In the fall of 2023, we posited that legacy long-term care (LTC) insurance blocks might be part of the next wave of merger and acquisition (M&A) and reinsurance deals.¹ This turned out to be at least partially true. Since our original article, three large M&A deals have been announced that were structured around legacy LTC blocks. We have also seen additional deals involving LTC risk (either standalone LTC or hybrid/combo LTC products) take place.

Given the increased activity observed, we thought it would be prudent to provide an update comparing our predictions to the actual activity and to summarize what can be learned from these transactions.

What LTC M&A transactions have taken place recently?

There have been three significant reinsurance transactions involving standalone LTC blocks since late 2023.

Manulife reinsured US$4.4 billion in LTC reserves to Global Atlantic on a coinsurance basis in a deal that was announced in December 2023 and closed in February 2024. The LTC block was mature, with an average attained age of 83 years for active (i.e., non-claimant) lives. The transacted block contained policies with richer benefits than Manulife’s remaining business, with a higher portion of insureds with lifetime benefits and inflation protection. The deal also included U.S. structured settlement and Japan whole life business with a total reserve value of US$9.7 billion. Manulife also disposed of US$1.3 billion in alternative long-duration assets (ALDA) in the deal. As part of the transaction structure, Global Atlantic retroceded the LTC biometric insurance risk to a highly rated third-party global reinsurer.^2,3

Manulife continued the momentum from its first LTC deal, announcing a second coinsurance transaction in November 2024 with RGA that included US$1.9 billion in LTC reserves, which subsequently closed in January 2025. Compared to the Global Atlantic deal, this transaction was on a younger block of business, with an average attained age of 75 for active lives. The deal had a total reserve value of US$4.1 billion and included a U.S. structured settlement block. Manulife disposed of US$1.1 billion in ALDA as part of the transaction.^4,5

In February 2025, Unum announced a deal with Fortitude Re to cede US$3.4 billion of individual LTC reserves, along with US$120 million of individual disability insurance (IDI) in-force premium, both on a coinsurance basis. The deal closed in July 2025 and represented about 19% of Unum’s total LTC block and 20% of Unum’s IDI in-force premium. Similar to the Manulife deal with Global Atlantic, Fortitude Re retroceded the LTC biometric risk to a highly rated third-party global reinsurer.⁶

In addition to these deals, the following additional activity involving LTC liabilities occurred over the last few years:

• In July 2023, RGA reinsured a block of LTC policies from MassMutual with reserves of approximately US$1 billion, which had previously been ceded to LifeCare Assurance Company. RGA then retroceded the assumed LTC risk to John Alden Life Insurance Company.⁷
• In November 2023, Fortitude Re closed a deal with Lincoln Financial Group to reinsure US$28 billion of statutory reserves, including LTC risk from Lincoln’s MoneyGuard hybrid life/LTC product.⁸
• In September 2025, Continental General recaptured ceded LTC risk from Munich Re on Kanawha LTC policies that Continental originally acquired from Humana in 2018. Ceded reserves prior to the recapture were approximately US$350 million.^9,10
• In October 2025, Dreamscape Industries acquired the LifeSecure Insurance Company legal entity, which included approximately US$650 million in LTC reserves.^11,12
• In November 2025, Aquarian Capital announced a deal to acquire the Brighthouse Financial legal entity. The entity contains standalone LTC risk that is mostly ceded along with LTC hybrid policies issued by Brighthouse. Brighthouse’s gross LTC reserves are over US$5.8 billion, whereas the net retained reserves are less than US$100 million.^13,14
• In December 2025, Hildene Capital Management announced a deal to acquire the SILAC legal entity, which includes approximately US$200 million in LTC reserves net of reinsurance.^15,16

M&A considerations for de-risking LTC insurance blocks: Predictions vs. reality

In our first article, we mentioned three considerations for an insurer looking to de-risk its LTC portfolio.

1. The business should represent “stable” portions of the LTC block that have higher certainty regarding liability cash flows. Some examples are blocks with a higher proportion of insureds who have started utilizing their benefits or blocks with smaller portions of policies with lifetime benefits or inflation protection riders.
2. The business should be “bite-sized” with LTC liabilities having between US$1 billion and US$3 billion in statutory reserves.
3. A seller should consider “packaging” an LTC block with a block consisting of simpler liabilities. This provides two possible benefits: an increased deal size to create a larger number of potential buyers and diversification benefits of having liabilities with different characteristics/economics.

With the flurry of LTC activity described above, how did these considerations fare?

First off, we correctly surmised that conditions were right for deals to start occurring with LTC blocks. The LTC reinsurance market had been very quiet for a number of years, so the volume of deals referenced above, including three larger deals involving standalone LTC policies, was definitely an uptick in activity. Most of the transactions also involved asset managers/private equity, which is consistent with the thought that LTC blocks provided targets of interest for these buyers.

Second, in each of the large transactions, the LTC risks were packaged with other lines of business. Additionally, both the first Manulife deal and the Unum deal involved older, more mature, and more stable LTC blocks. This was consistent with our expectations. However, “bite size” was bigger than we anticipated, with Manulife and Unum executing transactions that included more than US$3 billion in LTC reserves.

Recent LTC M&A trends and notable themes

With the increased LTC M&A activity, we have been able to study the deals for new learnings and themes and have observed some notable trends.

In two of the deals (Manulife/Global Atlantic and Unum/Fortitude Re), we saw the inclusion of a “highly rated third-party global reinsurer” to specifically reinsure the LTC block’s biometric risk. This move largely neutralizes the inherent volatility stemming from mortality and morbidity for the LTC policies reinsured by Global Atlantic and Fortitude Re in these deals and transfers it to the third-party global reinsurer. It is noteworthy that both Global Atlantic and Fortitude Re are owned or supported by large asset managers (KKR for Global Atlantic and Carlyle for Fortitude Re). De-risking the LTC biometric risks allows KKR and Carlyle to concentrate on the asset investment risk, which has been their historical forte.

After the first Manulife deal was announced, there was increased momentum for additional transactions. Manulife discussed how it was able to transact on different types of business after its second transaction (e.g., both an older, more mature block and a younger block with more active lives). Unum sustained this momentum with its own large transaction shortly after the second Manulife deal. We have since observed continued interest in the LTC market throughout 2025, and several smaller transactions were announced as detailed above, although no additional large LTC transactions have been announced to date. The increase in activity suggests that the market is becoming more comfortable valuing LTC risks.

A final observation is that the three large deals ceded LTC risk on a quota share basis, with the ceding company retaining a portion of the risk, along with administration of the business. This allows for incentives to be aligned between cedent and reinsurer in areas such as rate increases, claim administration, wellness programs, and fraud, waste, and abuse initiatives.

LTC transaction outlook: 2026 and beyond

With what we have learned from LTC transactions over the last few years, we confirmed some of our prior predictions and subsequently updated our expectations for the future LTC M&A market.

LTC blocks will likely continue to be part of ongoing deal discussions and M&A activity. As additional sources of capital are infused into the market (e.g., note the sizeable entry of Aquarian Capital as buyer of Brighthouse Financial), deals involving more vanilla liabilities will continue to see a large number of interested buyers. Given heightened competition and limited supply in the vanilla block deal arena, it would not be surprising to see a select subset of these buyers, especially those with more industry experience, turn their attention to more complex liabilities such as LTC. The volume of transactions over the last couple of years is indicative of growing confidence of potential buyers in their ability to understand LTC risk. We also expect continued partnerships between asset intensive buyers and traditional reinsurance companies so that asset and biometric risks can be shared and aligned with the risk appetite and expertise of each partner.

The Manulife deals demonstrated that different vintages of LTC blocks can be included in packages that are attractive to buyers.⁴ We expect LTC blocks with a variety of characteristics to be included in future deals, rather than only mature blocks. The risk appetite and target duration of the buyers will influence which blocks will transact, as the market includes a wide range of blocks that are young vs. old, individual vs. group, and richer benefits (such as lifetime benefit period and inflation protection) vs. leaner benefits. Although the deal sizes have been higher than the “bite size” that we speculated, we continue to believe that the LTC deals will be on the smaller side and include packaging with other liabilities to increase the overall deal size.

We believe that 2026 and 2027 will be key years in advancing momentum in LTC block transactions. The recent activity can provide a springboard for additional transactions as existing LTC blocks are reevaluated and potential new buyers enter the market. We look forward to supporting the industry through this new era.

¹ Bergerson, M, & Chaudhury, P. (2023, September 5). Could legacy long-term care (LTC) blocks be the next wave of M&A Deals? Milliman. Retrieved January 26, 2026, from https://www.milliman.com/en/insight/could-legacy-long-term-care-blocks.

² Manulife. (2023, December 11). Manulife announces $13 billion reinsurance transaction, including $6 billion of Long-Term Care. Retrieved January 26, 2026, from https://www.manulife.com/content/dam/manulife-com/ca/financial-documents/investors/MFC_2023_GlobalAtlanticReins_Slides.pdf.

³ Assumes a conversion rate of US$1 = CA$1.352.

⁴ Manulife. (2024, November 20). Manulife announces $5.4 billion reinsurance transaction, including $2.4 billion of long-term care, with RGA. Retrieved January 26, 2026, from https://www.manulife.com/content/dam/manulife-com/ca/financial-documents/investors/MFC_PR_2024_RGA_LTC_Reins_EN.pdf.

⁵ RGA. (2024, November 20). RGA announces US$4.1 billion coinsurance transaction with Manulife. Retrieved January 26, 2026, from https://investor.rgare.com/news-releases/news-release-details/rga-announces-us41-billion-coinsurance-transaction-manulife.

⁶ Unum Group. (2025, July 1). Unum Group closes $3.4 billion long-term care reinsurance transaction with Fortitude Re. Retrieved January 26, 2026, from https://investors.unum.com/news-events/news/news-details/2025/Unum-Group-Closes-3-4-Billion-Long-Term-Care-Reinsurance-Transaction-with-Fortitude-Re/default.aspx.

⁷ $976 million reserve credit as of December 31, 2024. Massachusetts Mutual Life Insurance Company. December 31, 2024 Annual Statement, Schedule S – Part 3 – Section 2. Retrieved January 26, 2026, from https://www.capitaliq.spglobal.com.

⁸ Jimenez-Sanchez, K. (2023, November 21). Fortitude Re closes $28bn reinsurance agreement with Lincoln Financial. Retrieved January 26, 2026, from https://www.reinsurancene.ws/fortitude-re-closes-28bn-reinsurance-agreement-with-lincoln-financial/.

⁹ Longacre Square Partners. (2025, September 2). Continental General announces recapture of block of Kanawha Life and long-term care policies. Retrieved January 26, 2026, from https://www.businesswire.com/news/home/20250902792649/en/Continental-General-Announces-Recapture-of-Block-of-Kanawha-Life-and-Long-Term-Care-Policies.

¹⁰ $362 million reserve credit as of December 31, 2024. Continental General Insurance Company. December 31, 2024 Annual Statement, Schedule S – Part 3 – Section 2. Retrieved January 26, 2026, from https://www.capitaliq.spglobal.com.

¹¹ LifeSecure Insurance Company. (2025, October 6). Dreamscape acquires LifeSecure Insurance Company, Ross Aron named president and CEO. PR Newswire. Retrieved January 26, 2026, from https://www.prnewswire.com/news-releases/dreamscape-acquires-lifesecure-insurance-company-ross-aron-named-president-and-ceo-302575808.html.

¹² $666 million net reserves as of December 31, 2024. LifeSecure Insurance Company. December 31, 2024 Annual Statement, Long-Term Care Experience Reporting Form 1. Retrieved January 26, 2026, from https://www.capitaliq.spglobal.com.

¹³ Aquarian. (2025, November 6). Aquarian Capital to acquire Brighthouse Financial. Retrieved January 26, 2026, from https://aquarianlp.com/blog/2025/11/06/aquarian-capital-to-acquire-brighthouse-financial/.

¹⁴ $5,880 million direct reserves and $79 million net reserves as of December 31, 2024. Brighthouse Life Insurance Company. December 31, 2024 Annual Statement, Long-Term Care Experience Reporting Form 1. Retrieved January 26, 2026, from https://www.capitaliq.spglobal.com.

¹⁵ Araullo, K. (2025, December 8). Hildene to buy SILAC in $550 million all-cash annuity play. Insurance Business. Retrieved January 26, 2026, from https://www.insurancebusinessmag.com/us/news/mergers-acquisitions/hildene-to-buy-silac-in-550-million-allcash-annuity-play-559285.aspx.

¹⁶ $211 million net reserves as of December 31, 2024. SILAC Insurance Company. December 31, 2024 Annual Statement, Long-Term Care Experience Reporting Form 1. Retrieved January 26, 2026, from https://www.capitaliq.spglobal.com.