Group Long-Term Care CNA Long-Term Care Contents

Group Long-Term Care

CNA Long-Term Care Contents Overview Category Long Term-Care Services / Definitions Plan Highlights / Description of Benefits New York Partnership Plan Portability Qualifying for Benefits Eligibility / Who Can Enroll Premium Administration Claims Contacts / Customer Service Page 3 -5 6 -18 19 -20 21 22 23 -25 26 -28 29 -34 35 -36 37 -39

What is Long-Term Care? z Long-Term Care is a variety of services available to individuals who are unable to care for themselves z Services can be provided on a temporary or permanent basis z Services can range from simple help with meal preparation, to assistance with dressing or bathing, to complete 24 - hour monitored care 3

Where are Long-Term Care Services Provided? z Institutions • Nursing Home Facility • Alternate Care Facility • Hospice Care Facility z Community-Based Services • Home Health Care • Adult Day Care / Adult Foster Care • Home Hospice Care • Assisted Living Facilities 4

Assisted Living Facility z Eligible expenses for needed services that exceed standard charges for basic housing z Home-like environment, i. e. apartment complex or residential community z Insured allowed to make decisions and have control over life z Facility provides a combination of housing, personal support services and health care z Paid at community-based care benefit level 5

The Research Foundation Plan Highlights z Daily Nursing Home Benefits z Community-Based Care Benefit z Lifetime Maximum Benefit z Caregiver Training Benefit z Temporary Bed Holding Benefit z Emergency Alert Benefit z Care Assist Benefit 6

The Research Foundation Plan Highlights z Inflation Protection y. Standard x. Guaranteed Benefit Increase y. Optional x. Lifetime Automatic Benefit Increase z Waiting Period z Waiver of Premium 7

Daily Benefit Amounts z Daily Nursing Home Benefit y$100, $150, $180, $250 z Community-Based Care Benefit y 60% of daily nursing home benefit selected y$60, $90, $108, $150 8

Lifetime Maximum Benefit z Pool of available funds for eligible long-term care expenses z Based on the daily nursing home benefit selected and Lifetime Maximum Option chosen z Three Options Available y 1095 times the daily nursing home benefit(3 year) y 1825 times the daily nursing home benefit(5 year) y 5000 times the daily nursing home benefit(13. 5 year) 9

Lifetime Maximum Benefit z 1095 X (3 year) Lifetime Maximum $100 = $109, 500 $180 = $197, 100 $150 = $164, 250 $250 = $273, 750 z 1825 X (5 year) Lifetime Maximum $100 = $182, 500 $150 = $273, 750 $180 = $328, 500 $250 = $456, 250 z 5000 X (13. 5 year) Lifetime Maximum $100 = $500, 000 $150 = $750, 000 $180 = $900, 000 $250 = $1, 250, 000 10

Caregiver Training Benefit z Training for an informal caregiver to provide care for insured z Pays actual cost up to 3 times the community -based care daily benefit amount: Example: $60 x 3 = $180 11

Temporary Bed Holding z Pays up to the daily nursing home benefit for fees charged by a nursing home when insured leaves due to a temporary absence (i. e. , hospitalization) y. The payment is required by the nursing home y. Benefits available up to 21 days per year Example: $100 x 21 = $2, 100 12

Emergency Alert z Pays for the rental of home emergency alert system z Reimburses actual monthly cost up to community-based care daily benefit: Example: $60/month 13

Care Assist Benefit z Provides benefits to allow informal caregiver the opportunity to take time away from responsibilities y. No waiting period applies y. Daily maximum is available up to 21 days per year y. Another informal caregiver may assist in the care of the insured 14

Waiting Period & Waiver of Premium Waiting Period z 90 calendar days following the date claimant is certified as chronically ill by Licensed Health Care Practitioner Waiver of Premium z Waives premiums which become due while receiving benefits z Begins after completion of the 90 day waiting period z If long term care services are no longer required, premiums will be waived for an additional 6 months 15

Inflation Protection Guaranteed Benefit Increase z Opportunity to purchase additional amounts of coverage z Timing of offers determined by The Research Foundation and CNA z Additional coverage guaranteed issue (GI) during “buy-up” periods only z Premium for additional benefit amount based on age when purchased z Premium for original benefit amount is not affected 16

Inflation Protection Example: 6/1/2003 — Age at entry = 40 Purchased 5 year(1825 x) plan with $100 daily benefit Bi-weekly premium = $6. 34 6/1/2006 — Now 43 years old - Accepts CNA offer to purchase additional coverage of $20. Bi -weekly cost for additional $20 = $1. 52 z New daily benefit = $120 z New Bi-weekly premium = $7. 86 z Note - Premium lower than someone just entering plan with same age and daily benefit amount (ex: New participant Age 43 Daily Benefit - $120 Bi-weekly Prem. $9. 11) 17

Inflation Protection Optional Benefit Lifetime Automatic Benefit Increase z All benefit amounts will automatically increase on each anniversary date of the insured’s coverage z Benefits will increase each year at a rate of 5% of the prior year’s amount z Compared to the Standard Plan, premiums will be two to three times greater, based on the insured’s age at time of purchase 18

New York Partnership Plan z Conforms to Basic Plan design in accordance with the New York Partnership for Long-Term Care z Provides asset protection when/if Long-Term Care benefits are exhausted y Must be a resident of New York(or return to NY) to receive the Medicaid Extended Coverage portion z Does not include many of the features included in The Research Foundation’s standard plans y Emergency Alert, Caregiver Training, Care Assist y Lower Community based care benefit percentage 19

New York Partnership Plan z Basic Plan Design y Maximum Daily Benefit for Nursing Home x$163(2003 minimum), $250 y Community Based Care x 50% of nursing home benefit y Lifetime Maximum x 1095 X(3 year) times the Daily Nursing Home Benefit y 100 day waiting period before benefits begin y 14 day respite benefit x. Similar to care assist except respite care must be provided by a formal(licensed) caregiver y Lifetime Automatic Benefit Increase is included x. Required for the NY Partnership Plan 20

Portability z Continuation of Coverage y. No change in benefits / rates y. No action necessary by Insured y. Receives a bill directly from CNA xquarterly, semi-annually or annually xmonthly - electronic funds transfer 21

Qualifying for Benefits z Must have a qualifying impairment y. Unable to perform, without substantial assistance, 2 of 6 Activities of Daily Living Bathing Transferring Continence Toileting Dressing Eating y. Cognitive Impairment requiring substantial supervision ( ex. Alzheimer’s Disease) z Impairment certified by licensed health care practitioner (i. e. physician) z Satisfy 90 calendar day waiting period 22

Who Is Eligible For Coverage? z Employees eligible for coverage yactively at work at least half time on a regular salaried schedule y 6 months of employment y. On payroll at the time of application z When to enroll with Guaranteed Issue y. During Special Open Enrollment 4/1/03 -4/30/03 y. Newly eligible for coverage - within 60 days following completion of 6 months of employment z Late Entrant Employees y. If enrolling at any other time, must provide evidence of insurability and coverage is not guaranteed 23

Who Is Eligible For Coverage? Certain family members z Spouse / Domestic Partner of eligible employee ymay apply at any time via a short form application ycoverage is not guaranteed ymust provide evidence of insurability and be approved 24

Who Is Eligible For Coverage? z Retirees and their spouses z Parents, Parents-in-law z Grandparents, Grandparents-in-law ymay apply for coverage at anytime via a long form application ycoverage is not guaranteed ymust provide evidence of insurability and be approved 25

What Determines Your Premium z Premiums are per individual z Coverage selected y Daily Benefit, Lifetime Maximum, Optional Lifetime Automatic Benefit Increase z Age as of coverage effective date z Effective date y Employees enrolling between April 1, 2003 through April 30, 2003…. effective date is June 1, 2002 z Others - First of the month following underwriting approval of coverage 26

Level Premiums z Premiums are based on age on effective date of coverage z Do not increase as you get older yincreases only if additional coverage is purchased or if y. CNA requests increase in rates for all insureds 27

Payment of Premium z Payroll deduction y. Eligible Employees y. Their Spouses / Domestic Partners y. Premiums deducted on an after-tax basis z Direct bill y. Retirees and their spouses, Parents, Grandparents (in-laws) y. Payment options available xquarterly, semi-annually or annually xmonthly-electronic funds transfer 28

Administration z Leave of Absence y. Not eligible for coverage until return to actively-at-work status yeligible for GI if done within eligibility timeframe (60 days following return to work) z Late Entrants y. Apply at anytime y. Coverage is not guaranteed y. Must complete short form application and be approved 29

Administration z Changes / cancellations / decreases in coverage allowed throughout the year z Employees must call CNA Group Long-Term Care Customer Service z CNA will make appropriate changes once notified by telephone or written request z Will notify The Research Foundation via monthly payroll update / billing to discontinue payroll deductions 30

Administration Effective Date of Coverage z CNA sets effective dates for all insureds z Effective dates are always the 1 st of the month z Effective dates based on y when enrollment forms / applications are received and coverage approved y Cut-off date for next monthly payroll / billing file 31

Administration Billing (Central Office Responsibility) z CNA sends monthly payroll update / billing file to The Research Foundation ystatement will reflect payroll deduction amount (Bi-Weekly) for each employee or spouse / domestic partner insured yshows deduction amount to be taken per pay period y. Pass changes in payroll deductions x. Codes N=new D=delete C=change 32

Administration Billing (Central Office Responsibility) z CNA will send a “short pay” statement to individual insureds if: ypremium shortages occur yno payroll deduction dollars received z CNA will direct bill participants due to yleave of absence ytermination (offer continuation of coverage) yafter 90 days if no payroll deduction premium received 33

Administration Claims z Notify CNA by calling 800 number z Claim Specialist discusses ycontract provisions yclaim process yrequests completion of authorization form medical records yschedule appointment w/Care Manager 34

Administration Claims z Care Manager yconducts telephone assessment interview ygathers information about functional and cognitive impairments yidentifies qualifying impairment y. Plan of Care is developed 35

CNA Contacts for The Research Foundation z Account Management-Corporate Steve March, National Account Manager 407 -919 -1951 (fax 407 -919 -1882) steven. march@cna. com z Account Management-Sales and Service Roxanne Price, Account Service Representative 585 -249 -7925 (fax 585 -249 -7905) roxanne. price@cna. com z Day-to-day Administration Rosemary Buchelli, Account Service Manager 407 -919 -1920 (fax 407 -919 -1880) rbuchelli@ltcg. com 36

Employee Questions? CNA CUSTOMER SERVICE: 1 -877 -777 -9072 HOURS OF OPERATION: Monday thru Friday 8: 00 a. m. to 6: 00 p. m. (ET) CNA Web Site for The Research Foundation www. ltcbenefits. com password: trfsunygltc 37

Mailing Address PO BOX CNA GLTC P O Box 946760 Maitland, FL 32794 -9776 STREET ADDRESS/OVERNIGHT CNA GLTC 65 Keller Road Orlando, FL 32810 38