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The VSDP Long-Term Care Plan provides benefits for an employee who needs help with everyday life tasks because of a prolonged health problem or following a major illness or injury. The VSDP Long-Term Care Plan helps pay for eligible services not covered by other health plans or Medicare.
If the member is a state employee in VRS Plan 1, VRS Plan 2 or the Hybrid Retirement Plan, the State Police Officers’ Retirement System (SPORS) or the Virginia Law Officers’ Retirement System (VaLORS) and participates in the Virginia Sickness and Disability Program (VSDP), the member is covered under the VSDP Long-Term Care Plan at no cost to the member.
VSDP Long-Term Care Plan Services
Covered services include nursing home care, hospice care, assisted living care, community-based care and at-home care, among others. The member’s caregiver also may be eligible for assistance under the plan. The maximum daily benefit amount is $96 with a lifetime maximum of $70,080.
VRS has contracted with illumifin Corp. to coordinate benefits under the plan. The member may contact illumifin Corp. toll-free at 1-800-761-4057 within 60 days of being certified as eligible for benefits. A family member or friend may call on the member’s behalf.
Plan Features
Plan Sponsor
The Virginia Retirement System (VRS) manages the long-term care program as part of the Virginia Sickness and Disability Program (VSDP).
Plan Administrator
VRS has contracted with illumifin Corp. to administer benefits under the plan. For more information about your coverage or to apply for benefits, contact illumifin Corp. toll free at 1-800-761-4057, or P.O. Box 64011, St. Paul, Minnesota 55164-0011.
Eligible Participants
You are covered under the VSDP long-term care plan if you participate in the Virginia Sickness and Disability Program (VSDP).
Benefit Eligibility
You are eligible for benefits when a licensed health care practitioner certifies that you:
- Are unable to perform at least two of six Activities of Daily Living without substantial assistance; or
- Have a severe cognitive impairment requiring substantial supervision.
Daily Benefit Maximum Amount
$96 per day. This is the maximum amount of coverage the plan will pay for covered services in any single day.
Lifetime Maximum Amount
$70,080. The lifetime maximum amount is based on the maximum daily benefit amount of $96 multiplied by 730 days (two years): $96 x 730 days = $70,080. Your coverage ceases when your total benefit payouts reach $70,080, regardless of how long you receive benefits.
Premiums
Free of charge as a VSDP participant.
How Benefits Are Paid
Your coverage pays a benefit equal to the lesser of:
- Actual qualified expenses incurred per day; or
- Allowable daily benefit amount.
Waiting Period
Your benefits are payable 90 calendar days after the beginning of each incident certified by a licensed health care practitioner as eligible for VSDP long-term care benefits.
Portability
If you leave your VSDP-covered position, you have the option to continue coverage in the VSDP Long-Term Care Program at group rates. You must elect to continue your coverage within 60 days of leaving VSDP-covered employment. Call illumifin Corp. toll free at 1-800-761-4057. You will be billed directly for the premiums.