Home > Technical Reference > Lifetime maximums, annual caps and spending account calculations

Lifetime maximums, annual caps and spending account calculations

Background

ProVal offers the following OPEB payment forms:

  1. Life Annuity to Member

  2. Life Annuity to Spouse

  3. Joint Life Annuity to Spouse

  4. Reversionary Annuity to Spouse

  5. Life Insurance on Member's Life

  6. Life Insurance on Spouse's Life

  7. Lump Sum to Member, No Life Contingencies

  8. Lump Sum to Member, Life Contingencies

Lifetime maximums, annual caps, and spending accounts are relevant only to the first four payment forms listed above. Lifetime maximums, annual caps, and spending accounts are not relevant to life insurance or lump sum payment forms because those payment forms represent one-time, rather than ongoing, payments. The remainder of this discussion pertains to lifetime maximums and spending accounts.

The present value for each of these payment forms (after decrement) takes the form:

Life Annuity to Member: image/ebx_1574579271.gif

Life Annuity to Spouse: image/ebx_-558786785.gif

Joint Life Annuity to Spouse: image/ebx_-1919243593.gif

Reversionary Annuity to Spouse: image/ebx_711449729.gif

Applying a lifetime maximum or spending account means substituting image/ebx_1532687269.gif for image/ebx_728052566.gif in the equations above, in which image/ebx_-610247254.gifis the amount of projected claims after the limit is applied. The general formula for computing image/ebx_-111335817.gif is given by:

 

(1) image/ebx_1765037516.gif

 

where

 

image/ebx_651846742.gif Probability distribution function for image/ebx_-382730558.gif. Probability of a contingent event occurring at time s (e.g., for a reversionary annuity, death of member) given that payment is received at time t (e.g., that member is dead at time t). s={0,1,…,t}.

image/ebx_-1729950501.gif Projected claims at time t before being limited

image/ebx_-1621765098.gif Projected lifetime maximum or spending account at time t

image/ebx_2086678347.gif Cumulative claims at time t, given that payment is received at time t (e.g., for a reversionary annuity, that member is dead at time t) and a contingent event occurred at time s (e.g., death of the member). s={0,1,…,t}.

 

Note that the value of image/ebx_-405882903.gifis limited to zero.

 

Below we will apply equation (1) to each payment form individually and then in combination.

 

Life Annuity to Member

For a life annuity to member, it is known that the member survives in order to receive payment at time t. There are no (unknown) contingent events at time t upon which payment depends. Therefore, we can determine image/ebx_-1589784609.gif by:

(2) image/ebx_1249316021.gif

EXAMPLE

Lifetime maximum: 100,000 

Discount rate: 5% 

     

t image/ebx_2085742240.gif image/ebx_-2000830767.gif image/ebx_1947964139.gif image/ebx_1472083748.gif image/ebx_1510354237.gif image/ebx_680712597.gif image/ebx_1190351496.gif
0 10,000 100,000 0 10,000 1 1 10,000
1 10,000 100,000 10,000 10,000 0.9 0.9524 8,571
2 10,000 100,000 20,000 10,000 0.8 0.9070 7,256
3 10,000 100,000 30,000 10,000 0.7 0.8638 6,047
4 10,000 100,000 40,000 10,000 0.6 0.8227 4,936
5 10,000 100,000 50,000 10,000 0.5 0.7835 3,918
6 10,000 100,000 60,000 10,000 0.4 0.7462 2,985
7 10,000 100,000 70,000 10,000 0.3 0.7107 2,132
8 10,000 100,000 80,000 10,000 0.2 0.6768 1,354
9 10,000 100,000 90,000 10,000 0.1 0.6446 645
10 10,000 100,000 100,000 0 0 0.6139 0
            Total 47,844

 

Life Annuity to Spouse

For a life annuity to spouse, it is known that the spouse survives in order to receive payment at time t. There are no (unknown) contingent events at time t upon which payment depends, so equation (2) applies here too.

Joint Life Annuity to Spouse

For a joint life annuity to spouse, it is known that the both the member and spouse survive in order to receive payment at time t. There are no (unknown) contingent events at time t upon which payment depends, so equation (2) applies here too.

Reversionary Annuity to Spouse

For a reversionary annuity to spouse, it is known that the member dies and the spouse survives in order to receive payment. However, we do not know when the member dies. The probability that the member dies at time s given that we know the member is dead at time t is image/ebx_-236168103.gif for s={0,1,…,t-1}. (Note that the sum of these probabilities from s={0,1,…,t-1} should, and does, equal 1.) Applying these probabilities to the cumulative claims starting the year after the member’s death (s+1), we can determine image/ebx_1530897736.gif by:

(3) image/ebx_1008923633.gif

EXAMPLE

Lifetime maximum: 50,000 

Discount rate: 5%

 

t image/ebx_-714489674.gif image/ebx_-2123482721.gif image/ebx_721259535.gif
0 10,000 0.1 0.1
1 10,000 0.1 0.1
2 10,000 0.1 0.1
3 10,000 0.1 0.1
4 10,000 0.1 0.1
5 10,000 1 0.1
6 10,000 1 0.1
7 10,000 1 0.1
8 10,000 1 0.1
9 10,000 1 0.1
10 10,000 1 0.1

(a). Probability of contingent events = image/ebx_742548189.gif for s={0,1,…,t-1}

  s                  
t 0 1 2 3 4 5 6 7 8 9
0                    
1 1                  
2 0.52632 0.47368                
3 0.369 0.3321 0.29889              
4 0.29078 0.2617 0.23553 0.21198            
5 0.24419 0.21977 0.1978 0.17802 0.16022          
6 0.1 0.09 0.081 0.0729 0.06561 0.59049        
7 0.1 0.09 0.081 0.0729 0.06561 0.59049 0      
8 0.1 0.09 0.081 0.0729 0.06561 0.59049 0 0    
9 0.1 0.09 0.081 0.0729 0.06561 0.59049 0 0 0  
10 0.1 0.09 0.081 0.0729 0.06561 0.59049 0 0 0 0

(b). Cumulative claims, given contingent events in (a) = image/ebx_-277487937.gif for s={0,1,…,t-1}

  s                    
t 0 1 2 3 4 5 6 7 8 9 10
0                      
1 0                    
2 10,000 0                  
3 20,000 10,000 0                
4 30,000 20,000 10,000 0              
5 40,000 30,000 20,000 10,000 0            
6 50,000 40,000 30,000 20,000 10,000 0          
7 60,000 50,000 40,000 30,000 20,000 10,000 0        
8 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0      
9 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0    
10 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0  

(c). Limited claims = image/ebx_1225108613.gif for s={0,1,…,t-1}

  s                    
t 0 1 2 3 4 5 6 7 8 9 10
0                      
1 10,000                    
2 10,000 10,000                  
3 10,000 10,000 10,000                
4 10,000 10,000 10,000 10,000              
5 10,000 10,000 10,000 10,000 10,000            
6 0 10,000 10,000 10,000 10,000 10,000          
7 0 0 10,000 10,000 10,000 10,000 10,000        
8 0 0 0 10,000 10,000 10,000 10,000 10,000      
9 0 0 0 0 10,000 10,000 10,000 10,000 10,000    
10 0 0 0 0 0 10,000 10,000 10,000 10,000 10,000  

 

(d). Probability * Limited claims = (a) * (c) = image/ebx_-1446400069.gif

  s                      
t 0 1 2 3 4 5 6 7 8 9 10 image/ebx_525925139.gif
0                       0
1 10,000                     10,000
2 5,263 4,737                   10,000
3 3,690 3,321 2,989                 10,000
4 2,908 2,617 2,355 2,120               10,000
5 2,442 2,198 1,978 1,780 1,602             10,000
6 0 900 810 729 656 5,905           9,000
7 0 0 810 729 656 5,905 0         8,100
8 0 0 0 729 656 5,905 0 0       7,290
9 0 0 0 0 656 5,905 0 0 0     6,561
10 0 0 0 0 0 5,905 0 0 0 0   5,905

(e). Present Value = image/ebx_-1847486583.gif

t image/ebx_-1739651473.gif image/ebx_-736877582.gif image/ebx_-256396241.gif image/ebx_-1665420104.gif image/ebx_-182518202.gif
0 0 0 1 1 0.00
1 10,000 0.1 0.9 0.952381 857.14
2 10,000 0.19 0.81 0.907029 1,395.92
3 10,000 0.271 0.729 0.863838 1,706.59
4 10,000 0.3439 0.6561 0.822702 1,856.29
5 10,000 0.40951 0.59049 0.783526 1,894.66
6 9,000 1 0.531441 0.746215 3,569.13
7 8,100 1 0.478297 0.710681 2,753.33
8 7,290 1 0.430467 0.676839 2,123.99
9 6,561 1 0.38742 0.644609 1,638.51
10 5,905 1 0.348678 0.613913 1,263.99
        Total 19,059.54

 

Note: This example can be checked by comparing to the present value of a Reversionary Annuity to Spouse that continues only for 5 years after the member’s death (i.e.,).

image/ebx_1386991753.gif

Combinations of Payment Forms

Lifetime maximum, annual caps, and spending accounts may cover Benefit Definitions with different payment forms. In this case, image/ebx_-763338701.gif depends on which benefit you are valuing, as shown in equations (4), (5), (6), and (7) below. Note: image/ebx_1279493430.gif is a sum of claims from all Benefit Definitions with Payment Form of:

image/ebx_1353220593.gif Life annuity to member

image/ebx_-118406261.gif Life annuity to spouse

image/ebx_-601936712.gif Joint life annuity to spouse

image/ebx_-1462552202.gif Reversionary annuity to spouse

When valuing benefit i with payment form of life annuity to member, we know that the member is alive at time t. We multiply by the probability of the spouse living or dying. Notes: image/ebx_-1396445265.gif is paid regardless of whether the spouse lives or dies; image/ebx_-1952431469.gif and image/ebx_-1454127151.gifstop the year after the spouse’s death (s+1); image/ebx_-1777028004.gif is not paid because the member is known to be alive.

(4) image/ebx_1615194806.gif

When valuing benefit i with payment form of life annuity to spouse, we know that the spouse is alive at time t. We multiply by the probability of the member living or dying. Notes: image/ebx_406539880.gif is paid regardless of whether the member lives or dies; image/ebx_-1228400708.gif and image/ebx_1927421615.gif stop the year after the member’s death (s+1); image/ebx_1422242195.gif begins the year after the member’s death (s+1).

(5) image/ebx_292370967.gif

When valuing benefit i with payment form of joint life annuity to spouse, we know that both the member and spouse are alive at time t, so there are no contingent events. Note: image/ebx_524663810.gifis not paid because the member is known to be alive.

(6) image/ebx_1911803424.gif

When valuing benefit i with payment form of reversionary annuity to spouse, we know that the member is dead and the spouse is alive. However, we do not know when the member died. We multiply by the probability that the member dies at time s given that we know the member is dead at time t. Notes: image/ebx_-652676847.gif is paid regardless of whether the member lives or dies; image/ebx_-2023907314.gif and image/ebx_1319409319.gif stop the year after the member’s death (s+1); image/ebx_1495646051.gif begins the year after the member’s death (s+1).

(7) image/ebx_-796402548.gif

 

Effect of percent married and election probabilities

The equations above assume one contingent life for every primary life.  That is, if the member participates then so does the spouse (or vice versa if valuing a spouse benefit).  This will not be the case if:

In these cases, ProVal determines the limited claims with and without a contingent life and then weights them by their respective probabilities, that is, by the probability that the contingent life participates (or doesn’t) given that the primary life participates.

 

EXAMPLE

Family lifetime maximum: 100,000 

Discount rate: 5%

 

Benefit Payment Form

x Life Annuity to Member

y Life Annuity to Spouse

 

t image/ebx_-1755753769.gif image/ebx_-1667132280.gif image/ebx_1369879139.gif image/ebx_5833690.gif
0 10,000 10,000 0.1 0
1 10,000 10,000 0 0
2 10,000 10,000 0 0
3 10,000 10,000 0 0
4 10,000 10,000 0 0.1
5 10,000 10,000 0 0
6 10,000 10,000 0 0
7 10,000 10,000 0 0
8 10,000 10,000 0 0
9 10,000 10,000 0 0
10 10,000 10,000 0 0

 

image/ebx_-1907566796.gif and image/ebx_-1199639191.gif represent the projected claims for benefits x and y, respectively.

image/ebx_832545413.gif and image/ebx_-1324763561.gif are developed below.

 

PART 1: Benefit x (x + y subject to family maximum)

(a). Probability of contingent events = image/ebx_612907109.gif

  s                    
t 0 1 2 3 4 5 6 7 8 9 10
0 1                    
1 0 1                  
2 0 0 1                
3 0 0 0 1              
4 0 0 0 0 1            
5 0 0 0 0 0.1 0.9          
6 0 0 0 0 0.1 0 0.9        
7 0 0 0 0 0.1 0 0 0.9      
8 0 0 0 0 0.1 0 0 0 0.9    
9 0 0 0 0 0.1 0 0 0 0 0.9  
10 0 0 0 0 0.1 0 0 0 0 0 0.9

 

(b). Cumulative claims, given contingent events in (a)

 = image/ebx_51940839.gif

  s                    
t 0 1 2 3 4 5 6 7 8 9 10
0 0                    
1 20,000 20,000                  
2 30,000 40,000 40,000                
3 40,000 50,000 60,000 60,000              
4 50,000 60,000 70,000 80,000 80,000            
5 60,000 70,000 80,000 90,000 100,000 100,000          
6 70,000 80,000 90,000 100,000 110,000 120,000 120,000        
7 80,000 90,000 100,000 110,000 120,000 130,000 140,000 140,000      
8 90,000 100,000 110,000 120,000 130,000 140,000 150,000 160,000 160,000    
9 100,000 110,000 120,000 130,000 140,000 150,000 160,000 170,000 180,000 180,000  
10 110,000 120,000 130,000 140,000 150,000 160,000 170,000 180,000 190,000 200,000 200,000

(c). Limited claims = image/ebx_825590000.gif

  s                    
t 0 1 2 3 4 5 6 7 8 9 10
0 10,000                    
1 10,000 10,000                  
2 10,000 10,000 10,000                
3 10,000 10,000 10,000 10,000              
4 10,000 10,000 10,000 10,000 10,000            
5 10,000 10,000 10,000 10,000 0 0          
6 10,000 10,000 10,000 0 0 0 0        
7 10,000 10,000 0 0 0 0 0 0      
8 10,000 0 0 0 0 0 0 0 0    
9 0 0 0 0 0 0 0 0 0 0  
10 0 0 0 0 0 0 0 0 0 0 0

 

(d). Probability * Limited claims = (a) * (c)

  s                      
t 0 1 2 3 4 5 6 7 8 9 10 image/ebx_-1357542971.gif
0 10,000                     10,000
1 0 10,000                   10,000
2 0 0 10,000                 10,000
3 0 0 0 10,000               10,000
4 0 0 0 0 10,000             10,000
5 0 0 0 0 0 0           0
6 0 0 0 0 0 0 0         0
7 0 0 0 0 0 0 0 0       0
8 0 0 0 0 0 0 0 0 0     0
9 0 0 0 0 0 0 0 0 0 0   0
10 0 0 0 0 0 0 0 0 0 0 0 0

(e). Present Value = image/ebx_-432549923.gif

t image/ebx_-415428144.gif image/ebx_-750982786.gif image/ebx_472151474.gif image/ebx_-357027882.gif
0 10,000 1 1 10,000
1 10,000 0.9 0.952381 8,571
2 10,000 0.9 0.907029 8,163
3 10,000 0.9 0.863838 7,775
4 10,000 0.9 0.822702 7,404
5 0 0.9 0.783526 0
6 0 0.9 0.746215 0
7 0 0.9 0.710681 0
8 0 0.9 0.676839 0
9 0 0.9 0.644609 0
10 0 0.9 0.613913 0
      Total 41,914

 

PART 2: Benefit y (x + y subject to family maximum)

(a). Probability of contingent events = image/ebx_1127218689.gif

  s                    
t 0 1 2 3 4 5 6 7 8 9 10
0 1                    
1 0.1 0.9                  
2 0.1 0 0.9                
3 0.1 0 0 0.9              
4 0.1 0 0 0 0.9            
5 0.1 0 0 0 0 0.9          
6 0.1 0 0 0 0 0 0.9        
7 0.1 0 0 0 0 0 0 0.9      
8 0.1 0 0 0 0 0 0 0 0.9    
9 0.1 0 0 0 0 0 0 0 0 0.9  
10 0.1 0 0 0 0 0 0 0 0 0 0.9

 

(b). Cumulative claims, given contingent events in (a)

 = image/ebx_153507645.gif

  s                    
t 0 1 2 3 4 5 6 7 8 9 10
0 0                    
1 20,000 20,000                  
2 30,000 40,000 40,000                
3 40,000 50,000 60,000 60,000              
4 50,000 60,000 70,000 80,000 80,000            
5 60,000 70,000 80,000 90,000 100,000 100,000          
6 70,000 80,000 90,000 100,000 110,000 120,000 120,000        
7 80,000 90,000 100,000 110,000 120,000 130,000 140,000 140,000      
8 90,000 100,000 110,000 120,000 130,000 140,000 150,000 160,000 160,000    
9 100,000 110,000 120,000 130,000 140,000 150,000 160,000 170,000 180,000 180,000  
10 110,000 120,000 130,000 140,000 150,000 160,000 170,000 180,000 190,000 200,000 200,000

(c). Limited claims = image/ebx_-1087899483.gif

  s                    
t 0 1 2 3 4 5 6 7 8 9 10
0 10,000                    
1 10,000 10,000                  
2 10,000 10,000 10,000                
3 10,000 10,000 10,000 10,000              
4 10,000 10,000 10,000 10,000 10,000            
5 10,000 10,000 10,000 10,000 0 0          
6 10,000 10,000 10,000 0 0 0 0        
7 10,000 10,000 0 0 0 0 0 0      
8 10,000 0 0 0 0 0 0 0 0    
9 0 0 0 0 0 0 0 0 0 0  
10 0 0 0 0 0 0 0 0 0 0 0

 

(d). Probability * Limited claims = (a) * (c)

  s                      
t 0 1 2 3 4 5 6 7 8 9 10 image/ebx_1673114924.gif
0 10,000                     10,000
1 1,000 9,000                   10,000
2 1,000 0 9,000                 10,000
3 1,000 0 0 9,000               10,000
4 1,000 0 0 0 9,000             10,000
5 1,000 0 0 0 0 0           1,000
6 1,000 0 0 0 0 0 0         1,000
7 1,000 0 0 0 0 0 0 0       1,000
8 1,000 0 0 0 0 0 0 0 0     1,000
9 0 0 0 0 0 0 0 0 0 0   0
10 0 0 0 0 0 0 0 0 0 0 0 0

(e). Present Value = image/ebx_-193479918.gif

t image/ebx_736099986.gif image/ebx_2037518846.gif image/ebx_2056210515.gif image/ebx_432471453.gif
0 10,000 1 1 10,000
1 10,000 0.952381 1 9,524
2 10,000 0.907029 1 9,070
3 10,000 0.863838 1 8,638
4 10,000 0.822702 1 8,227
5 1,000 0.783526 0.9 705
6 1,000 0.746215 0.9 672
7 1,000 0.710681 0.9 640
8 1,000 0.676839 0.9 609
9 0 0.644609 0.9 0
10 0 0.613913 0.9 0
      Total 48,085