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HEALTH INSURANCE | Long term care

Sun LTCI overview:

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ADVISOR GUIDE

SUN LONG TERM CARE INSURANCE

ADVISOR USE ONLY

Life’s brighter under the sun

1SUN LONG TERM CARE INSURANCE

WithSunLifeFinancial,you’reworkingwithCanada’sleadingLTCIproductandamarketleaderwithexperiencepayingover$36.9millioninclaimsasofDecember2013.2

Asyoubuildandreviewretirementincomeplansforclients,it’simportanttohelpthemrecognizeandconsidertheirfuturehealthcareneedsandtheimpacttheirchoicesandexpectationswillhaveontheirplans.Longtermcareinsurancecanhelpwithfinancialprotectionfortheirplansandthemeanstopayforthelevelofcaretheywantandexpect.

Why include long term care insurance (LTCI) in your portfolio of product solutions?

It’s easy to take our ability to perform day-to-day activities for granted, but this can change, especially as we age.

Fortunately, most of these changes aren’t dramatically different from one day to the next – it’s more of a gradual process.

The level of health care and personal assistance we need, and the cost to meet these needs, will increase with age with the average Canadian experiencing nine to 14 of the final years of their life in diminished health.1

At birth...

theaveragelifeexpectancyofaCanadianmaleis78years.Overnineofthoseyearsareexpectedtobewithadiminishedqualityoflife.1

theaveragelifeexpectancyofaCanadianfemaleis83years.Justover14ofthoseareexpectedtobewithadiminishedqualityoflife.1

0 20 40 60 80 100

Male

Onset of health impairment

Age

Female

1 StatisticsCanada,20122 LifeInsuranceMarketingResearchAssociation(LIMRA),December2013;SunLifeFinancial,December2013.

What is the LTCI target market?

TheLTCIsolutioncanfitwithinthefinancialplanofanumberofdifferenttargetmarkets.Thesearebestsegmentedbythefollowinglifestages:

Planningforretirement Closetoretirement Retirees

TheLTCIproductoptionsavailablewillbedifferentforeachmarketandfitintotheirplanningdifferently.

This guide contains the information you need to:

understandSunLongTermCareInsurance(SunLTCI),

successfullyselltherightplan,and

helpclientsmanagetheirpolicy.

ProductinformationinthisguidereferstopoliciessoldafterDecember6,2013(2013series),unlessotherwiseindicated.

Inthisguide,the symbolisusedtoidentifyaSunLifeFinancialcompetitiveadvantage.Pleaserefertopage39forasummaryofthesecompetitiveadvantages.


Product at a glance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Product details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Issueages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7Howwedeterminedependency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7DEFINITION:Activitiesofdailyliving. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8DEFINITION:Assistivedevices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Plan details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Benefittype. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Weeklybenefitamount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Waitingperiod. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Benefitperiod. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Additional options that may be applied for . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Inflationprotection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Returnofpremiumondeath(ROPD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12DEFINITION:Returnablepremiumamount. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Plan features that are automatically included . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Waiverofpremium(whenaclaimisapproved). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Spousalwaiver. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13DEFINITION:Spouse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Firstpaymentbonus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Extendedterminsurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Planofcare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

LifestageCare™ service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Applying for a Sun LTCI policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Residencyrequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Backdating. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Ownershiprules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Whoreceivespayment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Completingtheapplication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Payments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Underwriting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Underwritingevidencerequirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22Riskclasses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23Typesofunderwritingdecisions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23Financialunderwriting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

CONTENTS


Premium details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24Premiumfrequency–monthlyorannually. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24Withdrawablepremiumfund. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25Premiumpaymentoptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25Premiumguarantee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25Whenwewaivepremiums. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26Non-forfeitureprovision..............................................................26

Issuing a Sun LTCI policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Policydate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26Whentheinsurancecomesintoeffect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26

Plan changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Changingcoverageoptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27Terminatinganoption. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27Conversions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27Internalreplacements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27Reinstatements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28Reinstatementrulesataglance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Making a claim for Sun Long Term Care Insurance benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Whentomakeaclaim. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29Howtomakeaclaim. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30Exclusionsandlimitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Tipsforanefficientclaimsprocess. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Taxation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Product history . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34ClaricaLTCIpoliciesdatedDecember,2000-December,2003. . . . . . . . . . . . . . . . . . . . . . . . . . .34ClaricaLTCIpoliciesdatedDecember2003-September2005. . . . . . . . . . . . . . . . . . . . . . . . . . .36SunLTCIpoliciesdatedSeptember,2005–December,2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38

Competitive advantages – summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Where to go for more information? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40


PRODUCT AT A GLANCE

PLAN DETAILS

Coverage Acomprehensiveincome-stylebenefitwhentheinsuredpersonisdependent.It’sdesignedtohelpoffsetthecostofcareservicesinanyenvironment,1including:

apersonalresidence, aretirementhome,or along-termcarefacility.

1Wewon’tpaybenefitswhentheinsuredpersonisoutsideCanadaortheUnitedStates

formorethaneightconsecutiveweeks.

How we determine dependency

Theinsuredpersonisdependentwhen:

Theyneedconstantsupervisionforprotectionfromthreatstotheirphysicalhealthandsafetyastheresultofdeteriorationinoralossof:

− short-orlong-termmemory,− orientationasitrelatestopeople,placeandtime,− reasoning,or− judgmentasitrelatestosafetyawareness.

Theyrequiresubstantialphysicalassistance,withorwithoutassistivedevices,tosafelyandcompletelyperformtwoormoreactivitiesofdailyliving(bathing,dressing,toileting,transferring,continenceandfeeding).

Theyrequirestand-byassistanceforbathingandtransferring.(Stand-byassistance2meansanotherpersonmustalwaysbewithinarm’sreachoftheinsuredpersonsotheymaysafelyandcompletelyperformtheactivitiesofbathingandtransferring).

2Iftheinsuredpersonrequiresstand-byassistanceforonlyoneofbathingortransferring,

weconsiderthemdependentwhentheyalsorequiresubstantialphysicalassistanceto

performoneoftheotheractivitiesofdailyliving.

Issue ages 21-80

Benefit amounts Minimumweeklybenefit:$150 Maximumweeklybenefit(forallLTCIcoverageononelifeinsured):$2,300

Benefit periods 100weeks(1.9years) 250weeks(4.8years) 150weeks(2.8years) Unlimited


Palliative care (end-of-life care)

Regardlessofthewaitingperiod,aclaimmaybesubmitted30daysaftertheinsuredperson:

requiressubstantialphysicalassistanceforatleastfouractivitiesofdailyliving,

hasbeendiagnosedwithaterminaldiseaseorillnessbyaqualifiedphysicianoranotherhealthcareprofessionalacceptabletous,and

isreceivingpalliativecarethatissupportiveandprovidescomfort.

First payment bonus

Whenweapproveanewclaim,thefirstpaymentincludesabonusamount,equalto12timestheweeklyamount.

Whentheinsuredpersonisreceivingpalliativecareandqualifiesforbenefits,thebonusisequaltofourtimestheweeklyamount.

Whenthepolicyincludesinflationprotection,thebonusincludesanyaccumulatedincreasestotheweeklyamount.

Thefirstpaymentbonusdoesnotaffectthenumberofweeksremaininginthepolicy’sbenefitperiod.

Waiver of premium Whenweapproveaclaimforbenefitsontheinsuredperson,wewaivepremiumsforthepolicy.Thepremiumsmustbepaiduntilwenotifythepolicyownerthatwe’veapprovedtheclaim.

Spousal waiver of premium

Toqualify,eachpolicymusthavethespousalwaiverprovisionandmusthavebeencontinuouslyineffectwithnoapprovedclaimfromthedatestheycameintoeffectuntil:

bothpolicieshavereachedtheir10thpolicyanniversary,or

theinsuredpersonandtheirspousehavehadtheir86thbirthday.

Wewillwaivepremiumsforthepolicy:

Whenwe’repayingbenefitsforthespouse’spolicy.− Thiscontinuesevenifwe’vepaidthebenefitsfortheentirebenefit

periodofthespouse’spolicy.

Ifthespousedieswhiletheirinsuranceisineffect,regardlessofwhetherornotwewerepayingbenefits.

FEATURES (Automatically included)

Waiting periods 90days 180days

Thewaitingperiodisthelengthoftimetheinsuredpersonmustbecontinuouslydependentbeforeaclaimissubmitted.

Premium payment periods

Thelifetimeofthepolicy(untilthepolicyanniversaryfollowingthe100thbirthdayoftheinsuredperson);or

Thelatestof25yearsortothepolicyanniversaryafterage65.


Extended term insurance

Ifthepremiumsarenotpaid,coveragemayautomaticallycontinueforaperiodoftimeassetoutintheExtendedterminsuranceschedule.Theweeklyamount,waitingperiodandbenefitperiodwillnotchange.

Premium guarantee Thepremiumwon’tchangeforthefirstfivepolicyyears.Afterthisperiod,wemayincreaseordecreasethepremiumonapolicyanniversary.Ifwechangethepremium,wewilltellthepolicyownerinadvanceandthatpremiumisguaranteedforatleastanotherfivepolicyyears.

LifestageCare™

Services (non-contractual feature)

Includesaccesstoamembers’-onlywebsiteandtoll-freetelephonesupportservice–anational,bilingualservice,available24hoursaday,sevendaysaweek.Offersclientsunbiasedinformationaboutlocal,qualifiedhealthcareandpersonalcareprovidersthatmeetstheirindividualandfamilyneeds,ateverystageoflife.LifestageCareiscurrentlyavailabletonewandexistinglongtermcareinsurancepolicyownersofSunLifeFinancial.Itisnotaguaranteedfeatureoftheproductandmaybewithdrawnatanytime.

ADDITIONAL OPTIONSReturn of premium on death (ROPD)

Availableforissueages21-65.

Iftheinsuredpersondieswhilethepolicyisineffect,wewillpaythereturnablepremiumamounttotheROPDbeneficiarynamedinwriting,orifnonearenamed,thepolicyownerortheirestate.

Thereturnablepremiumamountisthesumofallpremiumspaidforthepolicy,minusanyunpaidpremiumsplusinterest,andanybenefitpaymentsmade.

Inflation protection Whileinflationprotectionisineffect,weincreasetheweeklyamountoneachpolicyanniversary.3

Option A:

Weeklybenefitincreasesby3%whiletheweeklybenefitispayable.

Option B:

Weeklybenefitincreasesby2%iftheweeklybenefitisnotpayableanditincreasesby3%whiletheweeklybenefitispayable.

3There’snocaponincreases;they’recompoundedannuallyandroundedtothenearestdollar.

LifestageCareisatrademarkofTakingCareInc.


SunLTCIprovidesanincome-stylebenefitwhentheinsuredpersonisdependent.Ithelpscoverthecostofcareoveralengthyperiodoftime,givingthepeaceofmindthatcomeswithknowingthatthefinancialburdenofcarewon’trestentirelywithlovedones.

SunLifeFinancialoffersthefollowingstand-aloneplandesignsforsinglelives:

Apermanentinsurancepolicythatprovidesprotectionfortheentirelifetimeoftheinsuredpersonwhentheymeettherequirementstoqualify,aslongastherequiredpremiumsarepaidorextendedterminsuranceisavailableassetoutinthepolicy.

Coveragewillendwhentheinsuredpersondiesorwhenthepolicyiscancelled.*

Issue ages Ages21-80

How we determine dependency Theinsuredpersonisdependentwhenwe’vedeterminedthroughobjectivemeasuresthattherearefunctionallimitationsforeitherdeterioratedmentalability(cognitiveimpairment)oractivitiesofdailylivingincludingstand-byassistanceforbathingandtransferring,asdescribedbelow.

PRODUCT DETAILS

*Thepolicymayendforotherreasonsasdescribedonpage31ofthisguide.

Deteriorated mental ability (cognitive impairment)

Theinsuredpersonisdependentwhentheyneedconstantsupervisionbyanotherpersonforprotectionfromthreatstotheirphysicalhealthandsafetyastheresultofdeteriorationinoralossof:

short-termorlong-termmemory,

orientationasitrelatestopeople,placeandtime,

reasoning,or

judgmentasitrelatestosafetyawareness.

Constant supervision by another person

because of deteriorated mental ability

Substantial physical assistance with at least

two activities of daily living

Stand-by assistance to perform bathing

and transferringOR OR


DeterioratedmentalabilitymustresultfromanorganicbraindisordersuchasAlzheimer’sdisease,irreversibledementia,orbraininjury.ThediagnosismustbemadebyaspecialistlicensedandpractisinginCanadaortheUnitedStatesbasedon:

clinicalexamination,

radiologicalstudies,and

psychologicaltesting.

Activities of daily living (ADL)

Theinsuredpersonisdependentwhentheyrequiresubstantialphysicalassistance,withorwithoutassistivedevices,tosafelyandcompletelyperformtwoormoreactivitiesofdailyliving.Activitiesofdailylivingincludebathing,dressing,toileting,transferring,continenceandfeeding.

DEFINITION: Activities of daily living

Bathingmeanswashingwithorwithouttheaidofassistivedevices:

inabathtuborshower,includinggettinginandoutofthebathtuborshower,or

byspongebath.

Bathingdoesnotincludetheabilitytoreachandwashthebackorfeet.

Dressingmeansputtingon,takingoff,fasteningandunfastening,withorwithouttheaidofassistivedevices:

clothing,and

medicallynecessarybracesorartificiallimbs.

Thereisnodependencyifreasonablealterationstoorchangesintheclothingtheinsuredpersonusuallywearswouldenablethemtodresswithoutsubstantialphysicalassistance.

Toiletingmeansgettingtoandfromandonandoffthetoilet,withorwithouttheaidofassistivedevices,andperformingassociatedpersonalhygiene.

Transferringmeansmovingintooroutofabed,chairorwheelchair,withorwithouttheaidofassistivedevices.

Continencemeanstheabilitytocontrolbothbladderandbowelfunctionsormaintainareasonablelevelofpersonalhygiene(includingcaringforcatheterorcolostomybag)whennotabletocontrolbowelorbladderfunctions.

Feedingmeanstheabilitytogetfoodintothebody,withorwithouttheaidofassistivedevices,throughthemouthorbyfeedingtube.Feedingdoesnotincludecookingorpreparingameal.


Stand-by assistance for bathing and transferring

Theinsuredpersonisalsodependentwhentheyrequirestand-byassistanceforbathingandtransferring.Stand-byassistancemeansanotherpersonmustalwaysbewithinarm’sreachoftheinsuredpersonsotheymaysafelyandcompletelyperformtheactivitiesofbathingandtransferring.

Iftheinsuredpersonrequiresstand-byassistanceforonlyoneofbathingortransferring,weconsiderthemdependentwhentheyalsorequiresubstantialphysicalassistancetoperformoneoftheotherADLs.

DEFINITION: Assistive devices

Assistivedevicesareaidsthatwedeterminecouldbeusedtoimprovetheinsuredperson’sfunctioning.Theseincludeadjustablebeds,buttonhooks,canes,crutches,grabbars,handheldshowerheads,bathbrushes,seatlifts,transferbenches,walkersandwheelchairs.IfusinganassistivedeviceallowstheinsuredpersontoperformanADLsafelyandcompletely,theinsuredpersonisnotdependentforthatactivity.


Regardlessofthewaitingperiod,aclaimmaybesubmitted30daysaftertheinsuredperson:

requiressubstantialphysicalassistanceforatleastfouractivitiesofdailyliving,

hasbeendiagnosedwithaterminaldiseaseorillnessbyaqualifiedphysicianoranotherhealthcareprofessionalacceptabletous,and

isreceivingpalliativecarethatissupportiveandprovidescomfort.

–competitiveadvantage


Scenario: not dependent

Theinsuredpersonisa55-year-oldmalewhorecentlyhadkneesurgeryandstrugglestodresshimself.

Heisnotconsidereddependentbecausehedoesnotrequireassistanceforanyactivityofdailyliving.

Scenario: dependent

Theinsuredpersonisa76-year-oldfemalewhosufferedastrokeandneedsassistanceforbathing,dressing,feeding,toileting,transferringandcontinence.

Sheisdependentbecauseshecannotindependentlyperformmanyoftheactivitiesofdailyliving.

Bathing

Dressing

Toileting

Transferring

Continence

Feeding

Constant supervision for deteriorated

mental ability

Substantial physical assistance with at least

two activities of daily living (ADL)

Stand-by assistance within arm’s reachOR OR

OR

Short- or long-term memory

Bathing and transferring

Bathing or transferring

and

Substantial physical assistance with one

or more ADL

Orientation to people, place and time

Reasoning

Judgment as it relates to safety awareness


PLAN DETAILS

Benefit type Wepayaweeklyincome-stylebenefittothepolicyownerwhentheinsuredpersonqualifiesforit.Theclaimantdoesn’tneedtosubmitreceiptsforservicestoreceivethebenefitoncetheinsuredpersonqualifiesforthebenefit.Thepolicyownercanusethemoneyhowevertheychoose.

Weekly benefit amount Thebenefitiscalculatedweeklyandpaidmonthly.

Minimum weekly benefit amount: $150

Maximum weekly benefit amount (for all LTCI coverage on one insured person):$2,300

Waiting periodThewaitingperiodisthelengthoftimetheinsuredpersonmustbecontinuouslydependentbeforeaclaimissubmitted.

ItstartsonthedatetheyfirstrequireassistancefortwoormoreADLsorthedatetheyfirstrequirecontinualsupervision.Therearetwooptionstochoosefrom:

90days 180days

Benefit period Thebenefitperiodisthelengthoftimewemaypayaclaim.

100weeks(1.9years) 250weeks(4.8years) 150weeks(2.8years) Unlimited

Ifthebenefitperiodislimitedtoamaximumnumberofweeks,eachpaymentwemakereducesthenumberofweekseligibletobepaid.Thenumberofweeksinthebenefitperioddoesnotstartoverwithanewclaim.

Ifthebenefitperiodisunlimited,it’snotaffectedbythepaymentswemake.



Therearenocapsonincreases.

Ifanapplicantwishestoobtaincoverageformorethanthemaximumweeklybenefitamountof$2,300,thiscanbeachievedbyselectingInflationprotectionoptionB.Withthisoption,theinitialcoverageamountwilldoubleinapproximately35years.

Return of premium on death (ROPD) Iftheinsuredpersondieswhilethepolicyisineffect,wewillpaythereturnablepremiumamount,asdescribedbelow,totheROPDbeneficiarynamedinwriting,orifnonearenamed,thepolicyownerortheirestate.

DEFINITION: Returnable premium amount

Thereturnablepremiumamountisthesumofallpremiumspaidforthepolicy,minus:

anyunpaidpremiumsplusinterest,and anybenefitpaymentsmade.

Inflation protection Whileinflationprotectionisineffect,weincreasetheweeklyamountoneachpolicyanniversary,asdescribedbelow.Increasesarecompoundedannuallyandroundedtothenearestdollarandtherearenocapsonincreases.

Atthetimeofpurchase,theclientmayselectoneofthefollowingoptions.

Option A:

Whileinflationprotectionisineffect,weincreasetheweeklybenefitamountbythreepercentoneachpolicyanniversarywhenbenefitsarepayable.Increaseswillbecompoundedannuallyandroundedtothenearestdollarandtherearenocapsonincreases.

Ifbenefitsarenolongerpayableonapolicyanniversary,theweeklybenefitamountwillnotincrease.Anyaccumulatedincreaseremainsineffect.

Option B:

Whileinflationprotectionisineffect,weincreasetheweeklybenefitamountoneachpolicyanniversary.Theincreaseweapplyis:

Twopercentifwearenotpayingbenefitsonthepolicyanniversarydateor Threepercentifwearepayingbenefitsonthepolicyanniversarydate.

ADDITIONAL OPTIONS THAT MAY BE APPLIED FOR



DEFINITION: Spouse

Spousemeansthepersonwhoismarriedtotheinsuredperson,isinacivilunionwiththeinsuredperson,orthepersonwholiveswiththeinsuredpersoninaconjugalrelationshipforatleast12consecutivemonthsbeforethedateaclaimissubmittedforthespouse.

Torequestpremiumsbewaived,thepolicynumbermustbeincludedonthespouse’sclaimform.Wemayaskforproofofthespouse’srelationshiptotheinsuredperson.

Wewillwaivepremiumsforthepolicywhenwe’repayingbenefitsforthespouse’spolicy.Wewillcontinuetowaivepremiumsforthepolicyevenafterwe’vepaidbenefitsfortheentirebenefitperiodfortheirpolicy.

Wewillalsowaivepremiumsforthepolicyifthespousedieswhiletheirinsuranceisineffect,whetherornotwewerepayingbenefitsatthetimetheydie.Wewillrequireproofofthespouse’sdeath.

Thepremiumsforthepolicymustbepaiduntilwenotifytheclientthattherequestisapproved.

Anyexcesspremiumspaidwillbedepositedtothepolicy’swithdrawablepremiumfund.

Waiver of premium (when a claim is approved)Whenweapproveaclaimforbenefitsontheinsuredperson,wewaivepremiumsforthepolicy.Thepremiumsmustbepaiduntilwenotifythepolicyownerthatwe’veapprovedtheclaim.

Spousal waiver Ifwe’veissuedalongtermcareinsurancepolicyontheinsuredperson’sspouseandapprovedaclaimforbenefitsonthatpolicy,wemaywaivepremiumsfortheinsuredperson’spolicy.

Tohavepremiumswaived,bothpoliciesmusthaveSpousalwaiver.Eachpolicymusthavebeencontinuouslyineffectwithnoapprovedclaim,fromthedatestheycameintoeffectuntil:

bothpolicieshavereachedtheir10thpolicyanniversary,or theinsuredpersonandtheirspousehavehadtheir86thbirthday.

PLAN FEATURES THAT ARE AUTOMATICALLY INCLUDED



ElizabethownsaSunLTCIpolicywhichhasa90daywaitingperiod,a$750weeklybenefitandanunlimitedbenefitperiod.

WhenElizabethsuffersastrokeshebecomesunabletobathe,dressandfeedherself.Aftermeetingthe90daywaitingperiodshesubmitsaclaimwhichisapproved.Whenshereceivesherfirstbenefitpaymentitincludesanadditional$9000($750x12weeks)whichcanhelptooffsetsomeofthecoststhatmighthavebeenincurredwhilesatisfyingthewaitingperiod.

First payment bonus Whenweapproveanewclaim,thefirstpaymentincludesabonusamount.Itisequalto12timestheweeklyamount.

Iftheinsuredpersonisreceivingpalliativecareandqualifiesforbenefits(asdescribedearlier),thebonusisequaltofourtimestheweeklyamount.

Ifthispolicyincludesinflationprotection,thebonusincludesanyaccumulatedincreasestotheweeklyamount.

Thefirstpaymentbonusdoesnotaffectthenumberofweeksremaininginthepolicy’sbenefitperiod.

Wewillnotpayabonusif:

thereisacontinuationofapreviousclaim,or thepolicycontinuesasExtendedterminsurance,ifavailable.

MartinandJoannebothhaveSunLTCIpoliciesin-forcefor10years.NeitherofthemhasreceivedbenefitsfromtheirLTCIpolicyduringthefirst10yearsofcoverage.Inthefuture,ifoneofthembecomesdependentasdefinedinthepolicyandaclaimisapproved,orifoneofthemdies,wewillwaivepremiumsontheother’spolicy–aslongastheyarestillspousesatthetimeoftheevent.

However,ifeitherofthembecomesdependentasdefinedinthepolicyandisapprovedforbenefitsinthefirst10yearsoftheirpoliciesbeingin-force,theSpousalwaiverbecomesnullandvoid.The10yearperioddoesnotstartover.



Extended term insurance IfpremiumsarenotpaidandthepolicyhasbeenineffectforthenumberofyearssetoutintheExtendedterminsurancescheduleinthepolicy,thepolicywillautomaticallycontinueforaperiodoftime.Attheendofthatperiod,thepolicyends.

Thepolicycontinuesineffectif:

wedonotreceivetherequiredpremiumwithin31daysafteritisdue, thereisnotenoughmoneyinthewithdrawablepremiumfundtopaytherequiredpremium,and extendedterminsuranceisavailable.

Theweeklyamount,waitingperiodandbenefitperiodwillnotchange.

Whilethepolicycontinuesasextendedterminsurance:

thepolicyownermaynotpaypremiums, thepolicyownermaynotputmoneyintothewithdrawablepremiumfund, wewillnotpayafirstpaymentbonus, Returnofpremiumondeathends,ifincludedinthepolicy,and Inflationprotectionends,ifincludedinthepolicy.(Anyaccumulatedincreasetotheweeklyamountremainsineffect).

Ifweapproveaclaimwhileextendedterminsuranceisineffect,thepolicycontinuesassetoutintheschedule.Ifwestoppayingaclaimbeforetheendofthelastavailableyearshownintheschedule,thepolicycontinuesasextendedterminsurance.

Ifwe’restillpayingbenefitsattheendofthelastavailableyearshownintheschedule,wewillcontinuetopaybenefitswhiletheinsuredpersonqualifies.Onthedatetheynolongerqualify,thepolicyends.

ThetablepresentedonthefollowingpageisanexampleofanExtendedterminsuranceschedulebasedona53yearoldfemale,whohaspurchasedthefollowingpolicy:

$650WeeklyBenefit UnlimitedBenefitperiod 90dayWaitingPeriod Withoutadditionaloption Paidforannuallyonalifetimebasis(untiltheanniversaryafterage100)



Number of years this policy has been in effect Client age

Number of policy years Extended term insurance

is available1 54 0

2 55 0

3 56 0

4 57 0

5 58 0

6 59 0

7 60 0

8 61 0

9 62 0

10 63 0

11 64 0

12 65 0

13 66 1

14 67 2

15 68 3

16 69 4

17 70 5

18 71 5

19 72 5

20 73 5

21 74 5

22 75 5

23 76 4

24 77 4

25 78 4

26 79 3

27 80 3

28 81 3

29 82 3

30 83 2

31 84 2

32 85 2

33 86 2

34 87 2

35 88 1

36 89 1

37 90 1

38 91 1

39 92 1

40 93 0

41 94 0

42 95 0

43 96 0

44 97 0

45 98 0

46 99 0

47 100 0


Reversing Extended term insurance

Thepolicyownercanapplytoreverseextendedterminsuranceandresumepayingpremiumsforthispolicyiftheinsuredpersonisalive.

Toreverseextendedterminsurance:

applywithintwoyearsofthedatetherequiredpremiumwasnotpaid, giveusnewevidenceofinsurabilitythatweconsidersatisfactory,and makeapaymentequaltothereinstatementchargeweset.

Ifwedon’tapprovetheapplication,werefundanyamountpaidwhentherequestwassubmitted.

Plan of careTheinsuredpersonisentitledtoonefreeplanofcare.Arequestforaplanofcarecanbemadeafteraclaimhasbeenapprovedandwhiletheinsuredpersonisdependent.

Theplanofcarewilloutlinethetypeandamountofcaretheinsuredpersonrequires.Itwillalsoexplainhowcarecanbeprovidedandifgovernmentprogramsareavailable.

Fromthemomentthepolicyisissuedandaslongasitremainsinforce,thepolicyownerhasimmediateandunlimitedaccesstothevaluableresourcesprovidedthroughLifestageCareservices.

LifestageCareiscurrentlyavailabletonewandexistinglongtermcareinsurancepolicyownersofSunLifeFinancial.Itisnotaguaranteedfeatureoftheproductandmaybewithdrawnatanytime.

Accessing LifestageCare

Thepolicyownercanaccessthisuniqueserviceimmediatelyafterthepolicyisissuedandwithouthavingtomakeaclaim,aslongasthepolicyremainsinforce.LifestageCareservicesareforthepolicyowner’spersonalusebutcanalsobeusedtohelpanyfamilymember.

AccessingLifestageCareiseasy–logintotheLifestageCarewebsiteorcallthetoll-freenumber.TheLTCIpolicynumberistheclientidentifier.TheclientcanstartusingLifestageCareservicesimmediately:

www.sunlife.mylifestagecare.ca 1877-301-1515

Helping families help themselves

Theserviceprovidesunlimitedaccesstoinformationaboutlocal,qualifiedhealthcareandpersonalcareproviderscloselymatchingindividualandfamilyneeds,ateverystageoflife.

Seniors–foraging,retirementresidences,nursinghomes,homecare,andcommunitycare

Self-care–forpersonaladviceandwell-being,addictiontreatment,budgetandcreditcounseling,andphysicalrehabilitation

Children and teens –forparenting,childcare,andspecialneedsservices


LIFESTAGECARE™ SERVICE


APPLYING FOR A SUN LTCI POLICY

Residency requirements

Non-residents

WeconsiderresidentsofCanadatobeindividualswhoresideinCanadaforsixmonthsormoreeachyear.SunLifeFinancialproductsarepricedforindividualslivinginCanada.WedonotacceptapplicationsforindividualswhodonotliveinCanada.

Permanent residents of Canada

Iftheindividualhaspermanentresidentstatus,theycanbeconsidered.However,iftheyliveinCanadalessthan12monthsperyear,wewillrequireaparamedicalandbloodprofile.

Expert advice. Specific information. Confidential service.

LifestageCareisamembers’-onlywebsite,andtoll-freetelephonesupportserviceisavailabletolongtermcareinsurancepolicyownerswithSunLifeFinancial.

Expert–expertagentsareavailable24hoursaday,7daysaweektoanswerquestionsbyphoneoremail

Specific–helpsplanandmanagefamilycareresponsibilitiesandfindresourcesbasedonspecificrequirementsandpostalcode.Theinformationreceivedismatchedspecificallytotheindividual’sneeds

Confidential–acomplete,unbiasedservice;anyinformationprovidediskeptstrictlyconfidential

Care resources for the policy owner and their family

LifestageCarefocusesontheinformationandsupportneededtoprovidethebestcareforthewholefamily.Theserviceallowsthepolicyownerandtheirfamilytoquicklyandeasily:

Findacompleterangeofqualifiedlocalprofessionals,carefacilitiesandhealthcareresourcesanywhereinCanada.

Determinewhathomecare,rehabilitationtreatment,educationalandresidentialserviceswillcost.

Obtainprofessionaladviceongeriatriccareandcareforteensandchildrenincludingresourcesforspecialneeds.

Readsimpleexplanationsoftreatmentoptions.

Findtherightquestionstoaskwhenchoosingaprofessionalcaregiver.

Stayinformedaboutmultiplegovernmentfinancialassistanceprograms.

LifestageCareisatrademarkofTakingCareInc.


Non-landed immigrants

Generallyspeaking,non-landedimmigrantsarenoteligibletoapplyforlongtermcareinsurance.However,exceptionsmaybemadefordoctors,professionals,investors,entrepreneursandotherindividualsapprovedunderaprovincialnomineeprogram(withtheexceptionofrefugees).Inthesecaseswewillrequireacopyoftheiremploymentcontractandworkvisaorprovincialnomineeacceptanceletter.

Ifthereismedicalhistoryrequiringtreatmentorfollow-up,weexpecttheproposedinsuredpersontohaveamedicaldoctorinCanadabeforewecanconsiderthem.

MaximumLTCIcoverageof$1,000perweekmaybeconsidered.

IftheyhaveresidedinCanadalessthan12months,wewillrequireaparamedicalandbloodprofile.

Temporary work visa

LTCIisgenerallynotavailable.

Exception:TheproposedinsuredpersonmustbearesidentofCanadaforaminimumofoneyearbeforeapplication.Theymustprovideacopyoftheiremploymentcontractandworkvisaandconfirmtheyintendtoapplyfortheirpermanentresidentstatuswheneligible.

Ifthereismedicalhistoryrequiringtreatmentorfollow-up,weexpecttheclienttohaveamedicaldoctorinCanadabeforewecouldcanthem.

MaximumLTCIcoverageof$750perweekmaybeconsidered.

Other temporary residents (includingthoseonastudentvisa)

LTCIisnotavailable.

BackdatingWepermitbackdatingtosaveageuptoamaximumofthreemonths.

Backdatingisonlypermittedtoreducepremiumsasaresultofthelowerissueage.Apolicycannotbebackdatedinordertoapplyforcoveragethatwouldotherwisebeunavailable.

Forexample,wecannotbackdatetoage80toapplyforaSunLTCIpolicy.

Ifapolicyisbackdatedtoretainage,evidencerequirementsarebasedontheproposedinsuredperson’sactualageatthetimetheapplicationissubmitted.Forexample,iftheclientturned70inthelastthreemonths,theycanbackdatetoretainage69ratesbuttheevidencerequirementswouldbebasedontheiractualageof70.


Ownership rules

When the owner(s) and insured person are not the same:

Owner Insured person Example

Individualperson Individualperson(differentfromtheowner)

Husbandownsthepolicy;wifeistheinsuredperson

Adultchildownsthepolicy;fatheristheinsuredperson

Corporation Individualperson Corporationownsthepolicy;employeeistheinsuredperson

Contingent ownership:

Theownercanappointacontingentowneratthetimeofapplication.

ThenameofthecontingentownermustbeincludedintheSpecialInstructionsintheAdvisorStatementsectionofthepaperapplication.IfthecontingentownerisnotspecificallyindicatedinSpecialInstructions,thepolicywillbeissuedwithoutacontingentowner

Tomakethechangeafterthepolicyhasbeenissued,submitformE28–Contingentownerchangeform.

Transferring ownership:

Thepolicyownermaytransferownershiptoanotherperson.Transferringownershipisalsoknownasabsoluteassignmentandcouldhavetaximplications.

Theremaybetaxconsequencesifthetransferisfromacorporationtoashareholder,toanothercorporationorunincorporatedbusiness,orfromanunincorporatedbusinesstoanowneroremployee.

TherolloverrulesintheIncomeTaxAct(Canada)thatpermittax-freetransfersoflifeinsurancepoliciesincertaincircumstancesdonotapplytoLTCIpolicies.

Totransferownership,completeformE82–Assignmentofpolicyabsolute(transferofownership).


Who receives payment

Claim payment

Theweeklybenefitispaidtothepolicyownerorthepolicyowner’sestate.

Return of premium on death (ROPD)

TheROPDbeneficiarypayeecanbedesignatedwhencompletingtheapplication.ThenameofthebeneficiarymustbeincludedintheSpecialInstructionssectionofthepaperapplication.Indicatethefullname(s)oftheROPDbeneficiary(ies)(withapercentage,ifapplicable),therelationshiptotheinsuredpersonforCommonlawpolicies(orpolicyownerforQuebec),andifnamingaspouse,indicatewhethertheappointmentisrevocableorirrevocable.Ifthisisnotspecifiedontheapplication,theROPDbeneficiarywillbetheownerorestateoftheowner.

FuturechangescanbesubmittedinwritingtoSunLifeFinancial’sheadoffice.Therequestmustincludethepolicyowner’sname,policynameandnumberandnewbeneficiaryappointment(asabove).Therequestmustbesignedanddatedbythepolicyowner.Ifthebeneficiarywasirrevocable,theymustalsosigngivingtheirconsenttochange.

Completing the applicationCompletetheSunLifeFinancialpaperapplication,form810-3523(English)or820-3523(French),availableonwww.sunlife.ca/advisororfromyourRegionalSalesDirector.Pleaserefertotheinstructionsonthefrontcoveroftheapplication.

PleasesubmittheoriginalcopytoSunLifeFinancialthroughyourMGAorNationalAccountofficeorbackoffice.

Supportingdocumentsyoumaywishtoincludeare:

illustration, coveringletterormemowithdetailsofthesale,and completedunderwritingquestionnaire,ifapplicable

Oncetheapplicationisreceived,itwillbeassignedtoanunderwriter.Applicationstatuscanbecheckedonwww.sunlife.ca/advisor.Ifyouneedassistance,pleasecallourAdvisorServiceCentreat1800-800-4SUN(4786).

PaymentsDependingonthepremiumfrequencychosenbytheclient,paymentscanbemadeonamonthlybasisthroughourpre-authorizedchequing(PAC)processorannuallybycheque.

IfPACischosen,monthlypaymentsaredeductedautomaticallyfromthepayor’sbankaccountandappliedtothepremiumowing.Monthlypremiumsarecalculatedbymultiplyingtheannualpremium(includingthe$150policyfee)by0.09(themodalfactor).

Forexample,aSunLTCIpolicywithanannualpremiumof$3,000willhaveamonthlypremiumof$270.

Monthlypremium:$3,000x.09=$270

Ifthepolicyownerchoosestopayannuallybycheque,paymentscanberemittedtoourheadofficebeforethepolicyanniversarydate.Anannualstatementissenttotheownerapproximatelythreeweeksbeforethepolicyanniversary,remindingthemthattheirannualpremiumisdue.


TheunderwritingprocessforLTCIevaluatestheriskofaproposedinsuredpersonbecomingdependentonanotherpersonfordailyassistance.TheunderwritingrequirementsforLTCIdifferfromthoseoflifeinsurance,whichevaluatestheriskofdeath,andcriticalillnessinsurance,whichevaluatestheriskofbeingdiagnosedwithspecificcoveredconditions.

Underwriting evidence requirementsEvidencerequiredtounderwriteSunLTCIwilldependontheplantypeselectedandtheageoftheproposedinsuredperson.

Plan type Sun LTCI

Ages 21 – 49 50 – 69 70 – 80

Requirements Application Application Phoneinterview

Application Face-to-faceinterview Medicalrecords

PleaserefertothefollowingSunLTCIunderwritingresourcesformoreinformation:

UNDERWRITING

How to field underwrite Sun Long Term Care Insurance (810-3821)—providesyouwithinformationonthemostcommonreasonstopostponesubmittinganapplication,themostcommonreasonswedeclineanapplicationandwhotocontactifyouneedmoreinformation.

Pre-screening checklist (810-3579)—savesyoutimeandhelpsincreaseyourplacementratebyidentifyingcommonrisksthatleadtoadecline;anditprovidesyouwithcontactinformationifyouhavequestions.

The health interview / The memory exercise (810-3852)—helpsyouprepareeachclientforthehealthinterviewandincludescontactinformationiftheclienthasquestionsorconcernsabouttheprocess.

The Long term care insurance field underwriting guide (downloadable PDF) —providesguidancetohelpyoudetermineifaparticularconditionwouldbeconsideredforLTCI,aswellasinformationaboutstabilityperiodrestrictions.


Risk classes Male Female

Types of underwriting decisions

Whilelife,criticalillness(CII)anddisabilityinsurance(DI)productscanberated,SunLTCIcannot.

LikeDIproducts,SunLTCIcanbemodifiedtoalongerwaitingperiod(i.e.from90daysto180days),ashorterbenefitperiod(i.e.fromunlimitedto250weeks)oranoverallmaximum(i.e.$250,000)tobepaidout.

Inthosesituationsyou’llbeaskedtoworkwiththeclienttodetermineiftheyareinterestedinasmalleramountoveralongerbenefitperiodoralargeramountoverashorterbenefitperiod(seetheexamplebelow).

Ifamodifiedofferismade,thepremiumsareadjustedtothenewwaitingperiodandbenefitperiod,andthereisnoextrapremiumcharge.

Approved MODIFIED Postponed Declined

Example:Theunderwritermightindicatethatthemaximumamountwecanofferis$250,000.

Youwoulddeterminethevariousoptionswhichwouldinclude$1,000weeklyfor250weeksor$1,650weeklyfor150weeks.Youwouldthendiscusstheoptionswiththeclienttodeterminewhichwouldbestmeettheirneeds.

WhenwepostponeaSunLTCIapplication,theunderwriterwillindicatewhenwecouldreconsiderourdecision.However,whenwedeclineanapplication,reconsiderationofthedecisionisgenerallynotpossible.

Financial underwritingThetotalamountofLTCImustbereasonablecomparedtotheclient’scurrentstandardofliving.

Todetermineiftheamountisreasonable,we’lllooktoensurethepremiumisnotafinancialhardshipandthattheclientisn’tbetterofffinanciallythantheywerebeforebecomingphysicallydependent.Weexpectthatthemajorityofthetimetheamountappliedforfitswiththeclient’sfinancialcircumstances.

Ourpricingassumestheinsuredpersonismotivatedtorecoverfromphysicaldependencyiftheirconditionpermitsrecovery.Ifapersonisbetterofffinanciallywhilereceivingbenefits,theremaybelessmotivationtorecover.


Whencompletinganapplication,youwillbeaskedforthetotalannualincomeandnetworthfortheproposedinsuredpersonandtheirspouse/partner,ifapplicable.Makingsuretheamountappliedforisalignedwiththeclient’sfinancialsituationwillhelpyousubmitqualitybusinessandmaintainyourreferralrelationships.

Bankruptcy (personal/business bankruptcy, current not yet discharged)

Inthissituation,thefollowingfactorsaretakenintoaccountwhenconsideringeligibility:

Stableemployment

Aminimumgrossannualsalaryof$30,000

Ifself-employedusegrossincomelessbusinessexpenses

Ifapplicationsarereceivedonbothspouses,onewithbankruptcynotyetdischargedandtheothernotworking,aminimumgrossannualsalaryof$60,000

Maximumweeklybenefitamountof$500forallapplicants

Unlimitedbenefits,ifallisfavourable;otherwise,wemayconsiderareducedbenefitamount

AllpremiumsmustbepaidinCanadianfundsanddrawnfromanaccountataCanadianfinancialinstitution.

Premium frequency – monthly or annually

Monthly payments

Ifthepolicyownerchoosestopaymonthlybypre-authorizedchequing(PAC),monthlypaymentsaredeductedautomaticallyfromthepayor’sbankaccountandappliedtothepremiumowing.Monthlypremiumsarecalculatedbymultiplyingtheannualpremium(includinga$150policyfee)by0.09(themodalfactor).

PREMIUM DETAILS

Example:ASunLongTermCareInsurancepolicywithanannualpremiumof$3,000.00willhaveamonthlypremiumof$270.00.


Annual payment

Ifthepolicyownerchoosestopayannuallybycheque,paymentscanberemittedtoSunLifeFinancial’sheadofficebeforethepolicyanniversarydate.Anannualstatementissenttothepolicyownerapproximatelythreeweeksbeforethepolicyanniversarytoremindthemthattheirannualpremiumisdue.

Withdrawable premium fundIfwereceivemoremoneythanisowedinpremiums,wewillholdtheexcessamountinthewithdrawablepremiumfund.Wemaysetamaximumamountthatcanbeinthefund.Thisfundcanbeusedtopaypremiumsatanytime.

Theamountinthewithdrawablepremiumfundwillearninterestdaily.Wesettheinterestrateeachdaybasedonshort-terminterestrates.Interestearnedonthepremiumfundistaxable.

Themoneyfromthisfundcanbewithdrawnatanytime.Theremaybelimitsonwithdrawalamountsandwemaychargeafeeforthesewithdrawals.You’llbeinformedofanyrulesandlimitationswhenyousubmitawithdrawalrequest.

PleasecalltheAdvisorServiceCentreat1800-800-4SUN(4786)fordetails.

Premium payment options Theapplicantmustselectoneofthefollowing:

Premiumsarepayableforthelifetimeofthepolicy(untilthepolicyanniversaryfollowingthe100thbirthdayoftheinsuredperson,or

Premiumsarepayabletothelatestof25yearsortothepolicyanniversaryafterage65.

Premium guarantee ThepremiumshownonthePolicysummarywon’tchangeforthefirstfivepolicyyears.Afterthisperiod,wemayincreasethepremiumonapolicyanniversary.Ifwechangethepremium,wewilltellthepolicyownerinadvanceandthatpremiumisguaranteedforatleastanotherfivepolicyyears.

Anypremiumchangeisbasedontheinsuredperson’sageonthepolicydate.Wedonotconsidertheinsuredperson’shealthwhenwemakeapremiumchange.

Inthisscenario,thepurchasedateofthepolicywasJanuary20,2013.

2010 2015 2020 2025 2030

Premium

Year

After the 2018 (five year) policy anniversary: option to increase premium, but no

increase is applied at this point in time2022: premium increase occurs;

rates locked in for the next five years

Cycle can repeat2013: policy purchased


When we waive premiumsWhenweapproveaclaimforbenefits,wewaivepremiumsforthepolicy.Thepremiumsmustbepaiduntilwenotifythepolicyownerthatwe’veapprovedtheclaim.

Non-forfeiture provision (Extended term insurance)IfpremiumsarenotpaidandthepolicyhasbeenineffectforthenumberofyearssetoutintheExtendedterminsurancescheduleinthepolicy,thepolicywillautomaticallycontinueforaperiodoftime.Attheendofthatperiod,thepolicyends.

FormoredetailsaboutthisprovisionpleaseseeExtendedTermInsuranceonpage15.

Policy dateThepolicydateindicatedinthepolicyisthestartdateofthatpolicy.

Thepolicydateisthedatethepolicyisissued,ortheretainedagedateifrequested.

Pleaserefertotheadvisorsiteformoredetailsonpolicydeliveryrequirements.

When the insurance comes into effectThesepoliciescomeintoeffectwhenallsettlerequirementsarereceivedandapproved.

ISSUING A SUN LTCI POLICY


Changing coverage options Thereareavarietyofchangespossibleincluding:

decreasingtheweeklybenefitamount, decreasingthebenefitperiod, lengtheningthewaitingperiod, changingtheinflationprotectionoptionfromtwopercent/threepercenttozeropercent/threepercent,

decreasingthebenefitamountattributedtoinflationprotectionincreases,and changingthepremiumpaymentfrequency.

TorequestanyofthesechangesuseformE220–Changeform–Longtermcareinsurance.

Wedeterminetheminimumbenefitamountthatmustremainineffect.

Terminating an optionItispossibletoterminateanoption,suchas:

Inflationprotection,or OptionalReturnofpremiumondeath.

TorequestthisuseformE220–Changeform–Longtermcareinsurance.

ConversionsSunLongTermCareInsurancedoesn’thaveanyconversionoptions.

Internal replacementsAninternalreplacementallowsforaplanchangeoutsideofthecontractualright.Undermostcircumstances,evidenceofinsurabilitymustbesubmittedforinternalreplacements.Anewapplicationisalwaysrequired.Quebecspecific-InQuebec,advisorsmustfollowthereplacementprocedure.

Examplesofinternalreplacementsinclude:

increasingthebenefitamount, increasingthebenefitperiod, shorteningthewaitingperiod, addingoptionalReturnofpremiumondeath(ROPD), addingInflationprotection, changingInflationprotectionbenefitfromzeropercent/threepercentwhilereceivingbenefitstotwopercent/threepercentwhilereceivingbenefits,and

lengtheningpremiumpaymentperiod.

PLAN CHANGES


Note:Becausethisisnotacontractualright,therulesforinternalreplacementsmaychange.

Exception–AninternalreplacementwithoutevidenceispossibleforSunLTCIinthefollowingscenarios:

Ifthenewapplicationisexactlythesameastheoldoneexcepttheclientwishesto:

a)Shortenthepremiumpaymentperiod.

b)Shortenthepremiumpaymentperiodincombinationwithanyofthefollowing:

− Iftheoriginalpolicy(eitherClaricaorSunLife)hasROPD,nounderwritingisrequiredtohaveROPDonthenewpolicy.

− IftheoriginalpolicyisaSunLifeFinancialplanwithInflationprotection,nounderwritingisrequiredtohaveInflationprotectiononthenewpolicy.

− Iftheoriginalpolicy(eitherClaricaorSunLife)hasaccumulatedInflationprotectionamountsandtheclientselectsaplanamounttotallingtheexistingbasebenefitplusanyaccumulatedamountsforthenewpolicy,nounderwritingisrequired.(Example:Theexistingpolicyhasa$500basebenefitwith$75.00add-inInflationprotectionaccumulation,thenewplancanhave$575.00withnounderwritingrequired).

ReinstatementsTherequiredpremiumsforthepolicymustbepaidbytheduedate.Ifpremiumsarenotpaidwhendue,wewillwithdrawtheunpaidpremiumfromthewithdrawablepremiumfundifithassufficientfunds.

Thepolicywillendif:

premiumsarenotreceivedbeforetheendofthe31stdayaftertheyaredue, thereareinsufficientfundsinthewithdrawablepremiumfund,and extendedterminsuranceisnotavailable.

Ifthepolicyendsthisway,itiscalledalapse.Ifthepolicyendedbecauseitlapsed,thepolicyownercanapplytohaveitputbackintoeffect(reinstated)iftheinsuredpersonisalive.

Toreinstatethepolicy,thepolicyownermust:

applywithintwoyearsofthedatethepolicyended, providenewevidenceofinsurabilitythatweconsidersatisfactory,and makeapaymentequaltothereinstatementchargeweset.

Ifwedon’tapprovetheapplication,werefundtheamountpaidtoputthepolicybackintoeffect.


Number of days from the premium due date

Amount and type of insurance

Evidence requirements

Lessthan62 Any None

62to180 Any Applicationforreinstatement–ClaricaorSunLongTermCareInsurance,formE226

Greaterthan180 Any Applicationforreinstatement–ClaricaorSunLongTermCareInsurance,formE226

MedicalinformationandfunctionalabilityquestionnaireforLTCIformE223,and

Usualunderwritingevidence,basedonattainedageatreinstatement

REINSTATEMENT RULES AT A GLANCE

MAKING A CLAIM FOR SUN LONG TERM CARE INSURANCE BENEFITS

When to make a claimThepolicymustbeineffectonthedateaclaimissubmitted.Theinsuredpersonmustbecontinuouslydependentforlongerthanthewaitingperiod,andtheconditionsdescribedundertheheading,Howwedeterminedependencymustbesatisfied.

Aclaimmaybesubmittedwhena30-daywaitingperiodissatisfiediftheinsuredpersonisreceivingpalliativecare.Thisisdescribedundertheheading,Palliativecare(end-of-lifecare).

Wemustreceivetheclaimimmediatelyfollowingtheendofthewaitingperiodandnolaterthan120daysfromthatdate.Anyclaimreceivedafterthattimeislateandwemaydeclineitwithoutassessingdependency.

We’llconsideralateclaimexceptionif:

wereceivetheclaimnolaterthanoneyearfromthedatetheinsuredpersonbecamedependent,and

theclaimantprovidesawrittenexplanationdescribingwhytheclaimislateandweagreetheexplanationisreasonable.


How to make a claim

Step 1: Notify us

Contact us–Tomakeaclaim,theclaimantshouldcontactSunLifeFinancialusingthetollfreenumberlistedintheirpolicy.Thisnumberis1877-SUN-LIFE(786-5433).Wewillthensendtheappropriateclaimformtobecompleted.YoucancallIndividualClaimsServicestollfreeat1800-800-4SUN(4786)[email protected].

Form–Thepersonmakingtheclaimmustcompletetheform(s)andgiveustheinformationweneedtoassesstheclaim.

TheinsuredpersonmustbeinCanadaortheUnitedStatesatthetimeaclaimismade.Iftheyarenot,theymustreturntobeassessedbyaphysicianlicensedandpractisinginCanadaortheUnitedStates.

Beforeweapprovetheclaim,theinsuredperson’sdateofbirthmustbeverified.Ifthedateofbirthgivenontheapplicationisincorrect,we’lladjusttheamountwepaytoreflecttheinsuredperson’scorrectage.

Pay premiums–Policypremiumsmustcontinuetobepaiduntilweadvisethatwe’veapprovedtheclaim.

Send forms–Theform(s)andinformationmustbesentto:

IndividualClaimsServicesSunLifeAssuranceCompanyofCanada227KingStS,POBox1601,StnWaterlooWaterlooONCanadaN2J4C5

Fees–Physiciansmaychargeafeetocompletecertainforms.Thepersonmakingtheclaimisresponsibleforanyfeesforthisinformation.

Step 2: Collection of medical information

Information we need–Theclaimantmustgiveustheinformationweneedtoassesstheclaim.Thisincludesourformwhichmustbecompletedbyaphysicianoranotherhealthcareprofessionalacceptabletous.Thephysicianmustdescribetheinsuredperson’smedicalcondition,limitationsandfunctionalabilitiesandprovideobjectivemedicalinformationabouttheirdependence.

Additional information–We’lladviseifweneedanyotherinformationtoassesstheclaim.Thiscouldincludemedicalrecords,clinicaltests,physiotherapyreports,psychologicaltestsandanyotherobjectivemedicalinformationthatsupportstheclaim.

Fees–Anyfeeschargedbyphysicianstocompleteformsorprovideinformationaretheclaimant’sresponsibility.


Doctors–Physicians,specialistsorhealthcarepractitionerswhoprovideinformationtousmustbelicensedandpractisinginCanadaortheUnitedStates.Theymaynotbethepolicyowner,insuredperson,anyoneentitledtomakeaclaimunderthispolicy,oranyrelativeorbusinessassociateofthesepeople.

Documentation by us–Wemayrequiretheinsuredpersontobeexaminedbyanyhealthcarepractitionersthatweappoint.Thesemaybelicensedphysicians,physiotherapists,occupationaltherapists,psychiatrists,psychologistsorothers.Wepayfortheseexaminations.

Wemayalsorequiretheinsuredpersontoauthorizeustogatheranduseinformationfromotherinsurersorgovernmentagencies.

Step 3: Making the claims decision

Oncewereceiveallinformationwerequire,wewillassesstheinformationandmakeadecision.Wecommunicatethisdecisionandpaythebenefittothepolicyownerortheestate,ifapplicable.

Ifwedenyaclaim,wesendaletterexplainingthedecisiontothepolicyowner.Ifthepolicyownerandtheinsuredpersonarenotthesameperson,wewillsendtwodeclineletters:

onelettertotheclaimant,fullyexplainingourpolicydecision,and asecondlettertothepolicyowner,confirmingourdenialoftheclaim.Nomedicalinformationisgiventothepolicyownerforprivacyreasons.

TocontacttheIndividualClaimsServicesdepartment,use:

Email:[email protected]:1800-800-4SUN(4786)Fax:1866-487-4745

Exclusions and limitationsThepolicyendsandbenefitsarenotpayableiftheinsuredperson’sdependencystartedbeforethelaterof:

themostrecentdateanapplicationforthispolicywassigned, thepolicydateshownundertheheadingPolicysummary,or themostrecentdatethispolicywasputbackintoeffect,ifthepolicyhasbeenreinstated.

Wewon’tpaybenefitswhentheinsuredpersonisoutsideCanadaortheUnitedStatesformorethaneightconsecutiveweeks.Ifwe’vepaidbeyondtheeightconsecutiveweeklimitation,wehavetherighttodeducttheoverpaymentfromanyfuturebenefits.

Wewon’tpaybenefitsiftheinsuredperson’sdependencyisdirectlyorindirectlycausedbyorassociatedwiththeinsuredpersonoperatingavehiclewhiletheirbloodalcohollevelismorethan80milligramsofalcoholper100millilitresofblood.Avehicleincludesanyformofground,airormarinetransportationthatcanbeputintomotionbyanymeans,includingmuscularpower.Wedonottakeintoaccountwhetherornotthevehicleisinmotion.



Wewon’tpaybenefitsiftheinsuredperson’sdependencyisdirectlyorindirectlycausedbyorassociatedwiththeinsuredperson:

committingorattemptingtocommitacriminaloffence,

attemptingtotaketheirownlife,regardlessofwhethertheinsuredpersonhasamentalillnessorunderstandsorintendstheconsequencesoftheiraction(s),

causingthemselfbodilyinjury,regardlessofwhethertheinsuredpersonhasamentalillnessorunderstandsorintendstheconsequencesoftheiraction(s),

intentionallytakinganydrugotherthanasprescribedbyalicensedmedicalpractitionerandinaccordancewiththeinstructionsgiven,and/or

intentionallytakinganyintoxicant,narcoticorpoisonoussubstance.Thisdoesnotincludesmokingcigarettes,cigarillos,cigars,chewingtobaccooroccasionaluseofalcohol.

Wewon’tpaybenefitsiftheinsuredperson’sdependencyisdirectlyorindirectlycausedbyorassociatedwithcivildisorderorwar,whetherdeclaredornot.

Tips for an efficient claims process Makesureyouunderstandtheclaimtriggersandthattheinsuredpersonmeetsthedefinitionofdependenceasdefinedbythecontract.Thiswillhelpreduceineligibleclaims,setbetterexpectationsfortheinsuredpersonandreducepotentialexpenses.

Verifythewaitingperiodsetoutinthepolicy.Afterthewaitingperiodhasbeenmet,completeandsubmittheclaimform.

Makesuretheformiscomplete,signedanddatedbeforeyousubmitit.Youneedtoinclude:

− thefulladdress(includingpostalcode)ofalldoctorstheinsuredpersonhasconsulted,and− thephonenumberofalldoctorstheinsuredpersonhasconsulted.

Verifytheinsuredperson’sdateofbirthandcheckitagainstthatshowninthepolicy.

Itisimportantthatweobtainallmedicalreportsfromthephysiciantosupporttheclaim.Ifthereportsarenotsenttous,wecannotdoafullevaluationandthiswillcausedelays.


TAXATION

TherearenospecifictaxlawsgoverningLTCIpolicies.

BasedoncurrenttaxlawsandguidancefromtheCanadaRevenueAgency,weexpectthat:

Premiumspaidforalongtermcareinsurancepolicyownedbyanindividualorindividualswillnotbetaxdeductible.

Anycashbenefitspaidfromalongtermcareinsurancepolicywillbetax-freewhenthepolicyownerandbenefitpayeearethesame.

Ifthepolicyisownedbyacorporation,differenttaxlawsmayapplytosomecircumstances:

Premiumspaidforalongtermcareinsurancepolicyownedbyacorporationwillnotbetaxdeductible,exceptinstrictlylimitedcircumstancesthatarebeyondthescopeofthisguide.

Anycashbenefitspaidfromalongtermcareinsurancepolicywillbetax-freewhenthepolicyownerandbenefitpayeearethesame.

Paymentofanypartofthecashbenefitfromthecorporationoranunincorporatedbusinesstoanemployeeorshareholdercouldproducetaxconsequencesfortherecipient.

Sincelongtermcareinsuranceisnotlifeinsurance,nopartofthelongtermcareinsurancebenefitthatacorporationreceivescanbepaidtoitsshareholdersasatax-freecapitaldividend.

Ifthecorporationtransfersownershipofalongtermcareinsurancepolicytooneofitsshareholdersoremployees,theremaybetaxconsequencesfortherecipient.

Theforegoingisonlyageneralsummary.Ataxprofessionalshouldbeconsultedformoreinformation.FormoreinformationconsulttheCanadianHealthInsuranceTaxGuide:www.sunlife.ca/advisor/HealthTaxGuide


Clarica Long Term Care Insurance (Dec. 4, 2000 to Dec. 11, 2003)

Issue ages 31–80

Coverage type Comprehensive

Whentheinsuredpersonqualifiesforthisincome-stylebenefit,wepayitnomatterwheretheyliveorreceivecarewithinCanadaortheUnitedStates.

Withincome-stylebenefits,clientsdonotneedtosubmitreceiptstoreceivetheirweeklybenefit;theycanusethemoneyhowevertheychoose.

Claim triggers Aclaimispaidwhentheinsuredperson:

alwaysneedssubstantialphysicalassistancefromanotherpersontocompletetwoormoreoftheactivitiesofdailyliving(bathing,dressing,toileting,movingtoorfromabedorchair,continence,andfeeding),or

hasdeterioratedmentalability.

Weekly benefit amounts

Minimum$150 Maximum$2,000

Waiting periods 30days 90days 180days

Benefit periods 100weeks 150weeks

250weeks 500weeks Unlimited

Payment period options

15years 20years Lifetime


Thereturnableamountisbasedonhowlongthepolicyhasbeeninforce.

Claimsaresubtractedfromthereturnableamount.

Thereisnoreturnofpremiumifthepolicyisonextendedtermcoverage.

PLAN DETAILS

PRODUCT HISTORY

Inforceproductnolongersold


Inflation protection Everythreeyearsanincreaseincoverageisoffered,withoutnewevidenceofinsurability,basedontheincreaseinlongtermcarecosts.

Theofferwillbepricedaccordingtoattainedage.

Offersarenotmadeif:

twooffershavebeendeclined, therehasbeenaclaimagainstthepolicy, premiumsarebeingwaivedunderthespousalwaiverbenefit, thepolicyispaidup,or theinsuredpersonhasreachedage85.

Waiver of premium when claim is approved

Premiumsarenotrequiredwhilebenefitsarebeingpaid,butpremiumsarepayableduringthewaitingperiod.

Premiumsarealsonotpayableifwe’vepaidthetotalnumberofweeksofthebenefitpaymentperiod.


Toqualifyforthisbenefit,allrequiredpremiumsmusthavebeenpaidonbothspouses’policiesandbothpolicieshavebeencontinuouslyineffectandwithoutclaimfor10years(oruntilbothspouseshavereachedage86ifearlier).

Premiums are waived if:

benefitsarebeingpaidonthespouse’spolicy,or

thespousedies(whetherornottheywereonclaimatthetime).


Ifpremiumsarenotpaid,coveragewillcontinueforanadditionalperiodoftimedeterminedbyhowlongcoveragehasbeeninplace,age,genderandpremiumpaymentperiod.Benefitswillnotchange.

Premium guarantee Premiumsareguaranteedonafiveyearrollingbasis.

Plan of care Yes

Withdrawable premium fund

Yes

Support services LifestageCare™services

In2012,LifestageCare™serviceswereretroactivelymadeavailabletoallLTCIpolicyowners.

Itincludesaccesstoamembers-onlywebsiteandtoll-freetelephonesupportservice-anational,bilingualservice,available24hoursaday,7daysaweek.

Itoffersclientsunbiasedinformationaboutlocal,qualifiedhealthcareandpersonalcareprovidersthatmeettheirindividualandfamilyneeds,ateverystageoflife.

LifestageCare™isathird-partyserviceandisnotaguaranteedpartoftheLTCIpolicy.Itmaybewithdrawnoralteredatanytime.

Policy fees $150.00



Clarica Long Term Care Insurance (Dec. 12, 2003 to Sep. 18, 2005)

Issue ages 31–80

Coverage type Comprehensive

Whentheinsuredpersonqualifiesforthisincome-stylebenefit,wepayitnomatterwheretheyliveorreceivecarewithinCanadaortheUnitedStates.



alwaysneedssubstantialphysicalassistanceorstandbyassistancefromanotherpersontosafelyandcompletelyperformtwoormoreoftheactivitiesofdailyliving(bathing,dressing,toileting,movingtoorfromabedorchair,continence,andfeeding),or

hasdeterioratedmentalability.

Weekly benefit amounts

Minimum$150 Maximum$2,000

Waiting periods 30days 90days 180days


250weeks 500weeks Unlimited

Payment period options

15years 20years Lifetime


Returnableamountisbasedonhowlongthepolicyhasbeeninforce.


Thereisnoreturnofpremiumifthepolicyisonextendedtermcoverage.


PLAN DETAILS


Inflation protection Everythreeyearsanincreaseincoverageisoffered,withoutnewevidenceofinsurability,basedontheincreaseinlongtermcarecosts.

Theofferwillbepricedaccordingtoattainedage.

Offersarenotmadeif:

twooffershavebeendeclined, therehasbeenaclaimagainstthepolicy, premiumsarebeingwaivedunderthespousalwaiverbenefit, thepolicyispaidup,or theinsuredpersonhasreachedage85.



Premiumsarealsonotpayableifwe’vepaidthetotalnumberofweeksofthebenefitpaymentperiod.




Benefitsarebeingpaidonthespouse’spolicy.

Thespousedies(whetherornottheywereonclaimatthetime).

Wepaidthemaximumlongtermcareinsurancebenefitundertheotherpolicyifapplicable.


Ifpremiumsarenotpaid,coveragewillcontinueforanadditionalperiodoftimedeterminedbyhowlongcoveragehasbeeninplace,age,genderandpremiumpaymentperiod.Benefitswillnotchange.


Plan of care Yes


Yes





Policy Fees $150.00



Sun Long Term Care Insurance (Sep. 19, 2005 to Dec. 6, 2013)

Issue ages 21-80

Coverage type ComprehensiveWhentheinsuredpersonqualifiesforthisincome-stylebenefit,wepayitnomatterwheretheyliveorreceivecarewithinCanadaortheUnitedStates.

Facility Care Wepaythisincome-stylebenefitifcareisprovidedinalong-termcarefacilityinCanada.AsimilarfacilityintheUnitedStatesmaybeconsidered,subjecttoourapproval.



alwaysneedssubstantialphysicalassistanceorstand-byassistancefromanotherpersontosafelyandcompletelyperformtwoormoreoftheactivitiesofdailyliving(bathing,dressing,toileting,transferring,continence,andfeeding),or

requirescontinualsupervisiontoprotecttheirhealth.

Weekly benefit amounts Minimum(foreachcoverageselected):$150

Maximum(forallselectedcoverage):$2,000

Ifbothbenefittypesareselected,thecomprehensiveweeklybenefitamountmustbeatleast50%ofthefacilitycareweeklybenefitamount.

Forexample,ifthefacilitycarebenefitis$1,000,thecomprehensivebenefitmustbeatleast$500.

Waiting periods Comprehensive

30days 90days

Facility Care

0days(onlyavailableifbothcoveragetypesareselected)

30days 90days


250weeks Unlimited

Thepolicyownermaychooseadifferentbenefitdurationforeachbenefittype.

Payment period options Lifetime Thelongerof20yearsortoage55


PLAN DETAILS



Thisoptionalbenefitreturnsaportionofpremiumstotheownerofthepolicy(ortheowner’sestate)iftheinsuredpersondies.

Returnableamountisbasedonhowlongthepolicyhasbeeninforce.

Calculatedseparatelyforeachbenefittype.


Doesnotincludepremiumsforinflationprotectionbenefit.

Ifbothbenefittypesareselected,thisoptionappliestoboth.

Inflation protection Option A

− Weeklybenefitincreasesby3%eachpolicyanniversary-thedatethepolicybecameeffective-whiletheweeklybenefitispayable.

Option B

− Weeklybenefitincreasesby2%eachpolicyanniversaryiftheweeklybenefitisnotpayable.

− Weeklybenefitincreasesby3%eachpolicyanniversarywhiletheweeklybenefitispayable.

Thesameoptionmustbechosenforbothbenefittypesbutitworksindependentlyforeach.

Increasesarecompoundedannually.

Nocaponincreases.

Benefitmaximummayexceed$2,000perweekduetoinflationprotectionincreases.



Premiumsarealsonotpayableifwe’vepaidthetotalnumberofweeksineitherthecomprehensiveorfacilitycarebenefitperiod.




Benefitsarebeingpaidonthespouse’spolicy.

We’vepaidthetotalnumberofweeksinthecomprehensiveorfacilitycarebenefitperiodforthespouse’spolicy.

Thespousedies(whetherornottheywereonclaimatthetime).



Extended term insurance Ifpremiumsarenotpaid,coveragemaycontinueforalimitedtimebasedon:

Basebenefittype(comprehensiveorfacilitycare) Ageatpurchase Gender Premiumpaymentperiod Thenumberofyearsthepolicyhasbeeninforce

Whileextendedterminsuranceisineffect:

Noreturnofpremiumondeathbenefitispaid Noinflationprotectionincreasesaremade


Plan of care Yes


Yes





Policy fees $150.00



Stand-by assistance for bathing and transferring

WhenitcomestoLTCI,definitionsmakeallthedifference.Stand-byassistanceisanimportantpartofourdefinitionofdependence.Itmeansthattheinsuredpersonmaybeeligibletomakeaclaimsoonerorlongerthanwithapolicythatdoesn’tincludethisaspartoftheirdependencedefinition.


Regardlessofthewaitingperiod,thepolicyownercansubmitaclaim30daysaftertheinsuredperson:

hasbeendiagnosedwithaterminaldiseaseorillness, requiressubstantialphysicalassistanceforatleastfouractivitiesofdailyliving,and isreceivingpalliativecarethatissupportiveandprovidescomfort.

Income-style benefit

ManyLTCIplansofferanincome-stylebenefitwhichisdesignedtooffsetthecostofcareservicesprovidedbyprofessionalorfamilycaregiverswhetherinapersonalresidence,retirementhomeorlong-termcarefacilitybecauseofalossofindependence.Thistypeofplanoffers:

flexibility–thebenefitcanbeusedforanypurpose,and simplicity–there’snoneedtosubmitproofofservice.

Unlimited benefit period option

Anunlimitedbenefitperiodisanexcellentoptionforclientswhoarelookingforthepeaceofmindthatcomesfromhavingaccesstoanunlimitedstreamofbenefitsincaseofaprolongedcareneed.Thismeansthatwhentheyneedthecare,clientsdon’thavetoworryaboutthebenefitsending.

Inflation protection option

Theimpactofinflationonthefuturecostofcareisoftenoverlooked.Talktoclientsaboutaddinginflationprotectiontotheircoverageorpurchasingalargeramountofcoveragetooffsetinflationrisk.


WithSunLTCI,clientscanenhancetheircoveragewithasimple,easy-to-understandReturnofpremiumoption.Iftheinsuredpersondieswhilethepolicyisineffect,wewillpaythereturnablepremiumamounttotheROPDbeneficiarynamedinwriting.Ifnoneisnamed,wepaytothepolicyownerortheirestate.Thereturnablepremiumamountisthesumofallpremiumspaidforthepolicy,minusanyunpaidpremiums(plusinterest)andanybenefitpaymentsmade.

Spousal waiver

ThespousalwaiverbenefitisuniquetoSunLife.Ifbothspousesarecoveredunderpoliciesthatincludespousalwaiver,premiumswillbewaivedifonespousediesorifwe’repayingbenefitsoneitherpolicy.Evenafterwe’vepaidbenefitsfortheentirebenefitperiodonthespouse’spolicy,premiumswillbewaived.

COMPETITIVE ADVANTAGES – SUMMARY


Toqualifyforthebenefit,eachspousemusthaveapolicythathasbeencontinuouslyineffectwithnoapprovedclaimfromthedatestheycameintoeffectuntil:

bothpolicieshavereachedtheir10thpolicyanniversaries,or bothspouseshavehadtheir86thbirthdays.

First Payment bonus

Whenweapproveanewclaim,thefirstpaymentincludesabonusamountequalto12timestheweeklyamount.Iftheinsuredpersonisreceivingpalliativecareandqualifiesforbenefits,thebonusisequaltofourtimestheweeklyamount.Thisbonuscanhelpoffsetsomeofthecoststhatmighthavebeenincurredwhilesatisfyingthewaitingperiod.


WithSunLTCI,iftheclientcan’tpaythepremiums,extendedterminsurancemayhelp.Ifthisprovisionapplies,thepolicymaystayinforceforaspecifiedtime,andthebenefitamount,benefitperiodandwaitingperioddon’tchange.

LifestageCare™ services

ThepolicyownerhasimmediateandunlimitedaccesstoLifestageCare–anational,bilingualinformationserviceavailable24hoursaday,sevendaysaweek–oncethepolicyisissuedandaslongasit’sinforce.

Clientsgetaccesstounbiasedinformationaboutlocal,qualifiedhealthandpersonalcareprovidersthatmeetstheirindividualandfamilyneedsateverystageoflife.ThepolicyownercanuseLifestageCareservicestohelpanyfamilymember.

Premium guarantee

Allinsurersguaranteetheirratesforthefirstfivepolicyyears.However,manymaychangetheirratesanytimeafterward.AtSunLifeFinancial,ifwechangeourrates,wewon’tchangethemagainforatleastanotherfiveyears.

Coverage extended outside of Canada and the United States

Mostinsurersdon’tprovidecoverageforanyamountoftimespentoutsideofCanadaortheUnitedStates.SunLTCIprovidescoverageforeightconsecutiveweekswhentheinsuredpersontravelsoutsideeithercountry.

WHERE TO GO FOR MORE INFORMATION?ContactyourRegionalSalesDirectorortheSalesSupportteamformoreinformationonlongtermcareinsuranceproducts.

Telephone:1800-800-4SUN(4786)Email:[email protected]

It’simportanttomeetwithclientsregularlytoreviewtheircoverageandhelpthemwithanycontractualconversionsorrenewalstoensuretheyhavetheprotectionthatmeetstheirneeds.

SunLifeAssuranceCompanyofCanadaisamemberoftheSunLifeFinancialgroupofcompanies.

©SunLifeAssuranceCompanyofCanada,2017.

810-3352-Digital-07-17

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