LONG-TERM CARE

REQUIRED LONG-TERM CARE INSURANCE FORMS & DISCLOSURES FOR RETIRED LAPRA members



Please read and print the list of long-term care insurance forms and disclosures below.

 

Review Your Plan Details

Familiarize yourself with the details of your plan.

DOCUMENT 

Plan Highlights

Outline of Coverage

LTC Premium Worksheet and Rates for Retired LAPRA Member

LTC Premium Worksheet and Rates for Spouse/RDP* of Retired Member

LTC Insurance Certificate of Coverage for Retired Member

* Registered Domestic Partner

Important Information About Your Enrollment

Please read and print the following documents for your records. These are state-required documents to assist with long-term care insurance decisions. Nothing in this section needs to be returned in order to apply during your initial enrollment, unless it is also specified as a required form for enrollment in the section below.

DOCUMENT

Things You Should Know Before You Buy Long-term Care Insurance

Replacement Notice of Accident and Sickness or Long-term Care Insurance

Notice of Information Practice Disclosure

A Consumer's Guide to Long-term Care

Election to Continue Your LTC Insurance Coverage

 

Retired Member Enrollment

Print out the forms below. Complete, save a copy for your records, and submit these forms to LAPRA (if the forms are required to be completed).

DOCUMENT

Long Term Care Insurance Application

Retired Member Benefit Election Form

Spouse/Registered Domestic Partner of Retired Member Benefit Election Form

 

> Back to top