PRICING MODELS AND OPTIONS Continuing Care at Home: Finding Success in a Brave New World SUSAN HAWKINS Executive Director, Cadbury Consulting

CONTRACT DESIGN  Continuing Care at Home programs offer contracts similar to CCRC Type A and Type B Lifecare contracts  Plan options evolved as we better understood our consumers  Pricing based on: Period of service coverage Services included and costs (in today’s dollars) Defined cap (daily and lifetime) Elimination period Inflation coverage Underwriting Consulting

FEE STRUCTURE Consulting  One time membership fee based on age and plan option  Monthly fee based on plan option  Discount for couples  Tax deductible as a medical expense  Monthly fees have annual increases

PLAN OPTIONS Consulting All Inclusive Plans – Traditional Lifecare Lifetime coverage All services included No co-pays 2% declining refund Member fees range $46,337 - $86,433 Monthly fees range $366 - $566

PLAN OPTIONS Consulting Co-Pay Plans Lifetime coverage All Services included 2% Declining Refund Co-pay when services are needed - 15% for home care services - 30% for community based services Member Fees range - $36,078 -$69,436 Monthly Fees range - $345 - $545 Other co-pay amount plans

PLAN OPTIONS Consulting Home Care Plans Lifetime coverage Only home care services included 2% declining refund Assisted living or nursing care available fee-for-service Member fees range $16,487 - $38,554 Monthly fees range $269 - $468 Additional options for community-based care

PLAN OPTIONS Consulting Refundable Options Same lifetime benefits as All Inclusive 90% Refundable Member Fees range $99,199 - $262,341 Monthly Fees $466 Blending with Long-Term Care Insurance Evaluate individual policy benefits Credit insurance benefit toward program costs Program costs will vary depending on policy benefits

PLAN OPTIONS Consulting Type B Options Small membership fees included in monthly fees Defined limits and coverage options similar to long-term care insurance, e.g. waiting period; daily benefit limit; lifetime benefit limit; etc. Prices are lower because benefit is limited Daily benefit $75 - $250 Elimination period days Appeals to a younger member Provides less up front cash to cash flow new program

PLAN VARIATIONS Consulting  Co-pay options of 15%, 20%, 25%, 30% and 50%.  Facility only plans  Refundable options of 25% and 50% (this adds life insurance to the long-term care insurance)  Elimination periods of 0, 30, 60 and 90 days  Varying daily and lifetime caps

PLAN VARIATIONS Consulting  Flexible payments – higher member/lower monthly, lower member/higher monthly  Membership fee paid over a number of years  Consultative Care on a fee-for-service basis or a package of care coordination and services  Care coordination navigation  Wait List options  Referral and concierge programs  Additional community programs and activities