Group LTC Insurance for Employers: How the Four-Carrier Market Actually Works

Most HR directors evaluating group long-term care insurance are searching for a product that, in the form they imagine it, almost no carrier writes for employers under 500 anymore.

The standalone group LTC contracts that defined the market in the 1990s and 2000s have largely exited this segment. Genworth and the legacy carriers either stopped writing new group business, raised pricing past usability, or restricted themselves to public-sector and jumbo-employer placements.

Today, four U.S. carriers serve this need for employers under 500: Transamerica, Trustmark, Chubb, and Allstate. None writes standalone long-term care insurance for this segment. They write group guaranteed-issue life insurance with a long-term care or chronic care acceleration rider. The base policy is universal life, whole life, or permanent term life. The LTC benefit accelerates the death benefit when the insured needs qualifying care.

This is not a marketing distinction. It is the actual product structure, and it changes funding flexibility, claim mechanics, tax treatment, and state-mandate opt-out eligibility.

This article reflects Hollowtree's market view as a distributor, current as of 2026-06-16. If a fifth carrier enters or one of the four exits, the answer changes.

The two product chassis you will see

Chassis 1: Standalone group long-term care insurance

The policy exists for one purpose: paying qualified long-term care expenses. No death benefit, no cash value, no life insurance component.

This chassis still exists in the U.S. market, but almost exclusively at very large employers and in public-sector, education, and healthcare verticals. For private employers in the 50 to 500 range, standalone group LTC is functionally unavailable. The carriers that wrote it pulled out after the rate-increase cycles of the 2010s.

If your broker mentioned group LTC and you assumed standalone, the four carriers below are not writing it.

Chassis 2: Group guaranteed-issue life insurance with LTC or chronic care rider

The chassis the four current carriers write is built differently. The base policy is a group life insurance contract (universal life, whole life, or permanent term life to age 121). The LTC benefit comes from a rider that accelerates the death benefit when the insured meets the trigger criteria.

Trigger criteria are standardized across the four carriers, drawing from federal tax-qualified LTC standards: a licensed health care practitioner certifies the insured as either unable to perform at least two of six Activities of Daily Living (bathing, continence, dressing, eating, toileting, transferring) for 90 days, or as having severe cognitive impairment requiring substantial supervision. Annual recertification is typical. Carriers differ in operational mechanics (home health care frequency thresholds, elimination periods, per-month payment percentages), but the trigger criteria converge.

Five consequences follow:

The LTC benefit is bounded by the death benefit. A $100,000 policy with a 4% monthly LTC rider pays $4,000 per month until the full face amount is accelerated. Extension of Benefits riders can double the available care benefit on most chassis. Restoration riders can restore the death benefit to 100 percent after care is used.

Tax treatment varies by rider. Some accelerated death benefit riders are intended to be tax-qualified (Transamerica's LTC Rider TRLC1200-0422). Others are explicitly not tax-qualified (Transamerica's Chronic Condition Rider; Trustmark's chronic care benefit; the Allstate ADB-LTC rider in most states). Confirm product-by-product before contract signing.

Cash value behavior varies. Universal life and whole life policies build cash value the employee can access through loans or surrender. Permanent term to age 121 does not.

State payroll-tax opt-out eligibility is jurisdictional. Several states (Washington's WA Cares Fund, with others expanding) have established payroll tax-funded LTC trust programs. Whether a group life policy with an LTC acceleration rider counts as qualifying private LTC insurance varies by state regulator. Employers planning to position the benefit as a state mandate opt-out should verify per-state before making the claim to employees.

State product availability varies. Some carriers do not write in every state, and several have specific state exclusions on their LTC riders. For multi-state employers, this narrows the shortlist before any other dimension is evaluated.

The rest of this article uses "group LTC benefit" or "the product" to refer to Chassis 2, because that is what the market sells. Standalone group LTC is named explicitly when meant.

The four carriers writing in the 50 to 500 segment

Transamerica

Base policy: Transamerica Universal Life Insurance (UL10 series), underwritten by Transamerica Life Insurance Company. Permanent universal life with flexible premiums, cash value accumulation, and a 10-year premium payment schedule on the UL10 product.

LTC benefit: Delivered through one of two riders. The LTC Rider (TRLC1200-0422) accelerates the death benefit at 2, 3, or 4 percent monthly for home and adult day care, or 4 to 6 percent monthly for confinement-based care, until the full face amount is accelerated. Intended to be tax-qualified. The Accelerated Death Benefit for Chronic Condition Rider (TRLLT500) pays 4 percent monthly for 25 months or a 20 percent lump sum, and is explicitly not tax-qualified. Both can be paired with Extension of Benefits and Benefit Restoration riders.

Group size: Multi-year guaranteed issue and the $50,000 higher spousal GI are gated to groups of 2,000 or more eligible lives. Smaller-group GI parameters are set by the Transamerica representative case-by-case.

Portability: Yes. The UL contract is portable; the rider rides with the policy.

Inflation protection: Not visible in the materials reviewed. Confirm per case.

Trustmark

Two products serve the LTC-benefit need:

Trustmark Life + Care is permanent term life to age 121 with a chronic care rider. Pays 4 percent of the face value monthly for professional care or 2 percent for family care, 90-day elimination period. Maximum benefit $200,000. Trustmark's own disclosure: "The Trustmark Life + Care Chronic Care benefit is an acceleration of the death benefit and is not Long-Term Care insurance."

Trustmark Universal Life and Universal LifeEvents is universal life with an LTC rider. Pays 4 percent of the face value monthly for professional care, 90-day elimination period. Maximum benefit $300,000. Jurisdictional disclosure: "is an acceleration of the death benefit. It does not provide long term care benefits and is not long-term care insurance; except in FL, LA and VA, where the Universal Life long-term care benefit is long-term care insurance."

Group size: Minimum case size 10 employees. Employer-paid offering available with a minimum of 10 employees on the employer-paid plan. Buy-up and voluntary options on groups of 100 or more.

Distinctive feature: Trustmark's LTC and chronic care benefits are tied to the face amount, not the death benefit. LTC benefits are not reduced if the death benefit is reduced. On Universal Life products, life insurance premiums are guaranteed. Of the four carriers, this is the strongest fixed-LTC-benefit posture in the market.

Portability: Yes, on both products.

Inflation protection: EZ Value rider. Premium increases by $1 per week annually for a set number of years, no underwriting required at increase. The benefit grows by what the additional $1 buys, including LTC-tied benefits. Of the four carriers, Trustmark is the only one with a documented inflation rider in the materials reviewed.

Care management included: Cariloop caregiver support platform at no additional cost.

Chubb

Underwriter and product name: LifeTime Benefit Term (LBT) with the Accelerated Death Benefit for Long Term Care Rider. Underwritten by Combined Insurance Company of America, a Chubb subsidiary. Materials and paperwork are branded "Combined." This article uses "Chubb" for consistency with market reference.

Base policy: Permanent term life to age 121. Distinct from Transamerica (universal life) and Allstate (whole life). Premiums guaranteed to age 100; coverage continues thereafter without further premium to age 121.

Death benefit structure: 100 percent guaranteed through age 70 or 25 years from issue, whichever is greater. After 70, designed to last through age 99 for non-tobacco users and 95 for tobacco users at current interest rate and mortality assumptions; worst-case guaranteed floor is 50 percent of initial benefit. The death benefit reduction at 70 affects the LTC benefit available, since the rider accelerates from the death benefit.

LTC benefit: 4 percent of the death benefit per month for up to 25 months. The death benefit reduces proportionately as LTC is paid; after 25 months, the death benefit is fully accelerated. Life insurance premiums are waived during LTC payment. Covers home health care, assisted living, adult day care, and nursing home care.

LTC trigger criteria: Standard ADL or cognitive impairment per the chassis-level criteria above. For home health care or adult day care, a minimum of 8 separate days of care per Rider Month is required to maintain eligibility.

Maximum benefit: Death benefit up to $250,000 without LTC selected. With the LTC Benefit added, maximum death benefit is reduced to $150,000.

State availability: LifeTime Benefit Term is not available in New York. The LTC Rider is not available in Massachusetts or New York. For multi-state employers operating in any of these states, this is an immediate placement constraint.

LTC premiums: Not guaranteed. The carrier discloses that LTC premiums may be adjusted based on group experience. Premiums will not be increased solely because of an independent claim.

Funding structure: Documented as voluntary payroll deduction. Employer-paid arrangements should be confirmed with the carrier representative.

Portability: Yes. Fully portable and guaranteed renewable for life as long as premiums are paid.

Inflation protection: Not visible in the materials reviewed.

Paid-up benefit: After 10 years, a paid-up benefit begins to accrue. If premiums stop after that point, a reduced paid-up benefit is issued and cannot lapse.

Group size, participation requirements: Not stated in the materials reviewed. Confirm with the carrier representative.

Allstate

Base policy: Group Whole Life Insurance (policy form GWLP), underwritten by American Heritage Life Insurance Company, an Allstate subsidiary. Permanent whole life with cash value accumulation and locked-in premiums at issue age. Also offered as Group Universal Life (GUL23) and Group Term to 100 (GPTL).

LTC benefit: Accelerated Death Benefit for Long Term Care Rider with Restoration and Extension of Benefits (forms GWPLTCRE, GWPLTCRE1). Pays 4 percent of the death benefit monthly for up to 50 months, or 6 percent monthly for up to 34 months. With Extension of Benefits, the death benefit can be accelerated up to 200 percent. Restoration restores the death benefit to 100 percent after care has been used. Described as an accelerated death benefit; generally not classified as long-term care insurance, though state classifications should be confirmed.

Group size: Minimum 10 eligible lives. Underwriting parameters are tighter in the 10 to 249 bracket; rate guarantees and GI maximums increase in the 250 to 999 and 1,000-plus brackets.

Funding structure: Documented as voluntary (employee-paid) chassis. Employer-paid arrangements should be confirmed per case.

Portability: Yes. The employee continues coverage by paying premiums directly to Allstate Benefits within 31 days of certificate termination. Coverage levels and premiums are not affected by leaving the group.

Inflation protection: Not visible in the materials reviewed. The face amount appears locked at issue. Confirm whether any inflation rider is available.

Eligibility: Employee, working spouse, non-working spouse, and dependent children. Issue ages 18 to 70.

Carrier comparison summary

No two of the four are the same. The structural differences that matter most:

• Base chassis: Transamerica universal life, Trustmark permanent term to 121 or universal life, Chubb permanent term to 121, Allstate whole life. Cash value behavior, premium flexibility, and death benefit structure all differ accordingly.
• LTC benefit anchored to face amount versus death benefit: Trustmark is the only carrier where the LTC and chronic care benefits are tied to the face amount and do not reduce as the death benefit is accelerated. The other three accelerate from the death benefit.
• Maximum benefit limits: Trustmark Life + Care $200K, Trustmark Universal Life $300K, Chubb $150K with LTC selected ($250K without), Allstate per-bracket and case-by-case.
• State availability: Chubb has documented gaps (no NY, no MA for LTC, no NY for base). Other carriers' gaps were not detailed in materials reviewed.
• Inflation protection: Trustmark has a documented rider (EZ Value). The other three did not surface in materials reviewed.
• Premium guarantees: Trustmark Universal Life premiums are guaranteed on the life insurance. Chubb explicitly notes LTC premiums may be adjusted based on group experience. Other carriers' LTC premium guarantees should be confirmed.
• Tax qualification: Transamerica's LTC Rider TRLC1200-0422 is intended to be tax-qualified. The other riders are accelerations of the death benefit and, with state-specific exceptions in the Trustmark materials, are not classified as long-term care insurance.

The distributor's work is to match the employer to the carrier on the dimensions that matter for that group, on the funding structure that fits the P&L objectives, and on the rider mechanics that align with what the workforce will actually use.

For broader context on why employers are evaluating these benefits now, see the LTC Hub.

What guaranteed issue means at the group level

Guaranteed issue is the feature most HR directors price incorrectly. The phrase is often heard as a marketing claim ("everyone is accepted"), which leads to predictable problems: employees told something not quite accurate, and CFOs assuming the product cannot possibly be priced sustainably.

Both readings are wrong. Guaranteed issue at the group level means the carrier accepts every eligible employee without individual medical underwriting, within the parameters of the group enrollment window. The carrier is not underwriting the person. The carrier is underwriting the group.

Three consequences matter.

Participation requirements apply. For GI to hold, the carrier typically requires a minimum participation rate across the eligible base. Industry-standard thresholds run in the 5 to 20 percent range depending on carrier, group size, and product, enforced through periodic review. If participation falls below the threshold, the carrier can tighten case-level requirements or re-underwrite. This is the mechanism that makes group GI economically viable, and it translates open enrollment communication directly into a working product. (Thresholds reflect Hollowtree's market view across the four carriers.)

Eligibility is defined by the group, not by the carrier's medical desk. Eligible employees are defined in the group contract, typically active full-time employees with a minimum tenure. Employees outside that definition (1099 contractors, part-time below the hour threshold, recent hires within a waiting period) are not covered by the GI offer. The gap between "everyone gets coverage" and "every eligible employee gets coverage" is where employee disappointment lives.

The economics work because the carrier prices the group, not the person. Carriers use group experience data, workforce demographic assumptions, and assumed take-up rates. The employee with a recent cancer diagnosis is not surcharged. The 28-year-old in excellent health is not discounted. Both get the same rate within the rate band defined by age and benefit selection. The pricing model assumes a mix.

This is the structural reason group GI life-with-LTC-rider products behave differently from individually-underwritten LTC or life policies, and why most HR directors arrive at this conversation carrying objections that do not apply. The most common objection is the rate-increase history of the individual standalone LTC market. That history is real, but it is also the wrong reference frame. The carriers writing today survived the standalone LTC pricing cycle of the 2010s by exiting it. They write group life with LTC riders on different actuarial assumptions, with different product structures.

How funding flexibility changes the math

Funding flexibility is the lever HR and CFO conversations actually turn on.

Employer-paid (non-contributory). The employer pays the full premium. Take-up is 100 percent by definition, which strengthens participation, which strengthens carrier pricing, which generally produces the most favorable group rates. The employer carries the cost on the P&L. Trustmark explicitly documents an employer-paid offering (minimum 10 employees). Transamerica is built for both employer-paid and voluntary. Allstate and Chubb materials describe primarily voluntary placement; employer-paid arrangements should be confirmed case-by-case.

Employee-paid (voluntary). The employee pays the full premium through payroll deduction. The employer enables access and runs enrollment but carries no premium cost. Take-up typically runs 20 to 50 percent, depending heavily on enrollment communication. All four chassis support voluntary placement.

Split-funded. Employer pays a base benefit and the employee buys up; or employer pays for one tier and employee pays for another; or employer pays through year three and the employee assumes the premium thereafter. Trustmark explicitly offers buy-up arrangements on groups of 100 or more. Other carriers' split structures should be confirmed per case.

For a CFO at a 200-person employer, the math that matters is annual cost predictability. Employer-paid is fully predictable and fully on the P&L. Voluntary is fully off the P&L but participation-dependent. Split-funded sits between.

A second factor for the CFO conversation: whether LTC premiums are guaranteed or subject to experience-rated increases. Trustmark Universal Life premiums are guaranteed on the life insurance. Chubb explicitly notes LTC premiums may be adjusted based on group experience. Other carriers' LTC premium guarantees should be confirmed product-by-product. This matters more on employer-paid and split-funded structures than on voluntary, because the employer carries the exposure.

The payroll-deduction mechanics matter operationally. Carriers differ in whether they bill the employer monthly via list bill, integrate with the payroll provider, or use a third-party administrator. The difference between a clean payroll integration and a manual list-bill reconciliation is meaningful, and worth asking about before signing.

For a side-by-side cost view across premium-payment structures, see the 10-pay versus traditional lifetime-pay cost comparison. The Hollowtree LTC calculator estimates employer cost across 10-pay and lifetime-pay structures.

What "10-pay" actually means

"10-pay" is the phrase most likely to be misunderstood in this market. It does not refer to a 10-pay standalone LTC contract. It refers to the premium payment schedule on the underlying universal life or whole life policy.

A 10-pay structure means premiums are paid in full over 10 years, after which the base policy continues without further premium. On a universal life chassis (Transamerica UL10), the policy is funded for 10 years; coverage continues thereafter on the cash value accumulated. On a whole life chassis (Allstate GWL), an analogous structure is available. The LTC or chronic care rider rides with the policy and continues after the 10-year window closes, subject to rider terms.

This is materially different from a hypothetical 10-pay standalone LTC contract that would pay up the LTC benefit at year 10. The chassis being sold in this market does not work that way. The premium window closes; the policy and rider continue.

10-pay structures make sense when:

• The employer wants a defined funding window, not an indefinite obligation.
• The employer is using the LTC benefit as a retention finish line: employees who stay through 10 years receive paid-up life coverage with LTC rider access.
• The CFO values exposure caps over annual cost minimization. 10-pay premiums are higher per year, but they end.
• Workforce demographics support it: low turnover, where the 10-year horizon is realistic for a substantial fraction of employees.

Lifetime-pay structures make sense when:

• The employer wants the lowest possible annual cost and is willing to carry the premium indefinitely.
• The workforce has higher turnover, where most employees will not stay long enough to reach a 10-year vesting threshold.
• The CFO values cost predictability over exposure caps.
• Cash flow constraints make the higher 10-pay premiums infeasible in the near term.

There is no universally correct answer. For a 200-person employer with 30 percent annual turnover and a CFO whose primary objective is keeping the benefits line predictable, lifetime-pay fits. For a low-turnover employer with a retention mandate and a tolerable P&L window, 10-pay fits.

Not all four carriers offer a 10-pay structure on their base policy. Transamerica's UL10 is the most clearly documented 10-pay base policy. If 10-pay is the structure that fits, the carrier shortlist narrows. For a deeper treatment, see 10-pay group LTC insurance and how 10-pay LTC functions as an employee retention finish line.

What to ask a distributor before you commit

Which of the four carriers do you have an active producer agreement with? Some distributors are limited to one or two. A distributor with all four can run a true comparison.

Are you placing me on standalone group LTC or on group life with an LTC or chronic care rider? The distributor should be able to name the product, the form number, and whether the LTC benefit is the base policy or a rider acceleration. If they cannot, that is itself information.

Is the LTC rider tax-qualified, and is it classified as long-term care insurance in our state? Both answers vary by product and by state.

Is the carrier available in all the states where we have employees? Chubb has documented state-level product gaps. Multi-state employers should confirm placement state-by-state before signing.

Are the LTC premiums guaranteed, or can they be adjusted based on group experience? This determines whether the employer or the employee carries the long-tail premium exposure.

What is your stance on 10-pay versus lifetime-pay? This reveals whether the distributor is fitting the product to the employer or pushing a structure they have placed before.

How do you handle enrollment communication? Participation requirements make enrollment communication the single most consequential operational variable in group GI placements. A distributor with a defined process (timeline, materials, employee Q&A, manager training) is materially different from one who hands the employer a packet and walks away.

What happens at renewal? Group contracts run multi-year. A distributor whose role ends at first-year enrollment is a different proposition from one who stays involved.

How do you handle portability when employees leave? Portability is written into the carrier contract, but the operational handoff (notification, conversion forms, education) is the distributor's responsibility.

If we are using this benefit to position a state payroll tax mandate opt-out, can you confirm the rider qualifies under our state's specific rules? The answer is jurisdictional and should be confirmed in writing before the employer communicates the opt-out positioning to employees.

Can you walk me through a recent placement in my size and industry? Generic answers are a flag.

To compare structures across the four carriers for your specific group, the Hollowtree 10-pay product page covers the structure in depth.

For employers in the 50 to 500 range, the first decision is not whether to offer something. It is which of the two chassis fits, and within that chassis, which of the four carriers writes the structure that fits your group. The work is matching one of them to your workforce.

Anyone selling you a single answer hasn't done the work.

To see how the structures compare, review the Hollowtree 10-pay product page.

Compliance disclosure

The long-term care and chronic care benefits described in this article are riders that accelerate the death benefit of an underlying group life insurance policy, with limited exceptions noted in the carrier-specific sections. These riders are not, in the carriers' own disclosure language, long-term care insurance, except where specifically noted (Transamerica LTC Rider TRLC1200-0422 is intended to be tax-qualified; Trustmark Universal Life LTC rider is classified as long-term care insurance in Florida, Louisiana, and Virginia).

Carrier and underwriter relationships: Chubb's LifeTime Benefit Term is underwritten by Combined Insurance Company of America, a Chubb subsidiary; Allstate's group whole life and LTC rider are underwritten by American Heritage Life Insurance Company, an Allstate subsidiary; Transamerica products are underwritten by Transamerica Life Insurance Company; Trustmark products are underwritten by Trustmark Insurance Company and Trustmark Life Insurance Company of New York.

Tax treatment, state classification, and state-mandate opt-out eligibility vary by rider, by carrier, and by state. Hollowtree provides distribution and program design services, not tax or legal advice. Specific tax, legal, and regulatory questions should be directed to the employer's tax advisor, legal counsel, and the relevant state insurance regulator.