Selected Facts and Figures about Long-Term Care Insurance (0510) by iem58695

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									                               Selected Facts and Figures about
                               Long-Term Care Insurance (05/10)


I. Number of insured persons

      Social Long-Term Care Insurance                                 about 69.77 m (as of: 01.01.2010)
      Private Long-Term Care Insurance                                about 9.29 m (as of: 31.12.2008)

II. Total number of beneficiaries                                                about 2.37 million
    (home and institutional care)

      Home care                                                                  about 1.63 million
      Institutional care                                                         about 0.74 million

III. Number of beneficiaries in home care

      1. Social Long-Term Care Insurance
         (source: business statistics of the LTCI funds)

         a) Total number of dependent persons in home care                                 about 1.54 million

         b) Broken down by care levels


                  as of:                         31.12.2008                             31.12.2009 1

                  Care level I           861.575              =60.1 %           936.223            = 60.8 %
                  Care level II          439.605              = 30.7 %          466.728            = 30.3 %
                  Care level III         131.354              = 9.2 %           138.147            = 9.0 %
                                        1.432.534                              1.541.098




1
    The increase in the outpatient sector as compared to 2008 has been exaggerated by approximately 10.000 due to
    data collection procedures.


                                                        -1-
  c)   Cash allowance / outpatient benefits-in-kind ratio

          Annual average                   Expenditure               Recipient

          1995                                 82 : 18                 88 : 12
          1996                                 74 : 26                 85 : 15
          1997                                 71 : 29                 84 : 16
          1998                                 68 : 32                 83 : 17
          1999                                 67 : 33                 81 : 19
          2000                                 65 : 35                 80 : 20
          2001                                 64 : 36                 80 : 20
          2002                                 64 : 36                 80 : 20
          2003                                 63 : 37                 80 : 20
          2004                                 63 : 37                 80 : 20
          2005                                 63 : 37                 80 : 20
          2006                                 62 : 38                 79 : 21
          2007                                 62 : 38                 79 : 21
          2008                                 62 : 38                 79 :21
          2009                                 62 : 38                 79 : 21

  d) Recognition as a particularly severe case (percentage of persons in need of long-
     term care of care level III – not more than 3 per cent -)
                                                                   on 31.12.2009 1.3 %
                                                                   on 31.12.2008 1.2 %

2. Private Mandatory Long-Term Care Insurance
  (source: business statistics of the private LTC Insurers)


  Total number (as of: 31.12.2008)                                approx. 92,000

  of which
  Care level I                      52,9%
  Care level II                     35.0%
  Care level III                    12.0%

  A total of 1.63 million dependent persons receive home care benefits from the social
  and the private mandatory long-term care insurance schemes.




                                               -2-
IV.        Number of beneficiaries in institutional (in -patient) care

      1. Social Long-term Care Insurance
         (source: business statistics of the LTCI funds)


         a) Total number of dependent persons in fully institutional care                    approx 702,000

              of whom not more than 79,000 are in full-time special support institutions for persons
              with disabilities

         b) Broken down by care levels


               as of:                             31.12.2008                            31.12.2009 2

               Care level I                   274,925 = 40.4%                     286,761        = 40.8 %
               Care level II                  273,016 = 40,1%                     277,495        = 39,5 %
               Care level III                 133,010 = 19.5%                     137,912        = 19.6 %
                                              680,951                             702,168

         c)   Recognition as a particularly severe case (percentage of persons in need of long-
              term care of care level III - not more than 5 per cent -)
                                                                            on 31.12.2009 3.7 %
                                                                            on 31.12.2008 3.5 %

      2. Private Mandatory Long-Term Care Insurance
         (source: business statistics of the private LTC Insurers)


         Total number (as of: 31.12.2008)                                              approx. 39,000

         Broken down by care levels

         Care level I               31.1%
         Care level II              43.7%
         Care level III             25.2%

         About 741.000 dependent persons receive institutional care benefits from the social
         and the private mandatory long-term care insurance schemes. (Therein included is the
         number of disabled persons in need of long-term care receiving benefits pursuant to
         § 43a of the Social Code Book XI in special support institutions for persons with
         disabilities).


2
    The increase in the outpatient sector as compared to 2008 has been exaggerated by approximately 10.000 due to
    data collection procedures.


                                                        -3-
V. Expenditure on benefits of the Social Long-Term Care Insurance scheme from
  1999 to 2009 in billion €

                   1999      2000      2001      2002       2003      2004      2005      2006      2007      2008      2009

                   approx.   approx.   approx.   approx.    approx.   approx.   approx.   approx.   approx.   approx.   approx.
      Home care:
                   8.4       8.4       8.2       8.3        8.2       8.2       8.2       8.2       8.4       8.9       9.6
      Institutiona approx.   approx.   approx.   approx.    approx.   approx.   approx.   approx.   approx.   approx.   approx.
      l care.      7.2       7.5       7.8       8.2        8.4       8.6       8.7       8.9       9.1       9.3       9.8
                   approx.   approx.   approx.   approx.    approx.   approx.   approx.   approx.   approx.   approx.   approx.
      Total:
                   15.6      15.9      16.0      16.5       16.6      16.8      16.9      17.1      17.4      18.2      19.3


VI.       Financial trend


                                                           Social LTCI                        Private LTCI

           Liquid funds end 2009                        approx. € 4.8 bn
          Nominal capital equipment                     approx. € 2.6 bn
                and reserves
                  Result in
                    1995                             approx. € 3.44 bn                     approx.   € 0.27   bn
                    1996                             approx. € 1.77 bn                     approx.   € 0.05   bn
                    1997                             approx. € 0.81 bn                     approx.   € 0.09   bn
                    1998                             approx. € 0.13 bn                     approx.   € 0.12   bn
                    1999                             approx. € - 0.03 bn                   approx.   € 0.10   bn
                    2000                             approx. € - 0.13 bn                   approx.   € 0.10   bn
                    2001                             approx. € - 0.06 bn                   approx.   € 0.13   bn
                    2002                             approx. € - 0.38 bn                   approx.   € 0.12   bn
                    2003                             approx. € - 0.69 bn                   approx.   € 0.10   bn
                    2004                             approx. € - 0.82 bn                   approx.   € 0.30   bn
                    2005                             approx. € - 0.36 bn                   approx.   € 0.19   bn
                    2006                             approx. € 0.45 bn                     approx.   € 0.36   bn
                    2007                             approx. € - 0.32 bn                   approx.   € 0.43   bn
                    2008                             approx. € - 0.62 bn                   approx.   € 0.38   bn
                    2009                             approx. € 0.99 bn




                                                            -4-
VII.   Entitlement to benefits and services for person insured under the
       German long-term care insurance scheme at a glance

                                                        Care level I      Care level II   Care level III
                                                       considerable     severe need for   extreme need
                                                       need for long-    long-term care    for long-term
                                                         term care                              care
                                                                                          (in particularly
                                                                                          severe cases)
Home care                 Benefit in kind up to
                          € per month
                                 th
                          until 30 June 2008               384               921              1,432
                                                                                             (1,918)
                                 st
                          as of 1 July 2008                420               980              1.470
                                                                                             (1,918)
                                 st
                          as of 1 January 2010             440              1,040             1,510
                                                                                             (1,918)
                                 st
                          as of 1 January 2012             450              1,100             1,550
                                                                                             (1,918)
                          Benefit in cash up to
                          € per month
                                  th
                          until 30 June 2008               205               410               665
                                 st
                          as of 1 July 2008                215               420               675
                                 st
                          as of 1 January 2010             225               430               685
                                 st
                          as of 1 January 2012             235               440               700
Stand-in (respite) care   Long-term care expenses
- by near relatives       for a period of up to four
- by other persons        weeks per calendar year
                          up to €
                                  th                           1)               1)                 1)
                          until 30 June 2009              205               410               665
                                                          1,432             1,432             1,432
                                 st                           1)                1)                1)
                          as of 1 July 2008               215               420               675
                                                          1,470             1,470             1,470
                                 st                           1)                1)                1)
                          as of 1 January 2010            225               430               685
                                                          1,510             1,510             1,510
                                 st                           1)                1)                1)
                          as of 1 January 2012            235               440               700
                                                          1,550             1,550             1,550
Short-time care           Long-term care expenses
                          up to € per year
                                  th
                          until 30 June 2008               1,432            1,432             1,432
                                 st
                          as of 1 July 2008                1,470            1,470             1,470
                                 st
                          as of 1 January 2010             1,510            1,510             1,510
                                 st
                          as of 1 January 2012             1,550            1,550             1,550




                                                  -5-
Part-time institutional   Long-term care expenses
care (day and night)      up to € per month
                                  th
                          until 30 June 2009               384              921              1,432
                                 st                           2)               2)                   2)
                          as of 1 July 2008               420              980               1,470
                                 st                           2)                  2)                2)
                          as of 1 January 2010            440             1,040              1,510
                                 st                           2)                  2)                2)
                          as of 1 January 2012            450             1,100              1,550
Supplementary             Long-term care benefits
benefits provided for     up to € per year
                                  th
long-term care            until 30 June 2008               460              460               460
patients with a
                                 st                              3)               3)                3)
considerable general      as of 1 July 2008               2,400           2,400              2,400
need for care
Full-time institutional   Provision of care up to a
care                      lump sum of € per month
                                  th
                          until 30 June 2009              1,023            1,279              1,432
                                                                                             (1,688)
                                 st
                          as of 1 July 2008               1,023            1,279              1,470
                                                                                             (1,750)
                                 st
                          as of 1 January 2010            1,023            1,279              1,510
                                                                                             (1,825)
                                 st
                          as of 1 January 2012            1,023            1,279              1,550
                                                                                             (1,918)
Care provided in full-    Long-term care expenses
time special support      amounting to
                                                         10% of the fee for the institutional care, but
institutions for
                                                               not more than € 256 per month
persons with
disabilities
Nursing aids intended     Expenses of up to
                                                                              31
for consumption           € per month
Technical nursing aids    Expenses amounting to            100% of the costs, on certain conditions,
and other nursing aids                                   however, a co-payment of 10%, amounting to
                                                        a maximum of € 25 per item has to be granted.
                                                        Technical nursing aids are made available for
                                                        use mainly on free loan, i.e. free of charge and
                                                              consequently without co-payment.
Measures to improve       Expenses of up to             € 2,557 per measure, considering a reasonable
the person’s living                                                      co-payment
environment
Payment of pension        depending on the                135,59           271,17            406,76
insurance                 intensity of care-giving up    (113,30)         (230,31)          (345,46)
contributions for         to € a month (new
                4)
informal carers           Federal Laender)
                                 st
Payment of                as of 1 July 2008                                  7.15
unemployment              € per month
insurance                 (new Federal Laender)                             (6,08)
contributions for
carers during their
periods of providing
care for relatives




                                                  -6-
                                             st
 Premium subsidies for              as of 1 July 2008
 health insurance and               € per month
 long-term care                     health insurance                                                  126.90
 insu rance granted to
 carers for the period              long-term care insurance                                           16.61
 of care-providing

1) On the basis of evidence furnished, the necessary expenses (loss of earning, travelling expenses etc.) of near relatives
   providing care shall be reimbursed up to the usual maximum amount applicable to other persons
2) In addition to the right to claim institutional day care, a right to claim either half of the benefit in kind granted for outpatient care
   or half of the benefit in cash shall remain
3) Depending on the personal long-term care situation on the basis of permanent and regular impairments or disabilities pursuant
   to Section 45a para 2 sentence 1 nos. 1 to 9 of Social Code Book XI, benefits up to an amount of 1,200 € (basis allowance)
   and/or up to an amount of 2,400 € (increased allowance) shall be granted.
4) In cases where the carer provides care for at least 14 hours per week and is gainfully employed on a weekly basis of not more
   than 30 hours and does not yet receive a full pension on the grounds of old-age.



                            Additional long-term care insurance measures
                                                   for insured persons

                                                                                  To improve the conditions of care in:

                                                                                 Home care                      Institutional care

Assistance through community-based long-term care                                           X                            X
support bases

Individual care counselling (Case Management)                                               X                            X

Transmission of
-   comparative lists of services and prices in approved                                    X                            X
    long-term facilities
-   comparative lists of services and prices in low                                         X                            X
    threshold support offers
-   information on self-help contact points and self-help                                   X                            X
    groups
-   information on integrated health care                                                   X                            X
    contracts/participation in integrated health care in the
    applicant's immediate environment

Long-term care courses for relatives and voluntary care-                                    X
givers

Remuneration supplements for auxiliary staff providing                                                                   X
assistance to persons in need of considerable general
care

Funding of activating and rehabilitative measures by                                                                     X
means of bonus payments to long-term care facilities with
a view to considerably reducing the demand for
assistance

Funding of long-term care structures for persons in need                                    X
of considerable general care

Funding of the creation and expansion of voluntary and                                      X                            X


                                                                   -7-
self-help structures


VIII.    Social Security for Care-Givers

   1. Number of care-givers compulsorily insured under the statutory pension insurance
      scheme

            1995                       approx. 394,000
            1996                       approx. 531,000
            1997                       approx. 575,000
            1998                       approx. 574,000
            1999                       approx. 574,000
            2000                       approx. 554,000
            2001                       approx. 530,000
            2002                       approx. 511,000
            2003                       approx. 492,000
            2004                       approx. 470,000
            2005                       approx. 454,000
            2006                       approx. 440,000
            2007                       approx. 430,000
        (Source: Pension insurance)



   More than 90 % of the compulsorily insured care-givers are women.

2. Contributions paid by the LTCI funds to the statutory pension insurance towards the care-
   givers' old age pension

   a) Contributions paid by the LTCI funds to the pension insurance scheme

            1995                       approx. € 0.3 bn
            1996                       approx. € 0.9 bn
            1997                       approx. € 1.2 bn
            1998                       approx. € 1.2 bn
            1999                       approx. € 1.1 bn
            2000                       approx. € 1.1 bn
            2001                       approx. € 1.0 bn
            2002                       approx. € 1.0 bn
            2003                       approx. € 0.9 bn
            2004                       approx. € 0.9 bn
            2005                       approx. € 0.9 bn
            2006                       approx. € 0.9 bn
            2007                       approx. € 0.9 bn
            2008                       approx. € 0.9 bn

                                             -8-
                 2009                                     approx. € 0.9 bn
             (the contributions for 1996 and 1997 include substantial back payments for 1995 and 1996, respectively)


          b) Calculation of the contributions to the pension insurance scheme

             In the statutory pension insurance scheme, care-givers who are not gainfully employed
             are given the same status as if they received an employee's salary amounting between
             26.6667 % and 80% of the reference amount, depending on the care level of the person
             in need of care and the duration of the care provided. It was the legislator's objective to
             provide security for a person providing at least 28 hours of care for a patient in Care
             Level III, on the basis of 75 % of the current average salary of persons covered by the
             statutory pensions insurance. However, since the reference amount only reflects the
             average salary of insured persons in the penultimate year, a 5 % allowance was added to
             bring it up to 80% in an effort to achieve approximately 75 % of the current average
             salary.



                           Contributions paid in 2010 by the LTCI funds to the
               statutory pension insurance system towards caregivers' old-age provision
                           (provided that the caregivers are regularly not gainfully employed alongside
                                            caregiving for more than 30 hours a week)


Care           Care required                                                                                           Caregiving for one
level of       per week             Contribution payment based on …%                  Monthly contribution             year translates to a
the            amounts to           of the reference amount in pension                   amount in €3                  monthly pension of
person         not less than                     insurance                                                                     €…4.
cared for      … hours
                                                        West              East             West             East         West          East

III            28                  80                2,044.00        1,736.00             406.76         345.46          20,85        18,67
               21                  60                1,533.00        1,302.00             305.07         259.10          15,63        14,01

               14                  40                1,022.00           868.00            203.38         172.73          10,42         9,34

II             21                  53.3333           1,362.67        1,157.33             271.17         230.31          13,90        12,45

               14                  35.5555             908.44           771.55            180.78         153.54           9,26         8,30

I              14                  26.6667              681.3           578.67            135.59         115.15           6,95         6,23




      3
        The contribution rate to the statutory pensions insurance is 19.9% in 2010. The monthly reference amount in the
      statutory pensions insurance is € 2,555 (West) and € 2,170 (East).
      4
        as of: July 2009 current pensions value: € 27,20 (West) and € 24,13 (East).


                                                                   -9-
IX.    Survey of the licensed long-term care facilities (as of: end 2007)


                                                                      Broken down into types of care*
                                              Insitutional
       Federal Land          Home care                            Full-time        Short-time        Part-time
                                                 Care
                                                                institutional     institutional    institutional
                                                                    care              care             care
      Baden-                        1,010             1,384              1,263               295              402
      Wuerttemberg
      Bavaria                       1,778             1,574             1,429              159               217
      Berlin                          431               364               292               30                58
      Brandenburg                     548               339               291              118                92
      Bremen                          113                90                84               14                15
      Hamburg                         334               177               161               14                14
      Hessen                          901               672               625              108               163
      Mecklenburg-                    406               268               218               21                49
      Western
      Pomerania
      Lower Saxony                  1,112             1,394             1,304               86               111
      North-Rhine                   2,136             2,138             1,918              251               295
      Westphalia
      Rhineland-                      390               435               405                99              211
      Palatinate
      Saarland                        115               134               128               64                48
      Saxony                          972               698               568              123               135
      Saxony-Anhalt                   492               407               360               39                57
      Schleswig-                      402               651               620              115                48
      Holstein
      Thuringia                       389               304               253                21                69

      Total                        11,529           11,029              9,919            1,557             1,984


      for information
      purposes:

      Number of                    10,977           10,424              9,414            1,529             1,779
      institutions
      at the end of
      2005*
      Number of                    10,619             9,743             8,775            1,603             1,720
      institutions
      at the end of
      2003*
      Number of                    10,594             9,165             8,331            1,436             1,570
      institutions
      at the end of
      2001*
      Number of                    10,820             8,859             8,073            1,621             1,487
      institutions
      at the end of
      1999*

       *Long-term care in-patient institutions offering different types of care were counted several times in this
       context.
       Source: Statistisches Bundesamt (German Federal Statistical Office), according to section 109 of the Social
       Code Book XI




                                                     - 10 -
X. Survey of working staff numbers in licensed long-term care institutions


                                                                            Changes against the
                                                                              previous period
                                  Institutional
                Home care                               Overall
                                      care                               in absolute
                                                                                          in per cent
                                                                            terms

    1999              183,782           440,940            624,722                -----             -----

    2001              189,587           475,368            664,935             40,213               6.4

    2003              200,897           510,857            711,754             46,819               7.0
                                                                                                    6.9
    2005              214,307           546,397            760,704             48,950

    2007              236,162           573,545            809,707             49,003               6.4

    Source:Statistisches Bundesamt (German Federal Statistical Office)




                                                  - 11 -
 XI. Annual distribution of investment funds under Article 52 Pflege -Versicherungsgesetz (Act providing for the social protection of pe rsons
         in need of long-term care) and their outflow – 'Aufbau Ost' (Start-up financing scheme – Eastern Germany)


                                                                                                                                                                                                                   Funds
               Annual     Outflow in   Outflow in   Outflow in   Outflow in   Outflow in   Outflow in   Outflow in   Outflow in   Outflow in   Outflow in Outflow in    Outflow in    Outflow in    Outflow
                                                                                                                                                                                                               available on
Federal Land entitlement   1995 in      1996 in      1997 in      1998 in      1999 in      2000 in      2001 in      2002 in      2003 in      2004 in    2005 in       2006 in       2007 in      overall in
                                                                                                                                                                                                               31.12.2007
             in million € million €     million €    million €    million €    million €    million €    million €    million €    million €    million €  million €     million €     million €    million €
                                                                                                                                                                                                                in million €

Berlin (East)        33.7        9.4         15.9         14.1         20.3         36.8         37.8         35.4         26.4         19.2         33.4       17.9           1.9           0.0         268.8          1.1

Brandenburg          66.3        0.0        132.5         61.3         29.8         32.8         35.1         27.5         13.1         50.8         95.4       16.8           2.1           0.0         497.4         32.7

Mecklenburg-

Western
Pomerania            48.7       30.0         36.5         44.6         44.8         46.4         58.2         44.6         44.6          9.3         23.5         4.6          -0.7          -0.6        385.6          3.8

Saxony             121.0         0.0        140.6         66.5        109.9        144.7        121.2        102.2        100.0         96.0         66.2       16.4           2.1           -0.8        965.1          3.1

Saxony-
Anhalt               73.0       14.2         44.8         83.3         73.8         63.3         88.2         72.7         59.4         35.9         39.6         8.3          0.0           0.0         583.7          0.0

Thuringia            66.4       26.5         29.5         39.8         80.0         89.3         80.1         50.0         38.9         37.6         26.9       28.7           3.3           0.0         530.8          0.1

Total              409.0        80.3        399.9        309.7        358.6        413.2        420.7        332.4        282.4        248.8       285.1        92.7           8.7           -1.3      3231,4          40.9

(Amounts may not add up due to rounding)




                                                                                                        - 12 -
XII.      Contribution assessment ceilings in the social insurance system and
      contributions to long-term care insurance


              Contribution assessment ceilings
          of the social insurance system and other
                                                                              Year       Month
      benchmark figures of the long-term care insurance
                       in 2010 in euros

    Pension and unemployment insurance – West                                66,000.00   5,5 00.00
    Pension and unemployment insurance – East                                55,800.00   4,650.00
    Health and long-term care insurance                                      45,000.00   3,750. 00
    Reference figure in pension insurance –West                              30,660.00   2,555.00
    Reference figure in pension insurance – East                             26,040.00   2,170.00
    Reference figure in health and long-term care insurance                  30,660.00   2,555.00

                                           5
    Insignificant and low income ceiling                                                  400.00

    Ceiling for family insurance without insignificant employment                         365.00
    Ceiling for family insurance with insignificant employment                            400.00

                                                                   6
    LTC minimum insurance contribution for voluntary members                              16.61
    LTC minimum insurance contribution for voluntarily insured self-                      37.37
                         7
    employed members
    LTC contribution ceiling                                                              73.12
                                                   8
    LTC contribution if insurance continues abroad                                         8.30
    LTC contribution for students WS 2009/2010 to SS 2010                                  9.99
    Contribution for students to private LTC insurance (up to age 34)                      16.80
    Civil servants' maximum contribution to private LTC insurance                          29.25
    Private LTC insurance for spouses                                                     109.68

Contribution rates to selected social security schemes:

Pension insurance                                        19.9    per cent
Unemployment insurance                                     2.8    per cent
Long-term care insurance                                  1.95   per cent
Health insurance                                         15.5    per cent




5
  up to this income the employer pays social insurance contributions alone
6
  assessment basis: 90th part of monthly earnings
7
  assessment basis: 40th part of monthly earnings
8
  assessment basis: 180th part of monthly earnings
                                                                                                     - 14 -
                                                       - 14 -


XIII.    Demographic trends in the Federal Republic of Germany

   1. Estimated future demography:

        An increase by 8 million in the number of elderly persons (65 years and older) between
        2008 and 2050 from 16.7 to 23.4 million translates to an increase from approx. 20 % of
        the total population to approx. 32 % of what will then be a population of approx. 74 million.
        (Source: 12th coordinated population projection; mean variant, migration balance 200 000)


   2. Life expectancy of:

        boy at birth:                                           77.2 years
        girl at birth:                                          82.4 years
        a 65-year-old man:                                      17.1 years
        a 65-year-old woman:                                    20.4 years
        (Source: mortality table 2006/2008)


   3. Risk of requiring long-term care:

        before reaching the age of 60 years:                                            approx. 0.8 %
        between 60 and 80 years of age:                                                 approx. 4.7%
        above the age of 80:                                                            approx. 29.0%

   4. Trends in the number of persons requiring long-term care:

        Assuming a constant probability of old-age-associated dependency, the Federal Statistical
        Office projects that the number of members of the statutory long-term care insurance who
        will require such care will be as follows:

        2009                                         2.24 million
        2020                                         2.81 million
        2030                                         3.27 million
        2040                                         3.72 million
        2050                                         4.36 million.




                                                                                                        - 15 -
                                                     - 15 -


XIV. Rules of thumb

   -   10,000 benefit recipients in out-patient sector                   =   66 million euros per year
   -   10,000 benefit recipients in institutional sector
       (excl. the disabled)                                              = 161 million euros per year
   -   10,000 benefit recipients in facilities for the disabled          = 31 million euros per year

   0.1 of the contribution rate          = 1.05 billion euros per year
   1 year of long-term care              = monthly pension claim
                                           between 6.95 and 20.85 euros
                                           (old Federal Laender) and
                                           between 6.23 and 18.67 euros
                                           (new Federal Laender).

								
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