Long Term Care Insurance Policy, Page 6

SAMPLE LONG TERM CARE INSURANCE POLICY

PART 1 - WORDS AND PHRASES

This part explains the special meaning given to certain words or phrases as they are used in this Policy. Other terms may be defined in the part in which they are most frequently used.

Defined terms are presented with capital letters to help You easily identify them. We urge You to pay special attention to facility and care provider definitions. The terms used in this Policy are Our way of referencing the collection of information contained in the definition.

Activities of Daily Living means the following activities:

• Bathing which means washing Yourself by sponge bath; or in either a tub or shower, including the task of getting into or out of the tub or shower.

• Continence which means the ability to maintain control of bowel and bladder functions; or
when unable to maintain control of bowel or bladder functions, the ability to perform associated personal hygiene (including caring for catheter or colostomy bag).

• Dressing which means putting on and taking off all items of clothing and any necessary braces, fasteners or artificial limbs.

• Eating which means feeding Yourself by getting food into the body from a receptacle (such as a plate, cup or table) or by a feeding tube or intravenously. Eating does not include preparing a meal.

• Toileting which means getting to and from the toilet, getting on and off the toilet, and
performing associated personal hygiene.

• Transferring which means moving into or out of a bed, chair or wheelchair. Transferring does not include the task of getting into or out of the tub or shower.

Adult Day Care means social and health-related services provided during the day in a community or group setting to six (6) or more persons. The purpose of the program is to support frail or impaired elderly, or other disabled adults who can benefit from care in a group setting outside the home.

Adult Day Care Center means a place that is licensed to provide Adult Day Care by the jurisdiction in which the services are provided. If licensing is not required, Adult Day Care Center means a place that provides Adult Day Care, has enough full-time staff to maintain no more than an 8 to 1 client-staff ratio, and has established procedures for obtaining appropriate aid in the event of a medical emergency. An Adult Day Care Center is a place that provides Adult Day Care for only part of a day.

Assisted Living Facility means a facility which:

• is licensed to provide Custodial Care according to the laws of the jurisdiction in which it is
located; or

• if licensing is not required, meets all of the following --

• has a 24-hour on-site staff to provide Custodial Care;

• provides Custodial Care services for a charge, including room and board;

• has established procedures for obtaining appropriate aid in the event of a medical
emergency;

• provides 3 meals a day and can accommodate special dietary needs;

• it provides, at a minimum, assistance with Bathing and Dressing; and

• provides Custodial Care services to 10 or more persons.

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