Senior Health Insurance Co. of Pennsylvania (SHIP): 2026 Status

Where SHIP stands today

For almost every policyholder, the choice between a rate increase and a benefit cut has already been made. The Rehabilitator’s site says Election Packages went to almost 28,000 policyholders between 2022 and 2025, and that “the Rehabilitator has completed all of the modifications required by the Approved Plan and all impacted policies have been modified accordingly.” The newsletter for Fall/Winter 2025 adds that in July 2025 the packages were mailed in the last remaining states. There is no open election window for the people the plan covered. Two groups are different and are covered below: the reinsured policies, and policies issued in North Dakota and Iowa.

Source: SHIP website (shipltc.com), Pennsylvania Supreme Court opinion No. 71 MAP 2021, NOLHGA FAQ of July 1, 2023, Rehabilitator’s annual report filed March 28, 2025, Wisconsin Insurance Security Fund.

The numbers the Rehabilitator has filed

Each spring the Rehabilitator files an annual report with the Commonwealth Court, with a financial package for the previous year-end. We read the reports filed March 31, 2022, April 10, 2023, March 31, 2024 and March 28, 2025. We could not open a 2026 report, so December 31, 2024 is the latest filed figure we can quote.

Source: Rehabilitator’s annual reports filed March 31, 2022, April 10, 2023, March 31, 2024 and March 28, 2025, Commonwealth Court No. 1 SHP 2020. The 2021 report says “total value of SHIP’s assets”; the later ones say admitted assets.

Our arithmetic: from 2021 to 2024 assets fell 58.2% ($1.242 billion to $519 million) and liabilities fell 29.2% ($2.531 billion to $1.792 billion), so assets shrank about twice as fast as liabilities. The 2023 improvement was liabilities, which dropped $529 million that year; in 2024 the report names a continued decline in income on invested assets, lower premium collection and revised actuarial assumptions as the main drivers of a $153 million deterioration. The Rehabilitator’s March 28, 2025 report says the plan has reduced projected policy liabilities by more than $500 million, and that a funding deficit of more than $1 billion remains.

How many policies are left depends on who counts. The Supreme Court opinion records 39,148 outstanding active policies at December 31, 2020, almost 10 percent held by Pennsylvanians (3,862), with an average policyholder age of 86 and 47 percent paying no premium because of premium waiver or a non-forfeiture option. The Wisconsin Insurance Security Fund says SHIP had “over 18,000” long-term care policyholders at December 31, 2025, 286 of them in Wisconsin. Those are two different counts from two different sources and we do not subtract one from the other.

The five options, and what policyholders chose

The plan sorted policyholders by whether the premium they paid was below the “If Knew Premium”, the premium that, charged from the start, would have produced a 60 percent lifetime loss ratio. Those below it had to choose; those at or above it could keep the policy unchanged. The Approved Plan describes the options as follows; the result columns are from the Election Status Report at December 31, 2024 and the SHIP newsletter for results at March 31, 2025.

Source: Approved Rehabilitation Plan (corrected September 30, 2021), section I.A.2 (summary description of the plan); Election Status Report as of December 31, 2024 (Exhibit B to the annual report filed March 28, 2025); The Navigator, Spring/Summer 2025.

Our arithmetic: at December 31, 2024, 48.6% of policyholders ended up with a reduced or converted policy (10.7 + 12.6 + 6.5 + 18.8) and 51.4% kept their benefits at a higher premium. About 88 percent returned an election form on time; the other 12 percent received the default option. The Rehabilitator says about 9,800 policyholders in force at December 31, 2024 made elections that would not have been available in liquidation, about 62 percent of the responses. Among premium-waiver policyholders, 2,233 chose options requiring a differential premium; 1,959 of them pay $5,000 or less and the rest up to more than $14,000.

Elections cannot be reopened on request. The plan says policyholders could change an election only before the Policyholder Election Date, and that a defective form meant the default option applied. The NOLHGA FAQ states that “any changes made to your SHIP policy as part of the rehabilitation are permanent changes.”

Who the plan did not reach, and the court fights

Reinsured policies. SHIP reinsured and administered certain long-term care policies of Transamerica, Primerica and American Health & Life. SHIP’s site says those policies were excluded from the plan: they were not modified, their holders made no elections, and SHIP is not financially responsible for the claims. Transamerica recaptured its policies effective October 1, 2020. The same page says that if SHIP were liquidated these policyholders would receive no guaranty association benefits and the three insurers would remain responsible, and that those insurers might seek future rate increases.

Opt-out states. The plan let states set their own rates. The Rehabilitator’s statement of December 21, 2021 counted eleven states and the District of Columbia (just over 19 percent of affected policies); by March 24, 2022 five of twelve had opted back in, leaving fewer than 1,200 policyholders. The fourth and last election distribution, about 800 opt-out policyholders, had not been scheduled at the date of the March 2025 report.

Iowa and North Dakota. Insurance commissioners in both states obtained state-court orders against implementing the plan. On March 11, 2025 the Commonwealth Court ordered modification of SHIP policies issued in each state: a policyholder had 60 days to ask the Rehabilitator in writing for information about the opt-in options, and a policyholder who did not ask could be modified under a “court default.” About 450 policyholders in the two states had not yet been mailed election packages when the March 28, 2025 report was filed. On April 15, 2025 the Rehabilitator’s counsel told the North Dakota court it would stop taking part in that case, writing that “keeping the current policies at the current premiums was not an option for around two thirds of SHIP’s policyholders.” If you hold a policy issued in either state, ask SHIP in writing which order applies to your policy.

If SHIP goes into liquidation

Rehabilitation and liquidation are different court orders. The Insurance Commissioner said in December 2021 that the plan was designed so that every policyholder in a state that stayed in the plan had at least one option giving potential benefits no less than a guaranty association would in liquidation, and that if SHIP were liquidated later, guaranty association benefits would still be available. NOLHGA, the trade group of the state associations, says the association of the state where you live at the time of liquidation generally continues coverage, that it guarantees “the lesser of the applicable statutory coverage limit or the amount you are entitled to receive under your policy,” and that the long-term care limit is $300,000 in most states. Which statute governs your state is a state-law question; our guaranty limits by state table covers annuity limits and shows how the combined $300,000 cap works in the states we read, but it is not a long-term care table.

Worked example (our arithmetic, not a prediction): a policy with $400,000 of remaining benefits in a state with a $300,000 long-term care limit would be guaranteed up to $300,000, or 75 percent of the $400,000. A policy that was downgraded under Option 1 to $250,000 of benefits would be guaranteed in full at $250,000 under the same limit. This is why the Insurance Commissioner’s 2021 statement estimated that at least 40 percent of policyholders would have claims above the guaranty limit, and why the choice mattered mainly for people with large benefit pools.

The Wisconsin Insurance Security Fund’s notice, dated October 29, 2026, is the only 2026 document we found that gives a direction. It says SHIP’s “financial situation has continued to deteriorate,” that on October 29, 2026 “it appears likely the company will enter liquidation in 2027,” and that to keep eligibility for benefits and continuation a policyholder must keep the policy in force. It is a guaranty fund’s statement and not a filing by the Rehabilitator or an order of the Commonwealth Court.

Next dated events

We found no hearing, vote or deadline on the docket for the next 60 days. The Rehabilitator filed annual reports on April 1, 2021, April 1, 2022, April 10, 2023, March 31, 2024 and March 28, 2025; by that pattern the next would be due around the start of April 2027 (our inference, not a court order). Watch for three documents: a Rehabilitator’s petition or application on Phase Two or liquidation in docket No. 1 SHP 2020; the Rehabilitator’s next annual report with its December 31, 2025 financial package; and notices from your state’s guaranty association. The docket itself is held by the Pennsylvania Unified Judicial System and the filings are mirrored on SHIP’s court documents page.

What this means if you hold a SHIP policy

This is analysis of public documents, not investment, legal or tax advice.

What a reader can do with this

• Keep the policy in force while you decide. SHIP’s FAQ answers whether there is a grace period with a plain “Yes”, and the Wisconsin notice says you must keep the policy in force to keep eligibility. Premium notices go out 20 days before the due date; if one does not arrive, call (877) 450-5824, which SHIP lists for customer service.
• Get your own paperwork in one place: the Rehabilitation Policy Endorsement and the Schedule of Benefits that SHIP mailed after your election, and the yearly Summary of Current Coverage. These documents define what the policy pays now.
• Put a trusted person on file. SHIP lets you name up to three third party designees who are told if the policy is about to lapse for unpaid premium, and accepts a power of attorney sent to P.O. Box 64913, St. Paul, MN 55164.
• File claims as soon as care starts. SHIP’s newsletter says you need not wait for an elimination period to end before filing, and that doing so does not change how the elimination period is applied.
• Ask SHIP in writing two questions: which election is recorded for the policy and what its remaining maximum benefit is; and, if you bought it under a state partnership program, whether the modified policy still qualifies. Our page on the long-term care partnership program explains what the Medicaid asset disregard depends on.
• Check the tax side separately. Premiums and benefits on a tax-qualified policy follow the rules on our pages for the premium deduction limits by age and hybrid long-term care policies.
• If a Medicaid application may come, read our guide to estate recovery by state before moving assets.

FAQ

Sources, read and saved on November 9, 2026: SHIP in Rehabilitation website, shipltc.com (About SHIP; About Rehabilitation; Other Rehabilitation Information; Common Questions; Newsletters; Important Communications); Pennsylvania Insurance Department press release of February 3, 2020; Approved Rehabilitation Plan, corrected September 30, 2021; Commonwealth Court of Pennsylvania No. 1 SHP 2020, Rehabilitator’s annual reports filed March 31, 2022, April 10, 2023, March 31, 2024 and March 28, 2025, and orders of March 11, 2025 directing modification of SHIP policies issued in North Dakota and Iowa; Supreme Court of Pennsylvania, In re Senior Health Insurance Company of Pennsylvania (In Rehabilitation), No. 71 MAP 2021 [J-54-2022], opinion filed January 29, 2024; Rehabilitator’s statements of December 21, 2021 and March 24, 2022; Cozen O’Connor letter of April 15, 2025 to the Burleigh County District Court; NOLHGA, SHIP Frequently Asked Questions, July 1, 2023; Wisconsin Insurance Security Fund, update of October 29, 2026.