Geoff Garfield of ACSIA Partners explains why long-term care planning can't wait, what it can cost, and how business owners can offer it as an employee benefit.
GROWTH PILLAR: Health & Wellness
WHO THIS IS FOR: SMB owners, HR leaders, solopreneurs, and families planning ahead
WHAT THEY'LL GAIN: A clear picture of the odds and costs of long-term care, how a plan pays out, and how to start the conversation with family or staff.
Most people think long-term care is something for later. It isn't. Wait for the diagnosis, and the coverage you needed may no longer be available.
Most families wait for a health crisis to think about care. By then, the options are fewer and the costs are higher.
Geoff Garfield of ACSIA Partners is a long-term care insurance specialist and a former Wall Street financial advisor. After his parents faced years of care with no plan, he saw how fast long term costs can drain savings and wear down a family caregiver. In this episode, he explains why long term care planning matters at every age. He covers who qualifies for benefits, what long term care insurance can cost, and how employers can offer it as a group benefit. He also shares U.S. numbers on caregiver support and care costs. This is for business owners, HR leaders, and families who want a plan before a health crisis forces rushed choices.
Key topics covered
• Why Geoff left Wall Street planning for long-term care insurance
• U.S. caregiving numbers: 63 million adult caregivers
• The odds of needing care compared with house fires and car accidents
• How plans start paying: two of six daily activities, or cognitive decline
• Why a cash plan pays you directly, tax free
• The cost of waiting to buy coverage
• Long-term care as a group benefit for employers
• The YourCare360 planning tool
Guest links
• Geoff Garfield — ACSIA Partners
Supporting persons mentioned: none named in this conversation.
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Geoff (00:05)
great to be here. looking forward to engaging with all the folks who who do get to see this.
I was a financial advisor in the New York City area for more than twenty-five years. big name firms Lehman Brothers, Morgan Stanley, Merrill Lynch, and the like. the last 10 years of that investment management and planning career was at a a high end RIA. We won't go too deep, but RIA is registered investment advisor and it's a fee based platform.
it catered to high net worth individuals and I was a sales guy, some some cold calling, I cold called for Lehman Brothers in the 90s in a boiler room like atmosphere and stuck with it for a long time. I did unfortunately lose my parents. my father right before COVID 2019,
And he had a long term care journey. And it affected my mom as the primary caregiver. in my medical opinion, the stress and and wear and tear wore her down and got her sick. And then so she followed up with her own long term care journey and passed. I have two brothers.
They don't live near me. my parents were from New Jersey, where I grew up. so I was the main son involved with my father's care. And you know, that meant normal stuff going out there when I could, which was because I'm in Connecticut probably once a week or so. And I helped with VA hospitals and adult daycares and home health aides.
coming into the house. but my mom was, like I said, was the primary caregiver. and it wore her down. after my father passed, and she got a diagnosis, she had some cancer, she actually moved down to Texas, where my older brother lived. we agreed since I was
primarily responsible from the child angle with my dad that it was his turn and he would take care of my mom. and she lived with he and his family for a couple of years in Houston, Texas. And then her condition deteriorated and she went into a nursing home. And it continued to deteriorate a bit from there and she was in a memory care unit. and I, of course, am not alone in this this journey, right? Everybody gets old.
we'll look at some numbers of people have long term care needs. but with the exposure that I got, not only with my dad in New Jersey, I did go down to Texas and help out, certainly not as often, but when I could, I gained a real appreciation for this long term care journey. So I did make a move and it's only been about a year and a half.
where I am focusing on long-term care. I'm a long-term care insurance specialist.
To speak of long-term care, it's October 19th today. November is Long-Term Care Awareness Month. the insurance companies and the the carriers, et cetera, are all coming out. And I I my goal really here today is just to talk to people and share with them the need to put a plan together to talk about it.
most people don't, right? And and you can look in yourself and you can talk to your neighbors or your family. But have you and your spouse, if you have one still, spoken about where you wanna spend your years if you need help? most people want to stay home for sure, and that can be done if you have the resources. Some people, either in the beginning or as their journey goes on.
need more professional help. So they would go to a assisted living facility or a nursing home or a memory care unit. There really are lots and lots of options. and there's especially lots of options if you have the funds to pay for it. And darn it, it's real expensive. my parents and I should have mentioned this, did not have long-term care insurance. And that's kind of why I sharing with all the known firms that I worked at, right? Merrill Lynch and Morgan Stanley.
are big names and you would think and that those were when I worked there it was over ten years ago. So they could be talking about long term care now. But back when I was at these firms, no one ever did. And even at the RIA I mentioned, that was a high end planning platform, right? We did all the estate planning and the tax planning and this planning and that planning, not not once was long term care ever mentioned.
So my parents never got it, even though I was their fantastic financial advisor. And it affected all of us. thankfully they they had some assets and they were able to afford good care. it certainly ate into their nest egg, what they they hoped to pass on to their children and grandchildren. That number was severely diminished. And and gosh, that's fine. I'm I'm just happy they were able to get the care that they needed. But
while I was going through it, I shopped for my wife and I. And I said, Okay, I'm not going to allow this stress that I blame my mother's demise on and the stress that the children and family and friends had to go through. I don't want that to happen in my situation with my spouse and and my children. So I did purchase some long term care insurance for my wife and I. And and we'll
We'll touch upon that in a little while, but just looking at these numbers for a moment, and and I apologize to my Canadian audience here, but in the United States, and that there are long-term care solutions in Canada and with my phone number email, if the folks watching today will would like any recommendation or
To work with me finding some of their long-term care solutions. Please be in touch. But in the United States, 63 million adults now provide ongoing care to an adult or child with a medical condition. One in four adults. That number has gone up in the last 10 years and certainly will continue to go up. And I find this one even scarier. Almost 40 million Americans of people age 15 and older.
provide unpaid care for an aged loved one. it's romantic and I think in different cultures even expected that family takes care of family. And I that's a beautiful thing. And I'm not by any means suggesting that that's not the way it should be. I do think the family should be very involved in helping with their loved ones care. But depending how long
That care goes on, it can be super expensive. frequently, the people who are expected to care, maybe the children, maybe a grandchild like the 15-year-olds in this slide, don't have five hours a day or two hours a day or twenty hours a week, whatever the need is. the best case scenario is where family is involved as much as they can be.
But they also have a plan set in place where there are some finances available if they need to bring in a home health care aide or round the clock several home health care aides. That unfortunately frequently happens. And then if the situation develops where they have to go into a more structured nursing home or assisted living facility, that the assets are there so that they can choose.
the best one nearest the family, so everyone can stay as involved as they wish. unfortunately, and I would certainly assume Canada is the same, America is not like that. When you when you don't have the the funds and you have to rely, let's say, on the government, you can get a crappy spot and it can be a couple hundred miles away. So it's today is really about stressing the need
for conversation and plans. And I bet you're going to see a lot of information on this in the in next month because of the Long-Term Care Awareness Month. it's so scary to me. yeah you have to have home insurance, right? When you when you have a mortgage and you own a home. That's wonderful. And if and if something happens to your home,
you're you're lucky that you have it and the assets can hopefully get you back to a a suitable living space. But wonderfully, the chances are not that large. It's one in four hundred that you're gonna lose your house in a fire. car insurance, similarly, car accidents. There's only a one in thirty-nine chance that you're gonna have a
A serious car accident that needs insurance claims. If we look at long-term care, the odds, that sounds like a good word, the odds are much higher. It's not a good word. One in two people, and it's really 70% of people, and this is America, but I believe Canada is similar. There's a 70% chance. I know this is one in two, it's even higher. There's a 70% chance people, if you make it to 65.
you're going to need some form of long-term care. Even a little scarier if you are married and you both make it to 65, the chances go up to 90% that one of you are going to need a long-term care
And it's expensive as we discussed. I'm in a I guess an expensive part of town. in Connecticut, my numbers are a lot higher and in this career I'm involved, right? I visit nursing homes and and talk to administrators and patients and everything. But a private room in in Connecticut, the average is like eighteen thousand. but you can see these numbers and and they're still super scary.
if you want to keep your loved one at home, and this is forty-four hours a week, right? So twenty four times seven, it's not round the clock, and that's frequently what's needed, and that's a lot of money, and it can go on for several years.
we'll talk about this, I'm gonna shift it a little bit. I'd like to let the audience know that my company is ACSIA Partners and they focus on the consumer market. So individuals or husbands and wives shopping for a long term care plan and coverage. And I certainly do that. I'm licensed and trained and and I do it every day.
But I've taken the different approach, the minority at my company, and I'm speaking to companies. So depending on the size of the company, right? they offer benefits. So if you're a regular company and they're offering you medical insurance and vision insurance and life insurance, et cetera, the right, that's a whole world, the benefit world.
long-term care can be a group benefit. And there are real advantages to that. with polls and and surveys and studies, and this is not going to surprise anybody except maybe the extent of it, almost three quarters of people report having to leave work early.
Because of a long-term care situation. Sixty percent of caregivers admit caregiving negatively impacted their job performance. Seventy percent of especially those top two ones, right? You have to leave early and you're not working to your desire. Of course, you're gonna be stressed out. Health expenditures. On average, employers pay eight percent more in health care costs for caregiver employees than non-caregivers. So
The point is if you are in human resources or an executive position at a company and this resonates, you might want to explore offering it to your employees as a benefit in in addition or instead of purchasing it just for your wife and yourself. obviously there's many different companies, many different sizes. a rule of thumb, if you have a company under a hundred employees,
A lot of those companies, employees are like family. Everyone wants to take care of each other and they've frequently grown together through through the years or decades. and a long-term care group benefit plan can not only be a a wonderful addition to help people, but it's also less expensive and less onerous to get covered. So that's an interesting angle as well.
this is actually from a presentation on a company that I presented to, and I took some of the slides. But you really want to understand what the risks might be and how to plan to cover them where where you it is very doable. The the the hardest part is is getting familiar.
With the situation. it's not that expensive, and we'll talk about that. So protection at all stages of life. if you become unable to take care of yourself and you're in your working years, your mortgage is at risk, your income and your family protection are at risk. it can affect your retirement savings, etc.
long-term care insurance is not just for the older people who might need it then, right? That that would be great if you could decide, okay, gosh, I'm sick or my wife is sick and I need insurance. Unfortunately, that's when you can't get it because the insurance company's not gonna want to underwrite somebody who
has an immediate need. So you want to plan and it doesn't matter what stage of life you are at. we'll get into this also. when you purchase coverage when you're young, it is certainly much more affordable than when you're older.
What is considered long-term care? I have a slide later for activities of daily living, A D L. But it's basically the six things that you do when you get out of bed in the morning. Can you get out of bed in the morning physically? Can you make it to the the restroom, the powder room? Can you do your business? Can you clean yourself? can you finish that up and go feed yourself? When you cannot do those two of those six.
activities of daily living, you qualify for the long-term care coverage to start paying out. Additionally, besides those six physical measurements, there's a cognitive measurement. If your doctor says my patient has a significant cognitive decline, they need help, you don't have to cover those two of those six. That that cognitive decline is enough. And importantly
either on the consumer side or the workplace side. we're talking about your doctor and and their knowledge of you. it's not a my company ACSIA or the insurance company's doctors deciding if you're ready. It is your personal doctor.
once again the age
situation. if you have coverage, it doesn't matter. it's not only for old people, I guess is a nice way to say it. If you had an accident, motorcycle or any other type and you were not able to do two of those six physical activities, the ADLs, then the benefit would start paying. And of course, if you're older and you have some Alzheimer's or a decline or a physical decline, the coverage is applicable there as well.
hopefully I'm dispelling some of these myths. one thing is I have enough life insurance, I have disability coverage. Though those are important coverages, no question. But this is not disability insurance or life insurance. with a caveat, the newer long-term care policies, group benefits as well as consumer to some degree.
Do frequently have a life insurance component also. And that's an improvement in the market in the last several years that consumers and people who are purchasing it are very happy with. the old concept and people didn't like the offer as much was use it or lose it. you would put your money away every month or every quarter to have your long-term care insurance. But then if you passed either early or
In a healthy situation when you in your older age, all that money was gone. Today, many, if not most, policies have a life insurance component. So if you haven't used the monies for long term care, your heirs get the payout in a life insurance manner. Or if you've only used half, then the heirs would get half. So it's a nice development in the marketplace.
this is national US averages. And and it's frightening, and quite frankly, I think these numbers are low, and not in all states obviously, because it's an average, but frequently it's a lot more expensive than these numbers.
the cost of waiting. understandably, when you're in your twenties and thirties and even forties, you're like, I'm not retiring, I'm not gonna retire for a long time. I'm not gonna do this coverage. the I hear you. And that's one way to look at it. But if something happens, you're not gonna be able to get the coverage at all. And if you are able to get it in your forties, late forties, fifties, sixties, it's gonna be expensive and potentially prohibitively expensive.
some of these concerns are exacerbated on the consumer side when an individual is purchasing. Sometimes the company benefit has some benefits there as well, which we'll talk about.
What if I have existing life insurance coverage? I would never say replace your existing life insurance policy with a long-term care plus life. it could work out that way, but you don't want to have a long-term care need for two or three years or four or five years and use up that benefit and then not have any life insurance if you or your family were were counting on it.
So this shows a corporate plan, a company benefit, and and what it what it does. if the employee, the person, has two of those six ADLs or a cognitive decline, then the benefit starts kicking in. So if you had a hundred thousand dollar policy.
Each month you would get a check for $4,000. And some of the plans and the ones that I'm typically working with have a rider built in there. So instead of $4,000 for 25 months, which would equal your $100,000 benefit, they actually double it. So you're going to get four thousand for a hundred thousand dollar policy, you're going to get four thousand dollars for fifty, five zero months.
which is actually a two hundred thousand dollar benefit. I'd be happy to discuss it with anybody. And that's the common way to go.
Same kind of thing. We talked about the life insurance component. But the tax-free pops out and I see it. that's an important distinction to to know these benefits are a tax-free payment. And another development in the marketplace in years gone by.
some insurance companies and some are still out there, but you do have a choice with with different companies that we work with. and I'm certainly going for the one that's a cash plan. And what that means is in this instance that we were just discussing, you're gonna get a check for four thousand dollars. Number one, that's tax free. But number two, it's just coming to you and you're gonna see how you want to spend it. You can spend it on the home health aide or you can spend it on
maybe equipment, and wheelchairs or and anything you you and your loved one might need for for their care. and then once if they have to go or you choose to go into an assisted living facility or nursing home, it just continues. You still get your check and you take your check and you pay for the for the care. It's there's no
submission of receipts and and reimbursement and any of that stuff. It's all a cash program. I think this is encouraging looking at how much things might cost. I was saying a hundred thousand dollars, but that was just for easy math. But
The these are ages, 25, 35, 45, 55. And on the top row are your benefit amounts. And you'll see it works pretty mathematically well, right? Six, twelve, eighteen. So a hundred would be twenty-four dollars a month if they're twenty-five years old. If they're fifty-five years old, it's gonna go up to am I that good? $28, about $110 a month. And that's
That would be for four thousand dollars a month in benefit.
and so th this is a rule of thumb and it it is a plan that I I I helped install last year. so so it is real life, but of course you you can't hold me to these numbers, but it it is a good example of how much it does cost. And in my opinion, it shows pretty well that it's not prohibitively expensive frequently.
long-term care is getting more popular, and a big reason is everybody's petrified. There's not enough home health aides, the nursing homes are super expensive, there's more and more people who are living longer and longer, and the need has never been greater. So everyone's freaking out.
Washington State was the first state in in America. They have established a payroll tax, and it's fifty-eight cents out of every one hundred dollars, no matter how much you make, that goes into a state long term care plan. It is not a great plan, even though every resident who works is paying for it. It is something, and that's a fantastic start. But we certainly believe that ACSIA Partners
Who is actually headquartered in Washington State, that more states are following. We we think California is close, we think Massachusetts is close. in five years, ten years, twenty years, the the epidemic, that's a strong word, of old folks needing help is just gonna be bigger and scarier.
so hopefully I'm interesting people enough to want some more information and I'm very available to talk without any obligation at any point. ACSIA, which is my company, has a fantastic differentiator. There are other companies, our competitors who offer long term care, both on the consumer side and the benefit side. But one way that my company differentiates themselves
Is with a program called YourCare360. And any individual who purchases it is qualified on the work site on and that's what we call the benefit side. It's even better. If you have a company that signs up with ACSIA and we enroll a plan, every employee gets access to YourCare360, whether they end up signing up for themselves or not.
And I wrote here your company dot your care, meaning if your company is IBM, this website would be IBM.yourcare360.com. So YourCare360, the your new planning tool, has lots of spokes on their wheel. They help you with caregiver support, expert guidance in lots of different ways, national provider directories. You you can see all this.
But the point is, and we said it in the beginning, having the discussion with your loved ones, and maybe it's with National Awareness Month, or maybe it's the holidays coming up, your parents and your spouse and yourself, I really strongly believe should have this discussion and this thought process. Where am I going? Where do I want to live my golden years?
If something happens to my health or my spouse's health, how are we going to be able to afford it? it's a it's a vitally important issue. Not enough people look at, it could save a tremendous amount of heartache and assets if you did look at it. it's a sad situation, but but frequently true. When when mom or dad or both get ill and the
children and family have to take care of them, sometimes issues occur, right? one child thinks they're doing too much, the the other child lives too far away and doesn't have the assets, et cetera. it's a horrible thing all frequently, but it's more horrible if you don't have a plan and ha and haven't had it thought through before you begin.
I have lots of educational materials that if people are interested in in receiving one or more, I'm I'm super available. Thank you.