Skip to main content
Log in

Factors Impacting Group Long-Term Care Insurance Enrollment Decisions

  • Original paper
  • Published:
Journal of Family and Economic Issues Aims and scope Submit manuscript


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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others


  • 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 

  • 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 

  • Bureau of the Census (2000). Americans with disabilities: 1997. Washington, D.C. Retrieved February, 13, 2003, from

  • 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.

  • 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.

  • 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.

  • 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 

  • 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 

  • 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 

  • Kemper, P. (1992). The use of formal and informal home care by the disabled elderly. Health Services Research, 27(4), 421–451.

    Google Scholar 

  • 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 

  • Mellor, J. M. (2000). Private long-term care insurance and the asset protection motive. Gerontologist, 40(5), 596–604.

    Google Scholar 

  • Munro, B. H. (1997). Statistical methods for health care research (3rd ed.). Philadelphia, PA: Lippincott-Raven.

    Google Scholar 

  • Paolucci, B., Hall, O., & Axinn, N. (1977). Family decision making: An ecosystem approach. New York: John Wiley.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Stucki, B. R. (2000). Expanding retirement strategies with long-term care insurance. Washington, D.C.: American Council of Life Insurers (ACLI).

    Google Scholar 

  • 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 

  • 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 

  • 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 

  • 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.

    Article  Google Scholar 

  • 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.

  • 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.

    Article  Google Scholar 

  • 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

  • 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 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Patricia L. Schaber.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schaber, P.L., Stum, M.S. Factors Impacting Group Long-Term Care Insurance Enrollment Decisions. J Fam Econ Iss 28, 189–205 (2007).

Download citation

  • Published:

  • Issue Date:

  • DOI: