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HUMANA, INC
Sales Intelligence™ Report
HUMANA, INC                                                  Sales Intelligence Report




April 2012


                             INSIDE THIS REPORT
                             Business Profile
                             Business Description, Models and Units

                             IT Landscape
                             Business and IT Alignment, Projects and Technologies

                             IT Outsourcing
                             Global Delivery Projects, Descriptions, Technologies

                             Key Business Developments
                             Developments, Operations and Initiatives

                             Key Decision Makers
                             Key Employees, Biography, Roles and Responsibilities




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Sales Intelligence™ Report
HUMANA, INC                                                          Sales Intelligence Report




TABLE OF CONTENTS
Humana Inc – Company Profile                                                            4
Humana Inc – Business Description                                                       5
Government Segment Products                                                             6
Commercial Segment Products                                                             7
Humana Inc – Business Units                                                             9
Humana Military                                                                         9
HumanaDental                                                                            9
HumanaOne.com                                                                           9
Humana/CompBenefits                                                                     9
Humana Ventures                                                                         10
Humana Medicare Plans                                                                   10
Acquisitions                                                                            11
Products Marketed to Government Segment Members and Beneficiaries                       12
Products Marketed to Commercial Segment Employers and Members                           14
Humana IT Landscape - Business Intelligence & Datawarehousing                           16
Business Intelligence – Technology Stack                                                16
Business Intelligence and Data warehousing Team                                         16
Pharmacy BI Analytics and Reporting                                                     17
IT Operation - Oracle Database                                                          18
Business Intelligence and Datawarehousing Projects                                      20
Premium Billing System (PBS)                                                        20
Main Street Web based enrollment                                                    22
Web-Claims, Member Medical Claims and CCP Application                               24
Web-based Application for Online Testing Created DFD, ERD, Test cases using Microsoft
Visio                                                                               26
Call Center and Online Consumer Web Application                                     27
Key Projects in Business Application                                                    28
Customer Billing System                                                                 28
Online Web Enrollment                                                                   30
Humana Inc – IT Outsourcing Vendors from India                                          32
Humana Inc – Information Technology Landscape in Outsourcing                            33
Business Application for Humana Inc from Syntel International Pvt. Ltd                  33




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Sales Intelligence™ Report
HUMANA, INC                                                         Sales Intelligence Report


Business Application for Humana Inc from Computer Science Corporation                  61
Business Application for Humana Inc from Apollo Healthstreet Ltd                       64
Business Application for Humana Inc from Affiliated Computer Services Pvt Ltd          66
Business Application for Humana Inc from Winyou Systems                                67
Humana Inc - Key Employees                                                             69
About Bruce J. Goodman                                                              70
Michael B. McCallister, Chairman, Chief Executive Officer and Chairman of Executive
Committee                                                                           76
James H. Bloem, Chief Financial Officer, Senior Vice President and Treasurer        77
James E. Murray, Chief Operating Officer                                            78
Venkata Rajamannar Madabhushi, Chief Innovation & Marketing Officer and Senior Vice
President                                                                           79
Bonita C. Hathcock, Chief Human Resources Officer and Senior Vice President         80
Humana Inc – Key Business Development                                                  81
Bnkers Life and Casualty Company Partners with Humana Inc. to Offer Humana Medicare
Prescription Drug Plans                                                          81
Humana Inc. Declares Quarterly Cash Dividend, Payable on October 28, 2011        81
Humana Inc. to Report Q1, 2012 Results on Apr 30, 2012                           81
Business Development during April 2009                                           82




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Sales Intelligence™ Report
HUMANA, INC                                                                   Sales Intelligence Report



Products Marketed to Commercial Segment Employers and
Members
   The Company has developed and offered various commercial products designed to provide
    options and choices to employers. These Smart plans, which can be offered on either a fully-
    insured or ASO basis, provided coverage to approximately 670,000 members as of December
    31, 2008, representing approximately 18.5% of Humana’s total commercial medical
    membership.
   Humana’s commercial HMO products provide prepaid health insurance coverage to its
    members through a network of independent primary care physicians, specialty physicians, and
    other healthcare providers who contract with the HMO to furnish such services. The member’s
    primary care physician must approve access to certain specialty physicians and other
    healthcare providers. These other healthcare providers include, among others, hospitals,
    nursing homes, home health agencies, pharmacies, mental health and substance abuse centers,
    diagnostic centers, optometrists, outpatient surgery centers, dentists, urgent care centers, and
    durable medical equipment suppliers.
   An HMO member, through the member’s employer, pays a monthly fee, which covers, together
    with some co-payments, healthcare services received from, or approved by, the member’s
    primary care physician. In 2008, commercial HMO premium revenues totaled approximately
    9.1% of the Company’s total premiums and ASO fees.
   The Company’s commercial PPO products, which are marketed primarily to employer groups
    and individuals, include some types of wellness and utilization management programs. In a
    PPO, the member is encouraged, through financial incentives, to use participating healthcare
    providers, which have contracted with the PPO to provide services at favorable rates. In the
    event a member chooses not to use a participating healthcare provider, the member may be
    required to pay a greater portion of the provider’s fees.
   As part of its PPO products, Humana offers HumanaOne, a medical product marketed directly to
    individuals. The Company offers this product in select markets where it can underwrite risk and
    utilize its existing networks and distribution channels. This individual product includes
    provisions mandated by law to guarantee renewal of coverage for as long as the individual
    chooses. In 2008, employer and individual commercial PPO premium revenues totaled
    approximately 12.6% of the Company’s total premiums and ASO fees.
   Humana offers ASO products to employers who self-insure their employee health plans. It
    receives fees to provide administrative services, which include the processing of claims, offering
    access to its provider networks and clinical programs, and responding to customer service
    inquiries from members of self-funded employers. These products may include all of the same
    benefit and product design characteristics of its fully-insured PPO, HMO or Smart plans and
    other consumer products described previously. In 2008, commercial ASO fees totaled 1.2% of
    the Company’s total premiums and ASO fees.




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Sales Intelligence™ Report
HUMANA, INC                                                             Sales Intelligence Report


   Humana offers various specialty products including dental, vision and other supplemental
    products, as well as disease management services under Corphealth, Inc. (doing business as
    LifeSynch) and mail-order pharmacy benefit administration services for its members under
    RightSourceRxSM. As of December 31, 2008, the Company had approximately 6.8 million
    specialty members, including 3.6 million dental members and 2.2 million vision members. In
    2008, specialty product premiums and ASO fees were approximately 3.3% of Humana’s total
    premiums and ASO fees.




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HUMANA, INC                                                                   Sales Intelligence Report




Humana IT Landscape - Business
Intelligence & Datawarehousing
Business Intelligence – Technology Stack
   Oracle BI - SQL code, preferably Oracle PL/SQL
   Oracle Business Intelligence Enterprise Edition
   Oracle Siebel
   SAP Business Objects Crystal Reports Crystal Reports XI/8.5/7
   SAP Business Objects Enterprise XI-R1/R2
   SAP Crystal Xcelsius
   SAP Business Objects Web Intelligence
   Informatica 5.1
   WebFocus BI



Business Intelligence and
Datawarehousing Projects
Premium Billing System (PBS)
   Premium Billing System (PBS) of Humana Health Insurance replaced their existing Legacy
    Billing system with a lot more new features.
   The Major partitions of the system are
           o   Billing
           o   Cash Posting Retro
           o   Collections
           o   Reconciliation
   To support its functionality PBS interfaces and exchanges data with different external systems
    like Customer Interface, Sales Management, General Ledger, Broker Commissions and Letter
    System.
   A data warehouse was built by extracting data from different sources and various analytical
    reports were generated.
   Informatica, ETL tool to extract data and Business objects used for reporting.




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Sales Intelligence™ Report
HUMANA, INC                                                                    Sales Intelligence Report


   Created universes by defining connections and retrieving data from the database.
   Used built-in and external strategies for creating components of a universe and created aliases
    and contexts for solving the join problems in Business Objects.
   Created new Classes, Dimensions, Details and Measures while designing Universes.
   Applied user, group and row level security.
   Applied access restrictions on documents, categories, folders, universes and connections.
   Created user objects when required during report generation.
   Created and modified WebI reports for various financial groups using Universe as a main data
    provider.
   Extensively used calculations, variables, dill down and slice and dice for creating reports.
    Developed complex reports using features like
           o   Slice and Dice
           o   Drill Capabilities
           o   Complex Freehand SQL queries
           o   @Functions
           o   Master Detail
           o   Cross Tab tables with multiple breaks
   Created Alerters to highlight columns based on business criteria.
   Published reports using Info view and trained users for adhoc reporting.
   Used stored procedures to improve response time for reports.
   Trouble shooting and customization of reports after upgrade.
   Technology Stack:
           o   Business Objects 5.1.6
           o   Informatica5.1
           o   Crystal Reports
           o   Oracle 8i
           o   Windows 2000




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Sales Intelligence™ Report
HUMANA, INC                                                               Sales Intelligence Report




Humana Inc – Information Technology
Landscape in Outsourcing
Business Application for Humana Inc from Syntel International Pvt.
Ltd

SI No   Project Name              Description                                 Technologies
111     Premium Billing Systems   The Project is related to billing for       Software: COBOL
                                  Humana Customers. The System is             JCL
                                  designed to bill customers who have         DB2
                                  enrolled through different Platforms like
                                                                              Eazytrieve
                                  MTV, Badger or CI. Humana has contract
                                                                              Coolgen.
                                  with Syntel for Maintenance and
                                  Enhancement for this application.
                                  Module management activities: Ensuring      Tools: Panvalet
                                  Weekly task creation and Closure in         File-Aid Platinum
                                  Equip, sending Weekly Status of             CA7
                                  Offshore deliverables to Client, handling
                                  Monthly SCM activities
122     Product        Database Product Database application is a             Software:
        Application             repository of HIPAA compliant                 COBOL
                                product related information at                JCL
                                Humana Inc. It maintains details for
                                                                              DB2
                                lines of Business for Health insurance
                                                                              MQ Series
                                plans, applicable benefits for every
                                line of business, list of services and
                                providers for every line of business          Tools:
                                and for every health insurance plan.          File-Aid
                                Humana has contract With Syntel for           Platinum
                                Maintenance and Enhancement for               Icetool
                                this application




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Sales Intelligence™ Report
HUMANA, INC                                                                Sales Intelligence Report



Business Application for Humana Inc from Computer Science
Corporation

SI No   Project Name          Description                                     Technologies
365     Humana Expedite       Expedite System provides a single                       -NA-
                              infrastructure that allows gathering
                              information at the point of need which
                              supports a single view of the sold group
                              portfolio for integration with production
                              systems (new and renewing business) and
                              reduces administrative effort in the sales
                              cycle. It also integrates the underwriting
                              activities to support reduction of the
                              administrative effort.



366     Humana - Enterprise   Humana is an Enterprise Financial                       -NA-
        Financial Recovery    Recovery (EFR) System which comprises
                              of Data Maintenance and Audit
                              Application. Also the Enterprise Financial
                              Recovery Project will create an
                              environment to support FR analysts in a
                              consistent manner regardless of the
                              platform (e.g. CAS, BADGER and MTV)
                              that a claim originates from.




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HUMANA, INC                                                                       Sales Intelligence Report



Business Application for Humana Inc from Apollo Healthstreet Ltd

SI No   Project Name                  Description                                     Technologies
471     Provider Information          Provider Single Point Plus is the enhanced      Java, J2EE (JSP,
        Management System             version of Provider Single Point, which is      Servlets, Struts
                                      developed by Apollo Health Street, India..      Framework)
                                      It was named as Pearl II project. This is the
                                      Providers Information Management                Application Server:
                                      System (PIMS). It is directly reflected on      Web logic 7.0.
                                      the Internet. The main aim of this              Windows XP
                                      application is to deal with the providers
                                      (Doctors/Physicians) Service locations          Oracle
                                      where he is practicing, practicing hours,
                                      type of specialty, details regarding the
                                      location like address, phone, mail…etc..

                                      Secondly these locations are interlinked
                                      with the PSP application and which is
                                      interlinked with the contract data he has
                                      agreement with Humana.

472     Provider Single Point - PSP   Provider Single Point has been developed        Java, J2EE (JSP,
                                      to computerize the contract system and          Servlets, Struts
                                      all transactions which are dealt between        Framework)
                                      the provider (i.e. Doctor / Physician) and
                                      the Humana Insurance company, such              Application Server:
                                      that every transaction like Adding a            Web logic 7.0.
                                      Contract, Maintenance of a Contract,            Windows XP
                                      Amendment of Contract and Termination
                                      of Contract for a particular provider are       Oracle
                                      taken place online.

                                      When there is a request from a provider
                                      regarding his contract agreement in the
                                      form of scanned attachments / hard copy,
                                      this application makes the insurance
                                      company people to update his contract




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HUMANA, INC                                                          Sales Intelligence Report


                             agreements as per the provider’s request.
                             This application is mainly developed only
                             for the computerization of contract,
                             which a provider requires / wants to
                             participate and maintain his contract as
                             per the requirement. This application
                             provides a faster and more accurate
                             processing of contract agreements with
                             less effort and intervention.




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Sales Intelligence™ Report
HUMANA, INC                                                           Sales Intelligence Report




Business Application for Humana Inc from Winyou Systems

SI No   Project Name            Description                              Technologies
574     Humana     ID     Card The HIDCMS allows authorized users to QTP 8.0, MS-Excel,
        Management      System view the current status and history of all Test Director 7.2
        (HIDCMS)               Medical Identification (ID) card request
                               from the Metavance (MTV) and Customer
                               Interface systems at any point in the life
                               cycle of that request. IDCMS also has the
                               ability for designated users or “Super
                               Users” to View, Approve, Pend and
                               Cancel pending ID card requests.




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DOCUMENT INFO
Description: Humana Inc – Company Profile Humana Inc – Business Description Government Segment Products Commercial Segment Products Humana Inc – Business Units Humana Military HumanaDental HumanaOne.com Humana/CompBenefits Humana Ventures Humana Medicare Plans Acquisitions Products Marketed to Government Segment Members and Beneficiaries Products Marketed to Commercial Segment Employers and Members Humana IT Landscape - Business Intelligence & Datawarehousing Business Intelligence – Technology Stack Business Intelligence and Data warehousing Team Pharmacy BI Analytics and Reporting IT Operation - Oracle Database Business Intelligence and Datawarehousing Projects Premium Billing System (PBS) Main Street Web based enrollment Web-Claims, Member Medical Claims and CCP Application Web-based Application for Online Testing Created DFD, ERD, Test cases using Microsoft Visio Call Center and Online Consumer Web Application Key Projects in Business Application Customer Billing System Online Web Enrollment Humana Inc – IT Outsourcing Vendors from India Humana Inc – Information Technology Landscape in Outsourcing Business Application for Humana Inc from Syntel International Pvt. Ltd Business Application for Humana Inc from Computer Science Corporation Business Application for Humana Inc from Apollo Healthstreet Ltd Business Application for Humana Inc from Affiliated Computer Services Pvt Ltd Business Application for Humana Inc from Winyou Systems Humana Inc - Key Employees About Bruce J. Goodman Michael B. McCallister, Chairman, Chief Executive Officer and Chairman of Executive Committee James H. Bloem, Chief Financial Officer, Senior Vice President and Treasurer James E. Murray, Chief Operating Officer Venkata Rajamannar Madabhushi, Chief Innovation & Marketing Officer and Senior Vice President Bonita C. Hathcock, Chief Human Resources Officer and Senior Vice President Humana Inc – Key Business Development Bnkers Life and Casualty Company Partners wi
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