Under a tax-qualified long-term care policy, an insured normally becomes eligible for benefits when they are unable to perform without substantial assistance how many of the six activities of daily living (ADLs)?
Explanation
The HIPAA standard, used by tax-qualified LTC policies and California's LTC framework, triggers benefits when the insured cannot perform at least 2 of the 6 ADLs (bathing, dressing, eating, toileting, transferring, continence) without substantial assistance for an expected period of at least 90 days. Severe cognitive impairment is a separate, independent trigger.
Law Reference: HIPAA tax-qualified LTC standard; Cal. Ins. Code §10232.8This topic, taught in full in the California Life & Health Insurance Producer Exam guide. California Life & Health Insurance Producer Exam — Complete Study Guide (2026) — PDF + EPUB, $19.99 · 14-day refund →
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