A Report on the Actuarial, Marketing, and Legal Analyses of the CLASS Program

Appendix B: HHS Letters to Congress About Intent to Create Independent CLASS Office

PDF Version: http://aspe.hhs.gov/daltcp/reports/2011/class/appB.pdf (11 PDF pages)



JUL 28, 2010

TO: The Secretary

Through: DS
     COS
     ES

FROM: Assistant Secretary for Aging

SUBJECT: Establishment of the Office of Community Living Assistance Services and Supports -- ACTION
     Action Requested by: ASAP

ISSUE

The Assistant Secretary for Aging requests that the Secretary approve the establishment of a new office within the Office of the Secretary, which will be assigned the following interim name, the Office of Community Living Assistance Services and Supports (CLASS Office). At a later date, HHS may decide to change this name to something that will be “catchier” and reflect key goals of the program.

DISCUSSION

HHS has been entrusted with the responsibility for implementing many major provisions of the Affordable Care Act of 2010, which the President signed into law on March 23, 2010. In order to efficiently and effectively implement the provisions of Title VIII, the Community Living Assistance Services and Supports Act (CLASS), it is necessary to create an office that has as its primary focus the implementation and management of this new and innovative program.

The new office will be responsible for establishing and administering the CLASS program. CLASS is a voluntary, federally administered long-term care financing plan that will be supported by individual premium contributions. CLASS will provide participating adults needing long-term services and supports a flexible source of funds that can be used to purchase goods and services aimed at helping them remain independent. The CLASS Office will establish the national voluntary insurance program, set premiums, set rules for enrollment and eligibility systems, and specify and design the benefit. It will also establish systems for advice and assistance and support a protection and advocacy network to serve beneficiaries of the program. In addition, the CLASS Office will convene and support two Federal Advisory Committees, the Personal Care Attendants Workforce Advisory Panel and the CLASS Independence Advisory Council. It is anticipated that the Office will coordinate with a number of public and private entities including: 1) the Department of Treasury, which will convene and support the Board of Trustees of the CLASS Independence Fund and maintain the CLASS Independence Fund; 2) the Social Security Administration; 3) employers; and 4) state Medicaid agencies.

Initial funding for the new program will come from the funds appropriated to administer health reform activities. Once the program is fully operational, administrative services will be funded from premium income as set out in the statute (under a 3 percent cap).

The CLASS Office will begin with staff detailed on a volunteer basis from HHS and other Departments, along with new federal staff we expect to bring on very quickly. It will work closely with the Office on Disability, the Administration on Aging, the Administration for Children and Families, the Centers for Medicare & Medicaid Services, and other organizations within HHS to ensure coordination with existing programs.

The new CLASS program and the proposed office will play an important role in helping Americans to take steps to protect their independence if they experience disability in the future.

RECOMMENDATION

I recommend that you approve this new Office and indicate your approval below.

Kathy Greenlee

SECRETARIAL DECISION

Approved: X       Disapproved:       Date: AUG -4 2010

Kathleen Sebelius


August 5, 2010

The Honorable Tom Harkin
Chairman
Subcommittee on Labor, Health and Human Services, Education and Related Agencies
Committee on Appropriations
United States Senate
Washington, D.C. 20510

Dear Chairman Harkin:

I am writing to inform you of the Department of Health and Human Services’ (HHS) plan to establish an office to administer the Community Living Assistance Services and Supports Act (CLASS Office) within the Office of the Secretary.

HHS has been entrusted with the responsibility for implementing many major provisions of the Affordable Care Act of 2010, which the President signed into law on March 23, 2010. In order to efficiently and effectively implement the provisions of Title VIII, the Community Living Assistance Services and Supports Act (CLASS), we find it necessary to create an office that has as its primary focus the implementation and management of this new and innovative program.

The new office will be responsible for establishing and administering the CLASS program. CLASS is a voluntary, federally administered long-term care financing plan that will be supported by individual premium contributions. CLASS will provide participating adults needing long-term services and supports a flexible source of funds that can be used to purchase goods and services aimed at helping them remain independent. The CLASS Office will establish the national voluntary insurance program, set premiums, set rules for enrollment and eligibility systems, and specify and design the benefit. It will also establish systems for advice and assistance to eligible beneficiaries on accessing services, and support a protection and advocacy network to serve beneficiaries of the program. In addition, the CLASS Office will convene and support two Federal Advisory Committees, the Personal Care Attendants Workforce Advisory Panel and the CLASS Independence Advisory Council. It is anticipated that the Office will coordinate with a number of public and private entities including: 1) the Department of Treasury, which will convene and support the Board of Trustees of the CLASS Independence Fund and maintain the CLASS Independence Fund; 2) the Social Security Administration; 3) employers; and 4) state Medicaid agencies.

Initial administrative funding for the new program will come from the funds appropriated to administer health reform activities. Once the program is fully operational, administrative services will be funded from premium income as set out in the statute, with a three percent limit on premium income that can be used for administrative costs.

The CLASS Office will begin with staff detailed on a volunteer basis from HHS and other Departments, along with new federal staff we expect to bring on very quickly. It will work closely with the Administration on Aging, the Office on Disability, the Administration for Children and Families, the Centers for Medicare & Medicaid Services, and other organizations within HHS to ensure coordination with existing programs.

The new CLASS program and the proposed office will play an important role in helping enrollees to take steps to protect their independence if they experience disability.

In appreciate your continued interest in and support of the Department’s programs. I have sent identical letters to Senator Cochran, Chairman Obey, and Representative Tiahrt.

Sincerely,

Kathleen Sebelius


August 5, 2010

The Honorable Thad Cochran
Ranking Minority Member
Subcommittee on Labor, Health and Human Services, Education and Related Agencies
Committee on Appropriations
United States Senate
Washington, D.C. 20510

Dear Senator Cochran:

I am writing to inform you of the Department of Health and Human Services’ (HHS) plan to establish an office to administer the Community Living Assistance Services and Supports Act (CLASS Office) within the Office of the Secretary.

HHS has been entrusted with the responsibility for implementing many major provisions of the Affordable Care Act of 2010, which the President signed into law on March 23, 2010. In order to efficiently and effectively implement the provisions of Title VIII, the Community Living Assistance Services and Supports Act (CLASS), we find it necessary to create an office that has as its primary focus the implementation and management of this new and innovative program.

The new office will be responsible for establishing and administering the CLASS program. CLASS is a voluntary, federally administered long-term care financing plan that will be supported by individual premium contributions. CLASS will provide participating adults needing long-term services and supports a flexible source of funds that can be used to purchase goods and services aimed at helping them remain independent. The CLASS Office will establish the national voluntary insurance program, set premiums, set rules for enrollment and eligibility systems, and specify and design the benefit. It will also establish systems for advice and assistance to eligible beneficiaries on accessing services, and support a protection and advocacy network to serve beneficiaries of the program. In addition, the CLASS Office will convene and support two Federal Advisory Committees, the Personal Care Attendants Workforce Advisory Panel and the CLASS Independence Advisory Council. It is anticipated that the Office will coordinate with a number of public and private entities including: 1) the Department of Treasury, which will convene and support the Board of Trustees of the CLASS Independence Fund and maintain the CLASS Independence Fund; 2) the Social Security Administration; 3) employers; and 4) state Medicaid agencies.

Initial administrative funding for the new program will come from the funds appropriated to administer health reform activities. Once the program is fully operational, administrative services will be funded from premium income as set out in the statute, with a three percent limit on premium income that can be used for administrative costs.

The CLASS Office will begin with staff detailed on a volunteer basis from HHS and other Departments, along with new federal staff we expect to bring on very quickly. It will work closely with the Administration on Aging, the Office on Disability, the Administration for Children and Families, the Centers for Medicare & Medicaid Services, and other organizations within HHS to ensure coordination with existing programs.

The new CLASS program and the proposed office will play an important role in helping enrollees to take steps to protect their independence if they experience disability.

In appreciate your continued interest in and support of the Department’s programs. I have sent identical letters to Chairman Harkin, Chairman Obey, and Representative Tiahrt.

Sincerely,

Kathleen Sebelius


August 5, 2010

The Honorable David R. Obey
Chairman
Subcommittee on Labor, Health and Human Services, Education and Related Agencies
Committee on Appropriations
House of Representatives
Washington, D.C. 20515

Dear Chairman Obey:

I am writing to inform you of the Department of Health and Human Services’ (HHS) plan to establish an office to administer the Community Living Assistance Services and Supports Act (CLASS Office) within the Office of the Secretary.

HHS has been entrusted with the responsibility for implementing many major provisions of the Affordable Care Act of 2010, which the President signed into law on March 23, 2010. In order to efficiently and effectively implement the provisions of Title VIII, the Community Living Assistance Services and Supports Act (CLASS), we find it necessary to create an office that has as its primary focus the implementation and management of this new and innovative program.

The new office will be responsible for establishing and administering the CLASS program. CLASS is a voluntary, federally administered long-term care financing plan that will be supported by individual premium contributions. CLASS will provide participating adults needing long-term services and supports a flexible source of funds that can be used to purchase goods and services aimed at helping them remain independent. The CLASS Office will establish the national voluntary insurance program, set premiums, set rules for enrollment and eligibility systems, and specify and design the benefit. It will also establish systems for advice and assistance to eligible beneficiaries on accessing services, and support a protection and advocacy network to serve beneficiaries of the program. In addition, the CLASS Office will convene and support two Federal Advisory Committees, the Personal Care Attendants Workforce Advisory Panel and the CLASS Independence Advisory Council. It is anticipated that the Office will coordinate with a number of public and private entities including: 1) the Department of Treasury, which will convene and support the Board of Trustees of the CLASS Independence Fund and maintain the CLASS Independence Fund; 2) the Social Security Administration; 3) employers; and 4) state Medicaid agencies.

Initial administrative funding for the new program will come from the funds appropriated to administer health reform activities. Once the program is fully operational, administrative services will be funded from premium income as set out in the statute, with a three percent limit on premium income that can be used for administrative costs.

The CLASS Office will begin with staff detailed on a volunteer basis from HHS and other Departments, along with new federal staff we expect to bring on very quickly. It will work closely with the Administration on Aging, the Office on Disability, the Administration for Children and Families, the Centers for Medicare & Medicaid Services, and other organizations within HHS to ensure coordination with existing programs.

The new CLASS program and the proposed office will play an important role in helping enrollees to take steps to protect their independence if they experience disability.

In appreciate your continued interest in and support of the Department’s programs. I have sent identical letters to Representative Tiahrt, Chairman Harkin, and Senator Cochran.

Sincerely,

Kathleen Sebelius


August 5, 2010

The Honorable Todd Tiahrt
Ranking Minority Member
Subcommittee on Labor, Health and Human Services, Education and Related Agencies
Committee on Appropriations
House of Representatives
Washington, D.C. 20510

Dear Representative Tiahrt:

I am writing to inform you of the Department of Health and Human Services’ (HHS) plan to establish an office to administer the Community Living Assistance Services and Supports Act (CLASS Office) within the Office of the Secretary.

HHS has been entrusted with the responsibility for implementing many major provisions of the Affordable Care Act of 2010, which the President signed into law on March 23, 2010. In order to efficiently and effectively implement the provisions of Title VIII, the Community Living Assistance Services and Supports Act (CLASS), we find it necessary to create an office that has as its primary focus the implementation and management of this new and innovative program.

The new office will be responsible for establishing and administering the CLASS program. CLASS is a voluntary, federally administered long-term care financing plan that will be supported by individual premium contributions. CLASS will provide participating adults needing long-term services and supports a flexible source of funds that can be used to purchase goods and services aimed at helping them remain independent. The CLASS Office will establish the national voluntary insurance program, set premiums, set rules for enrollment and eligibility systems, and specify and design the benefit. It will also establish systems for advice and assistance to eligible beneficiaries on accessing services, and support a protection and advocacy network to serve beneficiaries of the program. In addition, the CLASS Office will convene and support two Federal Advisory Committees, the Personal Care Attendants Workforce Advisory Panel and the CLASS Independence Advisory Council. It is anticipated that the Office will coordinate with a number of public and private entities including: 1) the Department of Treasury, which will convene and support the Board of Trustees of the CLASS Independence Fund and maintain the CLASS Independence Fund; 2) the Social Security Administration; 3) employers; and 4) state Medicaid agencies.

Initial administrative funding for the new program will come from the funds appropriated to administer health reform activities. Once the program is fully operational, administrative services will be funded from premium income as set out in the statute, with a three percent limit on premium income that can be used for administrative costs.

The CLASS Office will begin with staff detailed on a volunteer basis from HHS and other Departments, along with new federal staff we expect to bring on very quickly. It will work closely with the Administration on Aging, the Office on Disability, the Administration for Children and Families, the Centers for Medicare & Medicaid Services, and other organizations within HHS to ensure coordination with existing programs.

The new CLASS program and the proposed office will play an important role in helping enrollees to take steps to protect their independence if they experience disability.

In appreciate your continued interest in and support of the Department’s programs. I have sent identical letters to Chairman Obey, Chairman Harkin, and Senator Cochran.

Sincerely,

Kathleen Sebelius


A REPORT ON THE ACTUARIAL, MARKETING, AND LEGAL ANALYSES OF THE CLASS PROGRAM

For additional information, you may visit the DALTCP home page at http://aspe.hhs.gov/_/office_specific/daltcp.cfm or contact the office at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201. The e-mail address is: webmaster.DALTCP@hhs.gov.

Files Available for This Report

Main Report
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/index.shtml
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/index.pdf [48 PDF pages]
APPENDIX A: Key Provisions of Title VIII of the ACA, which Establishes the CLASS Program
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appA.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appA.pdf [6 PDF pages]
APPENDIX B: HHS Letters to Congress About Intent to Create Independent CLASS Office
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appB.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appB.pdf [11 PDF pages]
APPENDIX C: Federal Register Announcement Establishing CLASS Office
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appC.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appC.pdf [2 PDF pages]
APPENDIX D: CLASS Office Organizational Chart
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appD.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appD.pdf [2 PDF pages]
APPENDIX E: CLASS Process Flow Chart
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appE.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appE.pdf [2 PDF pages]
APPENDIX F: Federal Register Announcement for CLASS Independence Advisory Council
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appF.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appF.pdf [3 PDF pages]
APPENDIX G: Personal Care Attendants Workforce Advisory Panel
Full Appendix
   HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appG.htm
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appG.pdf [6 PDF pages]
Ga: Federal Register Announcement for Personal Care Attendants Workforce Advisory Panel
    PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appGa.pdf [3 PDF pages]
Gb: Advisory Panel List of Members
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appGb.pdf [2 PDF pages]
APPENDIX H: Policy Papers Discussed by the LTC Work Group
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appH.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appH.pdf [36 PDF pages]
APPENDIX I: CLASS Administration Systems Analysis and RFI
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appI.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appI.pdf [10 PDF pages]
APPENDIX J: Additional Analyses for Early Policy Analysis
Full Appendix
   HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appJ.htm
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appJ.pdf [150 PDF pages]
Ja: A Profile of Declined Long-Term Care Insurance Applicants
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appJa.pdf [23 PDF pages]
Jb: CLASS Program Benefit Triggers and Cognitive Impairment
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appJb.pdf [65 PDF pages]
Jc: Strategic Analysis of HHS Entry into the Long-Term Care Insurance Market
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appJc.pdf [33 PDF pages]
Jd: Managing a Cash Benefit Design in Long-Term Care Insurance
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appJd.pdf [28 PDF pages]
APPENDIX K: Early Meetings with Stakeholders
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appK.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appK.pdf [4 PDF pages]
APPENDIX L: In-Depth Description of ARC Model
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appL.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appL.pdf [62 PDF pages]
APPENDIX M: In-Depth Description of AvalereHealth Model
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appM.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appM.pdf [23 PDF pages]
APPENDIX N: September 22, 2010 Technical Experts Meeting
Full Appendix
   HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appN.htm
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appN.pdf [37 PDF pages]
Na: Agenda, List of Participants, and Speaker Bios
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appNa.pdf [7 PDF pages]
Nb: Presentation Entitled "Actuarial Research Corporation's Long Term Care Insurance Model"
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appNb.pdf [11 PDF pages]
Nc: Presentation Entitled "The Long-Term Care Policy Simulator Model"
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appNc.pdf [11 PDF pages]
Nd: Presentation Entitled "Comments on 'The Long-Term Care Policy Simulator Model'"
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appNd.pdf [7 PDF pages]
APPENDIX O: Actuarial Report on the Development of CLASS Benefit Plans
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appO.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appO.pdf [47 PDF pages]
APPENDIX P: June 22, 2011 Technical Experts Meeting
Full Appendix
   HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appP.htm
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appP.pdf [46 PDF pages]
Pa: Agenda and Discussion Issues and Questions
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appPa.pdf [8 PDF pages]
Pb: Presentation Entitled "Core Assumptions and Model Outputs"
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appPb.pdf [7 PDF pages]
Pc: Presentation Entitled "Actuarial Research Corporation's Long Term Care Insurance Model"
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appPc.pdf [11 PDF pages]
Pd: Presentation Entitled "The Avalere Long-Term Care Policy Simulator Model"
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appPd.pdf [11 PDF pages]
Pe: Presentation Entitled "Alternative Approaches to CLASS Benefit Design: The CLASS Partnership"
   PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appPe.pdf [8 PDF pages]
APPENDIX Q: Table 2: Actuarial and Demographic Assumptions
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appQ.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appQ.pdf [2 PDF pages]
APPENDIX R: Figure 1: Daily Benefit Amount for Increased Benefit
HTML   http://aspe.hhs.gov/daltcp/reports/2011/class/appR.htm
PDF   http://aspe.hhs.gov/daltcp/reports/2011/class/appR.pdf [2 PDF pages]


To obtain a printed copy of this report, send the full report title and your mailing information to:

U.S. Department of Health and Human Services
Office of Disability, Aging and Long-Term Care Policy
Room 424E, H.H. Humphrey Building
200 Independence Avenue, S.W.
Washington, D.C. 20201
FAX:  202-401-7733
Email:  webmaster.DALTCP@hhs.gov


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Last Updated:  11/16/2011