Election Package Resources

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Many policyholders received their Election Packages and submitted their Coverage Election Forms in early 2022. Election Packages will continue to be mailed to other policyholders during the next several months, as explained in the Election Package Overview section of this website. The Election Packages include a step-by-step guide to assist policyholders in making their decision, information explaining personalized options available to each policyholder, an election form, and a self-addressed stamped envelope that must be returned to SHIP.  Policyholders must return their Coverage Election Form indicating their decision by the due date printed on the form. This sample is provided online so family members and trusted advisors can see the information policyholders receive and to assist in making the coverage election decision. This Sample Election Package is provided without any data specific to a policyholder. 


The Election Package contents are listed below. You may view or download the Election Package contents by clicking on the images.  An Election Package Video Series is also available on this website as an additional Election Package resource.

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Introduction to the Election Package from SHIP’s Special Deputy Rehabilitator to highlight steps a policyholder should take.

Cover Letter

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Brochure designed to provide helpful information to better understand SHIP’s rehabilitation status and the important decisions policyholders must make under the Approved Rehabilitation Plan.

Important Information for Policyholders Brochure

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Form that each policyholder who receives an Election Package should complete and return to indicate the option that best suits their needs.

Coverage Election Form

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Supplemental information to advise a policyholder of the policy features and coverage included in their current long-term care insurance policy, and additional information related to future phases of the Approved Rehabilitation Plan.

Summary of Current Coverage

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Brochure includes coverage election options and useful information about the options, including a step-by-step guide and terminology to assist policyholders in selecting their option.

Choosing the Right Coverage Option Brochure

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Postage paid envelope a policyholder should use to return their Coverage Election Form.

Business Reply Envelope

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