licensed state to develop a course-taking strategy that will qualify you to represent long-term care insurance in each state without taking more courses than are needed.
How is the refresher training deadline calculated in the seven states that require a separate, state-specific course (GA, MA, MN, SD, VA, VT and WI)?
Your refresher training deadline - the date by which you must complete ongoing training - is based upon the date of your last course that satisfied the state's initial or refresher training requirement. In most cases this means a course of at least 8 or 4 hours, respectively.
Taking a state-specific course of less than four hours, such as 2-hour course on MassHealth to satisfy the initial training requirement in Massachusetts, will qualify you to represent LTCI in the state beginning on that date. However, the date by which you must complete your next course is based on your most recent 8 or 4 hour completion.
For example, a Massachusetts producer who completed a New Jersey 8 hour course on 1/1/2013 and a MassHealth 2 hour course on 7/15/2014 would be qualified to represent LTCI in Massachusetts effective 7/15/2014 - but would need to complete a course of at least 4 hours in length no later than 1/1/2015 to maintain that status.
So, if it has been more than a few months since your last 4 or 8 hour course, if you are attempting to fulfill the initial training requirement in GA, MN, VA, VT or WI, t makes sense to take an 8 hour course in the state, since this will also extend the date by which you must take your next ongoing course. For MA or SD a 4 hour course will fulfill the initial training requirement and extend your status.
To fulfill the refresher training requirment in MA, SD or WI - the three states that require a state-specific course to be completed if the 4 hour course is taken in a different state - it may make sense to take a 4 hour course instead of the available 2-hour (MA) or 1 hour (SD, WI) stand-alone course.
How does the South Dakota refresher training deadline work?
South Dakota requires the completion of refresher training during the same compliance period (July 1st of an even-numbered year to June 30th of the next even-numbered year) in which you complete initial training. For example, if you complete initial training on August 1st, 2012, you will also need to complete refresehr training (including the South Dakota Medicaid content) no later than June 30th of 2014). No other state requires refresher training until beginning with the compliance period after the period during which initial training was completed.
During future two-year periods, be sure to complete a refresher course plus, if the course is taken in a different state than South Dakota, a one hour South Dakota Mediciad course.