Journal of Family and Economic Issues

, Volume 28, Issue 2, pp 189–205 | Cite as

Factors Impacting Group Long-Term Care Insurance Enrollment Decisions

  • Patricia L. Schaber
  • Marlene S. Stum
Original paper


This paper examines factors that influence whether or not employees choose to enroll in a group long-term care insurance plan. A conceptual family decision-making framework is used to group factors to study the enrollment decision of 509 state employees who were offered a long-term care insurance plan in 2000. Logistic regression results revealed that employee age, perceived risk, perceived affordability, decision-making style (communication with others and use of information), goals of control and choice, goal of financial peace of mind, household income, and potential caregiver availability explained 68.7% of the decision to enroll. Results support the key role of perception, specifically the perceived risk of needing long-term care and the affordability of the insurance plan, in the decision outcome.


Family decision making Long-term care insurance 


  1. Atchley, R. C., & Dorman, M. S. (1994). Gaining marketing insights from the Ohio long-term care survey. Journal of the American Society of CLU and ChFC, 48(5), 66–71.Google Scholar
  2. Bubolz, M., & Sontag, M. (1993). Human ecology theory. In P. G. Boss, W. J. Doherty, R. LaRossa, W. R. Schumm, & S. K. Steinmetz (Eds.), Sourcebook of family theories and methods: A contextual approach (pp. 419–448). New York: Plenum Press.Google Scholar
  3. Bureau of the Census (2000). Americans with disabilities: 1997. Washington, D.C. Retrieved February, 13, 2003, from
  4. Health Insurance Association of America (1995). Who buys long-term care insurance? 1994–95 profiles and innovations in a dynamic market. Managed Care and Insurance Operations Report. Washington, D.C.: Lifeplans.Google Scholar
  5. Health Insurance Association of America (2000, October). Who buys long-term care insurance in 2000? A decade of study of buyers and non-buyers. Washington, D.C.: Lifeplans.Google Scholar
  6. Health Insurance Association of America (2001, October). Who buys long-term care insurance in the workplace? A study of employer LTCI plans. Washington, D.C.: Lifeplans.Google Scholar
  7. Henkens, K. (1999). Retirement intentions and spousal support: A multi-factor approach. Journals of Gerontology Series B: Psychological & Social Sciences, 54(2), S63–73.Google Scholar
  8. Holden, K., McBride, T., & Perozek, M. (1997). Expectations of nursing home use in the Health and Retirement study: The role of gender, health, and family characteristics. Journals of Gerontology Series B: Psychological & Social Sciences, 52(5), S240–251.Google Scholar
  9. Jecker, N. S. (2001). Family caregiving: A problem of justice. In D. N. Weisstub, D. D. Thomasma, S. Gauthier, & G. F. Tomossy (Eds.), Aging: Caring for our elders (pp. 19–28). Boston: Kluwer Academic.Google Scholar
  10. Kemper, P. (1992). The use of formal and informal home care by the disabled elderly. Health Services Research, 27(4), 421–451.Google Scholar
  11. McCall, N., Mangle, E., Bauer, E., & Knickman, J. (1998). Factors important in the purchase of partnership long-term care insurance. Health Service Research, 33(2), 187–203.Google Scholar
  12. Mellor, J. M. (2000). Private long-term care insurance and the asset protection motive. Gerontologist, 40(5), 596–604.Google Scholar
  13. Munro, B. H. (1997). Statistical methods for health care research (3rd ed.). Philadelphia, PA: Lippincott-Raven.Google Scholar
  14. Paolucci, B., Hall, O., & Axinn, N. (1977). Family decision making: An ecosystem approach. New York: John Wiley.Google Scholar
  15. Rettig, K. (1993). Problem-solving and decision-making as central processes of family life: An ecological framework for family relations and family resource management. Marriage and Family Review, 18(3/4), 187–222.CrossRefGoogle Scholar
  16. Sloan, F. A., & Norton, E. C. (1997). Adverse selection, bequests, crowding out, and private demand for insurance: Evidence from the long-term care insurance market. Journal of Risk and Uncertainty, 15, 201–219.CrossRefGoogle Scholar
  17. Stucki, B. R. (2000). Expanding retirement strategies with long-term care insurance. Washington, D.C.: American Council of Life Insurers (ACLI).Google Scholar
  18. Stucki, B. (2001a). Long-term care insurance at work: The retirement link and employee perspectives. Washington, D.C.: American Council of Life Insurers.Google Scholar
  19. Stucki, B. (2001b). Making the retirement connection: The growing importance of long-term care insurance in retirement planning. Washington, D. C.: American Council of Life Insurers.Google Scholar
  20. Stum, M. (2000). Later life financial security: Examining the meaning attributed to goals when coping with long-term care. Financial Counseling and Planning, 11(1), 25–37.Google Scholar
  21. Stum, M. (2001). Financing long-term care: Examining decision outcomes and systemic influences from the perspective of family members. Journal of Family and Economic Issues, 22(1), 25–53.CrossRefGoogle Scholar
  22. Stum, M. S., Zuiker, V. S., Pelletier, E., & Hope, L. (2001, December). To buy or not to buy: Examining long-term care insurance decision making from the employee perspective (Research Report). St. Paul, MN: University of Minnesota, Department of Family Social Science.Google Scholar
  23. Swamy, N. (2004). The importance of employer-sponsorship in the long-term care insurance market. Journal of Aging and Social Policy, 16(2), 67–84.CrossRefGoogle Scholar
  24. Waidmann, T. A. (2003, July). Estimates of the risk of long-term care: Assisted living and nursing home facilities. Urban Institute Report Office of Disability, Aging, and Long-Term Care Policy. Retrieved March 9, 2004 from
  25. Ware J. E. (2004). SF- 36 Health survey update. In M. Maruish (Ed.), Use of psychological testing for treatment planning and outcomes assessment (vol. 3, pp.693–718). Mahwah, NJ: Lawrence Erlbaum.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Program in Occupational TherapyUniversity of MinnesotaMinneapolisUSA
  2. 2.Department of Family Social ScienceUniversity of MinnesotaSt. PaulUSA

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