69
1 Get in the game with Humana! Let’s huddle up to discuss Humana’s integration with Cariten Healthcare! Broker Kick Off Event - Thursday, July 30

Kick-Off Presentation - July 30, 2009

  • Upload
    humana

  • View
    1.161

  • Download
    4

Embed Size (px)

Citation preview

Page 1: Kick-Off Presentation - July 30, 2009

1

Get in the game with Humana!

Let’s huddle up to discuss Humana’s integration with Cariten Healthcare!

Broker Kick Off Event - Thursday, July 30

Page 2: Kick-Off Presentation - July 30, 2009

2

Game Plan

Welcome & Humana Overview - Evans Looney

Integration Update - Tim Moorhead

Products, Solutions and Quote Processes

– Large Group & Specialty - Tim Moorhead

– Small Business & Specialty - Bryan Wenger

Q&A

Page 3: Kick-Off Presentation - July 30, 2009

3

Welcome & Humana Overview

Evans Looney

Page 4: Kick-Off Presentation - July 30, 2009

4

Fortune 100 company with revenues of approximately $30 billion, employing 29,000 associatesOne of the nation’s largest publicly tradedhealth benefits companies; founded in 1961 as nursing home and later evolved to hospital operator10.4 million medical members nationwideMore than 5 million specialty product members110 hospital system clients; largest single industry Integrated national networks with 450,000+ providersFirst health benefits company awarded ISO 9000Ranked #6 among all U.S. companies in all sectors for technology leadershipOffer full spectrum of consumer-choice solutions Industry-leading clinical, network, eHealth, service and technology solutions

National Snapshot

Page 5: Kick-Off Presentation - July 30, 2009

5

Integration Update

Tim Moorhead

Page 6: Kick-Off Presentation - July 30, 2009

6

Integration Journey

Where we have been…

Acquired Cariten/PHP on October 31, 2008Developed an integration plan to leverage strengths of both organizationsAligned Cariten teams within Humana structureCombined Cariten’s regional network with Humana’s national network to increase provider access and employer savingsAdded Open Access HMO and NPOS products to Humana-Tennessee’s portfolio of Traditional and Consumerism solutions

Page 7: Kick-Off Presentation - July 30, 2009

7

Commercial Network Strategy

PPOHMOPOS

PPOChoiceCare

ChoiceCare +Preferred PPO

HMOHMO PremierHMO Select

POSPreferred POS - OA

NPOS-OANPOS-OA+

Expansion to national &regional

network solutions

Humana Provider Networks

Cariten Provider Networks

Page 8: Kick-Off Presentation - July 30, 2009

8

Network Strength

Highly stable networks and positive provider

relationships

Humana ranked #1 in annual PayerView rankings by

Phyisician’s Practice magazine

Leading the industry to streamline claims process,

simplifying back office systems for doctors’ offices

In short – providers prefer us and that means fewer network disruptions for members

Page 9: Kick-Off Presentation - July 30, 2009

9

Our Medical Networks

National PPO & NPOS Networks

HMO (Most Competitive Cost of Care)

Humana Preferred Networks (HPN)

KnoxvilleTri-Cities

Page 10: Kick-Off Presentation - July 30, 2009

10

Humana Portfolio• PPOs• HDHP & HRA Plans• Gated HMO• Open Access HMO• National POS• CoverageFirst• SmartSuite• SmartResults• HumanaRewards• HumanaRX Solutions• HumanaOne• Humana Specialty

Commercial Product Strategy

Cariten Portfolio• PPOs • HDHPs• Gated HMO• POS• Sevier First• Vendor RX Support

Planful transition to Humana

solutions as business renews

Page 11: Kick-Off Presentation - July 30, 2009

11

Commercial Branding

Transition Branding Starting TODAY

Page 12: Kick-Off Presentation - July 30, 2009

12

Integration Journey

Where are we going…

New Humana Product Portfolio with Enhanced NetworkQuote new business starting 8/1/09 for 9/1/09 and later effectivesOffer Humana renewals to existing business starting 12/1/09

Create a Superior Experience …Broker and employer education sessionsProvider communications and education sessionsMember communications

Page 13: Kick-Off Presentation - July 30, 2009

13

New Business Quotes

Quoting & Effective Dates– Medical Products

– Quoting August for effective dates of September and later– Dental, Life, Disability, Voluntary, Stop Loss and Worksite Products

– Already in place

Get a Quote!– Small Business

– Contact your sales representative for 2-99 eligible employee groups– Go online to Easy Rate at Humana.com for single-location, 2-50 groups– Call Easy Rate at 1-800-327-9728 or 1-800-243-6827 for 2-99 groups– Fax to 1-800-344-3294 or 1-800-432-4805 for 2-99 groups– Email [email protected] for 2-99 groups

– Large Group– Contact your sales representative for 100-999 eligible employee groups– Contact Barry Boster at 615.221.2155 ext. 1030610 for 1000+ groups

Page 14: Kick-Off Presentation - July 30, 2009

14

Integration of Cariten Producer Compensation

Maintain (i.e., “grandfather”) existing commission schedules on customers initially sold Cariten plans, even after migration to Humana products and platform

All new business sold with a September or later effective date will be compensated based on Humana commission schedule and our Volume Growth bonus programs (Cariten had no volume-based program. We will credit all Cariten medical production, in force prior to 2009 and new in 2009, towards Humana's bonus(es) and Leader's Club criteria.)

Concierge service to handle your claims, billing, and enrollment, as well as customer service issues

HumanaWatch, a daily e-mail with news coverage about Humana, our competitors, and the healthcare industry

Preferred quote and new case processing

Invitation to special events with Humana leaders

Free continuing education courses

Leaders Club

Page 15: Kick-Off Presentation - July 30, 2009

15

Large Group Solutions(100 or more eligible employees)

Tim Moorhead

Page 16: Kick-Off Presentation - July 30, 2009

16

Our Approach

A comprehensive approach to help members manage their health through behavior change and improve their experiences in choosing, financingand using their benefits

•Engages consumers in sustainable behavior change•Involves action and participation of all parties

• Employers, members, providers, brokers, and Humana

•Results in improved health status for employees and an improved bottom line for employers

Page 17: Kick-Off Presentation - July 30, 2009

17

Financial Analysis and Forecasting

Product and Network Design

Consumer Education

Clinical Programs and Forecasting

Financial Analysis and Forecasting

The Humana

Guidance Solution

• Traditional plans • Disease Management• Transplant Management• Utilization Management• Concurrent Review• Case Management• HumanaBeginnings• HumanaFirst®

Clinical Programs and ForecastingProduct and Network Design

Consumer Education

The Humana Guidance Solution

2000

Page 18: Kick-Off Presentation - July 30, 2009

18

2008

Financial Analysis and Forecasting

Product and Network Design

Consumer Education

Clinical Programs and Forecasting

Financial Analysis and Forecasting

The Humana

Guidance Solution

• Traditional plans• Real-time operating platform • SmartSuite®

• CoverageFirst® PPO • HumanaAccessSM card• RxImpact• Wellness programs• Medical spending accounts• HDHP with Health Savings Account • Humana Preferred• 90-Days-at-Retail Program• RightSourceSM

• SmartResultsSM

• Online Enrollment Center and Wizard• MyHumana personal Web page• Physician Finder Plus• Transparency tools • Healing Kitchen• Family Health Budget• Comparative Pricing by Pharmacy• YourHumana Handbook• SmartSummarySM

• Disease Management• Transplant Management• Utilization Management• Concurrent Review• Case Management • HumanaBeginnings• HumanaFirst®• Humana Health Assessment • Personal Nurse®

• MyHumana personal web page • Maximize Your Benefit• Predictive modeling • Health Agent• Pharmacy MEDS Team

• SmartStart• Customer Reporting Package• Benefit Utilization Director for brokers• Employer portal tools• RxCalculatorSM

• Pharmacy Repricing and Formulary• Verisight Analysis• MD Consultation

Product and Network Design

Consumer Education

Clinical Programs and Forecasting

The Humana Guidance Solution

Page 19: Kick-Off Presentation - July 30, 2009

19

Product: A Multi-Year, Phased Approach

Low High

Single & DualOption TraditionalPlans Only

Transitional Plan Strategyand Clinical Guidance• Triple option, incl. a CDHP• “Bridge” contribution strategy • Reduce acute illness and chronic

condition costs• Early-stage impact on cost trend via

initial consumer engagement

Employer/Employee Engagement

Val

ue o

f Ben

efits

Stra

tegy

No/

Low

Hig

hTraditional Plans andDisease Management• Reduce acute illness costs• No consumer engagement

Smart Products and Population Health Management• 3-6 plans (min. of 2 CDHPs)• Defined contribution strategy• Reduce risk/cost variability• Moderate cost trends over time• Behavior change via actionable

information/transparency, clinical outreach/guidance and wellness/ workplace productivity initiatives

Premise #1: 12 months does not make a trendPremise #2: Consumers want choicePremise #3: There is no silver bullet

Page 20: Kick-Off Presentation - July 30, 2009

20

SmartResultsSM In Three Easy Steps

Employer chooses the plan strategy

Partnered approach for employee engagement

Employer, broker & Humana monitor progress against

targets

SmartSuiteTransitionalTraditional

• Trend factor as low as 9%

• Trend factor as low as 7.5%

•Trend factor as low as 6.0%

• Include a CDHP • Offer SmartSuite• Offer Humana HMO

or PPO plan

Health risk data for earlier intervention in health conditions

Employee participation for better choices and better health

Ongoing partnership with long-term impact

View progress on participation goals

Detailed program participation data

Track service level performance

Review Scorecard progress duringconsultative sessions

1

2

3

Page 21: Kick-Off Presentation - July 30, 2009

21

We employ over 1,600 employees and approximately 160 pharmacists

We process over 250 million prescriptions and over $13 billion in spend, approximately $11.5 billion is Humana’s risk

One of the first PBMs to earn the URAC Pharmacy Benefit Management Accreditation

Products: Rx3, Rx4, RxImpact and Mail-Order Rx (RightSource)

Humana Pharmacy manages its book of business using a “net cost management”approach versus a “rebate maximization approach”

In 2007, Reden & Anders compared our Rx claims data against their benchmark database (Caremark, ESI, Medco, United, etc.)

Member Guidance: Humana Pharmacy Solutions

-3.50%284.41274.5Utilization

-3.60%2.522.43Cost/Day

-7.10%59.8255.56Total PMPM

DifferenceBenchmarkHumana

Reden & Anders Comparison

Page 22: Kick-Off Presentation - July 30, 2009

22

Clinical: The Guidance Solution Delivers

Better health outcomes– Health promotion and disease prevention– Condition management– Increases productivity

Better opportunity for cost savings– Enhanced identification and engagement– Focus on major clinical conditions / cost drivers

Better health benefits experience – for everyone– Member support, whether ill or healthy– High employee satisfaction– Ease of administration (HumanaFirst)

The bottom line • Commercial members engaged 14%• Total costs engaged with Health Resources 64%• Total cost savings 4-6%• Savings PMPM $11-$15

Page 23: Kick-Off Presentation - July 30, 2009

23

Consumer: Tailoring Guidance

Cultural Identity

Channel

Condition

Change Stage

ConsumerSegment

Cultural Identity

Channel

Condition

Change Stage

ConsumerSegment

Page 24: Kick-Off Presentation - July 30, 2009

24

Consumer: Health & Wealth Guidancewww.staysmartstayhealthy.com

Click Here

Click Here

Page 25: Kick-Off Presentation - July 30, 2009

25

Humana’s CareHub•Complete integration of infrastructure and data (2008)

•A single view of the memberHumanaFirstHumanaBeginningsNICU Case ManagementBehavioral Health Management

Personal NurseDisease Management

(CAD, HF, Cancer, Asthma, CKD, ESRD, Diabetes, Rare Diseases)

Case ManagementTransplant ManagementUtilization ManagementEmployee Assistance Programs

A Continuum of Wellness Solutions

Custom Wellness (a la carte)• Wellness Consulting• Onsite Wellness Programs• Print Collateral• Physical Activity Incentive

and Reward Program

Core Wellness Package• Self-help web content

(MyHumana)• Wellness Monthly

Calendar• Preventive Reminders• Humana Health

Assessment (HHA)

Wellness Plus Package• Tailored Web Program• Telephonic Health

Coaching (Tobacco Cessation, Stress Management, Back Care, Weight Management, Physical Activity, Nutrition)

Wellness Designed to Fit

Page 26: Kick-Off Presentation - July 30, 2009

26

Engagement and communications to promote increased activity and track results– Members log exercise, count steps, measure results: BMI, body fat percentage, and blood

pressure using the LifeZone web site, GoZone pedometer, and HealthZone kiosk

Flexible Incentive fulfillment platform– Accumulate HealthMiles for effort, measurement, and achievement, then redeem miles for

rewards at over 40 leading U.S. retail partners

The first-of-its-kind incentive program for physical activity

Virgin HealthMiles

Page 27: Kick-Off Presentation - July 30, 2009

27

Over 47% improved and better manage back pain

Over 57% lost weight

Of those with a BMI of >30:

29% lost more than 5% of their body weight10% lost more than 10%

Weight Mgmt/Physical ActivityWeight Mgmt/

Physical Activity

Over 52%remained smoke freeafter 180 days of beginning the program

Smoking CessationSmoking Cessation

95% have made a positive change in their eating habits

NutritionNutrition

Over 56% decreased personal symptoms of stress after enrolling in the program

Stress Management

Stress Management Back CareBack Care

Our Results: Behavior Change and Improved Health

Page 28: Kick-Off Presentation - July 30, 2009

28

Get

Mov

ing!

!!

Humana Innovations

Page 29: Kick-Off Presentation - July 30, 2009

29

What is Perfect Service?

What Perfect Service means to HumanaDelivering unexpected value and qualityProviding guidance on complex needsGoing beyond satisfactionCreating engagement with those we serve.Building a proactive culture. Making what’s most important to those we serve, most important to usAn aspirational journey– that changes as those we serve

and as we ourselves change.

Page 30: Kick-Off Presentation - July 30, 2009

30

How we measure performance:

National Call QualityEnhanced our National Call Quality processes and measurements are aligned with Perfect Service in a new Call Quality form. Implemented -January 2007

REACHNew version rewards CCS for using the Perfect Service filter in what they do every day by a changed weighting system that better balances quality and time. Implemented - January 2007

ECHO – Voice of the CustomerProvides a random outbound-automated survey to our members, helping us ‘hear’ real opinions of their experience with Humana. Implementation – Pilot in progress

Member Service

Page 31: Kick-Off Presentation - July 30, 2009

31

Member Service: Customer Satisfaction Technology

Customer Rep knows that in the past 30 days almost

94% of her customers have been satisfied or very satisfied with the service she provides.

Customer Rep knows that in the past 30 days almost

94% of her customers have been satisfied or very satisfied with the service she provides.

Rep can access specific

information by clicking on

any of these.

Rep can access specific

information by clicking on

any of these.

CCS = Customer Care Specialist

Page 32: Kick-Off Presentation - July 30, 2009

32

How do we measure up?

SOURCE: JD Power 2009 Commercial Health Insurance Plan Study

High = top 25th percentile, Medium = middle 50th percentile, Low = bottom 25th percentile

Just released for 2009, J.D. Power ranks Humana # 1 in overall satisfaction and service delivery among all national health plans!

2009 Overall Plan Rankings & Satisfaction Score

1. Humana 7182. Wellpoint 7083. CIGNA 7064. Aetna 6985. United 696

Page 33: Kick-Off Presentation - July 30, 2009

33

Large Group Client Support Team

ImplementReport/Serve/Renew

Serve

TBAAccount Implementation Manager or Coordinator(Plan build project manager)

Melissa TrelfaDirector,

Account Services(Plan build oversight)

Account Executive(Overall client

relationship owner)

Lisa JohnsonDirector,

Account Management

Sales Executive(OE meeting

oversight)

Account Advisor(Escalated service

issue owner/liaison)

Market Resources Corporate ResourcesCorporate Resources

Melissa TrelfaDirector,

Account Services(Escalated service issue

oversight)

Page 34: Kick-Off Presentation - July 30, 2009

34

Specialty Benefits

Page 35: Kick-Off Presentation - July 30, 2009

35

Enhancing Our Product Portfolio

50 years of experienceSingle source solution for ancillary services and voluntary benefitsWell-respected TPA1.1M members

18 years of experienceDental and vision services4.8M membersBroad dental and vision networks

30+ years of experienceDental, life and vision services2.9M membersBroad dental and vision networks

Specialty Benefits

Page 36: Kick-Off Presentation - July 30, 2009

36

Options to Fit Your Clients’ Needs

DentalPPOTraditional PreferredAdvantage PlusDHMOPreventive Plus

LifeBasic termVoluntary termLevel termAD&DWhole lifeLifestyle – Care Life and Critical Life

VisionVision Care PlanAdvantage, Focus, Optimum

DisabilityShort-term income protectionLong-term disability

AccidentCritical illnessSupplemental health

Health & productivityEmployee assistance & work-lifeWellness / healthcare coaching

Behavioral health

You can offer employer-sponsored or voluntary funding options to clients of all sizes.

Page 37: Kick-Off Presentation - July 30, 2009

37

Add Specialty Benefits and Save

Page 38: Kick-Off Presentation - July 30, 2009

38

Small Group Solutions(2 to 99 or more eligible employees)

Bryan Wenger

Page 39: Kick-Off Presentation - July 30, 2009

39

Sales Support and Service

Local Humana sales executive helps you sell new business

Retention executives and online resources help you renew cases

Dedicated Small Business Customer Care team to serve your clients

Other benefits include:

• Centralized billing and enrollment

• Group-dedicated billing representative

• State-specific plan changeand service teams

You’ll receive exceptional sales support and service to sell and keep more business, and to maximize your earnings:

Page 40: Kick-Off Presentation - July 30, 2009

40

Our Business Is to Help You Grow Yours

Here’s what you can expect:Exceptional sales support and service

Online resources to quote, enroll, and manage your business

Broad product portfolio

Direct access to underwriters

Convenient, fast quotes

Welcome calls to all new groups

Wellness and employee assistance programs

Plan utilization reports

Comprehensive renewal reports

Competitive commission and recognition programs

Page 41: Kick-Off Presentation - July 30, 2009

41

Our Broad Product Portfolio

With Humana’s broad product portfolio, you can deliver an even more competitive benefits package to your customers. We offer employer-sponsored and voluntary benefits including:

• Medical

• Dental

• Vision

• Accident

• Life

• Disability

• Critical Illness

• Supplemental Health

Page 42: Kick-Off Presentation - July 30, 2009

42

Humana Product Continuum

Traditional benefits with a wide range of out-of-pocket options

First step toward consumer-directed plans

Innovative, cost-saving solutions with banking arrangements

Page 43: Kick-Off Presentation - July 30, 2009

43

P0S Product Small Business

In-Network Copay• $20/$35 to $20/$40• $25/$40 to $30/$50• $30/$45 to $30/$50• $35/$50 to $30/$50• $40/$55 to $30/$50

In-Network Out of Pocket (excludes deductible)• $750 to $2000• $1000 to $1000 (90% plan)• $1000 to $2000 (70% and 80% plan)• $1500 to $2000• $1750 to $2000• $2000 to $2000• $2250 to $3000• $3000 to $3000• $3500 to $4000• $4000 to $4000• $5000 to $4000• $5500 to $4000

Plan Design• 100/60 to 100/70• 90/70 to 90/60• 80/60 to 80/50• 70/50 to 80/50

In-Network Deductible Additional Deductible Options:• $250 to $250 $3000• $500 to $500 $4000• $750 to $1000 $5000• $1000 to $1000 $6000• $1500 to $1500 $7000• $2000 to $2000 $8000• $2500 to $2500

ER Copay• $100 to $150

POS: Cariten to Humana

Page 44: Kick-Off Presentation - July 30, 2009

44

PPO Product Small Business

In-Network Copay• $20 to $25• $25 to $25• $30 to $35• $35 to $35• $40 to $35

In-Network Out of Pocket (excludes deductible)• $750 to $2000• $1000 to $1000 (90% plan)• $1000 to $2000 (70% and 80% plan)• $1500 to $2000• $1750 to $2000• $2000 to $2000 • $2250 to $3000• $2500 to $3000• $3000 to $3000• $3500 to $4000• $4000 to $4000• $4500 to $4000• $5000 to $4000• $5500 to $4000

Plan Design• 100/60 to 100/70• 90/70 to 90/60• 80/60 to 80/50• 70/50 to 70/50

In-Network Deductible Additional Deductible Options:• $250 to $250 $3000• $500 to $500 $4000• $750 to $1000 $5000• $1000 to $1000 $6000• $1500 to $1500 $7000• $2000 to $2000 $8000• $2500 to $2500

ER Copay• $100 to $150

PPO: Cariten to Humana

Page 45: Kick-Off Presentation - July 30, 2009

45

Standard PCA (HRA)

A coinsurance PPO plan combined with a personal healthcare

spending account

Positively engage consumers — generates long-term savings

Employer funded

HumanaAccess card

Page 46: Kick-Off Presentation - July 30, 2009

46

You use funds to pay for eligible medical and pharmacy expensesPCA funds can be applied to the deductibleOnce all the funds are spent, you must satisfy the deductible and pay the specified coinsurance amountYou always have protection against medical expenses for catastrophic illness or injurySimple plan design:– Preventive covered 100%

– Exception endoscopic services for Small Business

– Everything else coinsurance after deductible

Personal Care Account (PCA)How does it work?

Page 47: Kick-Off Presentation - July 30, 2009

47

Humana HDHP 08 With Optional HSA

An HSA qualified HDHP plan available with or without an HSA

Preventive care at 100 percent

Medical and pharmacy—integrated deducible

HSA covers medical plan deductible, coinsurance, and other qualified services

HSA offered through UMB Bank

Both integrated and embedded family deductibles available

Page 48: Kick-Off Presentation - July 30, 2009

48

Humana CoverageFirst 08

The easy first step toward consumer-choice plans

No banking arrangements

All the benefits of a full PPO

plus an up-front allowance of $500

Allowance built in to the plan design

Motivates employees to

use their benefits wisely

Guides employees in becoming

informed consumers of health care

Page 49: Kick-Off Presentation - July 30, 2009

49

CoverageFirstProduct Details

$500 allowance covers:– Doctor’s office visits– Routine outpatient labs and x-rays– Hospital services, emergency room services and outpatient surgery– Other services such as home health care, physical therapy and

hospice careAllowance does not cover:

– Prescription drugs– Mental health treatments (unless mandated) – only until 11/1/09 due to

Federal Mental Health Parity– Copayments– Services from non-participating providers

Unused funds do not carry-over from year to year

Page 50: Kick-Off Presentation - July 30, 2009

50

CoverageFirst Positioning

Feels like traditional PPO plans– Par/Nonpar providers– Copayments for some benefits; ded/coins for others

First dollar coverage– $500 per member– Allowance is used for expenses prior to paying the deductible

Allowance promotes financial involvement and incentives– Members see allowance as “their” money– Members more apt to take active role in decision-making and budgeting– Encourage utilization from participating providers

Preventive covered at 100% after copay

NOT a lower price alternative, but a baby step into consumerism

Page 51: Kick-Off Presentation - July 30, 2009

51

Benefit Design Solutions for Today and Tomorrow

Provide guidance with choice and flexibility

Traditional benefit designs– Rx4: Tiered by cost, more sophisticated

Value-based benefit designs– RxImpact: Unique

Page 52: Kick-Off Presentation - July 30, 2009

52

Rx4

Most plans group drugs by generic, preferred brand, non-preferred brand and specialty– This is not sophisticated enough given the variance in the gap between

generic and brand drug pricing

Humana’s Rx4 groups drugs by cost– Tier 1 – lowest cost brands and generics– Tier 2 – higher priced brands and generics– Tier 3 – high cost (mostly) brands with less expensive alternatives– Tier 4 – Specialty drugs

Some drugs have been moved to less expensive tiers due to proven medical efficacy (e.g., Procrit and Lovenox)

Page 53: Kick-Off Presentation - July 30, 2009

53

RxImpact

Drugs grouped based on:– Medical efficacy– ROI– Timeframe for “medical payoff”

Each drug in a class is in the same level

Turns the member into the ultimate consumer

Drugs that may impact lifestyle(sexual dysfunction, cosmetic, obesity, smoking cessation)

Group D

Drugs that provide symptom relief(antihistamines, anti-inflammatory, antacids)

Group C

Evidence-based long-term effectiveness (chronic)(cancer, heart disease, MS)

Group B

Evidence-based short-term effectiveness (acute)(asthma, infections, juvenile diabetes, antidepressants)

Group A

Page 54: Kick-Off Presentation - July 30, 2009

54

RxImpact Example

Each tier has an allowance assigned to it – Members pay the difference between the allowance and the

discounted cost of the drug– Members had $0 expenses 65% of the time

$100.32$30.00$30.00$130.3230Cymbalta 30mg

$59.99$30.00$30.00$89.9930Lexapro 20mg

$0.0014.99$30.00$14.9930Fluoxetine 20mg

Member PayPlan PaysAllowanceRetail

CostQuantityDrug name

Drug price source: www.drugstore.com, 10/01/2008

Page 55: Kick-Off Presentation - July 30, 2009

55

Pharmacy Choices

Rx ImpactEmployers save 2 to 5 percent on premiumAbout 60 percent of prescriptions have no out-of-pocket cost to employeesIf there is a cost to the employee, the average is $16Out of pocket protection

– $100 cap per prescription– $2,500 annual maximum

(groups A, B, C)

Rx4Eliminate unexpected charges at the pharmacyDrugs are grouped into four levels, each with corresponding copayment amounts85 percent of prescriptions filled are those with the lowest copayments—those in the first two levels

Page 56: Kick-Off Presentation - July 30, 2009

56

Fast, Convenient Quotes

Receive medical, dental, and life quotes in easy-to-use Excel and PDF formats. You can:

• Quickly compare health plan choices

• See market popular plans

• Filter data to view specific plans and benefit options

• Model premium costs for your clients and their employees

Page 57: Kick-Off Presentation - July 30, 2009

57

Talk Directly to Your Underwriter

Direct access to underwriters

Local expertise to ensure your clients receive the best fit in products and rates

Meet face-to-face with your underwriting team during Underwriting Days

– Next session: September 16t and 17

Express underwriting/phone, fax and e-mail, or produce a quote request online and receive a firm risk rate, in most cases, within 48 hours

Humana’s underwriters provide you with the support you need to sell more cases, both new and existing business:

Page 58: Kick-Off Presentation - July 30, 2009

58

See How Your Clients Used Their Benefits

Using Humana’s exclusive Benefit Utilization Director (BUD)*, you can view how often employees:

• Visit their doctors

• Purchase prescription drugs

• Meet deductibles and out-of-pocket maximums

Knowing how health benefits are

used will help you build more effective

strategies for your clients.

Plus, create a customized packet to share with your clients.

* Available for groups with 5 - 99 employees

Page 59: Kick-Off Presentation - July 30, 2009

59

Easily Explain Your Clients’ Renewals

• Client renewal letters

• Renewal rates and rate details

• Census information and health status

• Alternate quote summaries

• Enrollment and plan change forms

The Renewal Center provides transparency of the renewal process and helps you clearly explain your clients’ renewals. The Renewal Center contains:

You can view the data the way

you prefer: e-mail, paper, or Web.

Page 60: Kick-Off Presentation - July 30, 2009

60

Communicate With Employers

Welcome calls to all new groups

Employer welcome kit sent to every new group

HealthMatters, which offers ideas on how to control healthcare costs and tips for managing their plan

Humana Health Plan Guide, which shows employers how their employees use their benefits

Humana works closely with you to help your clients manage their plans and control healthcare costs. We provide:

Page 61: Kick-Off Presentation - July 30, 2009

61

Help Members Choose, Use and Finance Their Benefits

Member enrollment kit

Member welcome kit

Educational materials on Humana’s wellness resources

SmartSummarySM, a quarterly statement to help employees keep track of their healthcare spending

MyHumana, a password-protected personal page on Humana.com

We help employees manage their plan, take control of their health, and better understand their healthcare costs by offering:

Page 62: Kick-Off Presentation - July 30, 2009

62

Humana’s Health Resources

Your 2 - 99 clients automatically receive a comprehensive health and wellness program that includes:

Healthier employees use

fewer healthcare dollars,

and have fewer claims,

miss less work, and are

more productive.

• Humana Health Assessment

• Personal health coaching

• Discounts on health products and gym memberships

• Employee assistance program

• Disease management / clinical programs

Page 63: Kick-Off Presentation - July 30, 2009

63

Quote, Enroll and Manage Your Business Online

• Order marketing materials

• Submit a quote

• View utilization reports

• Access comprehensive renewal information,including rate detail and census information

• Perform administrative functions on behalf of your clients

• Get details about our compensation, bonus, and Leaders Club recognition programs

If you haven’t registered yet,

go to Humana.com and

click on “Agents” and

“Register Today.”

The agent section on Humana.com has resources to help you do business with us, and service your clients. You can:

Page 64: Kick-Off Presentation - July 30, 2009

64

Producer Partnership Plan

Strong first-year and renewal commissions for all lines of coverage– 2-3 lives per case 5%– 4-25 lives per case 7%– 26-50 lives per case 5%

– Paid on base premium

Quarterly bonuses for growing block of business with Humana

Page 65: Kick-Off Presentation - July 30, 2009

65

Leaders Club

Concierge service to handle your claims, billing, and enrollment, as well as customer service issues

HumanaWatch, a daily e-mail that links news coverage about Humana, our competitors, and the healthcare industry

Preferred quote and new case processing

Invitation to special events with Humana leaders

Free continuing education courses

Become a member of Leaders Club and enjoy the beauty of San Francisco, along with other rewards such as: 20th Anniversary of

Humana’s Leaders ClubThe Ritz-Carlton Half Moon Bay, California

May 2-7, 2010

Page 66: Kick-Off Presentation - July 30, 2009

66

Summary

100 percent of our small business products are distributed through you, our valued broker partners

We help you educate your clients on solutions to control their healthcare costs

We give you information so you can recommend the most appropriate, cost-effective healthcare plan

We listen to you and act on your feedback

Page 67: Kick-Off Presentation - July 30, 2009

67

Q & ATN Management Team

Page 68: Kick-Off Presentation - July 30, 2009

68

Kick-Off Contest

First three producers who place Humana medical product sale

(8/1 and later quote date) will receive Garmin GPS devices

Producer who places first multi-line sale (8/1 and later quote date)

will receive:

8 tickets and use of skybox

UT vs. Auburn Game

October 3, 2009

Medical + Dental / Life / Voluntary / Worksite

Page 69: Kick-Off Presentation - July 30, 2009

69

Get in the game with Humana!

Thanks for attending!